Comparison of Systemic and Topical Hypericum Perforatum on Diabetic Surgical Wounds

Background: Surgical wounds in diabetic patients still remain a problem till the present day. As a common plant found around the world, Hypericum perforatum L. (Hypericaceae) is traditionally prepared as an oily extract and used as a folk remedy for various diseases such as wounds, burns, cuts, etc. This study aims to evaluate the effect of St. John's wort (Hypericum perforatum) on problematic wounds while comparing oral and topical applications. Methods: Incisional and excisional wound models were made on the dorsal regions of 54 diabetic Spraque–Dawley rats. The rats were divided into the following six groups (n = 9): Group 1: control, Group 2: diabetic, Group 3: diabetic oral Hypericum perforatum, Group 4: diabetic topical Hypericum perforatum, Group 5: diabetic oral olive oil, and Group 6: diabetic topical olive oil. Results: Groups 3 and 4 had significantly higher tensile strength, tissue hydroxyproline concentration, and collagen density compared with Group 2. Inflammatory cell density and collagen density on day 3 were significantly higher in Groups 3 and 6 compared with Group 2. On day 21, Groups 3 and 6 had significantly higher fibroblastic activity compared with Group 2. Conclusions: This study has proved that oral St. John's wort has more positive effects on problematic wounds compared with topical St. John's wort and olive oil, which is a vehicle. Hypericum perforatum results with faster inflammatory response and better healing. These results could be an addition to literature about the clinical usage of Hypericum perforatum on diabetic wounds

A New Useful and Renewable Tie-over Dressing Method Using Package Bands and Bra Hooks

The purposes of the tie-over dressing are to secure a skin graft toward the wound bed to avoid complications such as fluid or blood accumulation and to prevent graft movements over the wound bed. When there is a concern of uneventful graft take because of infection or blood accumulation underneath the graft, it is necessary to check the status of the graft at the postoperative first and subsequent days. Therefore, an ideal tie-over dressing method should not only ensure adequate immobilization and pressure but also be able to be renewed simply and quickly. We developed a new tie-over dressing method by using bra hooks and packing rubber bands to solve these problematic issues

A Conservative Treatment of Ingrown Toenails: Splinting Technique with Cyanoacrylate

Toenail ingrowing is a common and serious disease which affects social life. This article focuses on a noninvasive technique of nail splinting using cyanoacrylate. The cyanoacrylate splinting technique is an effective, noninvasive, easy-to-learn, quick, and inexpensive method with good cosmetic outcomes which aims to minimize the problems of surgical treatments

Bilateral Super Thin Groin Island Flap for Penile, Scrotal, and Pubic Reconstruction after Fournier\u27s Gangrene

Defects in the scrotal, perianal, and penile areas are problems that are difficult to repair. Methods for reconstruction of this region are limited, and none are ideal. We decided to use bilateral super thin groin island flaps for a patient with penile, scrotal, and pubic defects. A two-stage technique for scrotal sac and penile reconstruction using tissue expansion is described. A super thin groin island flap was elevated, and bilateral tissue expanders were placed. Using this, the penile, scrotal, and pubic defects were closed without difficulty. Both the aesthetic and functional aspects should be taken into consideration when covering a defect of both the testis and the penis. It is essential to have thin and durable cover for such a reconstruction. The technique described above was used to reconstruct this defect with good functional and cosmetic outcomes

Ameliorating effects of β-glucan on epigastric artery island flap ischemia-reperfusion injury

Background: Ischemia-reperfusion injury has been one of the culprits of tissue injury and flap loss after island flap transpositions. Thus, significant research has been undertaken to study how to prevent or decrease the spread of ischemia-reperfusion injury. Preventive effects of β-glucan on ischemia-reperfusion injury in the kidney, lung, and small intestine have previously been reported. In this study, we present the ameliorating effects of β-glucan on ischemia-reperfusion injury using the epigastric artery island-flap in rats. Materials and methods: Thirty Wistar-Albino rats were equally divided into three groups: sham, experimental model, and treatment groups. In the sham group, an island flap was elevated and sutured back to the original position without any ischemia. In the experimental model group, the same-sized flap was elevated and sutured back with 8 h of ischemia and consequent 12 h of reperfusion. In the treatment group, 50 mg per kilogram β-glucan was administered to the rats using an orogastric tube for 10 d before the experiment. The same-sized flap is elevated and sutured back to its original position with 8 h of ischemia and 12 h of consequent reperfusion in the treatment group. Tissue biopsies were taken on the first day of the experimental surgery. Tissue neutrophil aggregation and vascular responses were evaluated by histological examinations. Tissue oxidant and antioxidant enzyme levels are evaluated biochemically after tissue homogenization. Topographic follow-up and evaluation of the flaps were maintained, and photographs were taken on the first and seventh day of the experimental surgery. Results: Topographic flap survival was significantly better in the β-glucan administered group. The neutrophil number, malondialdehyde, and myeloperoxidase levels were significantly lower while glutathione peroxidase and superoxide dismutase levels were significantly higher in the β-glucan administered group respective to the experimental model group. Conclusions: Based on the results of our study, we can conclude that β-glucan is protective against ischemia-reperfusion injury. Our study presents the first experimental evidence of such an effect on skin island flaps.Erciyes Üniversites