The Roles of Physical Therapists in Wound Management: Part IV

Physical therapists are important members of the comprehensive wound management team. In addition to being able to provide standard wound care, they are well prepared to treat wounds with a variety of biophysical agents that introduce electromagnetic, acoustic, and mechanical energies that enhance healing. Physical therapists also address restoration of function that is frequently compromised in patients who suffer from chronically and acutely wounded tissues

Skin Cell Proliferation Stimulated by Microneedles

A classical wound may be defined as a disruption of tissue integrity. Wounds, caused by trauma from accidents or surgery, that close via secondary intention rely on the biological phases of healing, i.e., hemostasis, inflammation, proliferation, and remodeling (HIPR). Depending on the wound type and severity, the inflammation phase begins immediately after injury and may last for an average of 7–14 days. Concurrent with the inflammation phase or slightly delayed, cell proliferation is stimulated followed by the activation of the remodeling (maturation) phase. The latter phase can last as long as 1 year or more, and the final healed state is represented by a scar tissue, a cross-linked collagen formation that usually aligns collagen fibers in a single direction. One may assume that skin microneedling that involves the use of dozens or as many as 200 needles that limit penetration to 1.5 mm over 1 cm2 of skin would cause trauma and bleeding followed by the classical HIPR. However, this is not the case or at least the HIPR phases are significantly curtailed and healing never ends in a scar formation. Conversely dermabrasion used in aesthetic medicine for improving skin quality is based on “ablation” (destruction or wounding of superficial skin layers), which requires several weeks for healing that involves formation of new skin layers. Such procedures provoke an acute inflammatory response. We believe that a less intense inflammatory response occurs following microneedle perforation of the skin. However, the mechanism of action of microneedling appears to be different. Here we review the potential mechanisms by which microneedling of the skin facilitates skin repair without scarring after the treatment of superficial burns, acne, hyperpigmentation, and the non-advancing periwound skin surrounding the chronic ulcerations of the integument

Supervised Versus Independent Student Laboratories

The purpose of this study was to determine if classroom laboratory time could be reduced in a basic physical agents course. Fifty-seven junior physical therapy students were randomly assigned to three laboratory sections. All students received identical lectures, demonstrations, course materials, and laboratory manuals. The control group, Section 1, received supervision and assistance during laboratory practice. Students in Section 2 and Section 3 worked independent of instructor supervision but could receive assistance from the instructor in an adjacent room. Students in Section 2 were provided with feedback following periodic assessment by the instructor. Attitudinal questionnaire responses indicated that the students preferred the supervised laboratory section. The presence of the instructor during classroom laboratory practice of basic physical agents did not affect student performance. Comparison of written and practical examination results indicated no significant differences in student performance. Classroom laboratory time for faculty and students was reduced when students worked independently

Interacting Electrons on a Square Fermi Surface

Electronic states near a square Fermi surface are mapped onto quantum chains. Using boson-fermion duality on the chains, the bosonic part of the interaction is isolated and diagonalized. These interactions destroy Fermi liquid behavior. Non-boson interactions are also generated by this mapping, and give rise to a new perturbation theory about the boson problem. A case with strong repulsions between parallel faces is studied and solved. There is spin-charge separation and the square Fermi surface remains square under doping. At half-filling, there is a charge gap and insulating behavior together with gapless spin excitations. This mapping appears to be a general tool for understanding the properties of interacting electrons on a square Fermi surface.Comment: 25 pages, Nordita preprint 94/22