Journal articles: 'Wound bed parameters'

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Papadia, F., V. Dini, A. Paolicchi, F. Di Francesco, and M. Romanelli. "576 Correlation beetwen wound bed score and biochemical and histochemical parameters in chronic wounds." Journal of Investigative Dermatology 136, no. 9 (September 2016): S259. http://dx.doi.org/10.1016/j.jid.2016.06.600.

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Rikard, S. Michaela, Paul J. Myers, Joachim Almquist, Peter Gennemark, Anthony C. Bruce, Maria Wågberg, Regina Fritsche-Danielson, Kenny M. Hansson, Matthew J. Lazzara, and Shayn M. Peirce. "Mathematical Model Predicts that Acceleration of Diabetic Wound Healing is Dependent on Spatial Distribution of VEGF-A mRNA (AZD8601)." Cellular and Molecular Bioengineering 14, no. 4 (June 15, 2021): 321–38. http://dx.doi.org/10.1007/s12195-021-00678-9.

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Abstract Introduction Pharmacologic approaches for promoting angiogenesis have been utilized to accelerate healing of chronic wounds in diabetic patients with varying degrees of success. We hypothesize that the distribution of proangiogenic drugs in the wound area critically impacts the rate of closure of diabetic wounds. To evaluate this hypothesis, we developed a mathematical model that predicts how spatial distribution of VEGF-A produced by delivery of a modified mRNA (AZD8601) accelerates diabetic wound healing. Methods We modified a previously published model of cutaneous wound healing based on coupled partial differential equations that describe the density of sprouting capillary tips, chemoattractant concentration, and density of blood vessels in a circular wound. Key model parameters identified by a sensitivity analysis were fit to data obtained from an in vivo wound healing study performed in the dorsum of diabetic mice, and a pharmacokinetic model was used to simulate mRNA and VEGF-A distribution following injections with AZD8601. Due to the limited availability of data regarding the spatial distribution of AZD8601 in the wound bed, we performed simulations with perturbations to the location of injections and diffusion coefficient of mRNA to understand the impact of these spatial parameters on wound healing. Results When simulating injections delivered at the wound border, the model predicted that injections delivered on day 0 were more effective in accelerating wound healing than injections delivered at later time points. When the location of the injection was varied throughout the wound space, the model predicted that healing could be accelerated by delivering injections a distance of 1–2 mm inside the wound bed when compared to injections delivered on the same day at the wound border. Perturbations to the diffusivity of mRNA predicted that restricting diffusion of mRNA delayed wound healing by creating an accumulation of VEGF-A at the wound border. Alternatively, a high mRNA diffusivity had no effect on wound healing compared to a simulation with vehicle injection due to the rapid loss of mRNA at the wound border to surrounding tissue. Conclusions These findings highlight the critical need to consider the location of drug delivery and diffusivity of the drug, parameters not typically explored in pre-clinical experiments, when designing and testing drugs for treating diabetic wounds.

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Holmer, Amadeus, Jörg Marotz, Philip Wahl, Michael Dau, and Peer W. Kämmerer. "Hyperspectral imaging in perfusion and wound diagnostics – methods and algorithms for the determination of tissue parameters." Biomedical Engineering / Biomedizinische Technik 63, no. 5 (October 25, 2018): 547–56. http://dx.doi.org/10.1515/bmt-2017-0155.

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Abstract Blood perfusion is the supply of tissue with blood, and oxygen is a key factor in the field of minor and major wound healing. Reduced perfusion of a wound bed or transplant often causes various complications. Reliable methods for an objective evaluation of perfusion status are still lacking, and insufficient perfusion may remain undiscovered, resulting in chronic processes and failing transplants. Hyperspectral imaging (HSI) represents a novel method with increasing importance for clinical practice. Therefore, methods, software and algorithms for a new HSI system are presented which can be used to observe tissue oxygenation and other parameters that are of importance in supervising healing processes. This could offer an improved insight into wound perfusion allowing timely intervention.

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Van Gauwbergen, D., and J. Baeyens. "Macroscopic fluid flow conditions in spiral wound membrane elements: packed bed approach." Water Science and Technology 41, no. 10-11 (May 1, 2000): 85–91. http://dx.doi.org/10.2166/wst.2000.0615.

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The modelling of the reverse osmosis process is needed to fully evaluate its potential and facilitate scale up. The definition of the flow regime in the concentrate channel is of paramount importance. The present paper describes our experimental investigations on RTD and relates the RTD response curves to the regime of flow in the concentrate channel. Results demonstrate (i) that dead zones are present; (ii) that both a Plug Flow with Dispersion (PFD) and Probabilistic Time Delay (PTD) model can be used to characterise the flow; and (iii) that PFD- and PTD-model parameters assume nearly constant values for a given geometry which simplifies the prediction of the RTD for any desired flow rate.

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Aliahmad, Behzad, Aye Nyein Tint, Sridhar Poosapadi Arjunan, Priya Rani, Dinesh Kant Kumar, Julie Miller, Jeffrey D. Zajac, Gayathiri Wang, and Elif Ilhan Ekinci. "Is Thermal Imaging a Useful Predictor of the Healing Status of Diabetes-Related Foot Ulcers? A Pilot Study." Journal of Diabetes Science and Technology 13, no. 3 (September 26, 2018): 561–67. http://dx.doi.org/10.1177/1932296818803115.

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Introduction: In clinical practice, both area and temperature of the ulcer have been shown to be effective in tracking the healing status of diabetes-related foot ulcer (DRFU). However, traditionally, the area of the DRFU is measured regardless of the temperature distribution. The current prospective, observational study used thermal imaging, as a more accurate tool, to measure both the area and the temperature of DRFU. We aimed to predict healing of DRFU using thermal imaging within the first 4 weeks of ulceration. Method: A pilot study was conducted where thermal and color images of 26 neuropathic DRFUs (11 healing vs 15 nonhealing) from individuals with type 1 or 2 diabetes were taken at the initial clinic visit (baseline), at week 2, and at week 4. The thermal images were segmented into isothermal patches to identify the wound boundary and area corresponding to temperature distribution. Five parameters were obtained: temperature of the wound bed, area of the isothermal patch of the wound bed, area of isothermal patch of periwound, number of isolated isothermal patches of the wound region, and physical wound bed area from color image. The ulcers were also measured by experienced podiatrists over 4 consecutive weeks and used as the healing reference. Results: For healing cases, the ratio of the area of the wound bed to its baseline measured using thermal images was found to be significantly lower at 2 weeks compared to nonhealing cases and this corresponded with a 50% reduction in area of DRFU at 4 weeks (group rank-based nonparametric analysis of variance P = .036). In comparison, neither the planimetric area measured using color images nor the temperature of the wound bed was associated with the healing. Conclusion: This study of 26 patients demonstrates that change in the isothermal area of DRFU can predict the healing status at week 4. Thermal imaging of DRFUs has the advantage of incorporating both area and temperature allowing for early prediction of the healing of these ulcers. Further studies with greater sample sizes are required to test the significance of these results.

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Shao, Pei-Lin, Jiunn-Der Liao, Shun-Cheng Wu, Yu-Hsing Chen, and Tak-Wah Wong. "Microplasma Treatment versus Negative Pressure Therapy for Promoting Wound Healing in Diabetic Mice." International Journal of Molecular Sciences 22, no. 19 (September 24, 2021): 10266. http://dx.doi.org/10.3390/ijms221910266.

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The delayed healing response of diabetic wounds is a major challenge for treatment. Negative pressure wound therapy (NPWT) has been widely used to treat chronic wounds. However, it usually requires a long treatment time and results in directional growth of wound healing skin tissue. We investigated whether nonthermal microplasma (MP) treatment can promote the healing of skin wounds in diabetic mice. Splint excision wounds were created on diabetic mice, and various wound healing parameters were compared among MP treatment, NPWT, and control groups. Quantitative analysis of the re-epithelialization percentage by detecting Ki67 and DSG1 expression in the extending epidermal tongue (EET) of the wound area and the epidermal proliferation index (EPI) was subsequently performed. Both treatments promoted wound healing by enhancing wound closure kinetics and wound bed blood flow; this was confirmed through histological analysis and optical coherence tomography. Both treatments also increased Ki67 and DSG1 expression in the EET of the wound area and the EPI to enhance re-epithelialization. Increased Smad2/3/4 mRNA expression was observed in the epidermis layer of wounds, particularly after MP treatment. The results suggest that the Smad-dependent transforming growth factor β signaling contributes to the enhancement of re-epithelialization after MP treatment with an appropriate exposure time. Overall, a short-term MP treatment (applied for 30 s twice a day) demonstrated comparable or better efficacy to conventional NPWT (applied for 4 h once a day) in promoting wound healing in diabetic mice. Thus, MP treatment exhibits promise for treating diabetic wounds clinically.

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Ricci, Elia, and Monica Pittarello. "Wound bed preparation with hypochlorous acid oxidising solution and standard of care: a prospective case series." Journal of Wound Care 30, no. 10 (October 2, 2021): 830–38. http://dx.doi.org/10.12968/jowc.2021.30.10.830.

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Objective: This prospective case series aims to evaluate the clinical impact of a hypochlorous acid oxidising solution (AOS) in association with usual standard of care (SoC) on wound bed preparation (WBP) in patients with hard-to-heal ulcers of various aetiologies. The AOS (Nexodyn, APR Applied Pharma Research S.A., Switzerland) comprises three main features: highly pure and stabilised hypochlorous acid, acidic pH and high reduction–oxidation potential. Method: Between February 2015 and February 2017, patients who met the inclusion criteria were treated with AOS and usual SoC. Data collection ran for 70 days: T0–T70. A baseline assessment was undertaken at T0; parameters assessed at fortnightly visits included: WBP score, area and depth of ulcer, duration, pain, Bates–Jensen score and infection status. Results: A total of 60 patients took part in the study. By T70, 68.3% of wounds had healed or improved and a significant wound size reduction of 21% was observed (p<0.001), despite a mean wound duration of 20.6 months. All wounds were free of local infection and cellulitis; 10% were colonised. WBP scores improved, while Bates–Jensen and pain scores fell significantly over time. Conclusion: This evaluation suggests that AOS might represent a valuable therapeutic addition for an optimal WBP in the routine management of hard-to-heal ulcers of different aetiologies. Declaration of interest: ER worked as a consultant for APR Applied Pharma Research S.A. The authors have no other conflicts of interest.

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Kumar, Birbal, R. S. Mohil, Sajith K. Mohan, Navnik Singh Bhardwaj, Arush Pasricha, Kashinath Singh, Raghav Garg, and Ratnakar Namdeo. "Comparison of vacuum assisted closure therapy with conventional dressing in the management of necrotizing fasciitis wound." International Surgery Journal 8, no. 12 (November 26, 2021): 3587. http://dx.doi.org/10.18203/2349-2902.isj20214750.

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Background: The purpose of our study was to compare the effect of vacuum assisted closure (VAC) therapy and conventional dressings in patients with open wounds due to necrotizing fasciitis (NF) on the basis of healing rate, infection control, frequency of dressing and pain score.Methods: The study evaluated 50 patients admitted with NF requiring surgery over a period of 18 months. The patients were randomized to two groups. In group A patients, the wounds were managed with conventional dressings and in group B patients, negative pressure wound therapy (NPWT) was applied. Serial assessment of both groups was done for four weeks. The parameters including size of wound, wound bed, granulation tissue formation, color, amount and odor of exudate, edema, frequency of dressing, re-debridement and pain were monitored and analysed.Results: In our study, patients with NF wounds who underwent VAC therapy had earlier granulation tissue formation, resolution of infection and readiness for skin grafting. The frequency of dressing, requirement of re-debridement, resolution of edema, odor, skin maceration, inflammation around wound and pain significantly reduced in group B (VAC) when compared to conventional dressing group.Conclusions: When compared to the conventional dressing on NF wound, application of VAC helped in early appearance of granulation tissue, significant reduction of inflammation, wound odor, exudate, need for re-debridement, frequency of dressing and pain. Thus, VAC dressing can be considered as a better option in the management of NF wounds.

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Raizman, Rose, Danielle Dunham, Liis Lindvere-Teene, Laura M. Jones, Kim Tapang, Ron Linden, and Monique Y. Rennie. "Use of a bacterial fluorescence imaging device: wound measurement, bacterial detection and targeted debridement." Journal of Wound Care 28, no. 12 (December 2, 2019): 824–34. http://dx.doi.org/10.12968/jowc.2019.28.12.824.

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Objective: Diagnostics which provide objective information to facilitate evidence-based treatment decisions could improve the chance of wound healing. Accurate wound measurements, objective bacterial assessment, and the regular, consistent tracking of these parameters are important aspects of wound care. This study aimed to assess the accuracy, clinical incorporation and documentation capabilities of a handheld bacterial fluorescence imaging device (MolecuLight i:X). Method: Benchtop wound models with known dimensions and clinical wound images were repeatedly measured by trained clinicians to quantify accuracy and intra/inter-user coefficients of variation (COV) of the imaging device measurement software. In a clinical trial of 50 wounds, wound dimensions were digitally measured and fluorescence images were acquired to assess for the presence of bacteria at moderate-to-heavy loads. Finally, fluorescence imaging was implemented into the routine assessment of 22 routine diabetic foot ulcers (DFU) to determine appropriate debridement level and location based on bacterial fluorescence signals. Results: Wound measurement accuracy was >95% (COV <3%). In the clinical trial of 50 wounds, 72% of study wounds demonstrated positive bacterial fluorescence signals. Levine sampling of wounds was found to under-report bacterial loads relative to fluorescence-guided curettage samples. Furthermore, fluorescence documentation of bacterial presence and location(s) resulted in more aggressive, fluorescence-targeted debridement in 17/20 DFUs after standard of care debridement failed to eliminate bacterial fluorescence in 100% of DFU debridements. Conclusion: The bacterial fluorescence imaging device can be readily implemented for objective, evidenced-based wound assessment and documentation at the bedside. Bedside localisation of regions with moderate-to-heavy bacterial loads facilitated improved sampling, debridement targeting and improved wound bed preparation.

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Yari, Abazar, Fatemeh Heidari, Sanaz Joulai Veijouye, and Maliheh Nobakht. "Hair follicle stem cells promote cutaneous wound healing through the SDF-1α/CXCR4 axis: an animal model." Journal of Wound Care 29, no. 9 (September 2, 2020): 526–36. http://dx.doi.org/10.12968/jowc.2020.29.9.526.

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Objective: An appropriate source of adult stem cells for therapeutic use is stem cells deriving from the hair follicle bulge. Following injury, ischaemic tissues produce a variety of cytokines and growth factors that are essential for tissue repair. This study sought to investigate the temporal effects of hair follicle bulge stem cells (HFSCs) on cutaneous wound healing in rats using the SDF-1α/CXCR4 axis. Method: HFSCs obtained from rat vibrissa, labeled with DiI and then special markers, were detected using flow cytometry. The animals were divided into five groups: control (non-treated, n=18), sham (PBS, n=18), AMD (treated with AMD3100, n=18), HFSC + AMD (treated with HFSCs + AMD3100, n=18) and HFSC (treated with HFSCs, n=18). A full-thickness excisional wound model was created and DiI-labeled HFSCs were injected around the wound bed. Wound healing was recorded with digital photographs. The animals were sacrificed 3, 7 and 14 days after the surgery and were used for histological (H&E, Masson's trichrome staining) and molecular (ELISA and q-PCR) assays. Results: The flow cytometry results demonstrated that HFSCs were CD34-positive, nestin-positive, but Kr15-negative. The morphological analysis of the HFSC-treated wounds showed accelerated wound closure. The histological analysis of the photomicrographs exhibited more re-epithelialisation and dermal structural regeneration in the HFSC-treated wounds compared with the control group. In the HFSC + AMD group, the histological parameters improved on the same days, but showed a significant decrease compared with the HFSC group in all the days assayed. In the AMD group, there was a significant reduction in the noted parameters. qRT-PCR and ELISA showed a high expression level of SDF-1α, CXCR4 and VEGFR-2 in the HFSC-treated wounded skin tissue, but the expression of CXCR4 and VEGFR-2 showed a significant reduction in the HFSC + AMD group compared with the HFSC group. Conclusions: Based on the findings of this study, HFSC transplantation affects wound closure parameters and the expression of SDF-1α and CXCR4. As the SDF-1α expression level increases in the injured area, the HFSCs contribute to wound repair through the SDF-1α/CXCR4 axis. This result is extremely valuable because it raises the possibility of wounds healed by isolating autologous HFSCs from the patient.

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Mallow, Peter J., John M. Hiebert, and Martin C. Robson. "Cost-Effectiveness of Hypochlorous Acid Preserved Wound Cleanser versus Saline Irrigation in Conjunction with Ultrasonic Debridement for Complex Wounds." Journal of Health Economics and Outcomes Research 8, no. 2 (November 1, 2021): 76–81. http://dx.doi.org/10.36469/jheor.2021.28429.

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Objective: Low-frequency ultrasound debridement with irrigation is an effective method of wound bed preparation. A recent clinical study compared hypochlorous acid preserved wound cleanser (HAPWOC) to saline and found HAPWOC to be a more effective adjunct to low frequency ultrasound debridement. However, HAPWOC has an added cost. The primary objective of this study was to assess the cost-effectiveness of HAPWOC as an irrigation modality with low-frequency ultrasound debridement for the treatment of severely complex wounds that were destined to be closed primarily via a flap. The secondary objective of this study was to estimate the number needed to treat (NNT) to avoid a wound-related complication and its expected cost per NNT. Methods: A patient-level Monte-Carlo simulation model was used to conduct a cost-effectiveness analysis from the US health system perspective. All clinical data were obtained from a prospective clinical trial. Cost data were obtained from the publicly available data sources in 2021 US dollars. The effect measure was the avoidance of wound-related complications at 14-days post-debridement. The primary outcome was the incremental cost-effectiveness ratio (ICER), a measure of the additional cost per benefit. The secondary outcomes were the NNT and expected cost per NNT to avoid one complication (complementary to the ICER in assessing cost-effectiveness). Deterministic and probabilistic sensitivity analyses (PSA) were performed to gauge the robustness and reliability of the results. Results: The ICER for HAPWOC versus saline irrigation was US$90.85 per wound complication avoided. The expected incremental cost per patient in the study and effect was US$49.97 with 55% relative reduction in wound-related complications at day 14 post debridement procedure. The NNT and cost per NNT were 2 and US$99.94, respectively. Sensitivity analyses demonstrated that these results were robust to variation in model parameters. Conclusion: HAPWOC was a cost-effective strategy for the treatment of complex wounds during ultrasonic debridement. For every two patients treated with HAPWOC, one complication was avoided.

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Cerusico, Nicolas, Romina Chavez-Jara, Silvana Lopez, Eugenia Sesto Cabral, Aida Ben Altabef, and Alberto Ramos. "Comparison Between Numeric Parameters From Acute and Chronic Venous Leg Ulcers: Identification of Potential Objective Nonhealing Parameters." Wound Management & Prevention 68, no. 11 (November 1, 2022): 15–21. http://dx.doi.org/10.25270/wmp.2022.11.1521.

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BACKGROUND: Some authors claim that the clinical methods often employed to assess chronic venous leg ulcers (CVLU) are based on subjective interpretation. The treatments based on a subjective characterization could become a trial-and-error therapy, resulting in longer evolutions and high recurrence rates. PURPOSE: The aim of this work was to compare numeric parameters from acute and chronic venous leg ulcers to identify potential objective nonhealing parameters. METHODS: The study was performed with hospital outpatients from 2016 to 2019. Cohorts were established according to the ulcer evolution time. Data collected related to ulcer characteristics included exudate pH, lactate and glucose concentrations, temperatures, microbiology findings, and imaging study results. RESULTS: Approximately 83% of the examined ulcers were chronic. Seventy-one percent of CVLUs and 59% of the acute ulcers had a pH ≥8. A high variability was found for the concentration of glucose and lactate in exudates of both acute and chronic ulcers. Variations of temperatures of normal skin (ΔT1) and periulcer zone (ΔT2) in reference to the wound bed temperature with values above 1 could indicate the presence of an inflammatory process and be used as a new potential marker of inflammation. All the acute ulcers and 88% of CVLUs showed <80% of granulation tissue in the imaging study. Finally, more than 105 organisms per gram of tissuewere found in 100% of the analyzed samples. CONCLUSIONS: Whereas there were not significant differences among the clinical measured parameters between acute and chronic ulcers, further research on the use of objective measurable parameters is needed to establish cutoff points to differentiate the “chronic state” of an ulcer as a “nonhealing state” regardless of the evolution time. Also, the use of these easily obtainable and low-cost nonhealing parameters would be a new approach to accurately monitor this pathology.

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Dissemond, Joachim, Michael Dietlein, Ingo Neßeler, Lutz Funke, Oliver Scheuermann, Elisa Becker, Laetitia Thomassin, Udo Möller, Serge Bohbot, and Karl-Christian Münter. "Use of a TLC-Ag dressing on 2270 patients with wounds at risk or with signs of local infection: an observational study." Journal of Wound Care 29, no. 3 (March 2, 2020): 162–73. http://dx.doi.org/10.12968/jowc.2020.29.3.162.

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Objective: A description of wounds treated with a poly-absorbent silver dressing (with technology lipido-colloid with silver ions, TLC-Ag), and evaluation of the short-term clinical impact of the dressing on the wound healing process, under real-life conditions. Method: A large, prospective, multicentre, observational study of patients in 81 centres in Germany, presenting with an exuding wound at risk or with clinical signs of local infection for whom the evaluated TLC-Ag dressing (UrgoClean Ag, Laboratoires Urgo, France) has been prescribed. Main outcomes included: reduction in number of wound infections diagnosed and clinical signs of local infection, wound healing rate, clinical assessment of wound healing progression, relative wound area reduction (RWAR), local tolerability, handling and acceptance of the dressing. Results: A total of 2270 patients with acute and chronic wounds of various aetiologies were treated with the evaluated dressing for a mean duration of 22±13 days. All clinical signs of local infection and the diagnosed wound infections were substantially reduced at two weeks after the treatment initiation. All wound infection parameters continued to reduce until the last visit. In the meantime, clinical improvement in wound healing was reported in 98.9% of acute wounds, with a wound closure rate of 68.5%. In chronic wounds, a median RWAR of 57.4% was achieved, with an improvement in healing process documented by clinicians in 90.6% of cases, stabilisation in 6.1% and worsening in 3.2%. Similar results were reported, regardless of exudate level and proportion of sloughy and granulation tissues in the wound bed at baseline. The dressing was well tolerated and well accepted by both patients and health professionals. Conclusion: These results, documented in a large cohort of patients treated in current practice, support and complete the clinical evidence on the healing properties and safety profile of the TLC-Ag dressing in the management of wounds at risk or with clinical signs of local infection, regardless of wound and patient characteristics. Declaration of interest: This study was supported by a grant from Laboratoires Urgo. UM, EB, LT and SB are employees of Laboratoires Urgo. JD, KCM and MD provided advisory and speaking services to pharmaceutical and other healthcare organisations including, but not limited to, Laboratoires Urgo. Data management and statistical analyses were conducted independently by INPADS GmbH, Germany.

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Atkin, Leanne, Simon Barrett, Paul Chadwick, Rosie Callaghan, Mark G. Rippon, Alan A. Rogers, and Sue Simm. "Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series." Journal of Wound Care 29, no. 3 (March 2, 2020): 174–82. http://dx.doi.org/10.12968/jowc.2020.29.3.174.

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Objective: The primary objective of this study was to evaluate the fluid management capabilities of a superabsorbent wound dressing (Zetuvit Plus Silicone), with secondary objectives related to parameters that support whether the dressing enables undisturbed healing. Method: This study was an open labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. Results: A total of 50 patients were included in the study. Results related to the primary objective demonstrated that the superabsorbent wound dressing was able to absorb all levels of exudate across the range (low to high). At each assessment time point these results show that in 98% of assessments the superabsorbent dressing was rated as ‘very good’ (91%) or ‘good’ (7%) at exudate management. Secondary objectives relating to wound bed preparation, healing and management of pain were also positive. Additionally, at the end of each patient treatment, the dressing's fluid management capabilities were rated overall as ‘excellent’ (100% of cases). There was little pain associated with the wound or at dressing change throughout the study and its flexibility/conformability allowed for comfort and patient satisfaction aligned with increased quality of life. Additionally, inclusion of a silicone adhesive layer allowed painless and atraumatic removal of the dressing, increasing patient comfort, both during wear and at dressing removal, and supported the description of enabling undisturbed wound healing. Conclusion: The superabsorbent wound dressing achieved the primary objective relating to wound exudate management in all the assessments undertaken in this study. In addition, the silicone interface allowed for undisturbed healing as evidenced by little or no adherence of the dressing to underlying tissue, preventing damage to periwound skin. Overall, the superabsorbent wound dressing with the addition of the silicone interface could offer advantages over other superabsorbent polymer dressings (that might adhere to the wound surface) or silicone wound dressings (that might not have the absorbent properties of this type of dressing).

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Grigoryan, A. Yu, A. I. Bezhin, B. S. Sukovatykh, and Yu Yu Blinkov. "A clinical trial of the efficacy of a combination of antiseptic and antimicrobial agent in the treatment of inflammatory processes of the skin and soft tissue." Research and Practical Medicine Journal 8, no. 2 (June 23, 2021): 51–61. http://dx.doi.org/10.17709/2410-1893-2021-8-2-5.

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Purpose of the study. To conduct a clinical trial of the local treatment efficacy of skin and soft tissue inflammatory processes combination with sodium carboxymethylcellulose, immobilized miramistin and metronidazole.Patients and methods. The study involved patients with purulent-inflammatory skin processes, divided into two groups – control and experimental – 30 in each. The most common nosological form were abscesses of various localization. In the control group, local treatment was carried out with dioxomethyltetrahydropyrimidine ointment with chloramphenicol, and in the experimental group – with a combination of sodium carboxymethylcellulose with miramistin and metronidazole. We studied the local temperature, wound pH, wound planimetry, the appearance of wounds, the species composition of infectious agents in the discharge from the wound, a general blood test (with the determination of leukocyte indices), blood biochemical parameters, and the number of bed-days in the hospital. The data obtained were processed statistically.Results. The percentage of reduction in the area and volume of wounds in the experimental group was significantly higher than in the control. The maximum rate of wound healing in the experimental group was noted on days 1-3 and amounted to 9.7 (6.3; 15.5) % / day, and in the control group – 5.6 (2.9; 7.7). Starting from the 5th day of treatment, the local temperature indices in the experimental group were significantly lower than in the control group, and the pH values of the wounds in the experimental group tended to neutral values from the 5th day of treatment, and in the control group there was an increase in pH. Most often, S. epidermidis and S. aureus were inoculated from the wound discharge (in total, more than 50 % of observations); in the control group, pathogenic microorganisms were inoculated 1.6 times more often than in the experimental group.Conclusion. Patients in the experimental group were hospitalized for 2.5 days less than patients in the control group. It is possible to recommend further study and application of the combination of miramistin and metronidazole immobilized on the sodium salt of carboxymethylcellulose in the treatment of wounds.

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Ngo, Hien Thi Minh, Linh Quang Huynh, Liao Jiunn Der, and Thuy Ngu Son Nguyen. "Stimulation of wound healing process through ROS/RNS signals indirectly generated by N2/Ar micro-plasma - in vitro and in vivo studies." Science and Technology Development Journal 18, no. 2 (June 30, 2015): 29–37. http://dx.doi.org/10.32508/stdj.v18i2.1069.

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In this work, non-thermal N2/Ar micro-plasma was applied to fibroblast cells and second degree burn in mice to investigate the bio-safety and bioefficiency of micro-plasma device for studying wound healing process. The chosen parameters of the device were the addition of 0.5% N2 in argon plasma and RF supplied power of 17 W and 13 W in vitro and in vivo studies, respectively. Firstly, micro-plasma was applied to fibroblast cells and the induced biological effect was studied in vitro. The result showed that cells number increased three folds for plasma exposure time of 5 or 10 sec, followed by cell culture for 48 hrs. The cell coverage rate rose 20% for the same plasma exposure time, followed by cell culture for 6 or 12 hrs. Secondly, micro-plasma was applied to the second degree burn wound mice, followed by related ex vivo and in vivo assessments. For the former, 0.5% N2/Ar micro-plasma was competent to generate ROS/RNS signals for advancing healing process by the increase of ROS/RNS concentration around the plasma-exposed wound bed. The induced effect is most probably correlated with the angiogenesis and epithelialization processes of the burn wound on mice.

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Pronina, Оlena М., Serhii М. Bilash, Mykola М. Кobeniak, Mykhailo M. Koptev, Angelina V. Pirog-Zakaznikova, Valentyna V. Onipko, and Volodymyr I. Ischenko. "MORPHOMETRIC FEATURES OF THE STRUCTURAL COMPONENTS OF THE HEMOMICROCIRCULATORY BED IN THE PERIVULNAR REGION OF THE CAECUM IN WOUND DEFECT SUTURED WITH POLYFILAMENT SUTURE MATERIAL." Wiadomości Lekarskie 74, no. 6 (2021): 1382–88. http://dx.doi.org/10.36740/wlek202106118.

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The aim: The study focuses on the morphometric features specification concerning the structural components of the hemomicrocirculatory bed of the perivulnar region of the cecum in rabbits when suturing a wound defect with synthetic polyfilament surgical suture Vicryl. Materials and methods: The research was carried out on rabbits (n = 30: 5 animals made up the control group and 25 animals made up the experimental group) and included surgery based on the method of surgical intervention on the large intestine patented by the authors, which was performed in the conditions of the operating room at the Department of Clinical Anatomy and Operative Surgery. When determining the main morphometric parameters, we took biopsy specimens of the cecum and used paraffin and epoxy resin embedding considering the generally accepted methods. Results: The study determined that the implantation of Vicryl surgical suture material in the tissues of the cecum became a trigger for the formation of active inflammatory focus and occurrence of leukocyte infiltrate in the perivulnar region. Conclusions: Arterioles, as a resistive link, capillaries, as an exchange link and venules, as a capacitive link in the hemomicrocirculatory bed, actively participate in response to the inflammatory process and formation of a connective tissue scar. The process of structural organization of microvessels begins in the formed granulation tissue in the perivulnar region of the cecum starting from the 14th day of the experiment.

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Löwik, Claudia A. M., Frank-Christiaan Wagenaar, Walter van der Weegen, Rudolf W. Poolman, Rob G. H. H. Nelissen, Sjoerd K. Bulstra, Yvette Pronk, et al. "LEAK study: design of a nationwide randomised controlled trial to find the best way to treat wound leakage after primary hip and knee arthroplasty." BMJ Open 7, no. 12 (December 2017): e018673. http://dx.doi.org/10.1136/bmjopen-2017-018673.

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IntroductionTotal hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful treatment modalities for advanced osteoarthritis. However, prolonged wound leakage after arthroplasty is linked to prosthetic joint infection (PJI), which is a potentially devastating complication. On the one hand, wound leakage is reported as a risk factor for PJI with a leaking wound acting as aporte d’entréefor micro-organisms. On the other hand, prolonged wound leakage can be a symptom of PJI. Literature addressing prolonged wound leakage is scarce, contradictory and of poor methodological quality. Hence, treatment of prolonged wound leakage varies considerably with both non-surgical and surgical treatment modalities. There is a definite need for evidence concerning the best way to treat prolonged wound leakage after joint arthroplasty.Methods and analysisA prospective nationwide randomised controlled trial will be conducted in 35 hospitals in the Netherlands. The goal is to include 388 patients with persistent wound leakage 9–10 days after THA or TKA. These patients will be randomly allocated to non-surgical treatment (pressure bandages, (bed) rest and wound care) or surgical treatment (debridement, antibiotics and implant retention (DAIR)). DAIR will also be performed on all non-surgically treated patients with persistent wound leakage at day 16–17 after index surgery, regardless of amount of wound leakage, other clinical parameters or C reactive protein. Clinical data are entered into a web-based database. Patients are asked to fill in questionnaires about disease-specific outcomes, quality of life and cost effectiveness at 3, 6 and 12 months after surgery. Primary outcome is the number of revision surgeries due to infection within a year of arthroplasty.Ethics and disseminationThe Review Board of each participating hospital has approved the local feasibility. The results will be published in peer-reviewed scientific journals.Trial registration numberNTR5960;Pre-results.

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Khanevich, M., and A. Khazov. "Wound Complications After Multimodal Treatment of Soft Tissue Sarcomas." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 218s. http://dx.doi.org/10.1200/jgo.18.88200.

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Background: Surgical removal of the tumor remains the only 1 radical treatment of patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. Aim: To evaluate the risk of the wound process complications after surgical treatment of soft tissue sarcomas using endovascular embolization and cryosurgery. Methods: We have assessed the quantity and quality of postoperative complications of wound process in 199 patients with soft tissue sarcomas and their recurrences. The study group consisted of 53 patients, who underwent radical surgery with selective preoperative endovascular embolization and intraoperative cryosurgery. The control group consisted of 146 patients who had radical surgery without any additional methods. Preoperative embolization and cryosurgery on the wound bed after tumor removal was used to prevent local recurrence of soft tissue sarcomas. Preoperative angiography with selective embolization of vessels feeding the tumor was performed 1-1.5 hours before the main surgical treatment. Cryosurgery was carried out by the method of “Olympic rings” with 3 minutes duration. The temperature of exposure was −186°C. In the course of cryosurgery we adhere to the principle of “quick freezing - an independent slow thawing”. All postoperative wounds tightly sutured with silicone drains by Redon, if necessary. Results: Complications of wound healing have been diagnosed in 15 (28.3%) patients of the main group and in 34 (23.3%) control group patients. Inflammatory-suppurative complications were observed in the remaining 8 (15.1%) patients of the main group and in 18 (12.3%) control group patients ( P > 0.05). Long lymphorrhea was observed in 6 (11.3%) patients of the main group and 11 (7.5%) control group patients. Bleeding in the postoperative period was observed in 1 (1.9%) case of main group patients and in 5 (3.4%) cases of control group. Conclusion: The additional using of selective preoperative endovascular embolization and cryosurgery is safe and does not worsen immediate results of surgical treatment of soft tissue sarcomas.

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Zoppo, Gianluca, Francesco Marrone, Monica Pittarello, Marco Farina, Alberto Uberti, Danilo Demarchi, Jacopo Secco, Fernando Corinto, and Elia Ricci. "AI technology for remote clinical assessment and monitoring." Journal of Wound Care 29, no. 12 (December 2, 2020): 692–706. http://dx.doi.org/10.12968/jowc.2020.29.12.692.

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Objective: To report the clinical validation of an innovative, artificial intelligence (AI)-powered, portable and non-invasive medical device called Wound Viewer. The AI medical device uses dedicated sensors and AI algorithms to remotely collect objective and precise clinical data, including three-dimensional (3D) wound measurements, tissue composition and wound classification through the internationally recognised Wound Bed Preparation (WBP) protocol; this data can then be shared through a secure General Data Protection Regulation (GDPR)- and Health Insurance Portability and Accountability Act (HIPAA)-compliant data transfer system. This trial aims to test the reliability and precision of the AI medical device and its ability to aid health professionals in clinically evaluating wounds as efficiently remotely as at the bedside. Method: This non-randomised comparative clinical trial was conducted in the Clinica San Luca (Turin, Italy). Patients were divided into three groups: (i) patients with venous and arterial ulcers in the lower limbs; (ii) patients with diabetes and presenting with diabetic foot syndrome; and (iii) patients with pressure ulcers. Each wound was evaluated for area, depth, volume and WBP wound classification. Each patient was examined once and the results, analysed by the AI medical device, were compared against data obtained following visual evaluation by the physician and research team. The area and depth were compared with a Kruskal–Wallis one-way analysis of variations in the obtained distribution (expected p-value>0.1 for both tests). The WBP classification and tissue segmentation were analysed by directly comparing the classification obtained by the AI medical device against that of the testing physician. Results: A total of 150 patients took part in the trial. The results demonstrated that the AI medical device's AI algorithm could acquire objective clinical parameters in a completely automated manner. The AI medical device reached 97% accuracy against the WBP classification and tissue segmentation analysis compared with that performed in person by the physician. Moreover, data regarding the measurements of the wounds, as analysed through the Kruskal–Wallis technique, showed that the data distribution proved comparable with the other methods of measurement previously clinically validated in the literature (p=0.9). Conclusion: These findings indicate that remote wound assessment undertaken by physicians is as effective through the AI medical device as bedside examination, and that the device was able to assess wounds and provide a precise WBP wound classification. Furthermore, there was no need for manual data entry, thereby reducing the risk of human error while preserving high-quality clinical diagnostic data.

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Luan, You Shun. "A Novel once-through Process for Methanol and DME Synthesis from Syngas." Advanced Materials Research 183-185 (January 2011): 1505–8. http://dx.doi.org/10.4028/www.scientific.net/amr.183-185.1505.

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A novel process for methanol and dimethyl ether(DME) synthesis was developed, in which two methanol-synthesis fixed-bed reactors were followed by an identical one for DME synthesis with cooling sections in between. Self-made Cu-Zn-Al catalyst for methanol synthesis and DME synthesis were used in this process. Tests of catalysts showed that both of them had activity and favorable stability and wound be capable of long-term industrial operation under the conditions. The investigation of processing parameters and stability led us safely to ensure the optimal condition: T1-200oC,T2-190 °C,T3-210 °C,5Mpa,total Space Velocity-1000h-1(T1,T2,T3 defined as temperature of catalytic beds in three serial reactors). Under that the catalytic system kept stable during the investigated hours.

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Kramar, S. B., K. S. Volkov, and Z. M. Nebesna. "Morphometric studies of the damaged skin area after experimental thermal trauma and during correction with a cryo-lyophilized xenograft skin substrate." Reports of Morphology 24, no. 4 (December 27, 2018): 22–28. http://dx.doi.org/10.31393/morphology-journal-2018-24(4)-03.

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According to WHO, burns rank third place among other injuries, and in some countries, the second, after traffic injuries. One of the promising tools for treating burn wounds is the use of lyophilized xenograft skin substrate. The purpose of this work was to determine the morphometric parameters of the affected by burns area of the skin in the dynamics after an experimental thermal trauma and in the case of correction by crushed lyophilized xenograft skin substrate. Burning of third degree on the shaved skin of the back of the guinea pig was applied to the vapor under general anesthetic. Morphometrically, at 7, 14, and 21 days of the experiment, the thickness of the epidermis (thin skin without a layer of scales), the number of fibroblast cells per unit area, the outer and inner diameter of the capillaries were determined in the boundary and central areas of the wound. Morphometric studies were carried out using programs VideoTest-5.0, KAAPA Image Base and Microsoft Exсel on a personal computer. Statistical processing of the obtained quantitative data was carried out using methods of variation statistics with the determination of the mean arithmetic and its error (M±m), Student’s criterion (t) and reliability index (p). Differences are considered valid at р≤0.05. It has been established that already in the 7 day of the experiment, under conditions of wound closure by xenograft skin substrate marked a significant thickening of the epidermis on the periphery of the wound appear. Activation of the process of boundary epithelization contributes to the renewal of components of the microcirculatory bed, the formation of granulation tissue. It was found that on the 14 day of application of the corrective factor in the peripheral zone of the wound, the number of cells of the fibroblast row and the mean value of the thickness of the epidermis reach their peak value, significantly (p<0.001) exceeding such indices of animals in intact group and group of animals without correction. The morphometric parameters of capillaries in this period of the experiment indicate a good development of the microcirculation, which improves regional epithelization. On the 21 day of the experiment, under the condition of correction, the border between the regional and central parts of the wound is almost lost. Thus, the results of morphometric studies indicate that the use of cryo-lyophilized xenograft skin substrate after a thermal trauma of the skin contributes to the healing of the wound defect with the formation of connective tissue of the dermis, angiogenesis, and complete epithelization of the surface of the affected epidermis layer.

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Kozyreva, E. E., and M. A. Ryabova. "Experimental justification of laser parameters for preventive laser (970 nm) vessel coagulation in intraoperative bleeding." Regional blood circulation and microcirculation 17, no. 4 (February 19, 2019): 57–61. http://dx.doi.org/10.24884/1682-6655-2018-17-4-57-61.

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Intraoperative bleeding impairs visualization of the surgical field. Working in a practically bloodless operating field reduces the duration of surgery and reduces the need for cautery use, which reduces pain in the postoperative period and the risk of delayed bleeding after tonsillectomy.Objective – to select the parameters of a diode laser with a wavelength of 970 nm in order to get optimal hemostatic effect and to develop a technique for safe preventive coagulation of vessels in the surgical wound using diode laser with a wavelength of 970 nm for their bloodless section.Materials and methods. 47 Wistar rats weighing 300–400 g were used in the experiment. After preparation of the surgical field, three groups of vessels were isolated from each rat. The rat vascular bed was used as a model of tonsillar vascular bed in the patients undergoing tonsillectomy. All animals were divided into groups, depending on the laser power. For the experiment we used a diode surgical laser with a wavelength of 970 nm in a constant mode, a fiber diameter of 400 microns. After coagulation of each vessel, a visual and microscopic assessment of the vessels was performed. The study of the possibility of vascular coagulation was evaluated after the vessel was cross-sectioned with a scalpel.Results. Damage to the walls of blood vessels was not observed at powers from 5.0 W to 7.0 W. At the same time, at the laser power from 5.0 W to 6.0 W there was no hemostasis after crossing the vessels. At a power of 6.5 W, adequate hemostasis was observed only in 42 % of cases. The coagulation mode of a diode laser with a wavelength of 970 nm, which is the most effective and safe for surrounding tissues, was observed at a power of 7.0 WConclusions. Exceeding the power levels of a diode laser with a wavelength of 970 nm leads to the formation of carbonization of the surrounding tissues, to a damage of the vascular wall. In order to prevent bleeding, arteries with a diameter of more than 1.5 mm must be stitched. Small vessels with a diameter of less than 0.4 mm do not require preventive coagulation and can be coagulated during the incision with a laser fiber.

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Mihai, C., A. G. Ene, R. G. Hertzog, D. Popescu, and A. F. Vladu. "PREDICTIVE MATEHMATICAL MODEL FOR ABSORBANT SUBSTRATE ACHIEVEMENT, THROUGH ELECTROSPINNING PROCESS." TEXTEH Proceedings 2021 (October 22, 2021): 355–62. http://dx.doi.org/10.35530/tt.2021.59.

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The new generations of wound dressings aim to create an optimal environment that allows epithelial cells to move easily in order to support regeneration. Such optimal conditions include a humid environment around the wound bed, efficient oxygen circulation to help regenerate cells and tissues, and low bacterial contamination. Composite matrices have several layers and can be used as primary or secondary dressings. Most composite dressings have three layers, respectively a semi-adherent or non-adherent layer, an absorbent layer, and a bacterial barrier layer. A method to obtaining these materials, which can be assimilated to layerby- layer deposition, or which can be operated in this regime, is represented by electrospinning. However, the deposition technique by electrospinning on textile surfaces (fabrics or nonwovens) raises some problems related to the electrostatic behaviour of textile fibres with dielectric properties. In this case, the characteristics of the jet are affected directly proportional with the thickness of the textile material, resulting in defects of nano- or micro-fibrillar deposition, such as unevenness and/or sputter (formation of drops, which are deposited in mixture with electro spun fibres). The article presents a mathematical model that predicts the diameter of the fibres in the composition of the absorbent layer of the multilayer matrix structure for the treatment of burns or gunshot wounds, taking into account the nonlinear relationships between the parameters explained above and specific theories of electrodynamics for thin profiles (for instance, those used in aeronautics) for the prediction of the behaviour of the electrospinning jet.

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Hegde, Bhagyashree Parameshwar, Syeda Ather Fathima, Geetanjali Hiremath, Shivalingappa J Arakeri, and Mohasin Kadegaon. "A CLINICAL STUDY TO EVALUATE THE EFFICACY OF JATYADI GHRITA VIKESHIKA DRESSING IN THE MANAGEMENT OF DUSHTAVRANA W.S.R. TO VENOUS ULCER." International Ayurvedic Medical Journal p6, no. 1 (November 25, 2021): 3186–94. http://dx.doi.org/10.46607/iamj05p6012021.

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Venous ulcers are a frequently encountered problem in the present era produced commonly as a complication of varicose veins and it causes long-term agony to the patient. The properties of a venous ulcer-like non-healing na- ture, severe discharge pain itching etc. come under the umbrella of Dushtavrana explained by Acharya Sushruta. Management of chronic venous ulcers is a challenging one. Commonly practised gauze dressing for chronic ulcers may be disruptive for wound healing as it gets adhered to wound bed hampering breathing of wound and causing damage to granulation tissue during its removal. These factors may be responsible for delayed wound healing. In modern science, there are plenty of sterilized, packed dressing materials available in the market. But nowhere Ayurvedic ready to use dressing material is manufactured or made available in the market. Keeping these into con- sideration, Jatyadi Ghrita Vikeshika i.e., the cloth containing Jatyadi Ghrita is prepared, packed and sterilized. This is compared with the Sofra-tulle of modern science. In the present comparative study, 40 patients were select- ed and divided into 2 groups of 20 patients each and trial group patients were treated with Jathyadi Ghrita Vike- shika dressing & control group patients were treated with Sofra-tulle dressing for 28 days. The study revealed highly significant results in both groups statistically. On observation except for pain, in all other parameters, Jatyadi Ghrita Vikeshika was found more effective. Hence Jatyadi Ghrita Vikeshika can be undoubtedly used in Dushtavrana which promotes both Shodhana (Cleansing) and Ropana (Healing)of Vrana. Keywords: Dushtavrana, Venous Ulcer, Jatyadi Ghrita Vikeshika, Sofra-Tulle dressing.

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Korymasov, Evgenii Anatol'evich, Evgenii Petrovich Krivoschekov, Maksim Yurievich Khoroshilov, Sergey Anatol'evich Ivanov, Vladimir Vladimirovich Kolesnikov, and Bahtiar Madatovich Rakhimov. "Features of Drainage of the Implant Placement Area in Patients with Incisional Ventral Hernias." Journal of Experimental and Clinical Surgery 15, no. 2 (June 24, 2022): 113–21. http://dx.doi.org/10.18499/2070-478x-2022-15-2-113-121.

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Introduction. There are different and sometimes conflicting points of view regarding the drainage of the implant placement area in patients with postoperative ventral hernias. This is due to the variability of drainage methods and the commitment of surgeons to one or another technique. In addition, the results of surgical treatment and features of the postoperative period differ in these patients. Current contradictions in the drainage techniques and management of patients with seromas after hernioplasty for PVH determine the relevance of this issue and the need to obtain additional data on benefits and drawbacks of one method or another.The aim of the study was to analyse clinical outcomes of patients with postoperative ventral hernias depending on the drainage technique of the implant placement area.Methods. The study included 392 patients diagnosed with postoperative ventral hernia, who were treated in GBUZ "Samara Regional Clinical Hospital named after V.D. Seredavin" in 2017-2020. Patients clinical outcomes were compared and analysed. Group I included 110 patients with passive drain of the surgical wound, group II included 282 patients with active drain. The groups were assessed based on major parameters of the drainage impact on the surgical treatment outcomes. Non-parametric values were compared by calculating the chi-square (2), parametric - by calculating the Student's t-score. Results. In group I, the average duration of hospitalization was 22,564,45 bed-days. The average terms of drainage were 2,020,69 days. Clinically significant seroma was diagnosed in 35 (32%) patients. The average number of US-guided puncture-drainage interventions was 1,870,89 procedures. Suppuration of the surgical wound was diagnosed in 16 (14,5%) patients. The postoperative mortality rate in the group was 3,6%, 4 patients died. In group II, the average duration of hospitalization was 13,572,92 bed-days. The average terms of drainage were 6,332,12 days. Clinically significant seroma was diagnosed in 42 (14,9%) patients. The average number of US-guided puncture-drainage interventions was 0,650,39 procedures. Suppuration of the surgical wound was diagnosed in 21 (7,4%) patients. The postoperative mortality rate was 2,1%, 6 patients died.Conclusion. Active drain of the implant placement area in patients with postoperative ventral hernias statistically significantly reduces the duration of patients stay in hospital (Student t-score = 11,51 p0,01), frequency of clinically diagnosed seromas (2 = 14,36, p0,01), frequency of suppuration of postoperative wounds (2 = 4,665, p0,05). When choosing the drainage option for the implant placement area, preference of choice should be given to active penetrating open drain or active penetrating closed drain.

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Jangde, Rajendra, Gamal Osman Elhassan, Sulekha Khute, Deependra Singh, Manju Singh, Ram Kumar Sahu, and Jiyauddin Khan. "Hesperidin-Loaded Lipid Polymer Hybrid Nanoparticles for Topical Delivery of Bioactive Drugs." Pharmaceuticals 15, no. 2 (February 10, 2022): 211. http://dx.doi.org/10.3390/ph15020211.

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Hesperidin is a bioflavonoid constituent that among many other biological activities shows significant wound healing properties. However, the bioavailability of hesperidin when applied topically is limited due to its low solubility and systemic absorption, so novel dosage forms are needed to improve its therapeutic efficacy. The objectives of this study were to develop hesperidin-loaded lipid-polymer hybrid nanoparticles (HLPHNs) to enhance the delivery of hesperidin to endogenous sites in the wound bed and promote the efficacy of hesperidin. HLPHNs were optimized by response surface methodology (RSM) using the Box-Behnken design. HLPHNs were prepared using an emulsion-solvent evaporation method based on a double emulsion of water-in-oil-in-water (w/o/w) followed by freeze-drying to obtain nanoparticles. The prepared formulations were characterized using various evaluation parameters. In addition, the antioxidant activity of HLPHN 4 was investigated in vitro using the DPPH model. Seventeen different HLPHNs were prepared and the HLPHN4 exhibited the best mean particle size distribution, zeta potential, drug release and entrapment efficiency. The values are 91.43 nm, +23 mV, 79.97% and 92.8%, respectively. Transmission electron microscope showed similar spherical morphology as HLPHN4. Differential scanning calorimetry verified the physical stability of the loaded drug in a hybrid system. In vitro release studies showed uniform release of the drug over 24 h. HLPHN4 showed potent antioxidant activity in vitro in the DPPH model. The results of this study suggest that HLPHNs can achieve sustained release of the drug at the wound site and exhibit potent in vitro antioxidant activity.

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Khomenko, I. P., V. Y. Shapovalov, O. S. Herasymenko, R. V. Gybalo, and R. V. Yenin. "Ventral hernia repair surgery after abdominal gunshot wound." General Surgery, no. 2 (December 30, 2022): 29–38. http://dx.doi.org/10.30978/gs-2022-2-29.

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Gunshot wounds to the abdomen frequently result in significant damage to the abdominal organs, which is accompanied by peritonitis and the further development of different complications (anastomotic leakage, formation of abscesses, repeated bleeding, etc.), which require repeated surgical interventions that contribute to the formation of postoperative ventral hernias. The surgical management of ventral hernias is challenging due to severe adhesion in the abdominal cavity (irrespective of the time period since the injury and the last surgical interventions), the difficulties in closing massive defects of the muscle‑aponeurotic component of the anterior abdominal wall, contracture of the anterior abdominal wall, and the development of the abdominal compartment syndrome in the postoperative period. As a result, there is still some debate over the best surgical treatment for postoperative ventral hernias. Objective — to carry out a comparative analysis of open and video‑assisted laparoscopic operations for the selection of the most optimal surgical strategy for the management of ventral hernias after gunshot wounds to the abdomen. Materials and methods. We analyzed the surgical treatment of 45 wounded patients with postoperative ventral hernias that developed after operations for abdominal gunshot wounds. The patients were treated at the Military Medical Clinical Center of the Southern Region (Odesa) from 2014 to 2021; 32 of them had penetrating gunshot wounds, and 13 patients had a closed gunshot wound to the abdomen with injuries to the abdominal organs. 66.7 % of those injured had one operation on their abdominal organs, 22.2 % had two operations, 6.7 % had three operations, and 4.4 % had five operations. The size of the hernia orifices and severity of recurrence risk were determined according to the SWE classification: W1 (width of the hernia orifices up to 4 cm) — 28.9 %, W2 (from 4 to 10 cm) — 44.4 %, and W3 (over 10 cm) — 26.7 % of patients. The patients who had laparoscopic hernia repair (LHR) (IPOM‑Plus method — 17 patients, sIPOM — 2 patients) belonged to the LHR group (n = 19). The patients who had open hernia repair (OHR) (IPOM‑Plus method — 7 patients, sublay technique — 11 patients, onlay technique — 8 patients) were added to the OHR group (n = 26). The patients of both groups did not statistically differ by age, nature of a gunshot injury, number of operations before hernia repair, or hernia parameters (all p > 0.05). Results. Postoperative hernias after gunshot wounds are associated with pronounced adhesions in the abdominal cavity. The mean value of the peritoneal adhesion index averaged 11.7 ± 0.7 points (from 5 to 23 points) and did not statistically differ between groups: in the OHR group — 12.4 ± 0.9 points, in the LHR group — 10.8 ± 0.9 points (p = 0.339). Laparoscopic and open hernia repair in injured patients did not differ in the frequency of intraoperative complications — 19.2 % and 15.8 %, respectively (p = 0.766). There were fewer postoperative complications (10.5 % vs. 38.5 %, p = 0.036), a shorter operation duration — 79.5 ± 6.8 min vs. 105.9 ± 4.7 min, p = 0.002, a shorter bed‑day — 8.6 ± 0.4 days vs. 10.8 ± 0.5 days, p = 0.004, and fewer patients required narcotic analgesics within the first two days after surgery (p < 0.05). During the one‑year follow‑up, no hernia recurrence or adhesion signs were detected in the groups. Conclusions. In the structure of postoperative ventral hernias after gunshot wounds to the abdomen, patients with open gunshot injuries predominate and amount to 71.1 % (р = 0.007). Among them, patients with combined and multiple wounds make up 65.6 %, while those with isolated wounds make up 34.4 % (р = 0.112); 33.3 % of patients require more than one operation before hernia repair. The laparoscopic IPOM‑Plus technique should be considered the operation of choice in the treatment of hernias after gunshot wounds to the abdomen. At the same time, for extensive cosmetic defects of the anterior abdominal wall, open operations are preferable, especially the IPOM‑Plus technique. If this is technically impossible, a sublay or onlay hernia repair using the tension‑free allohernioplasty technique should be performed.

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Ricci, Elia, and Monica Pittarello. "Hard-to-heal ulcers treated with hypochlorous acid oxidising solution and standard of care: a 32-week follow-up." Journal of Wound Care 30, no. 10 (October 2, 2021): 840–44. http://dx.doi.org/10.12968/jowc.2021.30.10.840.

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Objective: Immediately following a two-year prospective case series in which the wounds of 60 patients with hard-to-heal ulcers were treated with a hypochlorous acid oxidising solution (AOS) in addition to standard of care (SoC) for 70 days (T0–T70), a subset of 31 patients (51.7%) whose wounds had not fully healed by T70 opted to continue with treatment for a further 22 weeks (days T70–T224, a total treatment time of 32 weeks (224 days). The objective was to provide long-term evidence on the clinical performance and safety of AOS when used in association with the usual SoC in patients with stalled, hard-to-heal ulcers of various aetiologies. Method: As per the main study, wounds were formally assessed by the study lead at 28 days (±14 days, depending on patient attendance). Parameters assessed at fortnightly visits included area, depth and duration of ulcer; pain; wound bed preparation (WBP) score; and infection status. Wounds were managed in accordance with the SoC protocol. Results: By T224, 35.5% (n=11) of wounds healed completely and 83.9% showed some types of improvement. All wounds were free of infection and colonisation, the WBP score improved (100% A1–A2 at T196), and pain scores fell. Use of AOS in combination with several types of dressing (SoC) for such a long period confirmed a good safety profile. Conclusion: This follow-up evaluation, coupled with the primary study, suggests that AOS might represent a valuable therapeutic addition for the management of hard-to-heal ulcers for long periods of treatment. Declaration of interest: ER worked as a consultant for APR Applied Pharma Research S.A. The authors have no other conflicts of interest.

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Megahed, Mohammed Ahmed, Sherief Mohamed El Kashty, Ahmed Tharwat Nassar, Mohamed Aboulfetouh, and Mohammed Saad AboShaban. "Exposure of Skin Homografts from Related Living Donors to Radiotherapy and Its Effects on Acute Rejection and Wound Healing in Children with Deep Burns: A Randomized Controlled Trial." Indian Journal of Plastic Surgery 55, no. 01 (February 2022): 081–86. http://dx.doi.org/10.1055/s-0041-1740077.

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Abstract Background The ideal skin substitute should be more similar to normal skin function while causing fewer reactions. The purpose of this study was to assess the effect of radiotherapy on minimizing acute rejection and enhancing wound healing in children with deep burns. Patients and Methods A prospective randomized control study included 34 children admitted to the burn unit with deep burns under the age of 12 years. Through the tomotherapy device, a skin homograft from a related living donor was exposed to a local dose of radiotherapy of 500 centigray (cGy). It was immediately used for coverage of the prepared bed after the irradiation was completed. Results The mean values of the laboratory parameters (ESR, CRP, IL-6, and TNF) for all burn patients in the study showed a significant difference, with p < 0.001. The mean ± standard deviation (SD) of the time from homograft coverage to the appearance of rejection was 9.62 ± 1.45 in group 1 and 14.35 ± 2.8 in group 2, with p < 0.001 (highly significant difference), indicating that exposure to radiotherapy can reduce graft rejection. Conclusions The exposure of skin homografts from related living donors to a local low dose of radiotherapy can reduce a graft's ability to initiate inflammatory and immunological reactions, thereby minimizing rejection of a graft and enhancing epithelialization in children with deep second- and third-degree burns.

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Fortuna, Fory, Nandita Melati Putri, and Gentur Sudjatmiko. "Granulation Red Index To Assess Pressure Ulcer Granulation Tissue Quality Treated By Honey Gauze Dressing By Digital Image Analysis." Jurnal Plastik Rekonstruksi 6, no. 2 (February 20, 2020): 270–75. http://dx.doi.org/10.14228/jpr.v6i2.284.

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Background : Good formation of granulation tissue in the ulcer bed is regarded as one of the indicators of pressure ulcer healing. Granulation red index (GRI) had been published as an objective parameter to assess the quality of granulation tissue. Honey stimulates granulation of tissue and creates a moist healing environment. However, the assessment of granulation tissue quality of pressure ulcers treated by honey has yet to be proven in clinical settings. In this study, we evaluate the granulation tissue quality of pressure ulcers treated by honey using granulation red index by digital image analyses. Method: There were 12 subjects who fulfill inclusion criteria treated by honey gauze dressing and were evaluated every week for three times measurements of %GRI and DESIGN-‐score. Parameters of this study were the delta %GRI80 and DESIGN-‐R score. Correlations were evaluated by Spearman’s correlation coefficient. Result : The correlation of delta GRI80% and DESIGN-‐R score was statistically significant from baseline measurement to first week of treatment and to second week of treatment (r1=0.65, p1=0.02 and r3=0.832, p2=0.001). The correlation of delta GRI80% and DESIGN-‐R score from first to second week therapy was not statistically significant (r=0.23, p=0.47), but the GRI80% from first week therapy to second week of therapy was increasing and DESIGN R score was decreasing. Conclusion:This study shows the correlation of %GRI80 and DESIGN-‐R score of pressure ulcer after the treatment of honey gauze dressing. This study hopefully assists further study for wound bed preparation assessment and treatment of pressure ulcer for surgical intervention.

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Viltsaniuk, O. A., and M. V. Mazur. "JUSTIFICATION OF THE EFFECTIVENESS OF THE USE OF DALMAXIN RECTAL SUPPOSITORIES (THIOTRIAZOLIN) IN THE COMPLEX TREATMENT OF ACUTE PARAPROCTITIS." Kharkiv Surgical School, no. 1 (February 20, 2020): 54–62. http://dx.doi.org/10.37699/2308-7005.1.2020.06.

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Summary. The problem of treatment of acute purulent paraproctitis is one of the most urgent problems of modern coloproctology. Study objective. To evaluate the effectiveness of the use of Dalmaxin rectal suppositories in the complex treatment of acute paraproctitis. Materials and methods. The effectiveness of use of Dalmaxin rectal suppositories was conducted in 62 patients with acute subcutaneous paraproctitis, assigned to two groups, a main group of 30 patients and a comparison group of 32 patients. All patients underwent radical surgery. Antimicrobial, detoxification and symptomatic therapy was prescribed postoperatively. Local treatment of purulent wounds was carried out using hydrophilic ointments depending on the phase of the wound process; the patients of the main group were additionally administered Dalmaxin rectal suppositories twice a day. The effectiveness of the treatment was evaluated by the severity of the swelling, the nature of the discharge from the wound, the level of microbial contamination, the wound cleansing period, the appearance of granulation tissue and epithelialization, and by cytological examination. Furthermore, general laboratory and biochemical studies were performed. Endogenous intoxication (EI) and its changes in the course of treatment were evaluated by the level of average-mass molecules, leukocyte intoxication index and hematological intoxication index. Statistical processing and comparison of the obtained data was performed using the STATISTICA® 5.5 integrated system (STATSOFT® Inc., USA), license A XX 910A374605FA. Results. The study showed that in patients with acute paraproctitis, the severity of the postoperative period is due to the severe intoxication and the development of a systemic inflammatory response syndrome that were observed in patients at the time of hospitalization. After surgical intervention, clinical and laboratory parameters did not normalize in the first five days of the postoperative period, and only starting from the fifth day, there was a gradual decrease in the level of EI and laboratory indicators, reaching the normal ones only at the time of discharge from the hospital. EI complicates the course of the postoperative period, primarily by weakening the level of humoral immunity and inhibiting the processes of reparative regeneration. When comparing the results of treatment of acute paraproctitis in patients using Dalmaxin rectal suppositories with traditional methods. The hospitalization period of the patients of the main group was also shorter than in the comparison group, and was (9.2 ± 0.5) and (11.9 ± 0.9) bed days, respectively. Conclusions. A comparative evaluation of the use of Dalmaxin in the complex treatment of acute purulent paraproctitis showed that the drug, due to its properties, significantly improves the course of the postoperative period, as evidenced by faster reduction of endogenous intoxication, reduction of microbial contamination and wound cleansing from necrotic tissues, faster granulation and epithelialization, as well as wound healing, thus helping to reduce the time of hospitalization.

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Khan, Zakir, Naveed Ahmed, Asim ur Rehman, Faiz Ullah Khan, and Syed Muhammad Hamid. "Prescribing practices of antimicrobial prophylaxis in older patients in the surgical wards." Journal of Prescribing Practice 1, no. 9 (September 2, 2019): 446–53. http://dx.doi.org/10.12968/jprp.2019.1.9.446.

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Background: appropriate prescribing of antimicrobial prophylaxis (AP) is a main strategy of the antimicrobial stewardship programme. Aim: to investigate the prescribing practices of antimicrobial prophylaxis and adherence to recommended protocols in older patients in the surgical wards at a 600-bed teaching hospital in Islamabad, Pakistan. Method: researchers selected 240 surgical procedures retrospectively for patients aged 65 years and older admitted to four surgical specialties (abdominal, orthopaedic, urological and neurosurgery) during 1 year. The different parameters of antimicrobial prescription were compared with international clinical practice guidelines. Findings: There were more ‘clean’ surgical wound procedures (n=104; 43.3%) than ‘clean contaminated’ (n=97; 40.4%) and most of these were elective surgical procedures (n=226; 94%). The indication, selection, route, dose, and timing of antimicrobial were found to have adhered with the standard guidelines in 89.6%, 32.5%, 100%, 100% and 55.3% of cases, respectively (optimal value 100%). A statistically significant difference was observed between antimicrobial practices and surgical procedures (P< 0.001). The commonly prescribed antimicrobials were ceftriaxone followed by cefazolin. Conclusion: about 89% of participants who underwent surgical procedures received antimicrobials. The selection of therapeutic agent, the timing and use of broad-spectrum antimicrobial were the common problems in our setting.

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Chernyshov, S. V., S. I. Sychev, A. A. Ponomarenko, and E. G. Rybakov. "LAPAROSCOPIC RESECTIONS WITH TRANSANAL SPECIMEN EXTRACTION IN RECTAL CANCER SURGERY (a systematic review and meta-analysis)." Koloproktologia 19, no. 4 (December 16, 2020): 150–76. http://dx.doi.org/10.33878/2073-7556-2020-19-4-150-176.

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INTRODUCTION: the NOSES technique allows one to remove specimen without incisions on the anterior abdominal wall and is accompanied by fewer complications by reducing the frequency of wound infections. The results of these surgical operations on colorectal tumors are presented in a limited number of heterogeneous studies, which necessitates obtaining objective data using metaanalysis.STUDY OBJECTIVE: compare the short and long-term outcomes of two methods for surgical treatment of colorectal cancer.MATERIALS AND METHODS: a systematic review is carried out in accordance with PRISMA practice and recommendations.RESULTS: nine comparative studies were selected for the period from 2014 to 2019. 1693 patients were included in the meta-analysis: in 765 (45%), the tumor preparation was removed transanally (NOSES group) and in 928 (55%) it was removed via minilaparotomic access (LA group). The tumor size in the NOSES group was 0.5 cm smaller (OR=0.5, CI95% 0.2-0.8, p=0.0004) than in the LA group. In regards to other parameters the groups had no publication bias. The duration of the operation when comparing NOSES with LA was comparable (p =0.11). VAS pain was on average 2 points (OR=1.8, CI95% 1.2-2.4, p<0.00001) more pronounced in the LA group. The postoperative bed day was less in the group with transanal removal of the preparation (OR=0.8, CI95% 0.4-1.3, p=0.0003). The chance of developing postoperative complications in the NOSES group was (OR=0.5, CI95% 0.4-0.8, p=0.0004) with a frequency of 62/765 (8%) cases, compared with the control group - 130/931 (14%). The chance of developing wound infection was higher in the LA group (OR=0.2, CI95% 0.1-0.3, p <0.00001). There were no differences in the incidence of colorectal anastomotic leakage (p=0.97). There were also no differences in the five-year overall (p=0.74) and cancer-specific survival (p=0.76).CONCLUSION: using NOSES technologies creates better conditions for the rehabilitation of patients due to the low frequency of postoperative complications due to the absence of wound infection and is a safe manipulation. However, the presence of publication biases requires a careful interpretation of the data obtained.

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Kovpak, L. V., Ye S. Leschuk, S. Ye Leschuk, M. V. Maslyuk, M. Ya Martynets, and O. V. Ruzhytska. "Clinical and Laboratory Substantiation of Improvement of the Treatment Method of Boils and Carbuncles of Maxillofacial Area." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 4 (September 18, 2021): 134–41. http://dx.doi.org/10.26693/jmbs06.04.134.

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Selection of medications to apply locally for treatment of abscessive forms of boils and carbuncles of maxillofacial area still remains a debatable issue, despite their wide range. Alternative means for application use in surgical interventions in maxillofacial area are medications of natural origin. Drugs of natural origin that have anesthetic and anti-inflammatory properties include cayenne pepper fruits (Capsicum annuum). Therapeutic properties are caused by the presence in their structure of the main active ingredient – capsaicin alkaloid and other biologically active compounds (vitamins, flavonoids, minerals, etc.) which influence the main pathogenetic inflammation bonds. Capsaicin has a distinct keratoplastic effect and normalizes microcirculation in the tissues. Phytogel with anti-inflammatory and anesthetic action (patent for utility model No. 30032 “Phytogel with anti-inflammatory and anesthetic action”) was developed for clinical use based on phytosubstance of pepper cayenne fruits (patent for utility model No. 19547 “Method of obtaining phytosubstance with anti-inflammatory action”). The purpose of the study was to increase treatment efficiency of boils and carbuncles of maxillofacial area by using a medication based on the capsicum annuum fruits. Materials and methods. The analysis of inspection and treatment results of 45 patients having boils and carbuncles of maxillofacial area at abscessing stage is carried out. On the first, third, seventh and tenth day of treatment, a number of clinical indicators (presence and intensity of edema and infiltrate, condition of regional lymph nodes, presence and intensity of pain in the inflammation site, time of wound exudate clearance, intensity of regeneration, length of hospital stay treatment) and indicators obtained by laboratory methods (total number of leukocytes, leukocyte intoxication index, erythrocyte sedimentation rate) were studied and compared with the same parameters in the control group, where traditional treatment was carried out; and when using the comparison medication - 3% propolis ointment. Results and discussion. Analysis of the results showed that despite the similarity of the clinical picture and laboratory parameters on admission to the hospital, the healing of purulent wounds under the influence of capsicum annuum phytogel was more effective comparing with traditional methods of surgical treatment. Thus, wound epithelialization of patients in the experimental group No. 1 was observed on average on the seventh day, which was significantly faster than in other experimental groups. Sanation of the inflammatory focus also decreased body intoxication, which can be traced by the dynamics of changes in the degree of leukocytosis, leukocyte intoxication index, erythrocyte sedimentation rate. On the tenth day, the clinical blood parameters of patients of the experimental group No. 1 were close to the average norm. As a result, the length of stay in hospital was significantly reduced. The average bed-day for the experimental group No. 1 was 7.5 days, which is authentically less than for patients of the control and experimental group No. 2. Conclusion. According to the results of clinical and laboratory studies, the efficiency of the proposed method has been proved in comparison with traditional treatment of boils and carbuncles of maxillofacial area

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Kadam, Dinesh. "Novel expansion techniques for skin grafts." Indian Journal of Plastic Surgery 49, no. 01 (January 2016): 5–15. http://dx.doi.org/10.4103/0970-0358.182253.

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ABSTRACTThe quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal–epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials.

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Fan, Xiao Xu, Li Guo Yang, Hui Liang Zhang, and Hong Jian Chen. "Experimental Research on Impacts of Operation Parameters on Agglomeration Characteristics during CFB Biomass Gasification." Applied Mechanics and Materials 556-562 (May 2014): 375–79. http://dx.doi.org/10.4028/www.scientific.net/amm.556-562.375.

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The impacts of operation parameters on agglomeration characteristics during biomass gasification in fluidized bed were studied experimentally in a 0.02MWt CFB gasifier using cotton stalk pellet as fuel. The experimental results indicated that among the temperature range (600 °C-800 °C), bed agglomeration would occur after a period running with sand, high alumina bauxite or periclase as the bed material, and potassium gathered on the surface of bed materials. In the process of the fluidized-bed gasification of biomass, air velocity affected the degree of bed agglomeration, and the agglomeration problem in return valve was more serious than that in main bed.

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Habrat, B., O. Lytvak, B. Lysenko, and A. Habrat. "THE COMPARISON OF OUTCOMES AFTER LAPAROSCOPIC MYOMECTOMY WITH THE USE OF DIFFERENT UTERINE SUTURE TECHNIQUES." Клінічна та профілактична медицина 1, no. 1 (March 22, 2020): 58–69. http://dx.doi.org/10.31612/2616-4868.1(11).2020.07.

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Purpose: to improve the outcomes and speed up the recovery after laparoscopic myomectomy in females with uterine leiomyoma, based on the comprehensive study and comparison of different uterine suturing techniques. Material and methods. The study enrolled 130 patients, including 100 females underwent laparoscopic myomectomy. Based on the simple randomization, the sample of 100 surgically treated females was subdivided into two subsamples depending on the applied uterine suturing technique: group I – extracorporeal knotting (n=50); and group II – intracorporeal continuous suturing (n=50). The control group included 30 apparently healthy females (group III). The clinical examination was performed before surgery in the outpatient setting, and in the hospital – after procedure and at the discharge (day 2). We assessed the parameters of myometrium tissue perfusion and the severity of inflammation in the surgical alteration area 1 month before and 1 month following the procedure. The ultrasound signs of myometrium regeneration completeness in the uterine scar area were determine 3 months after surgery. The late outcomes after myomectomy and catamnesis of reproductive function were evaluated at 6-month and 1-year follow-up. Results and discussion. We established that the use of intracorporeal continuous suturing technique in patients underwent laparoscopic myomectomy was favorable for preservation of microcirculatory bed in myometrium, related to a more uniform distribution of suture tension in the tissue and a more even distribution of pressure exerted on the wound edges, as compared to extracorporeal knotting technique. These advantages of intracorporeal continuous suturing technique over the extracorporeal knotting one are useful for the significant reduce of tissue hypoxia and myometrium ischemia in the alteration area. Additionally, this technique is in favor of the physiological programmed suture absorption and the cell-mediated immunity, and associated with the lower risk of necrotic areas formation. In contrast to the intracorporeal continuous suturing technique, the tight and non-uniform extracorporeal knotting is associated with the suppression of staged elimination of blood microclots and other factors of aseptic inflammation in the surgical alteration area. Conclusions. The use of extracorporeal knotting technique had no advantages over the intracorporeal continuous suturing, and, in the majority of cases, was associated with longer duration of procedure, inappropriate blood loss, as well as excessive consumption of suture material. The intracorporeal continuous suturing is the most optimal technique for uterine wound edges approximation, and associated with the positive outcomes regarding the reproductive function (the reproductive function could be realized in 3 months after the use of intracorporeal continuous suturing technique, in contrast to 6 months – after the extracorporeal knotting one), the minimal frequency of complications and favorable economic profile. The laparoscopic myomectomy in case of myoma sized 10 cm and more is associated with the risk of significant uterine wall defect and excessive blood loss, indicating the need for the intracorporeal continuous suturing technique for closing tissue defects in the area of surgical alteration of myometrium.

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DZOGBEWU, Thywill Ccphas. "Laser powder bed fusion of Ti6Al4V-xCu: Process parameters." Journal of Metals, Materials and Minerals 31, no. 2 (June 27, 2021): 62–70. http://dx.doi.org/10.55713/jmmm.v31i2.1051.

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The original intent of coating biomedical and surgical devices surface with antibacterial agents is to prevent infections. However, the difference in the material properties between the biomedical devices and the coating materials causes the coating material to spall from the biomedical devices. To address the situation, the current research focused on investigating the possibility of using laser powder bed fusion process a subset of additive manufacturing technology to in situ alloy 1 at% Cu with Ti6Al4V. In situ alloying 1 at% Cu with Ti6Al4V would lead to the production of medical and surgical devices with inbuilt antibacterial property. To determine the optimum process parameters that could be used to manufacture the Ti6Al4V- 1 at% Cu alloy, single tracks were produced over a wide range of laser powers and scanning speeds and analyzed. Process parameters of 170 W, 1.0 ms-1 and hatch distance of 80 µm were identified as the possible optimum process parameters for manufacturing the Ti6Al4V- 1 at% Cu alloy. Rescanning was identified as a good strategy to improve the surface roughness, homogeneity and surface concentration of the Cu in the Ti6Al4V- 1 at% Cu alloy matrix.

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Darsin, Mahros, Renald Rochman Mauludy, Intan Hardiatama, Boy Arief Fachri, Mochamad Edoward Ramadhan, and Doddy Parningotan. "Analysis of the effect 3D printing parameters on tensile strength using Copper-PLA filament." SINERGI 26, no. 1 (February 10, 2022): 99. http://dx.doi.org/10.22441/sinergi.2022.1.013.

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This research aims to find the optimal combination of parameters to obtain the maximum tensile strength of 3D printing products made of eCopper, which consists of 45% Cu and 55% PLA. The parameters used were nozzle temperature, layer height, print speed and bed temperature with three levels each. The Taguchi L9 (3^4) experiment was used for design and analysis. The product was printed in the form of a tensile test specimen according to the ASTM D638 Type I standard using a Cartesian FDM 3D printer. The average response S/N ratio calculation found that the highest tensile strength would be obtained when applying combination parameters of nozzle temperature 230 oC, layer height 0.35 mm, print speed 90 mm/s and bed temperature 60 oC. While each parameter contributes to the tensile strength by the order are nozzle temperature, layer height, print speed, and bed temperature 59.44%, 20.53%, 18.06% and 1.97%, respectively.

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Wang, Ke, Guang Min Song, and Xing Wei Sun. "Dynamic Characteristics Design of the Grinding Machine Bed." Advanced Materials Research 503-504 (April 2012): 859–62. http://dx.doi.org/10.4028/www.scientific.net/amr.503-504.859.

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In order to analyzing the dynamic characteristics of the machine bed totally and grasping the dynamic parameters accurately, I make the use of conventional method to design fine-long rods machine firstly and research with FED dynamic property that machine in the processing . I use the FED method to find the region of defect and build the method of optimization. Dynamic property of Rib has affect bed of machine directly. The thesis would change and optimize rib. At the same time, they act as target of optimization and improve the dynamic property of bed with FED and achieve it. The thesis has offer evident of theory for changing bed.

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Yalin, S., and R. C. H. Russell. "SIMILARITY IN SEDIMENT TRANSPORT DUE TO WAVES." Coastal Engineering Proceedings 1, no. 8 (January 29, 2011): 12. http://dx.doi.org/10.9753/icce.v8.12.

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The paper concerns the movement by waves of cohesionless sediment lying on a horizontal bed. In particular it concerns the number of dimensionless parameters that are necessary to define the 2-phase motion at the bed; the specification of which would enable perfect similarity to be obtained. It is shown that in general four dimensionless parameters are necessary but that when the motion of the water at the bed can be adequately defined by an orbit length (a) and a period (T), the two-phase motion can be described by the numerical value of three dimensionless parameters. This condition is satisfied when the wave-height is low, because then the orbital motion at the bed is sinusoidal and the drift velocity is negligible. Model and prototype experiments were conducted in a wave channel, using low waves, in which the scale for depth of water and for wavelengths was -37?. The dependent parameters, three of -which are sufficient to verify similarity of all aspects of the phenomenon were chosen to be ripple height, ripple length and transport of sediment. The identity of the dimensionless numbers signifying the ripple height, ripple length and transport in model and prototype, shown in Figs, 8, 9 and 11, is proof that similarity had been obtained.

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Kulkarni, Mandar, and Rajive Ganguli. "Moving Bed Gasification of Low Rank Alaska Coal." Journal of Combustion 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/918754.

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This paper presents process simulation of moving bed gasifier using low rank, subbituminous Usibelli coal from Alaska. All the processes occurring in a moving bed gasifier, drying, devolatilization, gasification, and combustion, are included in this model. The model, developed in Aspen Plus, is used to predict the effect of various operating parameters including pressure, oxygen to coal, and steam to coal ratio on the product gas composition. The results obtained from the simulation were compared with experimental data in the literature. The predicted composition of the product gas was in general agreement with the established results. Carbon conversion increased with increasing oxygen-coal ratio and decreased with increasing steam-coal ratio. Steam to coal ratio and oxygen to coal ratios impacted produced syngas composition, while pressure did not have a large impact on the product syngas composition. A nonslagging moving bed gasifier would have to be limited to an oxygen-coal ratio of 0.26 to operate below the ash softening temperature. Slagging moving bed gasifiers, not limited by operating temperature, could achieve carbon conversion efficiency of 99.5% at oxygen-coal ratio of 0.33. The model is useful for predicting performance of the Usibelli coal in a moving bed gasifier using different operating parameters.

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Shao, Zi Yan, Wen Jia Chen, Lu Yang Li, Yong Jin Hu, and Guan Jian Li. "A Modeling Research of Wind Tunnel Test Based on ADAMS with Rigid and Flexible Body." Applied Mechanics and Materials 741 (March 2015): 471–74. http://dx.doi.org/10.4028/www.scientific.net/amm.741.471.

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A new wind tunnel test bed based on the parallelogram institution was chosen to be studied in this paper. In the first way the 3D model was built in detail in the SolidWorks, and then the model was imported into ADAMS to build a rigid model and a rigid-flexible model, finally got the curves of the barycenter position’s parameters through carrying out the simulation separately, which would lay the foundation for the simulation of kinematics and dynamics of the wind tunnel test bed.

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Komatina, Mirko, and HEINRICH W. GUDENAU. "The sticking problem during direct reduction of fine iron ore in the fluidized bed." Metalurgija-Journal of Metallurgy 10, no. 4 (December 31, 2004): 309–28. http://dx.doi.org/10.30544/378.

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In this review paper described are possible chemical reactions and their thermodynamic analysis during direct reduction. The sticking mechanism during direct reduction in the fluidized bed was analysed, and the reasons for the sticking appearance explained. The most important parameters on the sticking were analysed. The ways for prevention and observation were considered. The plan for experimental investigations was proposed. The investigations could be performed in fluidized bed reactor. Coal will be used as inert material. Separately, the influence volatile content in the coal on the reduction process and sticking appearance, will be analysed. As results of these investigations would be some improvements of the method direct reduction of iron ore in the fluidized bed.

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Downmore, Musademba, Simbi David Jambgwa, and Kuipa Pardon Kusaziwa. "Effect of bed particle size and temperature variation on the minimum fluidisation velocity: A comparison with minimum fluidisation velocity correlations for bubbling fluidised bed designs." Proceedings of the Institution of Mechanical Engineers, Part E: Journal of Process Mechanical Engineering 233, no. 5 (January 10, 2019): 1001–12. http://dx.doi.org/10.1177/0954408918821769.

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This work presents hydrodynamic studies on the effect of temperature and bed particle variation on minimum fluidisation velocity. A lab-scale bubbling fluidised bed made of stainless steel, with column height of 1 m and internal diameter of 0.15 m was used. Five Geldart-B-type alumina bed materials of mean particle sizes 75, 177, 250, 320 and 500 µm were used and the bed temperature was varied between 50 ℃ and 600 ℃. The hydrodynamic results showed that minimum fluidisation velocity varied directly with mean particle size and inversely with temperature. The pressure drop was found to increase with bed temperature for all the sizes of bed particles. The minimum fluidisation velocity is a key parameter in the design of fluidised bed systems and as such its prediction lies with good choice of correlation. The experimental values were compared with predicted minimum fluidisation velocity from six correlations, with the overall objective of verifying the most suitable correlation. Of the correlations used, the Hartman et al. correlation showed very good fitting with experimental data for beds of 75 and 177 µm particles, and the Mohanta et al. correlation showed good fitting with 250–500 µm bed particles. The models exhibited very good coefficient of multiple determination ( R2), very low fitting errors and low geometric standard deviations across the range of particle sizes and temperature variation. However, the lack of understanding of the parameters such as voidage, particle sphericity, density and viscosity would need more attention, particularly in view of the sensitivity of the minimum fluidisation velocity predictions to these parameters. Further studies are therefore recommended for the verification of the correlations in this regard.

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Vora, Jay, Nipun Parikh, Rakesh Chaudhari, Vivek K. Patel, Heet Paramar, Danil Yurievich Pimenov, and Khaled Giasin. "Optimization of Bead Morphology for GMAW-Based Wire-Arc Additive Manufacturing of 2.25 Cr-1.0 Mo Steel Using Metal-Cored Wires." Applied Sciences 12, no. 10 (May 17, 2022): 5060. http://dx.doi.org/10.3390/app12105060.

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The fabrication of components involves the deposition of multiple beads in multiple layers for wire-arc additive manufacturing (WAAM). WAAM performed using gas metal arc welding (GMAW) allows for the manufacturing of parts through multiple-bead multi-layer deposition, which depends on the process variables. Thus, the selection of process parameters along with their required levels is mandatory to deposit multiple layers for WAAM. To obtain the desired levels of parameters, bead-on-plate trials were taken on the base plate of low alloy steel by following an experimental matrix produced through the Box–Behnken design (BBD) on GMAW-based WAAM. Wire feed speed, travel speed, and voltage were chosen as the input parameters and bead width and bead height were chosen as the output parameters. Furthermore, the robustness and adequacy of the obtained regression equations were analyzed by using analysis of variance (ANOVA). For both responses of BW and BH, values of R2 and adj. R2 were found to be near unity, which has shown the fitness of the model. Teaching–learning-based optimization (TLBO) technique was then employed for optimization. Within the selected range of process variables, the single-objective optimization result showed a maximum bead height (BH) of 7.81 mm, and a minimum bead width (BW) of 4.73 mm. To tackle the contradicting nature of responses, Pareto fronts were also generated, which provides a unique non-dominated solution. Validation trials were also conducted to reveal the ability and suitability of the TLBO algorithm. The discrepancy between the anticipated and measured values was observed to be negligible, with a deviation of less than 5% for all the validation trials. This demonstrates the success of the established model and TLBO algorithm. The optimum feasible settings for multi-layer metal deposition were determined after further tuning. A multi-layer structure free from any disbonding was successfully manufactured at the optimized variables. The authors suggest that the optimum parametric settings would be beneficial for the deposition of layer-by-layer weld beads for additive manufacturing of components.

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Ťažký, Martin, Lenka Bodnárová, and Rudolf Hela. "Physico-Mechanical Properties of Lightweight Concrete with Fluidized Bed Combustion Fly Ash Based Light Weight Aggregate." Materials Science Forum 908 (October 2017): 106–10. http://dx.doi.org/10.4028/www.scientific.net/msf.908.106.

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Increasingly we see today among the conventional high temperature fly ash also with the production of fly ash from fluidized bed combustion. These fluidized bed combustions fly ashes, however, have little used this area, mainly for their chemical composition and morphology. Current efforts are directed towards the development of new technological processes and building materials that would allow the use of this industrial waste and its qualities. One possible way of fluidized bed combustion fly ash’s utilizing in construction industries the production of cold balled lightweight aggregate. Production of this material is economically advantageous and enables processing of large volumes of raw materials. This paper describes possibilities of using this aggregate for production of lightweight construction concrete and consequent testing of durability and resistance to various types of aggressive environment. For these lightweight structural concretes, will be verified in their thermal-technical parameters.

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Sabdin, S. D., N. I. S. Hussein, M. K. Sued, M. S. Ayob, M. A. S. A. Rahim, and M. Fadzil. "Effects of ColdArc welding parameters on the tensile strengths of high strength steel plate investigated using the Taguchi approach." Journal of Mechanical Engineering and Sciences 13, no. 2 (June 28, 2019): 4846–56. http://dx.doi.org/10.15282/jmes.13.2.2019.06.0403.

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The objective of this study is to investigate the effect of process parameters on ColdArc welding of cold rolled steel plate using 1.2 mm diameter mild steel welding wire. A Taguchi Design of Experiments (DOE) method with grey relational analysis approach was selected for data collection and optimization. 9 experiments were conducted following the L9 (33) Taguchi Orthogonal Array Design. The best result from the experiments for tensile strength was obtained for welding parameters of 70 A (current), 17.6 V (voltage) and 800 mm/min welding speed. Based on the results, the Taguchi analysis predicted the optimised tensile strength would be obtained when the welding current, welding voltage and speed are at 70V, 17.6A and 0.6 m/min, respectively. Thus, most significant parameters for tensile properties of cold rolled steel is welding speed (37%), voltage (34 %) and current (28%). These factors are critical in determining the tensile strength, where increasing the welding speed reduces the heat input. However, decreasing the heat input by lowering the welding voltage resulted in bad weld bead formation.

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Antico, Federica, Ana Ricardo, and Rui Ferreira. "The Logarithmic Law of the Wall in Flows over Mobile Lattice-Arranged Granular Beds." Water 11, no. 6 (June 4, 2019): 1166. http://dx.doi.org/10.3390/w11061166.

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The purpose of the present paper is to provide further insights on the definition of the parameters of the log-law in open-channel flows with rough mobile granular beds. Emphasis is placed in the study of flows over cohesionless granular beds composed of monosized spherical particles in simple lattice arrangements. Potentially influencing factors such as grain size distribution, grain shape and density or cohesion are not addressed in this study. This allows for a preliminary discussion of the amount of complexity needed to obtain the log-law features observed in more realistic open-channel flows. Data collection included instantaneous streamwise and bed-normal flow velocities, acquired with a two-dimensional and two-component (2D2C) Particle Image Velocimetry (PIV) system. The issue of the non uniqueness of the definition of the parameters of the log-law is addressed by testing several hypotheses. In what concerns the von Kármán parameter, κ , it is considered as flow-independent or flow-dependent (a fitting parameter). As for the geometric roughness scale, k s , it results from a best fit procedure or is computed from a roughness function. In the latter case, the parameter B is imposed as 8.5 or is calculated from the best fit estimate. The analysis of the results reveals that a flow dependent von Kármán parameter, lower than the constant κ = 0.40 , should be preferred. Forcing κ = 0.40 leads to non-physical values of k s and would imply extending the inner layer up about 50% of the flow depth which is physically difficult to explain. Considering a flow dependent von Kármán parameter allows for coherent explanations for the values of the remaining parameters (the geometric roughness scale k s , the displacement height Δ , the roughness height z 0 ). In particular, for the same transport rate, the roughness height obtained in a natural sediment bed is much greater than in the case of bed made of monosized glass spheres, underlining the influence of the bed surface complexity (texture and self-organized bed forms, in the water-worked cases) on the definition of the log-law parameters.

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Journal articles on the topic 'Wound bed parameters'

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