Online ISSN: 2515-8260

Keywords : WOUND HEALING


TO EVALUATE THE ROLE OF NEGATIVE PRESSURE WOUND THERAPY IN COMPOUND FRACTURES AFTER PRIMARY FIXATION

Dr. Nagulapati Vishnu Vardhan, Dr. Biju Ravindran, Dr. Kavarthapu Venkata Srikanth

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 75-83

INTRODUCTION: Vacuum-assisted closure (VAC) is a non-invasive, active wound management system that exposes a wound bed to local sub atmospheric pressure, removes fluid from the extravascular space, improves circulation, and enhances the proliferation of granulation tissue. The purpose of this study is to know the rate of wound infection, number of days required for making the wound fit for skin cover procedures, number of days required for formation of uniform granulation tissue bed in the wound healing treated by Vacuum Assisted Closure after primary fixation of fracture.
METHODOLOGY: Patients between 18 to 60 years were included in this prospective randomized controlled trial. Primary internal Fixation of fracture was done as soon as possible followed by VAC application. Functional outcome of cases recorded during each follow up according to Johner and Wruh’s (1983).
RESULT: According to this study, 30 patients with open fractures of both bone leg after primary internal fixation with VAC application. During follow up effective decrease (mean ± SD) in wound size after VAC therapy was 9.97±9.59 cm2 with P-value 0.0481. This technique has resulted in the effective decrease in wound size, infection and give a better functional outcome.
CONCLUSION: The greatest advantage of VAC was found to facilitate rapid formation of granulation tissue on wounds with exposed tendons, bones, raw area wounds and exposed implants hence decrease healing time and minimize soft tissue defect coverage procedures.

An evaluation of the effectiveness of dermabrasion in the treatment of external ulcers using a randomized controlled trial

Dr. Pokala Praveen Kumar, Dr. Budida Sharada, Dr. Vangari Ravi, Dr. M. Rajanikanth

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3189-3197

Background: Management of ulcers is a significant topic. Debridement of non-viable tissues, edema reduction, adequate dressing, and antibiotics if needed are fundamental ulcer management treatments. Disease control, Cover wounds with grafts or flaps. Bioburden is reduced via debridement to prepare the wound for healing. Without debridement, a wound is exposed to cytotoxic stimuli and competes for oxygen and nutrients with pathogens. Dermabrasion treats post-acne scars, naevi, sebaceous adenomas, and burns.
Aim & Objectives:

In this investigation, dermabrasion will be used to debride ulcers. Assess the usefulness and consequences of dermabrasion in ulcer care.
To compare dermabrasion to traditional treatment.
Assess wound healing.
Days in hospital Incision pain.

Materials and Methods: From the 120 patients presenting to outpatient clinic or admitted into the hospital with an ulcer on the extremity were recruited into the study.
Results: The mean VAS scores in this study were 5.11 ±1.31 in the conventional group and 2.52 1.089 in the trial group. The mean WOUND scores in this study were 13.97± 2.026 in the conventional group and 12.13 ±2.901 in the trial group. In terms of Wound scores, there was no statistically significant difference between the two groups (p=0.139). The mean ASEPSIS scores in this study were 47.89± 2.091 in the conventional group and 45.42 ±2.29 in the trial group. In terms of Wound scores, there was no statistically significant difference between the two groups (p=0.301).
Conclusion: Dermabrasion dramatically reduce discomfort during the surgery, enhances granulation and shortens healing time without injuring normal tissue or causing problems.

Efficacy of Dermabrasion in the Treatment of Externalulcers - A Randomised Controlled Trial

Velisala Madhuri,Dilip Vasant KA,Ambarapu Sowjanya Reddy, Nikhil Puduru

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11083-11091

Background:Management of ulcers is a topic of great interest. Some of the basic methods of
managing ulcers can be listed as Debridement of non-viable tissues, reduction of edema,
appropriate dressing, Antibiotics if necessary, Control of co-morbidities, Close wounds
surgically with grafts or flaps. Debridement prepares the wound for healing by reducing the
bioburden. Without an adequate debridement, a wound is persistently exposed to cytotoxic
stressors and competes with bacteria for scarce resources such as oxygen and nutrients.
Dermabrasion is a tool in the management of dermatological conditions like post-acne
scarring, naevi, adenoma sebaceum and also in the management of burns. In this study the
use of dermabrasion as a debridement tool in the management of ulcers shall be
evaluated.Aims and Objectives of the Study: To assess the usefulness and effects of
dermabrasion in the management of ulcers.To compare the outcome of dermabrasion with the
conventional method.Assessment of Wound healing.No of days of Hospital stay, Pain during
the procedure.
Materials and Methods: From the 100 patients presenting to outpatient clinic or admitted
into the hospital with an ulcer on the extremity were recruited into the study.
Results: In this study the mean VAS scores was 4.9± 1.110 in the conventional group and in
the trial it was 2.55 ± 1.227. In this study the mean WOUND scores was 13.22 ± 2.320 in the
conventional group and in the trial it was 12.28 ± 2.456. No statistically significant difference
was noted between the 2 groups in terms of Wound scores (p=0.139). In this study the mean
ASEPSIS scores was 48.38 ± 2.118 in the conventional group and in the trial it was 46.79 ±
2.310. No statistically significant difference was noted between the 2 groups in terms of
Wound scores (p=0.311).
Conclusion: Dermabrasion reduces the pain during the procedure significantly, promotes
granulation and decreases the healing time without damaging the normal tissue or producing
complications.

A comparative study of open versus closed haemorrhoidectomy in second and third degree haemorrhoids

Dr. Chinnabhovi M, Dr. Devandra Raju D, Dr. Jyothi L

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2545-2552

Haemorrhoids are one of the most frequently encountered anorectal conditions in the clinical practice of a surgeon. Haemorrhoidectomy is the most effective approach for haemorrhoidal disease especially for grade III and grade IV disease and also in grade II disease which do not respond to conservative and non-invasive treatment. However, postoperative pain is a major concern, and the surgery itself is with complications including notably bleeding, wound sepsis, pain, and anal stenosis. The patients were explained about their disease and modalities of treatment as Open or closed haemorrhoidectomy with advantages and disadvantages of each. 25 patients were operated by open haemorrhoidectomy and another 25 patients by closed haemorrhoidectomy under spinal anaesthesia. Data was collected according to proforma which included detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted. The mean immediate post-operative pain score in open group was 2.88 ± 0.53 VAS and in closed group was 2.44 ± 1.9 VAS; these differences were significant with p value of 0.027. The mean duration hospital stay in open group was 4.64± 0.9 days and in closed group was 4.28 ± 0.9 days (p value= 0.18) the differences were not significant. People who underwent open procedure took 17.5 days and closed group patient took 16. 4 days to resume their normal activity, these differences were not significant (p Value = 0.42).

Study of efficacy of superoxidised solution and gel (microdacyn) in the treatment of diabetic foot ulcer

Bhupinder Singh Walia, Pankaj Dugg, Navjot Singh, Sanjeev Sharma, Babu Lal Sunkaria

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 608-617

Introduction: Diabetic foot and diabetic ulcers are common complications of diabetes mellitus.
It affects daily life of patients and lead to amputations. The study was conducted to see the
effect and role of superoxidised solution and gel (microdacyn) in promoting the healing and
treatment of diabetic foot ulcer.
Material &Methods: The wound site was cleaned with normal saline followed by application
of superoxidised solution for 30 seconds and then followed by application of wound care
hydrogel. Observations were made during dressing and examination of the patients/ wounds
was done on the day 7,14,21,28 and at follow-up of 15 days. Rate of contraction of wound is
measured in cm2.
Results: Mean age of patients in the study was 50.0687±11.85 years with equal male to female
ratio. Superoxidised solution provides good wound healing and mean hospital stay was
10.49±4.24 days. Significant reduction of wound is seen in cases with short duration of ulcer
and short duration of diabetes (p<.05).
Conclusion: Superoxidised solution was associated with faster healing of ulcers without any
major complications, proving SOS to be safe and efficient as a wound care product in the
management of lower limb ulcers.

DMIST Scale for Predicting Healing Time within 12 Weeks in Patients with Diabetic Ulcer

Suriadi, RN, Ph.D, AWCS; Wida Kuswida Bhakti, RN, Ph.D

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 2285-2293

Background: An assessment scale, namely, the DMIST (deep, moisture, infection/inflammation, size, tissue type of wound bed, type of wound edge and tunnelling/undermining), was designed to identify the healing time of chronic ulcers. An evaluation was then conducted to test the predictive validity of DMIST. This study aimed to evaluate whether the total scores from the DMIST scale could predict healing time of diabetic ulcer.
Method: A prospective study cohort was obtained from the Kitamura Wound Clinic in Pontianak, Indonesia. A total of 33 patients with diabetic ulcer were recruited to participate in the study. Collected data included DMIST score, demographic information, Wagner wound classification, neuropathic status, ankle brachial index, HbA1c level and wound images. Using the DMIST scale, trained data collectors scored patients every 7 days until ulcers were healed or patients were discharged.
Results: A cutoff score of 9 was valid as a predictor of non-healing after 12 weeks. The DMIST scale was found to have high sensitivity (90%) and specificity (96%). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval, 0.856 to 1.000).
Conclusion: The DMIST scale was found to be a valid assessment scale to identify wound healing time in a period of 12 weeks in patients with diabetic ulcer.

EFFICACY OF HEMOCOAGULASE AS A TOPICAL HEMOSTATIC AGENT AFTER EXTRACTIONS: A REVIEW

Dr. Balakrishnan Ramalingam; Dr. Vijay Ebenezer

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1933-1936

Extractions are the most common surgical procedures carried out and postextraction bleeding is most commonly seen complication. The aim of this review was to determine the effectiveness of topical hemocoagulase as a hemostatic agent and its role in reducing postextraction bleeding and its comparison to routine saline pressure pack after tooth extraction. Various differences was present between the hemostatic agent and saline pressure pack in relation to pain, swelling, wound healing, bleeding time, and other complications. Topical hemocoagulase is effective in reducing bleeding, pain, and swelling after extraction when compared to saline pressure packs. It also act as a promoter of wound healing.