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Wound Healing, Ulcers, and Scars
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Saloni Shah, Christian Albornoz, Sherry Yang
Overview: The wound healing process can be divided into three main phases: A coagulation phase in which platelets are initially recruited to form a hemostatic plug. This phase also includes an inflammatory process involving the recruitment of immune cells, such as neutrophils, monocytes, and/or macrophages, to the site of injury.A migratory or re-epithelialization stage occurs early in the wound healing process.A dermal repair and remodeling phase occurs within months of the initial wound event. Any aberrations during these stages of wound healing can lead to chronic wound complications, as well as nonhealing ulcers.
Postpartum Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Elena R. Magro-Malosso, Sarah K. Dotters-Katz, Daniele Di Mascio
It is uncertain whether covering surgical wounds that are healing by primary intention with wound dressings reduces the risk of surgical site infections (SSIs) [69]. Studies on the timing of the wound dressing removal after cesarean delivery are also limited. Epithelialization is an essential component of wound healing and typically occurs in the 48 hours after surgery. Data from three small RCTs showed no significant differences between early (up to 48 hours after surgery) and delayed dressing (beyond 48 hours) removal from non-Cesarean surgical wounds in terms of incidence of SSIs, wound dehiscence, or serious adverse events within 30 days [70]. Additionally, a recent RCT of 320 women observing postsurgery dressing removal showed no increased wound complications with removal at 6 hours instead of 24 hours after a scheduled cesarean delivery. In this same study, women’s satisfaction was significantly increased when dressings were removed at 6 hours after the cesarean delivery, allowing them to care for their personal hygiene earlier [71].
Scar Care after Surgical Treatment in Oncology Patients
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
Wound controls should be performed at 6 and 15 days to check the correct epithelialization. After 6 weeks, the detection of warning signs makes it necessary to initiate a physician-directed treatment. The follow-up and assessment of scar changes will be made 3, 6, and 12 months after surgery.
Tenon's Patch Graft: A Review of Indications, Surgical Technique, Outcomes and Complications
Published in Seminars in Ophthalmology, 2022
Anahita Kate, Sonal Vyas, Rahul Kumar Bafna, Namrata Sharma, Sayan Basu
A good anatomical outcome with a well-formed anterior chamber has been reported following TPG in other series as well (Table 3). Sharma et al. found epithelialization to occur within 26 days of the surgery while in the report by Chaudhary et al, the same process was complete within 2 weeks.10,27 Scarring is inevitable in these cases, and the corneal scar following TPG offers a good tensile strength despite the significant thinning as demonstrated in the report by Chaudhary et al. Further visual rehabilitation with rigid contact lens or optical keratoplasties can be performed with good visual outcomes. These grafts fare better than grafts following tissue adhesives as there is less vascularization following TPG, thus decreasing the risk of graft rejection and subsequent failure.
Topical application of Jatyadi Ghrita and Jatyadi Taila accelerates wound healing in Sprague-Dawley rats: a study in gamma-radiation-induced skin wound model
Published in International Journal of Radiation Biology, 2021
Vanita Gupta, Anuradha Tyagi, Aseem Bhatnagar, Sukhvir Singh, Sudesh N. Gaidhani, Narayan Srikanth
Overall, the present study demonstrated that single dose of 45 Gy radiation to rat’s skin resulted in occurrence of radiation wounds which showed enhanced oxidative stress and extension of inflammatory phase till day 42, thereby, resulted in hampering the repair process and impaired healing of radiation wounds. Further, over-expressed inflammatory cells resulted in enhanced expression of TGF-β1 which can be correlated with increased collagen synthesis in irradiated group. This further hampered the repair process and caused delayed in wound healing. Application of JG and JT post irradiation resulted in faster healing of wounds especially moist desquamation by reducing oxidative stress, inflammation, and infection in irradiated skin which leads to faster re-epithelialization due to reduced collagen fibers deposition and TGF-β1 expression. Khanna et al. (2013) reported that controlling infection and facilitation of epithelialization are important for healing moist desquamation. Further, providing moist environment to wounds promoted faster re-epithelialization by easier migration and proliferation of epithelial cells and fibroblasts (Junker et al. 2013). Polyherbal components present in JG and JT may act synergistically in healing radiation wounds probably by rendering wide biological activities required for wound healing viz. antimicrobial, anti-inflammatory, wound cleansing, astringent, and antiseptic (Baljinder et al. 2011; Dhande et al. 2012; Ballakur and Prasad 2013).
Second intention healing of nasal ala and dorsum defects in Asians
Published in Journal of Dermatological Treatment, 2021
Wenyan Jin, Shan Jin, Zhouna Li, Zhehu Jin, Chenglong Jin
The results of the study are shown in Table 1. A total of 10 patients with 15 defects (<1 cm in diameter) of nasal ala and/or dorsum underwent second intention healing and proceeded to complete the regular follow-up and final photographs. Average size of the defects in their greatest diameter was 0.6 cm (range 0.4–0.9 cm; SD ± 0.16). Time to epithelialization and complete healing ranged from 5 to 17 days (mean 11.3; SD ± 4.18) and 10 to 24 days (mean 17.7; SD ± 4.85), respectively. There were no postoperative intense pain and wound infections. Overall, cosmetic outcome was good to excellent in 80% of defects (good, 41.7%; excellent, 58.3%). Patient with defect involving left alar groove had slightly elevated alar groove, but this was only minimally noticed on frontal view (Figure 1). In particular, defects of anterior ala showed the optimum results after second intention healing, even though the defects were larger than the others (Figures 2 and 3). However, defect of dorsum showed poorer cosmetic results with a depressed scar 6 months after surgery (Figure 2).