The Combination of a Hypertonic Saline Dressing and Negative Pressure Wound Therapy (NPWT) for Quick and Bloodless Debridement of Difficult Lesions in Complicated Patients

NPWT, also known as topical negative-pressure wound therapy, is widely used in managing and accelerating wound healing. However in wounds were slough is highly represented NPWT efficiency is low. In the patients included in this study clinical health conditions were precarious. We needed a rapid wound healing to not further compromise their health condition. So we added curity dressing to resolve the slough issue. In all the patients we observed slough reduction. This treatment provided beneficial for the patient, the surgeons and the National Health Service. Accelerating wound healing reduced hospitalization and thereby the patients achieved a reduction of risks of nosocomial infections and physical and psychological diseases

Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care

The Combination of a Hypertonic Saline Dressing and Negative Pressure Wound Therapy for Quick and Bloodless Debridement of Difficult Lesions in Complicated Patients

NPWT, also known as topical negative-pressure wound therapy, is widely used in managing and accelerating wound healing. However in wounds were slough is highly represented NPWT efficiency is low. In the patients included in this study clinical health conditions were precarious. We needed a rapid wound healing to not further compromise their health condition. So we added curity dressing to resolve the slough issue. In all the patients we observed slough reduction. This treatment provided beneficial for the patient, the surgeons and the National Health Service. Accelerating wound healing reduced hospitalization and thereby the patients achieved a reduction of risks of nosocomial infections and physical and psychological diseases

Self Organizing Maps to efficiently cluster and functionally interpret protein conformational ensembles

An approach that combines Self-Organizing maps, hierarchical clustering and network components is presented, aimed at comparing protein conformational ensembles obtained from multiple Molecular Dynamic simulations. As a first result the original ensembles can be summarized by using only the representative conformations of the clusters obtained. In addition the network components analysis allows to discover and interpret the dynamic behavior of the conformations won by each neuron. The results showed the ability of this approach to efficiently derive a functional interpretation of the protein dynamics described by the original conformational ensemble, highlighting its potential as a support for protein engineering

Integra in Scalp Reconstruction After Tumor Excision: Recommendations From a Multidisciplinary Advisory Board

Integra is a dermal regeneration template used in the reconstruction of burns, traumatic injuries or excision lesions in patients who present particular risk factors for traditional surgical procedures. A multidisciplinary advisory board of expert dermatologists and plastic surgeons have discussed the use of Integra in the reconstruction of scalp defects after tumor excision, focusing on the evidence derived from literature and on their experience in the treatment of approximately 400 patients. In this position paper, we summarize the main evidence discussed during the board, and the common practice guidelines proposed by the experts. The use of Integra is recommended in elderly patients with multiple comorbidities who have a higher risk for potential complications in traditional surgery; these patients may in fact benefit from a lower anesthetic risk, a less complicated post-surgical care and limited morbidity at the donor site obtained with the dermal template. Integra should also be used in the reconstruction of large and complex wounds and in case of bone exposure, as it helps to overcome the challenges related to wound healing in difficult areas. Notably, Integra has proven to be effective in patients who have undergone previous surgical procedures or adjuvant radiation therapy, in which previous incisions, scarring and radiation damages may hamper the effectiveness of traditional procedures. Finally, Integra is recommended in patients with recurrent and aggressive tumors who need closer tumor surveillance, as it gives easy access to the tumor site for oncologic follow-up examination

Hardware-Related Skin Erosion in Deep Brain Stimulation for Parkinson’s Disease: How Far Can We Go? An Illustrative Case Report

Skin erosion is a hardware-related complication commonly described after deep brain stimulation (DBS). Hardware exposure is often associated with the development of infection that can lead to implant removal. However, in selected cases, it is possible to manage skin erosion without having to remove the hardware. This article presents the case of a patient with recurrent skin erosions above the IPG, who underwent multiple surgeries. Given the failure of less invasive approaches, a more complex surgery with the employment of a pedunculated flap of pectoralis major in order to cover the IPG was attempted. Nevertheless, the IPG removal was finally unavoidable, resulting in a rapid decline in clinical performance. This illustrative case suggests how, in patients with sustained stimulation who benefit from a good degree of autonomy, it may be useful to use invasive surgical techniques to resolve skin erosions and save the DBS system. In spite of everything, sometimes complete or partial removal of the implant still becomes unavoidable, but this can lead to a severe worsening of PD symptoms. Definitive removal of the system should therefore be considered only in cases of frank infection or after failure of all other approaches