515 results match your criteria Closure of Complicated Wounds


Difference between delayed anastomosis and early anastomosis in damage control laparotomy affecting the infusion volume and NPWT output volume: is infusion restriction necessary in delayed anastomosis? A single-center retrospective analysis.

Trauma Surg Acute Care Open 2022 8;7(1):e000860. Epub 2022 Mar 8.

Department of Surgery, Iwate Medical University, School of Medicine, Iwate, Japan.

Objectives: During temporary abdominal closure (TAC) with damage control laparotomy (DCL), infusion volume and negative-pressure wound therapy (NPWT) output volume are associated with the success and prognosis of primary fascial closure. The same may also hold true for anastomosis. The aim of this research is to evaluate whether the difference between early anastomosis and delayed anastomosis in DCL is related to infusion volume and NPWT output volume. Read More

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Carboxymethyl chitosan-grafted polyvinylpyrrolidone-iodine microspheres for promoting the healing of chronic wounds.

Bioengineered 2022 04;13(4):8735-8746

Department of Endocrinology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Chronic wounds that fail to heal are the most common complications experienced by diabetic patients, and current treatment remains unsatisfactory, mainly due to the vulnerability of diabetic wounds to bacterial infections. Chitosan derivatives are widely used to treat chronic wounds due to their excellent hydrophilicity, biodegradability, and antimicrobial activity and substantial contribution to tissue regeneration. However, the antimicrobial effect of chitosan is not sufficient due to the complicated pathological mechanism of diabetes mellitus. Read More

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Vertical rectus abdominis myocutaneous flap to reconstruct thigh and groin defects: A retrospective cohort and systematic review.

J Plast Reconstr Aesthet Surg 2022 Jan 19. Epub 2022 Jan 19.

Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address:

Background: The vertical rectus abdominis myocutaneous (VRAM) flap is one of the options for soft-tissue reconstruction in the groin and thigh. The aim of this study is to evaluate the clinical outcomes, risk factors for complications, and the utility of using mesh to prevent abdominal hernia.

Methods: A retrospective review of patients who underwent VRAM flap reconstruction to reconstruct proximal thigh and groin defects from 1997 to 2018 was performed. Read More

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January 2022

Mechanical negative pressure wound therapy: real-world effectiveness in challenging patient presentations.

Authors:
Laura Swoboda

Wounds 2021 Dec;33(12):E85-E89

Froedtert and the Medical College of Wisconsin Community Hospital Division, Menomonee Falls, Wisconsin.

Introduction: When used for wound management, negative pressure wound therapy (NPWT) delivers subatmospheric pressure at the wound site, exerting multiple beneficial effects, including microstrain, macrostrain, edema management, granulation tissue formation, drainage management, and wound stabilization. Comparative effectiveness research has demonstrated similar wound healing and adverse event outcomes between traditional NPWT (tNPWT) and mechanical NPWT (mNPWT). Therefore, considerations for patient selection for mNPWT vs tNPWT are in alignment with current recommendations, including therapeutic goals, wound-related factors, patient satisfaction, quality of life, care setting, economic-related factors, and product design. Read More

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December 2021

Complicated wound closure following mastectomy and breast reconstruction.

J Cosmet Dermatol 2022 Jan 13. Epub 2022 Jan 13.

Department of Plastic Surgery & Burns, Rabin Medical Center, Beilinson Hospital, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Breast reconstruction incidence increased, including preventive surgery. In this context, providing women best surgical care and results is crucial, with minimum complications, such as wound dehiscence and skin flap necrosis. Tension-free closure of skin flaps is mandatory for successful healing. Read More

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January 2022

Mussel-Inspired, Injectable Polyurethane Tissue Adhesives Demonstrate In Situ Gel Formation under Mild Conditions.

ACS Appl Bio Mater 2021 06 13;4(6):5352-5361. Epub 2021 May 13.

College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Med-X Center for Materials, Sichuan University, Chengdu 610065, China.

Tissue adhesives are widely desired in surgical wound closure and interfacial modification of medical devices. However, poor adhesive strength, low mechanical compliance, high costs, and biotoxicity of traditional adhesives limit their biomedical applications. In this work, we fabricated a class of mussel-inspired polyurethane adhesives (MPUAs) with robust properties, including in situ gel formation under mild conditions, accommodation of intricate wounds, strong adhesion, and good biocompatibility. Read More

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Electrospun multifunctional nanofibrous mats loaded with bioactive anemoside B4 for accelerated wound healing in diabetic mice.

Drug Deliv 2022 Dec;29(1):174-185

Qingdao University Medical College, Qingdao, China.

With the worldwide prevalence of diabetes and considering the complicated microenvironment of diabetic wounds, the design and development of innovative multifunctional wound dressing materials are much wanted for the treatment of hard-to-heal wounds in diabetic patients. In the present study, anti-inflammatory ingredients loaded with nanofibrous wound dressing materials were manufactured by a promising blend-electrospinning strategy, and their capability for treating the diabetic wound was also systematically explored. A polymer blend consisting of Chitosan (CS) and polyvinyl alcohol (PVA) was electrospun into CS-PVA nanofibrous mats as control groups. Read More

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December 2022

Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis.

BMC Gastroenterol 2021 Dec 20;21(1):484. Epub 2021 Dec 20.

Department of Internal Medicine, Santo Tomas Hospital, Bella Vista, Panama City, Panama.

Background: Boerhaave syndrome is an uncommon condition that represents about 15% of all esophageal perforation. A subset of these patients has eosinophilic esophagitis, a chronic inflammatory disease of the esophagus, that carries a risk of perforation of about 2%. Esophageal perforations can rarely result in the development of an esophago-pleural fistula. Read More

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December 2021

Best Solutions for Perineal and Pressure Sore Reconstruction.

Plast Reconstr Surg 2021 Dec;148(6):1026e-1039e

From the Division of Plastic Surgery, Department of Surgery, Albany Medical Center.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand variations of the myocutaneous rectus abdominis muscle flap as it is used for perineal reconstruction and discuss common and alternative options for perineal defect reconstruction. 2. Read More

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December 2021

Direct Peritoneal Resuscitation in Trauma Patients Results in Similar Rates of Intra-Abdominal Complications.

Surg Infect (Larchmt) 2022 Mar 23;23(2):113-118. Epub 2021 Nov 23.

Division of Trauma and Acute Care, Department of Surgery, The Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.

Trauma patients undergoing damage control surgery (DCS) have a propensity for complicated abdominal closures and intra-abdominal complications. Studies show that management of open abdomens with direct peritoneal resuscitation (DPR) reduces intra-abdominal complications and accelerates abdominal closure. This novel study compares intra-abdominal complication rates and the effect of DPR initiation in patients who received DPR and those who did not. Read More

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Endoluminal vacuum closure of a duodenal perforation.

J Surg Case Rep 2021 Nov 5;2021(11):rjab479. Epub 2021 Nov 5.

Department of GI, Trauma and Endocrine Surgery, The University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Perforation is a known complication of endoscopic resection and has been managed with endoscopic defect closure, antibiotics and close observation. Closure of duodenal perforations are more challenging due to the presence of gastric and pancreaticobiliary secretions. The use of endoluminal vacuum therapy (EVT) to divert flow and aid closure is increasingly prevalent and may avoid high-risk surgery. Read More

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November 2021

Platelet-Rich Fibrin in Combination with Local Antibiotics Optimizes Wound Healing After Deep Sternal Wound Problems and Prevents Reinfection.

Surg Technol Int 2021 11;39:313-316

Heart Center Brandenburg, Department of Cardiovascular Surgery, University Hospital Brandenburg Medical School "Theodor Fontane", Bernau, Germany.

Objective: Disturbed wound healing is a significant problem in patients after cardiac surgery. Problems with deep sternal wound healing are rare, but can be quite difficult to treat. Furthermore, the therapy is highly expensive and consumes many of the patient's personal resources. Read More

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November 2021

Use of Blue Light in the Management of Chronic Venous Ulcer in Asian Patients: A Case Series.

Cureus 2021 Sep 4;13(9):e17703. Epub 2021 Sep 4.

Department of Vascular Surgery, Singapore General Hospital, Singapore, SGP.

Chronic venous ulcers, often complicated by late diagnosis and persistent infections, present major clinical and financial challenges. Recently, photobiomodulation therapy (PBMT) has been shown to be effective in overcoming physiological impairments such as hemostasis and inflammation, accelerating the wound healing process. This case series summarises our experience in the treatment of two Asian patients with lower-extremity chronic venous ulcers using PBMT with blue light. Read More

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September 2021

Dehydrated human amnion/chorion membrane allografts for myelomeningocele and wound reconstruction.

Childs Nerv Syst 2021 12 5;37(12):3721-3731. Epub 2021 Oct 5.

Department of Plastic & Reconstructive Surgery, The Johns Hopkins School of Medicine, 601 N. Caroline Street, Suite 8161, Baltimore, MD, 21287, USA.

A growing body of literature demonstrates the clinical promise of dehydrated human amnion/chorion membrane (dHACM), a cryopreserved tissue product derived from placental amniotic membrane, to enhance post-operative wound healing. The purpose of this study is to review the potential of dHACM to facilitate post-surgical and myelomeningocele wound repair. A comprehensive literature search of PubMed was conducted to identify studies investigating dHACM use in pediatric and surgical wound care published from inception to October 2020. Read More

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December 2021

Chitosan-Coated PLGA Nanoparticles Loaded with Alkaloids with Promising Antibacterial and Wound Healing Activities.

Nanomaterials (Basel) 2021 Sep 18;11(9). Epub 2021 Sep 18.

Department of Pharmaceutics and Biopharmaceutics, University of Marburg, Robert-Koch-Str. 4, 35037 Marburg, Germany.

Wound healing is a major healthcare concern, and complicated wounds may lead to severe outcomes such as septicemia and amputations. To date, management choices are limited, which warrants the search for new potent wound healing agents. Natural products loaded in poly (lactic-co-glycolic acid) (PLGA) coated with chitosan (CS) constitute a promising antibacterial wound healing formulation. Read More

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September 2021

Reconstruction of an Extensive Maxillofacial Avulsion Injury Caused by Bear Attack With a Double-Island Anterolateral Thigh Free Flap.

J Craniofac Surg 2021 Sep 22. Epub 2021 Sep 22.

The State Key Laboratory of Oral Diseases Department of Oral and Maxillofacial Surgery, West China College of Stomatology National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.

Abstract: Bear attack, a relatively rare cause of maxillofacial trauma, could lead to severe facial deformity as well as functional impairment. A 45-year-old male ranger was attacked by a bear and suffered an extensive maxillofacial avulsion injury, resulting in massive soft tissue loss (17.5 × 10 cm2) on his left temporal-facial region with an intraoral defect (3 × 2 cm2), surrounded by pus and necrotic tissue. Read More

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September 2021

SkinTE for the Treatment of a Complicated Wound after Synovial Sarcoma Resection: A Case Report.

Plast Reconstr Surg Glob Open 2021 Aug 23;9(8):e3764. Epub 2021 Aug 23.

Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, D.C.

Radiation therapy following oncologic resection can result in incisional breakdown, delay or cessation of wound healing, and exposure of structures. Impaired wound healing often mandates free tissue transfer for definitive closure and preservation of function. We present the case of a 16-year-old male patient who had a major incisional dehiscence following resection of a synovial sarcoma of the lower leg after postoperative irradiation. Read More

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Management of Large Pediatric Wound Defects Using a Continuous External Tissue Expander.

Plast Reconstr Surg Glob Open 2021 Aug 5;9(8):e3723. Epub 2021 Aug 5.

Division of Plastic Surgery, Department of Surgery, University of Utah Hospitals and Affiliates and Primary Children's Hospital, Salt Lake City, Utah.

Both internal and external tissue expanders take advantage of the innate adaptive mechanisms the skin exerts in response to mechanical tension, known as the stress-relaxation phenomenon. Internal tissue expander use is time-consuming and can be complicated by infection and extrusion. In this case series, continuous external tissue expanders used to manage large pediatric wounds were assessed. Read More

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Endovascular aortic repair for abdominal aortic injury complicated with bowel injury due to blunt abdominal trauma: A case report.

Int J Surg Case Rep 2021 Aug 18;85:106216. Epub 2021 Jul 18.

Department of General Surgery, Shonan Kamakura General Hospital, Kanagawa, Japan.

Introduction And Importance: Blunt abdominal aortic injury (BAAI) resulting from blunt abdominal trauma is rare; therefore, there are no standard guidelines for its treatment. Herein, we report the successful treatment of BAAI via endovascular aortic repair (EVAR) performed immediately after emergency laparotomy to repair a bowel injury.

Case Presentation: A 78-year-old man was injured after being caught between a shovel car and the bumper of his own car for approximately 15 s. Read More

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Healing hard-to-heal diabetic foot ulcers: the role of dehydrated amniotic allograft with cross-linked bovine-tendon collagen and glycosaminoglycan matrix.

J Wound Care 2021 Jul;30(Sup7):S47-S53

Department of Podiatry, Mount Sinai, South Nassau, US.

The treatment of diabetic foot ulcers is complex and costly with an increased risk for infection, which may even lead to amputation. This prospective case series aims to assess the effectiveness of a dehydrated amniotic membrane allograft combined with a bilayer dermal matrix for healing complicated foot ulcers in patients with comorbidities. A total of six patients with complicated full-thickness ulcers and comorbidities, such as diabetes and peripheral vascular disease were treated with this technique. Read More

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[Surgical treatment of giant false aneurysm of the axillary artery].

Khirurgiia (Mosk) 2021 (6):96-100

Sklifosovsky Research Institute of Emergency Care, Moscow, Russia.

Vascular damage is an important aspect in the structure of injuries. Untimely medical care in patients with peripheral artery damage is often followed by development of false aneurysm. This event may be complicated by aneurysm rupture and bleeding, peripheral arterial thromboembolism, hematoma infection and neuropathy following adjacent nerved compression. Read More

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Enhanced wound repair ability of arginine-chitosan nanocomposite membrane through the antimicrobial peptides-loaded polydopamine-modified graphene oxide.

J Biol Eng 2021 May 22;15(1):17. Epub 2021 May 22.

Department of Orthopaedic Surgery, The Second Hospital of Jilin University, Changchun, 130021, China.

Skin wound healing is a complicated and lengthy process, which is influenced by multiple factors and need a suitable cellular micro-environment. For skin wound, wound dressings remain a cornerstone of dermatologic therapy at present. The dressing material can create an effective protective environment for the wound, and the interactions between the dressing and the wound has a great impact on the wound healing efficiency. Read More

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Successful Management of a Severe Sacral Pressure Injury Penetrating to the Retroperitoneum.

Wounds 2021 Mar;33(3):E24-E27

Division of Pressure Ulcer Prevention, Graduate School of Medical Sciences, Kyushu University, Japan.

Introduction: Reports of retroperitoneal infection related to a sacral pressure injury (PI) are rare, and none of the reports described the direct spread of infection through the sacrum to the retroperitoneum. The authors present, to their knowledge, the first report of a severely infected PI that showed full-thickness sacral destruction and direct retroperitoneal penetration.

Case Report: A 63-year-old female was referred for management of a stage 4 sacral PI complicated by a retroperitoneal abscess. Read More

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Regenerative Properties of Autologous Fat Grafting in a Complicated Radiation-Induced Wound.

Wounds 2021 Feb;33(2):E20-E23

Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.

Introduction: Delayed wound healing and ulceration in radiated tissue is a surgical challenge. Autologous fat grafting can reverse skin changes secondary to radiation such as fibrosis, scarring, contracture, and pain. Adipose-derived stem cells are thought to contribute to the regenerative properties of fat. Read More

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February 2021

Flap Closure of Spinal Defects in High-Risk Patients: A 10-Year Institutional Experience.

Ann Plast Surg 2021 06;86(6):678-687

From the Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Background: Complication rates after spinal surgery are high, in part because of surgical advancements that have made procedures available to a broader range of medically complicated patients. The high rates of infection, hematoma, and dehiscence resulting in open wounds after spinal surgery often warrant plastic surgery involvement. In this study, we aim to examine the effects of preoperative and operative risk factors on complication rates, reoperation rates, and hospital length of stay after flap reconstruction of spinal defects. Read More

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-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid.

Int J Low Extrem Wounds 2021 Apr 15:15347346211004305. Epub 2021 Apr 15.

University Hospital Brno, Masaryk University, Jihomoravský, Czech Republic.

Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora (, , sp., and sp. Read More

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Closure of Challenging Pediatric Scalp Wounds by a Tension-Relief System.

J Craniofac Surg 2021 Oct;32(7):e650-e652

Department of Plastic Surgery and Burns, Rabin Medical Center, affiliated with the Sackler Faculty of Medicine, Petah Tikva, Israel.

Abstract: Pediatric scalp defects may be challenging, due to their variant tension level and specific etiologies. Tissue characteristics and pre- and post-management considerations may pose difficulties to reconstruction in the pediatric patient. Primary closure is the preferred surgical technique but is not always possible. Read More

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October 2021

Secondary below-knee amputation following open reduction and internal fixation of a closed pilon fracture: A case report and algorithm for management.

Medicine (Baltimore) 2021 Feb;100(7):e24791

Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University.

Rationale: Despite significant advances in surgical techniques and implants, the clinical outcome of high-energy pilon fractures remains unsatisfactory, which continues to represent numerous challenges for orthopedic trauma surgeons.

Patient Concerns: A 62-year-old man injured his right ankle after falling from a 3 m high place. There were no open wounds or other complications. Read More

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February 2021

Cecal volvulus complicated by evisceration case report.

J Surg Case Rep 2021 Jan 18;2021(1):rjaa562. Epub 2021 Jan 18.

Lewis Gale Medical Center, Edward Via College of Osteopathic Medicine, Blacksburg, VA 24060, USA.

This case of bowel obstruction with multiple postoperative complications provides unique insight into the challenges faced by providers caring for intellectually disabled patients with acute surgical abdominal pathology and poor compliance. In this case, the component separation was utilized as a method of facilitated wound closure and compliance in a postoperative course highlighted by both dehiscence and wound infection. The patient, only able to communicate the presence of abdominal pain due to his disability, was surgically managed for a bowel obstruction secondary to a cecal volvulus. Read More

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January 2021

Reverse oblique proximal femoral fracture in dystrophic epidermolysis bullosa: challenges and recommendations.

BMJ Case Rep 2021 Jan 25;14(1). Epub 2021 Jan 25.

Academic Department of Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, UK

A 35-year-old woman attended the emergency department after sustaining a reverse oblique proximal femur fracture, which was amenable to intramedullary nailing. Her presentation was complicated by a background of severe generalised recessive dystrophic epidermolysis bullosa, with extensive blistering of most of her skin, including the area over the standard surgical incision sites. For the successful management of this case, extensive input from the multidisciplinary team was required, with the team facing several challenges. Read More

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January 2021