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SAGE Open Medical Case Reports 2024Cultured epithelial autograft applications are limited by the associated cost and time constraints in resource-limited settings. A modified composite technique using the...
Case report of the first Caucasian burn patient transplanted with Cutimed Sorbact®-based cultured epithelial autografts technique at Tygerberg Hospital, Cape Town, South Africa: An 8-year follow-up.
Cultured epithelial autograft applications are limited by the associated cost and time constraints in resource-limited settings. A modified composite technique using the patients' own tissue and Cutimed Sorbact dressing was employed as a life-saving emergency measure. Since the non-Caucasian population was more commonly treated at the center, it was important to report the first Caucasian patient outcome, as the graft-take outcome for all populations was unknown. A 54-year-old male with extensive flame burns and a low chance of survival was admitted to the Tygerberg Burn Center. He received traditional skin grafts and cultured epithelial cells, after the 2 week-culture period using the current technique. Short- (⩽2 weeks) and long-term graft take (⩽8 years) was inspected. Good graft take and complete epithelialization was observed during short-term inspection with partially healed areas initially attributed to extensive burn depth and dressing removal. Long-term follow-up indicated a near normal tissue appearance and excellent pliability.
PubMed: 38250672
DOI: 10.1177/2050313X231223462 -
Cureus Dec 2023Keloids, benign fibrous growths resulting from atypical skin responses to injuries, present a complex challenge in dermatology. These lesions, characterized by excessive... (Review)
Review
Keloids, benign fibrous growths resulting from atypical skin responses to injuries, present a complex challenge in dermatology. These lesions, characterized by excessive collagen production, often lead to physical discomfort and psychological distress. While various treatment methods exist, the lack of a universally effective modality underscores the need for a systematic evaluation of current approaches. This systematic review aims to comprehensively analyze the current available treatment modalities used for the management of keloids in the pediatric population in terms of their effectiveness, safety, and quality of life outcomes. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted on PubMed and Google Scholar databases to identify relevant studies published in English. The review specifically focused on randomized controlled trials involving patients under 18 diagnosed with keloids, assessing different treatment modalities, and reporting validated measures of treatment efficacy, safety outcomes, and quality of life. The risk of bias was assessed using Cochrane's Risk of Bias Tool for randomized studies to ensure the methodological quality of the included trials. Four studies met the inclusion criteria, collectively involving 196 pediatric patients. Treatment interventions included glucocorticosteroid and fusidic acid cream with silicone gel patches, botulinum toxin type A injections, and Scarban silicone gel sheets. Patient-reported outcomes exhibited varying degrees of improvement in scar size, vascularity, and pliability. Complications, such as rash and wound infection, were reported in some cases. Based on our review of the selected studies and due to the incompletely understood pathogenesis of keloids, there is an ongoing lack of universally effective treatment modality for the management of keloids resulting in their persistently high recurrence rate.
PubMed: 38205454
DOI: 10.7759/cureus.50290 -
Medicine Jan 2024This study aimed to observe clinical efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) gel, medical collagen sponge and rhGM-CSF... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study aimed to observe clinical efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) gel, medical collagen sponge and rhGM-CSF gel in combination with medical collagen sponge on deep second-degree burns of head, face or neck in infants.
METHODS
A total of 108 infants with deep second-degree burns on head, face or neck were randomly divided into rhGM-CSF group, medical collagen sponge group, and rhGM-CSF + medical collagen sponge group. The scab dissolving time, healing time, bacterial positive rate and Vancouver scar scale were evaluated and analyzed.
RESULTS
The data analysis showed that scab dissolving time and healing time were shorter in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group, and the difference was statistically significant (P < .05). Bacterial positive rate was lower in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group (P < .05). After 3 months, score of Vancouver scar scale (scar thickness, pliability, pigmentation and vascularity) was less in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group (P < .05).
CONCLUSION
rhGM-CSF gel in combination with medical collagen sponge is significantly effective in treating deep second-degree burns of head, face or neck in infants. This combination is beneficial for infection control, acceleration of scab dissolving and wound healing, and reduction of scar hyperplasia and pigmentation, which is worthy of clinical application and promotion.
Topics: Infant; Humans; Cicatrix; Collagen; Treatment Outcome; Burns
PubMed: 38181297
DOI: 10.1097/MD.0000000000036304 -
Trials Jan 2024Keloid is a skin disorder that results from excessive fibrous tissue growth in the area of the initial trauma. Treating keloids can be challenging since the success of...
BACKGROUND
Keloid is a skin disorder that results from excessive fibrous tissue growth in the area of the initial trauma. Treating keloids can be challenging since the success of various treatments varies from one study to another. Triamcinolone acetonide injection, a standard treatment, can cause undesirable side effects. Meanwhile, the effectiveness of existing topical therapies for keloids is not always reliable. The pro-inflammatory, pro-proliferative, and pro-fibrotic effects of angiotensin II in human skin contribute to keloid formation. Losartan potassium, an angiotensin II blocker, has the potential to act as an anti-keloid agent. Due to the thicker skin structure of a keloid and ease of application, ethosome gel is chosen as a safe and comfortable carrier for losartan potassium, making it a good choice for treating keloids.
METHODS
In this randomised clinical trial, 46 adults with keloids were divided into two treatment groups. One group of 23 participants received 5% losartan potassium loaded in ethosomal gel, while the other group of 23 participants received intralesional injections of 10% triamcinolone acetonide. Over 12 weeks, changes in POSAS 3.0 scores, degree of erythema and pigmentation, surface area, thickness, and pliability of the keloids will be measured at four different times: baseline, 4 weeks, 8 weeks, and 12 weeks. Statistical analysis will be conducted using SPSS software version 24, with a significance level of p < 0.05.
DISCUSSION
Losartan potassium is believed to be beneficial for keloid management because it inhibits the angiotensin II receptor, which plays a role in inflammation, proliferation, and fibrosis. This study examines the efficacy of 5% losartan potassium loaded in ethosomal gel for human keloids.
TRIAL REGISTRATION
Clinicaltrial.gov identifier NCT05893108 . Registered on 7 June 2023.
Topics: Adult; Humans; Keloid; Triamcinolone Acetonide; Losartan; Angiotensin II; Treatment Outcome; Injections, Intralesional; Randomized Controlled Trials as Topic
PubMed: 38167064
DOI: 10.1186/s13063-023-07880-2 -
Clinical Case Reports Jan 2024Contractubex phonophoresis can be used in clinical setting to manage postsurgical scar after carpal tunnel release. Contractubex phonophoresis can improve pliability,...
KEY CLINICAL MESSAGE
Contractubex phonophoresis can be used in clinical setting to manage postsurgical scar after carpal tunnel release. Contractubex phonophoresis can improve pliability, height, and tenderness of the scar.
ABSTRACT
Scar is one of the most common complications after open release of carpal tunnel. Scars are mentally and physically disturbing, and they can result into itching and pain. Scar after release of carpal tunnel can lead to compression of median nerve and failure of surgery. Various treatments are suggested for scar management. topical drugs are one of these treatments. Phonophoresis of topical drugs can enhance delivery of topical drugs. In present case, author report the effect of phonophoresis of Contractubex on postsurgical scar after carpal tunnel release. Result indicated that phonophoresis of Contractubex can be effective in scar management.
PubMed: 38161644
DOI: 10.1002/ccr3.8389 -
Micromachines Nov 2023The emergence of magnetic polymer composites has had a transformative impact on the field of soft robotics. This overview will examine the various methods by which... (Review)
Review
The emergence of magnetic polymer composites has had a transformative impact on the field of soft robotics. This overview will examine the various methods by which innovative materials can be synthesized and utilized. The advancement of soft robotic systems has been significantly enhanced by the utilization of magnetic polymer composites, which amalgamate the pliability of polymers with the reactivity of magnetic materials. This study extensively examines the production methodologies involved in dispersing magnetic particles within polymer matrices and controlling their spatial distribution. The objective is to gain insights into the strategies required to attain the desired mechanical and magnetic properties. Additionally, this study delves into the potential applications of these composites in the field of soft robotics, encompassing various devices such as soft actuators, grippers, and wearable gadgets. The study emphasizes the transformative capabilities of magnetic polymer composites, which offer a novel framework for the advancement of biocompatible, versatile soft robotic systems that utilize magnetic actuation.
PubMed: 38138344
DOI: 10.3390/mi14122173 -
Heliyon Dec 2023Ablative fractional carbon dioxide laser has been used with triamcinolone to treat hypertrophic scars, resulting in promising success rates. However, there are different...
OBJECTIVES
Ablative fractional carbon dioxide laser has been used with triamcinolone to treat hypertrophic scars, resulting in promising success rates. However, there are different topical triamcinolone delivery methods used in scar treatment. To assess the efficacy among the different triamcinolone delivery methods, this study was designed to compare the efficacy and safety of ablative fractional carbon dioxide laser followed by penetration and injection of topical triamcinolone into thicker hypertrophic scars (height score of VSS ≥2).
STUDY DESIGN/MATERIALS AND METHODS
We performed a retrospective study of 155 thicker hypertrophic scar patients (height score of VSS ≥2), including 88 patients in the triamcinolone external application group and 67 patients in the triamcinolone intralesional injection group. One month after the patients had 3 treatment sessions at 4-week intervals, the scars were assessed by photography, the Vancouver Scar Scale (VSS), durometry and spectrocolorimetry. Any adverse effects were also evaluated.
RESULTS
The VSS scores and the hardness of the scars in both groups improved significantly compared to baseline. Moreover, the patients in the triamcinolone intralesional injection group had higher treatment efficacy (19.77 ± 21.25 %) based on their VSS scores than the patients in the triamcinolone external application group (5.94 ± 24.07 %), especially in the improvement of scar pliability, height and hardness. Meanwhile, in the triamcinolone injection group, more patients had mild and moderate improvement than in the triamcinolone application group. However, there were no differences in the distribution of the adverse effects in either group.
CONCLUSIONS
This study demonstrated that using the ablative fractional carbon dioxide laser followed by different topical triamcinolone delivery methods is effective and safe for thicker hypertrophic scar improvement. The method of using the ablative fractional carbon dioxide laser assisted with triamcinolone injection had a better therapeutic outcome in thicker hypertrophic scars, as compared with triamcinolone penetration.
PubMed: 38125450
DOI: 10.1016/j.heliyon.2023.e22818 -
Cardiovascular Engineering and... Apr 2024Inappropriate stent-graft (SG) flexibility has been frequently associated with endovascular aortic repair (EVAR) complications such as endoleaks, kinks, and SG... (Comparative Study)
Comparative Study
PURPOSE
Inappropriate stent-graft (SG) flexibility has been frequently associated with endovascular aortic repair (EVAR) complications such as endoleaks, kinks, and SG migration, especially in tortuous arteries. Stents derived from auxetic unit cells have shown some potential to address these issues as they offer an optimum trade-off between radial stiffness and bending flexibility.
METHODS
In this study, we utilized an established finite element (FE)-based approach to replicate the mechanical response of a SG iliac limb derived from auxetic unit cells in a virtual tortuous iliac aneurysm using a combination of a 180° U-bend and intraluminal pressurization. This study aimed to compare the mechanical performance (flexibility and durability) of SG limbs derived from auxetic unit cells and two commercial SG limbs (Z-stented SG and circular-stented SG models) in a virtual tortuous iliac aneurysm. Maximal graft strain and maximum stress in stents were employed as criteria to estimate the durability of SGs, whereas the maximal luminal reduction rate and the bending stiffness were used to assess the flexibility of the SGs.
RESULTS
SG limbs derived from auxetic unit cells demonstrated low luminal reduction (range 4-12%) with no kink, in contrast to Z-stented SG, which had a kink in its central area alongside a high luminal reduction (44%).
CONCLUSIONS
SG limbs derived from auxetic unit cells show great promise for EVAR applications even at high angulations such as 180°, with acceptable levels of durability and flexibility.
Topics: Stents; Humans; Prosthesis Design; Blood Vessel Prosthesis; Finite Element Analysis; Models, Cardiovascular; Endovascular Procedures; Stress, Mechanical; Blood Vessel Prosthesis Implantation; Iliac Aneurysm; Materials Testing; Prosthesis Failure; Pliability; Computer Simulation
PubMed: 38110763
DOI: 10.1007/s13239-023-00706-x -
The Journal of Cell Biology Feb 2024Basement membranes (BMs) are specialized sheets of extracellular matrix that underlie epithelial and endothelial tissues. BMs regulate the traffic of cells and molecules...
Basement membranes (BMs) are specialized sheets of extracellular matrix that underlie epithelial and endothelial tissues. BMs regulate the traffic of cells and molecules between compartments, and participate in signaling, cell migration, and organogenesis. The dynamics of mammalian BMs, however, are poorly understood, largely due to a lack of models in which core BM components are endogenously labeled. Here, we describe the mTurquoise2-Col4a1 mouse in which we fluorescently tag collagen IV, the main component of BMs. Using an innovative planar-sagittal live imaging technique to visualize the BM of developing skin, we directly observe BM deformation during hair follicle budding and basal progenitor cell divisions. The BM's inherent pliability enables dividing cells to remain attached to and deform the BM, rather than lose adhesion as generally thought. Using FRAP, we show BM collagen IV is extremely stable, even during periods of rapid epidermal growth. These findings demonstrate the utility of the mTurq2-Col4a1 mouse to shed new light on mammalian BM developmental dynamics.
Topics: Animals; Mice; Basement Membrane; Collagen Type IV; Extracellular Matrix; Fluorescent Dyes; Hair Follicle; Stem Cells
PubMed: 38051393
DOI: 10.1083/jcb.202309074 -
Science Advances Nov 20232LiX-GaF (X = Cl, Br, I) electrolytes offer favorable features for solid-state batteries: mechanical pliability and high conductivities. However, understanding the...
2LiX-GaF (X = Cl, Br, I) electrolytes offer favorable features for solid-state batteries: mechanical pliability and high conductivities. However, understanding the origin of fast ion transport in 2LiX-GaF has been challenging. The ionic conductivity order of 2LiCl-GaF (3.20 mS/cm) > 2LiBr-GaF (0.84 mS/cm) > 2LiI-GaF (0.03 mS/cm) contradicts binary LiCl (10 S/cm) < LiBr (10 S/cm) < LiI (10 S/cm). Using multinuclear Li, Ga, F solid-state nuclear magnetic resonance and density functional theory simulations, we found that Ga(F,X) polyanions boost Li-ion transport by weakening Li-X interactions via charge clustering. In 2LiBr-GaF and 2LiI-GaF, Ga-X coordination is reduced with decreased F participation, compared to 2LiCl-GaF. These insights will inform electrolyte design based on charge clustering, applicable to various ion conductors. This strategy could prove effective for producing highly conductive multivalent cation conductors such as Ca and Mg, as charge clustering of carboxylates in proteins is found to decrease their binding to Ca and Mg.
PubMed: 37992180
DOI: 10.1126/sciadv.adj9930