Functional recovery after implantation of artificial nerve grafts in the rat- a systematic review

<p>Abstract</p> <p>Purpose</p> <p>The aim of this study was to compare functional data of different nerve-gap bridging materials evaluated in rat experiments by means of a systematic review.</p> <p>Materials and methods</p> <p>A systematic review was conducted, searching MEDLINE, HTS and CENTRAL to identify all trials evaluating functional recovery of artificial nerve conduits in the rat model.</p> <p>Results</p> <p>There was a trend towards a favourable outcome of conduits coated with Schwann-cells compared to the plain synthetics. Histomorphometry, electrophysiology and muscle-weight correlated poorly with functional outcome.</p> <p>Conclusion</p> <p>Schwann-cell coated conduits showed promising results concerning functional recovery. Further standardization in outcome reporting is encouraged.</p

Micro-management: curbing chronic wound infection

Chronic wounds, including pressure ulcers, foot ulcers and venous leg ulcers have a detrimental impact on the health and well-being of an estimated 2% of people in the UK. Chronic wounds are normally colonised by bacteria and in some instances bacterial load increases sufficiently for infection to ensue. Once a chronic wound becomes infected it is difficult to resolve and a combination of continuous inflammation and bacterial proliferation makes these wounds difficult to manage. A state of prolonged inflammation can occur as a result of impaired homeostatic pathways which are exacerbated by bacterial growth. Chronic, infected wounds can persist for many months or even years, sometimes requiring surgical intervention in the form of regular debridement or amputation when other strategies such as antimicrobial treatments fail. The complex relationships between both oral microbiota and the host have been extensively characterised, including the shift from health to disease, and has allowed for the development of numerous control strategies. This knowledge combined with contemporary studies of chronic infected wounds can be used to develop an understanding of the relationship between the host and microorganism in the chronic wound environment. Such information has the potential to inform wound management including strategies to control infection and promote wound healing

Reccurrence rates of venous leg ulcers and the special importance of its surgical treatment

Zusammenfassung: Die chronisch venöser Insuffizienz (CVI) führt zu rezidivierenden Ulzera cruris, wobei der Einfluß von lokal- und phlebochirurgischen Maßnahmen auf die Rezidivraten unklar ist. In der vorliegenden Studie wurden 69 Patienten in einer Spezialsprechstunde behandelt. Initial erfolgte die Erhebung des Gefäßstatus (Phlebographie und Duplex Sonographie) und die Einteilung der Patienten nach der CEAP Klassifikation. Nekrosen wurden durch radikale Wunddebridements entfernt, die Wunden unter Kompression feucht behandelt und großflächige Ulzera durch Mesh-Grafts gedeckt. Je nach Befund erfolgte, wenn möglich, die chirurgische Therapie insuffizienter Venen. Die Ulzera waren nach 169 [Bereich: 30 bis 510] Tagen abgeheilt. Die Kontrolluntersuchungen erbrachten nach 30 Monaten eine durchschnittliche Rezidivrate von insgesamt 21 Ulzera, deren Nekrosen durch radikale Debridements entfernt oder die durch Mesh-Grafts gedeckt wurden, wiesen eine signifikant geringere Rezdidivrate auf (p=0.03 bzw. p=0.02 ). Der Schweregrades der CVI wurde in der Duplexsonographie bestimmt und korrelierte zur CEAP Klassifikation (p=0,04) und zu den Rezidivraten (p=0.023), wobei nach phlebochirurgischer Interventionen (bei 58 der Patienten durchgeführt) und Fortführung der Kompression eine hämodynamischen Verbesserung gesehen wurde. Allerdings fand sich im Vergleich zu konservativ behandelten Patienten (alleinige Kompression) keine unterschiedliche Rezidivrate (p= 0.44).Abstract: Venous insufficiency leads to recurrent leg ulcers. The reason for recurrence is still not clear. In this study 69 patients were treated in a special wound care centre. Before treatment the angiological status was evaluated (Phlebographie and Duplex Scan) and patients were scored according to the CEAP classification. During treatment compression therapy was performed and wounds were treated with moist wound dressings. Necrosis were removed by radical debridement and large ulcers were covered by mesh graft tissue transfer. If indicated, incompetent veins were treated surgically. Ulcers were healed after 196 [range 30 to 510] days. The follow up revealed an overall recurrence rate of 21 after 30 month. Ulcers treated by radical wound debridement or mesh graft tissue transfer had a significant lower recurrence rate (p=0.002 and p=0.002). According to duplex sonography, there was a correlation between the severity of venous insufficiency, the CEAP classification (p=0.04) and the recurrence rate (p=0.023). After venous surgery venous insufficiency was improved, but the recurrence rate was not different compared to patients who were treated by compression therapy alone(p=0.44)

Thymidine Kinase Sequence Analysis of Herpes Simplex Virus Type 1 Strains Present in Different Compartments in an Atypical Impetiginous Rash on the Lesional Skin of a Burn Patient▿

We report the case of a 23-year-old male burn patient with an unusual herpes simplex virus (HSV) skin manifestation. The clinical symptoms and results of HSV type 1 (HSV-1) UL23 polymorphism analysis from saliva and lesional skin underscores the need for performing molecular analysis of HSV-1 infections in burned patients presenting unusual skin lesions