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To evaluate the efficacy and safety of wet dressing combined with chitosan wound dressing for deep II degree burn wounds, and provide the basis for clinical application. From October 2019 to October 2021, 80 patients with second-degree deep burn treated in the Department of burn and plastic surgery of our hospital were selected as the research objects. Patients were randomly divided into two groups. The control group (40n) was treated with wet compress, and the study group (40n) was treated with wet compress combined with chitosan wound dressing. The wound healing time, wound healing percentage and pain score were used as the effectiveness indexes, and the incidence of adverse events and serious adverse events and the detection rate of bacterial culture of wound exudates were used as the safety indexes. The efficacy and safety of the two groups were compared. The wound healing time of the study group (19.53 ± 2.74 days) was shorter than that of the control group (24.78 ± 4.86 days), the difference was significant (t = 3.571, P = 0.015). The percentage of wound healing at the 14th after treatment in the study group was higher than that in the control group (65.00% versus 37.50%) (X2 = 6.054, P = 0.014). There was no significant difference in pain scores between the two groups at each time point. The scar growth was observed 3 months after wound healing. The scar score of the study group (6.00 ± 0.98) was lower than that of the control group (8.77 ± 1.19) (t = 2.571, P = 0.031). The positive rate of wound secretion culture on the 7th and 14th day was statistically significant (X2 = 4.528, P = 0.033; X2 = 6.646, P = 0.010), and the study group was lower than the control group (29.03% versus 81.82%; 8.11% versus 42.86%). There was no significant difference in treatment cost between the study group and the control group (1258.7 ± 223.6 versus 1248.9 ± 182.3) (t = 1.571, P = 0.071). No adverse events or serious adverse events occurred in both groups. Chitosan wound dressing can significantly shorten the time of wound healing and reduce wound pain and wound infection in patients with deep second-degree burns. And it can effectively improve the situation of scar hyperplasia, which is worthy of clinical application.
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Quemaduras , Quitosano , Humanos , Cicatriz , Quitosano/uso terapéutico , Estudios Prospectivos , Método Simple Ciego , Resultado del Tratamiento , Vendajes , Quemaduras/tratamiento farmacológico , DolorRESUMEN
Diabetic ulcer is a serious complication of diabetes. Compared with that of healthy people, the skin of patients with a diabetic ulcer is more easily damaged and difficult to heal. Without early intervention, the disease will become increasingly serious, often leading to amputation or even death. Most current treatment methods cannot achieve a good wound healing effect. Numerous studies have shown that a nanocomposite hydrogel serves as an ideal drug delivery method to promote the healing of a diabetic ulcer because of its better drug loading capacity and stability. Nanocomposite hydrogels can be loaded with one or more drugs for application to chronic ulcer wounds to promote rapid wound healing. Therefore, this paper reviews the latest progress of delivery systems based on nanocomposite hydrogels in promoting diabetic ulcer healing. Through a review of the recent literature, we put forward the shortcomings and improvement strategies of nanocomposite hydrogels in the treatment of diabetic ulcers.
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Introduction: Water soluble polysaccharides are versatile structural materials that can be used for the design of biocompatible hydrogels and wet dressings in wound healing applications. Glycol chitosan (GC) is an example of a multifunctional water-soluble chitosan derivative that has inherent wound healing properties and reactive sites for chemical modification.Areas covered: United States (US) patent US2019202998A1 describes the preparation of a novel wound healing technology based on a three-dimensional (3D) crosslinked GC hydrogel (GCH) wet dressing, prepared via the synthesis of PEG1K-biscarboxylic acid-g-Glycol Chitosan-g-methacrylate using visible light induced photocrosslinking. The selected polymeric network enables the encapsulation of additional growth factors or bioactives on reactive sites. Wet dressings in US2019202998A1 were evaluated against a commercially available control for in vitro release, cytotoxicity, and in vivo wound healing ability in a preliminary mouse model, with the overall wound healing performance consistent with related GC-based hydrogels.Expert opinion: Comprehensive biocompatibility and antimicrobial testing of the hydrogel is not reported in US2019202998A1, and is recommended as further work to enable clinical applicability. The invention disclosed in US2019202998A1 can potentially be integrated with 3D bioprinting and sensor technology for the preparation of 'smart' hydrogel wound dressings, and is a potential area for future research.
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Quitosano/farmacología , Hidrogeles , Cicatrización de Heridas/efectos de los fármacos , Animales , Bioimpresión , Quitosano/química , Reactivos de Enlaces Cruzados/química , Modelos Animales de Enfermedad , Humanos , Luz , Ratones , Patentes como Asunto , Polímeros/químicaRESUMEN
Patients with severe intestinal injury caused by trauma and malignant intestinal diseases require an artificial anus to be established through enterostomy to replace the original perineal anus for defecation. Although enterostomy has brought a new way of defecation to patients, the nursing requirements for an intestinal stoma after enterostomy are high. If complications arise from improper postoperative wound care, the quality of life of patients will be seriously reduced, and the psychological burden will be aggravated. This study compared the nursing effect of wet dressings and traditional dry dressings on patients undergoing enterostomy. Results showed that compared to patients using dry dressings, patients who used wet dressings had significantly lower postoperative dressing change frequency and complication rate, less pain during dressing change, and shorter hospital stays and intestinal stoma incision healing time. This suggests that wet dressings can promote wound healing in patients with enterostomy. In addition, it was found that compared to patients using dry dressings, the postoperative sleep quality, mood score, and quality of life of patients using wet dressings were significantly better. Evaluation of patient care comfort and satisfaction revealed that patients who used wet dressings felt significantly more comfortable and satisfied with their care than those who used dry dressings. Therefore, this study argues that wet dressings can facilitate the wound healing of the intestinal stoma in patients with enterostomy more than dry dressings, and better alleviate the bad moods and improve the quality of life of patients. Wet dressing can be used as a preferred nursing method for patients undergoing enterostomy.
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Objective: Recognized as pathogen-associated molecular patterns (PAMPs), ß-glucans, a naturally occurring heterogeneous group of polysaccharides, were investigated for their ability to accelerate wound healing in the form of high water-retaining hydrogel dressing. Approach: Full-thickness wounds on the dorsal side of mice created using a 5-mm biopsy punch were treated with ß-glucan-based hydrogel for 2 weeks. Standardized photographs of the wound site were taken at regular time intervals to calculate the percentage of wound closure. Tissues isolated from the wound area were subjected to histological examination and immunoblot analysis. Results: ß-Glucan-based hydrogel significantly accelerated the duration of wound healing and enhanced the development of skin appendages in the regenerated skin tissue. Increased expression of transforming growth factor-ß3 in the skin tissue isolated from the healed wound site indicated that skin regeneration rather than skin repair occurred, thereby minimizing cutaneous scarring. The expression level of cytokeratin 10 and cytokeratin 14 in the isolated skin tissue revealed that the wounds treated with hydrogel showed proper differentiation and proliferation of keratinocytes in the epidermal layer. Innovation: Immunomodulating ß-glucan (responsible for fighting infections at the wound site, and enhancing the migration and proliferation of keratinocytes and fibroblasts) in the form of a three-dimensional hydrogel membrane that retains a high water content (responsible for cooling and soothing effect around the wound site, thereby reducing pain) was prepared and analyzed for its effects on the cutaneous wound healing mechanism. Conclusion: ß-Glucan-based hydrogels are promising as wet wound dressings in the health care industry.
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Scarless wound healing is ideal for patients suffering from soft tissue defects. In this study, we prepared a novel wet dressing (ß-CD-ic-CUR/GC) based on the visible light-cured glycol chitosan (GC) hydrogel and inclusion complex between beta-cyclodextrin (ß-CD) and curcumin (CUR). We also evaluated its efficacy in the acceleration of wound healing as compared to that of CUR-loaded GC (CUR/GC). The conjugation of glycidyl methacrylate (GM) to GC for photo-curing was confirmed by ¹H-NMR measurement, and the photo-cured GC hydrogel was characterized by the analyses of rheology, swelling ratio, SEM and degradation rate. After visible light irradiation, the surface/cross-sectional morphologies and storage (G')/loss (G'') moduli revealed the formation of hydrogel with interconnected porosity. The dressing ß-CD-ic-CUR/GC exhibited a controlled release of 90% CUR in a sustained manner for 30 days. On the other hand, CUR/GC showed CUR release of 16%. ß-CD acted as an excipient in improving the water-solubility of CUR and affected the release behavior of CUR. The in vivo animal tests including measurement of the remaining unhealed wound area and histological analyses showed that ß-CD-ic-CUR/GC may have potential as a wet dressing agent to enhance soft tissue recovery in open fractures.
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Vendas Hidrocoloidales , Curcumina/farmacología , Preparaciones de Acción Retardada/farmacología , Hidrogeles/farmacología , Herida Quirúrgica/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Animales , Línea Celular , Proliferación Celular/efectos de los fármacos , Quitosano/química , Curcumina/química , Curcumina/farmacocinética , Preparaciones de Acción Retardada/síntesis química , Preparaciones de Acción Retardada/farmacocinética , Preparaciones de Acción Retardada/efectos de la radiación , Liberación de Fármacos , Compuestos Epoxi/química , Fibroblastos/citología , Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Hidrogeles/síntesis química , Hidrogeles/farmacocinética , Hidrogeles/efectos de la radiación , Luz , Metacrilatos/química , Ratones , Ratones Endogámicos BALB C , Procesos Fotoquímicos , Herida Quirúrgica/patología , Cicatrización de Heridas/fisiología , beta-Ciclodextrinas/químicaRESUMEN
Selecting an appropriate treatment for a given case of skin wound is crucial for inducing optimal healing. We used an animal model developed from normal rabbit ears in order to assess the efficacy of treatments for skin wounds with or without a wet dressing, anti microbial reagent or topical wound-stimulatory reagents. The degree of healing in each group was evaluated and compared using four histological parameters: (i) degree of reepithelialisation, (ii) amount of granulation tissue formation, and (iii) the number of capillary lumens and (iv) fibroblasts in the granulation tissue. Treatment using wet dressings resulted in an increase in capillary number compared with the open dry wound. Although the retention of povidone-iodine (PI) in wound tissue after application significantly inhibited reepithelialisation (P < 0.05), rinsing PI off with saline was comparable in effect to using only a wet dressing. The three topical reagents, namely, basic fibroblast growth factor, prostaglandin E1 and dibutyryl cyclic adenosine monophosphate, significantly improved reepithelialisation (P < 0.05). In conclusion, wounds should be kept hydrated by applying topical reagents. If there are any signs of bacterial infection, PI can be applied and rinsed later with saline in order to minimise its cytotoxic effects.
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Alprostadil/administración & dosificación , Bucladesina/administración & dosificación , Oído/lesiones , Factor 2 de Crecimiento de Fibroblastos/administración & dosificación , Povidona Yodada/administración & dosificación , Cicatrización de Heridas/efectos de los fármacos , Heridas y Lesiones/tratamiento farmacológico , Animales , Antiinfecciosos Locales/administración & dosificación , Modelos Animales de Enfermedad , Quimioterapia Combinada , Femenino , Fibroblastos/efectos de los fármacos , Fibroblastos/patología , Tejido de Granulación/efectos de los fármacos , Conejos , Piel/efectos de los fármacos , Piel/patología , Vasodilatadores/administración & dosificaciónRESUMEN
Moist wound healing for wound treatment has been becoming wide-spread for several years. Open wet-dressing therapy (OWT) is one of the useful therapies at a hospital in a mountainous area where many elderly find it difficult to go to hospital frequently the past. At our department of surgery we also heal pressure ulcers, so we regard Wound bed preparation as important, too. Choice of appropriate types of dressing materials based on concept of Wound bed preparation and Moist wound healing, OWT and information of them enable us to decrease the frequency of hospital visits by the elderly in the mountainous area. It is important for the community in the mountainous area to inform Wound bed preparation, Moist wound healing and OWT for the purpose of safety management of OWT.
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OBJECTIVE:To observe the clinical efficacy of Chinese medicine inunction wet dressing therapy and helium neon laser in the treatment of rheumatoid arthritis.METHODS:Both groups received Methotrexate tablets,Salazosulfapyridine tablets,Loxoprofen tablets.Observation group were additionally treated with Chinese medicine inunction wet dressing therapy and helium neon laser with a treatment course of 30 days.RESULTS:The effective rate was 70.00% for control group and 93.55% for observation group,there was significant difference between two groups(P
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Early treatment to facilitate the muscular blood flow can avert myonephropathic metabolic syndrome (MNMS) and major amputation for patients suffering with acute limb ischemia. Delayed reperfusion or microemboli in the small vessels can aggreviate: ischemic changes and lead to irreversible muscle necrosis. Amnion is an excellent biological dressing, and we tried using it to treat anterior compartment muscle necrosis (ACMN). The amnions were aseptically collected from caesarean sections. Additional betadine (1 : 3 solution) and vaseline-soaked gauzes were applied over the amnion as a daily biologic wet dressing. The amnion was replaced every three days. Finally, split skin grafting was performed on the healthy granulation tissue. We treated two patients who happened to have shin muscle necrosis. A 65-year-old man with a femoro-femoral arterial bypass showed graft thrombosis. Thirteen days after performing balloon angioplasty with stent insertion in the right femoral artery, new emboli were found in the stent and in the left popliteal artery. There was an attack of myocardial infarction the next day after embolectomy. The severe MNMS and ACMN at the right shin occurred after cardiopulmonary resuscitation. The dry gangrene was excised 3 months later, and this was followed by a skin graft 4 months later. An 81-year-old woman with atrial fibrillation showed left common femoral arterial obstruction and ACMN on the left shin during the management of congestive heart failure. The dry gangrene was excised 2 months later, and this was followed by a skin graft 3 months later. The amnion dressing shows promises for providing healthy granulation tissue for split skin grafts when treating muscle necrosis of the leg. Biologic dressing with using amnion is an option for limb salvage in the case of muscle necrosis that is caused by acute limb ischemia, although the treatment takes a long time.