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Soins; La Revue de Reference Infirmiere Sep 2022
Topics: Debridement; Detergents; Humans; Wound Healing
PubMed: 36180171
DOI: 10.1016/S0038-0814(22)00235-3 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2020Titanium- prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Titanium- prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control.
MATERIAL AND METHODS
A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. Results: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth.
CONCLUSION
T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions.
Topics: Alveolar Bone Loss; Debridement; Guided Tissue Regeneration, Periodontal; Humans; Platelet-Rich Fibrin; Titanium; Treatment Outcome
PubMed: 31880284
DOI: 10.4317/medoral.23231 -
The Cochrane Database of Systematic... Oct 2022There are several possible interventions for managing pressure ulcers (sometimes referred to as pressure injuries), ranging from pressure-relieving measures, such as... (Review)
Review
BACKGROUND
There are several possible interventions for managing pressure ulcers (sometimes referred to as pressure injuries), ranging from pressure-relieving measures, such as repositioning, to reconstructive surgery. The surgical approach is usually reserved for recalcitrant wounds (where the healing process has stalled, or the wound is not responding to treatment) or wounds with full-thickness skin loss and exposure of deeper structures such as muscle fascia or bone. Reconstructive surgery commonly involves wound debridement followed by filling the wound with new tissue. Whilst this is an accepted means of ulcer management, the benefits and harms of different surgical approaches, compared with each other or with non-surgical treatments, are unclear. This is an update of a Cochrane Review published in 2016.
OBJECTIVES
To assess the effects of different types of reconstructive surgery for treating pressure ulcers (category/stage II or above), compared with no surgery or alternative reconstructive surgical approaches, in any care setting.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was January 2022.
SELECTION CRITERIA
Published or unpublished randomised controlled trials (RCTs) that assessed reconstructive surgery in the treatment of pressure ulcers.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected the studies, extracted study data, assessed the risk of bias and undertook GRADE assessments. We would have involved a third review author in case of disagreement.
MAIN RESULTS
We identified one RCT conducted in a hospital setting in the USA. It enrolled 20 participants aged between 20 and 70 years with stage IV ischial or sacral pressure ulcers (involving full-thickness skin and tissue loss). The study compared two reconstructive techniques for stage IV pressure ulcers: conventional flap surgery and cone of pressure flap surgery, in which a large portion of the flap tip is de-epithelialised and deeply inset to obliterate dead space. There were no clear data for any of our outcomes, although we extracted some information on complete wound healing, wound dehiscence, pressure ulcer recurrence and wound infection. We graded the evidence for these outcomes as very low-certainty. The study provided no data for any other outcomes.
AUTHORS' CONCLUSIONS
Currently there is very little randomised evidence on the role of reconstructive surgery in pressure ulcer management, although it is considered a priority area. More rigorous and robust research is needed to explore this intervention.
Topics: Adult; Aged; Debridement; Humans; Middle Aged; Pressure Ulcer; Plastic Surgery Procedures; Wound Healing; Young Adult
PubMed: 36228111
DOI: 10.1002/14651858.CD012032.pub3 -
Ugeskrift For Laeger Jan 2021Necrotising soft-tissue infections (NSTI) is a new term for infections by bacteria, which cause ischaemia and necrosis of the affected tissue. Scientific advances during... (Review)
Review
Necrotising soft-tissue infections (NSTI) is a new term for infections by bacteria, which cause ischaemia and necrosis of the affected tissue. Scientific advances during the past decade have expanded our knowledge of the epidemiology, pathophysiology, prognosis and treatment of NSTI. Early, correct diagnosis and elimination of delay to surgical debridement is crucial for survival. The recommended antimicrobial treatment has recently been updated. This review summarises the latest advances concerning NSTI, and it is important, that all Danish clinicians are up to date on these.
Topics: Anti-Bacterial Agents; Debridement; Fasciitis, Necrotizing; Humans; Necrosis; Prognosis; Soft Tissue Infections
PubMed: 33491620
DOI: No ID Found -
CMAJ : Canadian Medical Association... Apr 2021
Topics: Antifungal Agents; Candidiasis, Oral; Debridement; Diagnosis, Differential; Guillain-Barre Syndrome; Humans; Intensive Care Units; Male; Middle Aged; Smoking; Tongue; Tongue, Hairy; Treatment Outcome; Xerostomia
PubMed: 33875461
DOI: 10.1503/cmaj.201559 -
Chinese Journal of Traumatology =... Jan 2022Chronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy... (Review)
Review
Chronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.
Topics: Chronic Disease; Debridement; Humans; Wound Infection
PubMed: 34315658
DOI: 10.1016/j.cjtee.2021.07.004 -
Journal of Diabetes Research 2023Impaired wound healing is common in patients with diabetes mellitus (DM). Different therapeutic modalities including wound debridement and dressing, transcutaneous... (Review)
Review
Impaired wound healing is common in patients with diabetes mellitus (DM). Different therapeutic modalities including wound debridement and dressing, transcutaneous electrical nerve stimulation (TENS), nanomedicine, shockwave therapy, hyperbaric (HBOT) and topical (TOT) oxygen therapy, and photobiomodulation (PBM) have been used in the management of chronic diabetic foot ulcers (DFUs). The selection of a suitable treatment method for DFUs depends on the hosts' physiological status including the intricacy and wound type. Effective wound care is considered a critical component of chronic diabetic wound management. This review discusses the causes of diabetic wounds and current therapeutic modalities for the management of DFUs, specifically wound debridement and dressing, TENS, nanomedicine, shockwave therapy, HBOT, TOT, and PBM.
Topics: Humans; Wound Healing; Hyperbaric Oxygenation; Chronic Disease; Diabetic Foot; Debridement; Diabetes Mellitus
PubMed: 36818748
DOI: 10.1155/2023/1359537 -
The Journal of Surgical Research Jan 2020In the management of indeterminate-depth burns (IDB), common challenges include the ability to predict time to healing and regenerative potential, risk of burn wound... (Review)
Review
In the management of indeterminate-depth burns (IDB), common challenges include the ability to predict time to healing and regenerative potential, risk of burn wound progression, and timing of excision. Several technologies exist to aid in determination of the depth of a burn injury, yet surgeons continue to rely on the naked eye-visual assessment-as the standard of care. Newer and improved imaging technologies are closing in on the goal of inexpensive, accurate, noninvasive modalities for depth determination. Likewise, management of IDB is becoming more sophisticated as newer wound healing technologies continue to be developed. By describing what is meant by "indeterminate" depth burns, and their associated challenges, we hope to stimulate interest in research to develop new therapies and management strategies. The ultimate goal is to treat IDB without the need for autografts.
Topics: Burns; Debridement; Disease Progression; Humans; Patient Selection; Severity of Illness Index; Skin; Skin Transplantation; Skin, Artificial; Standard of Care; Time Factors; Treatment Outcome; Uncertainty; Wound Healing
PubMed: 31421361
DOI: 10.1016/j.jss.2019.07.063 -
Medical Sciences (Basel, Switzerland) Jun 2021Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the... (Review)
Review
Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the integrity of the body surface by creating a resilient and stable scar. Surgical practice and strategies have an impact on the course of wound healing and the later appearance of the scar. By considering elementary surgical principles, such as the appropriate suture material, suture technique, and timing, optimal conditions for wound healing can be created. Wounds can be differentiated into clean wounds, clean-contaminated wounds, contaminated, and infected/dirty wounds, based on the degree of colonization or infection. Furthermore, a distinction is made between acute and chronic wounds. The latter are wounds that persist for longer than 4-6 weeks. Care should be taken to avoid surgical site infections in the management of wounds by maintaining sterile working conditions, using antimicrobial working techniques, and implementing the principles of preoperative antibiotics. Successful wound closure is influenced by wound debridement. Wound debridement removes necrotic tissue, senescent and non-migratory cells, bacteria, and foreign bodies that impede wound healing. Additionally, the reconstructive ladder is a viable and partially overlapping treatment algorithm in plastic surgery to achieve successful wound closure.
Topics: Anti-Bacterial Agents; Cicatrix; Debridement; Humans; Plastic Surgery Procedures; Surgical Wound Infection; Wound Healing
PubMed: 34208722
DOI: 10.3390/medsci9020045 -
Wounds : a Compendium of Clinical... Dec 2022Management of VLUs can be challenging, depending on wound complexity, and may require the use of several treatment modalities to achieve complete wound closure or... (Review)
Review
Management of VLUs can be challenging, depending on wound complexity, and may require the use of several treatment modalities to achieve complete wound closure or significant wound area reduction. This review presents a systematic approach to management of VLUs based on previous literature and the authors' clinical experience, with consideration given to wound size, etiology, and responses to prior treatment. Techniques described include debridement (autolytic, enzymatic, sharp/surgical), compression therapy, physical therapy, medical adjuncts, and cellular- and tissue-based therapy. The algorithm of care for VLUs is multimodal. Appropriate diagnostic studies must be performed, including venous duplex and appropriate pathophysiology to confirm the diagnosis of VLU. After the correct diagnosis is confirmed, appropriate treatment may commence. All patients should undergo appropriate wound debridement; the exact modality used is dependent on wound characteristics. Patients must also adhere to consistent compression therapy. Any underlying venous disease that is amenable to surgical intervention should be addressed. Treatment with a medical adjunct and physical therapy are recommended. For patients who do not achieve significant wound area reduction, the addition of CTP is recommended. Use of these methods should result in substantial wound area reduction and/or wound closure.
Topics: Humans; Compression Bandages; Wound Healing; Varicose Ulcer; Debridement; Treatment Outcome; Leg Ulcer
PubMed: 36622379
DOI: 10.25270/wnds/21160