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[Biomechanical aspects of vertebral augmentation].
Adjustable, low-fatigue pressure garments were developed for this porcine study to examine the role of daily duration of wear without confounding factors such as garment fatigue and patient adherence. CONCLUSION For maximum efficacy, pressure garments should be worn 23 to 24 hours per day; however, garments worn as little as 8 hours per day significantly improve scar outcomes versus no treatment.OBJECTIVE Full-thickness burn wounds require immediate coverage, and the primary clinical approaches comprise of skin allografts and autografts. The use of allografts is often temporary due to the antigenicity of allografts. On the other hand, the availability of skin autografts may be limited in large burn injuries. In such cases, skin autografts can be expanded through the use of a skin mesher, creating meshed split-thickness meshed skin grafts (MSTSG). Meshed split-thickness skin grafts have revolutionized the treatment of large full-thickness burn injuries since the 1960s. However, contractures and poor aesthetic outcomes remain a problem. We previously formulated and prepared an in-situ forming skin substitute, called MeshFill (MF), which can conform to complex shapes and contours of wounds. The objective of this study was to assess the aesthetic and wound healing outcomes in full-thickness wounds treated with a combination of MF and MSTSG in a porcine model. APPROACH Either meshed split-thickness skin grafts (MSTSG) or meshed split-thickness skin graft with MeshFill (MSTSG+MF) was applied to full-thickness excisional wounds in Yorkshire pigs. Wound healing outcomes were assessed using histology, immunohistochemistry, and wound area analysis from day 10 to day 60. Clinical evaluation of wounds was utilized to assess aesthetic outcomes. RESULTS The results demonstrated that the combination of MSTSGs and MF improved wound healing and aesthetic outcomes. INNOVATION Effects of MSTSGs and reconstituteable liquid MF in a full-thickness porcine model was investigated for the first time. CONCLUSION MeshFill provides promise as a combination therapeutic regimen to improve wound healing and aesthetic outcomes.Objective To investigate the prevalence, characteristics, and preventive status of skin injuries caused by personal protective equipment (PPE) in medical staff. Approach A cross-sectional survey was conducted online for understanding skin injuries among medical staff fighting COVID-19 in February 8-22, 2020. Participants voluntarily answered and submitted the questionnaire with cell phone. The questionnaire items included demographic data, grade of PPE and daily wearing time, skin injury types, anatomical sites, and preventive measures. Univariable analyses and logistic regression analyses were used to explore the risk factors associated with skin injuries. Results A total of 4,308 respondents were collected from 161 hospitals and 4,306 respondents were valid. The overall prevalence of skin injuries was 42.8% (95% confidence interval [CI] 41.30-44.30) with three types of device-related pressure injuries, moist-associated skin damage, and skin tear. Co-skin injuries and multiple location injuries were 27.4% and 76.8%, respectively. The logistic regression analysis indicated that sweating (95% CI for odds ratio [OR] 87.52-163.11), daily wearing time (95% CI for OR 1.61-3.21), male (95% CI for OR 1.11-2.13), and grade 3 PPE (95% CI for OR 1.08-2.01) were associated with skin injuries. Only 17.7% of respondents took prevention and 45.0% of skin injuries were treated. Innovation This is the first cross-sectional survey to understand skin injuries in medical staff caused by PPE, which is expected to be a benchmark. Conclusion The skin injuries among medical staff are serious, with insufficient prevention and treatment. A comprehensive program should be taken in the future.SIGNIFICANCE Pyoderma Gangrenosum (PG) is a rare neutrophilic ulcerative dermatosis that poses a high burden of morbidity due to underdiagnosis, resistance to therapy and limited therapeutic options. Optimization of wound care strategies and multimodal anti-inflammatory approaches are necessary to mitigate multiple converging pathways of inflammation leading to delayed healing, which is further complicated by additional factors such as pathergy. RECENT ADVANCES PG treatment typically involves reducing inflammation, controlling pain, promoting wound healing, and treating the underlying etiology. Recent advances have been made with regards to targeted therapies for PG with topical, intralesional and systemic medications. selleck products Wound management includes gentle cleansing without sharp debridement, limited topical antibacterial use, and maintenance of a moist environment to promote epithelial migration. CRITICAL ISSUES Wound dressings and compression therapy, in particular, introduce a wide variety of therapeutic options. Dressings should aim to target the specific PG wound type, depending on the depth and exudative nature of the wound as well local secondary factors such as habitus. Superficial wounds, eschar, exudative wounds, granulating wounds, and colonized wounds are managed with variable approaches to the same underlying principles of physical pathergy avoidance, moisture balance and reduction of immunogenic inflammatory stimuli. The importance of compression therapy to decrease edema and over-granulation fits within this treatment paradigm.SIGNIFICANCE Optimal skin wound healing is crucial for maintaining tissue homeostasis, particularly in response to an injury. The skin immune system is under regulation of mediators such as bioactive lipids and cytokines that can initiate an immune response with controlled inflammation, followed by efficient resolution. However, nutritional deficiency impacts wound healing by hindering fibroblast proliferation, collagen synthesis, epithelialization, among other crucial functions. In this way, the correct nutritional support of bioactive lipids and of other essential nutrients play an important role in the outcome of the wound healing process. Recent advances and critical issues Several studies have revealed the potential role of lipids as a treatment for the healing of skin wounds. Unsaturated fatty acids such as linoleic acid, α-linolenic acid, oleic acid, and most of their bioactive products have shown an effective role as a topical treatment of chronic skin wounds. Their effect, when the treatment starts at day 0, has been observed mainly in the inflammatory phase of the wound healing process.
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