Showing 14 results for Wound
Khorsandi Mt, Karimi Yazdi A, Dabir Moghadam P ,
Volume 60, Issue 4 (7-2002)
Abstract
Background: The role prophylactic antibiotics in otologic surgery continues to be debated and perhaps misused. Prior studies have provided conflicting evidence with benefits obtained from the use of prophylactic antibiotics in surgery for chronic otitis media.
Materials and Methods: The current study was designed to evaluate the role of prophylactic antibiotics in the wound infection and outcome of surgery for chronic ear disease. It was the authors' impression that there was no difference between topical and systemic antibiotics in such surgery. Patients who met the inclusion criteria (n=193) were randomly assigned to a topical treatment group or a control group receiving only intravenous antibiotics for 1 dose intra operatively and 3 dose there after. Patients were followed post-operatively and observed for clinical evidence of infection, graft failur and hearing status.
Results: There was no statistically significant difference between the two groups with regard to the incidence of postoperative infection or graft survival.
Conclusion: The use of prophylactic antibiotics in surgery for chronic otitis media can be recommended as an alternative method.
Haji Abdolbaghi M, Makarem J, Rasoolinejad M, Afahami Sh, Fazeli Ms, Unesian M, Adili F, Alavi S. Sh,
Volume 64, Issue 8 (8-2006)
Abstract
Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods.
Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance.
Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended.
Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.
Bazyari Delavar H, Fatahi Bafghi A, Fathol Olomi M R, Peyvandi A A,
Volume 66, Issue 3 (6-2008)
Abstract
Background: Total laryngectomy is the mainstay of treatment for laryngeal cancer. Fistula is one of the most common complications after total laryngectomy. In patients without risk factors such as prior radiotherapy, diabetes mellitus or chronic renal disease, the incidence of pharyngocutaneous fistula is related to wound healing and duration of operation. We have developed a new method that is both simple and without the complication of pharangocutaneous fistula. Herein, we report the efficacy of this innovative method for the closure of total laryngectomy compared to the conventional method for closure.
Methods: In this clinical trial, we included 40 patients with grade T3 or T4 squamous cell carcinoma of the larynx. The total laryngectomy of all patients was performed by the standard method. Twenty patients (case group) were repaired by the new method for closure and 20 patients (control group) were repaired by the standard method. Duration of surgery and hospital stay, bleeding, hematoma, seroma and fistula formation were characterized for every patient and statistically analyzed.
Results: The mean age was 59.8 ±7.8 years for the control group and 61.3 ±6.4 years for the case group. Duration of surgery was 150 ±23.2 minutes and 130 ±18.7 minutes for the control and case groups, respectively (p<0.001). Duration of hospital stay was 10.5 ±1.6 and 3.1 ±0.2 days in the control and case groups, respectively (p<0.002). Bleeding, hematoma or seroma were not seen in either group. Pharyngocutaneous fistula occurred in three patients in control group and was not observed in case group.
Conclusion: This new method for closure shortens the duration of surgery and hospital stay. Furthermore, the patients in the case group avoided the psychological and traumatic side effects of tube feeding associated with fistula. In addition, no other complications were observed with this method. We recommend the use of this simple and efficient method for wound closure after total laryngectomy.
Taghizadeh-Jahed M, Jarolmasjed Sh, Mohamadnejad S, Rezaii A, Delazar A,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Because of eventual side effects of chemical drugs, the efficacy of natural wound healing accelerators in long-term diseases and some situations is demanded to practitioners. The initial aim of our study was to assess full thickness excisional skin wound healing and inflammation diminution, Morphometrically and Histopathologically, after topical application of dried extract of Echinacea purpurea aerial part in rats, compared with zinc oxide.
Methods: Sixty wistar rats received four full thickness excisional wounds with the aim of surgical punch on the back skin under surgical anesthesia. All rats were randomly divided into groups 1, 2 and 3, of Echinacea purpurea, zinc oxide and control, respectively. All of them were treated topically once a day for 21 uninterrupted days. Healing of the wounds was daily measured by taking digital photographs and analysis. Histopathologic assessment was carried out in the 0th, 3rd, 7th, 14th, and 21st days of treatment period as well, and wound healing was assessed using 1 to 6 healing grades.
Results: According to Morphometric findings, the wound contraction rate in group 1 after 21 days of skin punching, with wound size of 0.18±0.03 mm2 in contrast with group 2, 2.81±0.21mm2, was much higher than that in other groups. Group 1 with wound contraction rate of 2.5 times in the day 7 and 3 times in the day 14 more than group 2, had the best wound contraction (p<0.01). histopathologic assessment revealed that, overall healing rate in the group 1 was highest (p<0.01).
Conclusion: Echinacea purpurea dried herbal extract could be a new capable remedy to accelerate skin wound healing because of its potential anti-phlogosis and wound healing stimulatory properties.
Mohammad Javad Zehtab , Ahmad Reza Mirbolook , Babak Syavashi , Mostafa Shahrezayi , Mostafa Mirmostafa ,
Volume 67, Issue 10 (1-2010)
Abstract
Background : Open fractures are associated with an increased risk of infection and healing complications. Management of open fractures is based on the following principles: assessment of the patient, classification of the injury, antibiotic therapy, debridement and wound management, Fracture stabilization, early bonegrafting, and supplemental procedures to achieve healing.
Methods : In a case- control retrospective study we evaluated 33 patients with open tibial fracture (type two gustillo) who were admitted in sina General hospital in Tehran, Iran during years 1999-2009 and were treated uniformly with external fixation as primary treatment in our center as case group and the other 33 patients with the same method and another 33 patients who had not been infected as control group. W e compared the folders of case and control groups retrospectively.
Results : There was no statisticant difference between two groups in mean age, gender, the mechanism of trauma and body mass index (p >0.05 ), while statistically significant difference between them in smoking habitus, blood transfusion, first debridment time, diabet mellitus, femoral shaft fracture (p <0.05 ).
Conclusions: Accompanying femoral fracture is the sign of high energy trauma and it is logical that it is an important risk factor for infection. In our study the time of the first debridment stablished as a significant factor influencing the infection rate in tibial open fracture. In some studies smoking had been recognized as a significant factor influencing in tibial bone open fracture our study reveals the same.
Hamid Ghaderi, Kourosh Shamimi, Fereydoon Moazzami, Seyed Hasan Emami Razavi, Ali Aminian, Seyed Mehdi Jalali, Reza Afghani, Morteza Noaparast, Seyyed Habibollah Dashti, Saeed Safari, Alireza Ahmadvand, Seyede Adeleh Mirjafari Daryasari, Fatemeh Sadat Naeemie,
Volume 68, Issue 1 (4-2010)
Abstract
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Background: Appendicitis is more common during the second
and third decade of life and appendectomy scar is important in terms of
cosmetic issues. The scar is an important factor in the patient's satisfaction.
Conventional teaching has an emphasis on the closure of skin incision with
"separate" sutures. The aim of this study was to reconsider this dogma.
Methods: Among 321 patients with acute
appendicitis who came to the emergency unit of Imam Khomeini Hospital in
Tehran, Iran since april 2007
till april 2008, 278 (86.6%) patients had
uncomplicated appendicitis and were enrolled in our clinical trial. The
patients were randomly assigned to two groups of interrupted suture closure (n=139) and subcuticular
suture closure (n=139). Anesthesia method and
surgical technique were similar between the two groups. All patients were
followed up post-operatively (four weeks) for the presence of infectious
drainage, pain, erythema, swelling and warmness at the surgical site.
Results: The patients' sex and
their mean age were not statistically different between the groups. There was
no significant difference in the frequency of surgical site complications between
the two groups (five cases in the "interrupted" group and eight cases in the
"subcuticular" group p=0.415).
Conclusion: This study showed that
appendectomy incision closure with subcuticular sutures did not increase the
risk of wound complications. From the point of better cosmetic outcome of
subcuticular sutures, this method may be the method of choice for the closure
of appendectomy incisions in uncomplicated appendicitis.
Mohammad Javad Fatemi , Amir Asadollah Khajerahimi , Babak Nikoumaram , Maryam Sakhaei , Shabnam Mostafavi , Amir Atashi , Mirsepehr Pedram , Seyed Hamid Reza Aghayan, Shirin Araghi , Majid Soltani , Majid Mossahebi Mohammadi ,
Volume 72, Issue 6 (9-2014)
Abstract
Background: Stem cells are applied in the treatment of wide range of diseases and can be separated from different tissues of the body. These cells can treat diseases by cytokine and growth factor secretion and also cell differentiation. Burn wound is a challenging problem of reconstructive surgery and stem cells may help wound healing process. We designed this study to evaluate the beneficial effect of fat derived stem cells for coverage of 3rd degree burn wound.
Methods: This study was experimental and has been done in Burn Research Center of Iran University of Medical Sciences during January 2012 to April 2013. Thirty rats randomly divided to three equal groups. Inguinal fat of 10 rats (one group) were used for preparation of autologous adipose-derived mesenchymal stem cells. Acellular amnion was used as a scaffold for stem cell transfer. Each of the thirty rats had been exposed to a cm deep 3rd degree burn on back area. 24 hours after surgery, the wound was excised and it had been covered by three methods: conventional dressing in the first group, acellular amnion in the second group and acellular amnion seeded with adipose-derived stem cell in the third group. The rate of wound healing and pathologic characteristics was compared in all three groups.
Results: Healing rate and decrease in wounds size was significantly better in acellular amnion seeded with adipose-derived stem cells compared with other two groups at 3rd and 15th days after surgery P<0.01.
Also in histopathology examination, fibroplasia and neovascularization of wounds were significantly better in stem cells group than the other two groups P<0.001.
Conclusion: Acellular amnion seeded with adipose-derived stem cell can result in faster wound healing and better histopathology characteristic. The amnion as a scaffold and the fat derived stem cells as healing accelerator are recommended for coverage of the 3rd degree burn wounds after excision and it may reduce the need for skin graft.
Nasrin Takzaree , Gholamreza Hassanzadeh , Mohammad Reza Rouini , Abbasali Keshtkar , Azadeh Manayi , Abbas Haajiakhondi ,
Volume 73, Issue 9 (12-2015)
Abstract
Background: One of the most important issues in medical sciences is wound healing and repair. Application of natural ingredients and herbs for treating ulcers has been in the history of human life. Nowadays, due to the lack of side effects of medicinal plants and a variety of effective compounds in plants, as well as numerous disadvantages of synthetic drugs there has been tendency to use medicinal plants in clinic. Aloe vera is an herbal drug used for treatment of dermal diseases. In this study we evaluated, effects of aloe vera on the wound healing through the microscopic techniques and cell counting.
Methods: In this experimental study, sixty Wistar rats weighing 200-250 g were placed under general anesthesia and sterile conditions. Then a square shape wound with 1.5´1.5 mm dimension was made on the back of the neck. Rats were randomly divided to control and experimental group’s. Each group was divided to three subgroups with 4, 7, and 14 study days. In 1st experimental group aloe vera was used twice on the wound surface and in 2nd experimental group was used once daily and the positive control group were applied phenytoin cream 1% from the zero days of surgery. The control group did not get any treatment on the wound surface. For histological studies, during the fourth, seventh and fourteenth day’s rats were sacrificed and samples were taken from the wound area and adjacent skin. After histological staining with hematoxylin and eosin (H&E) and Masson's trichrome stains, the cells were counted, wound surface and wound healing were investigated.
Results: The macroscopic and microscopic evaluation showed that wound healing increased because the fibroblast numbers in two experimental groups improved compared with control group. The percentage of wound healing on different days in the experimental and control groups were significant. Data were analyzed by using one-way ANOVA test and P< 0.05 was significant.
Conclusion: Present study showed that the twice application of topical aloe vera mucilage can result in rapid wound healing in rats.
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Hanieh Sharifian , Zahra Mollabashi ,
Volume 75, Issue 7 (10-2017)
Abstract
Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound) and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore) in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.
Mohammad Mehdi Saghafi, Mohammad Javad Fatemi , Tooran Bagheri , Mohammad Hasan Hablolvarid, Mitra Niazi, Mohsen Saberi, Shirin Araghi ,
Volume 75, Issue 11 (2-2018)
Abstract
Background: Burns is a major health problem due to severe side effects and limited financial resources. Some herbs are cheap and available, such as Arnebia euchroma can be effective treatment of burn wounds and reduce recovery time. The aim of this study was to evaluate the effect of Arnebia euchroma ointment on healing of deep second-degree burn wound in rats.
Methods: This experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.
Results: Results showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.
Conclusion: It seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.
Azadeh Zahedi, Seyed Mokhtar Esmaeilnejadganji , Sekineh Kamali Ahangar , Rahmatollah Jokar,
Volume 77, Issue 1 (4-2019)
Abstract
Background: Diabetes Mellitus is a prevalent disease worldwide and foot ulcer is one of the serious complications of chronic uncontrolled diabetes which could lead to various complications such as amputation of the extremity if left untreated. Total contact casting (TCC) is the gold standard in treatment of neuropathic and neuro ischemic diabetic foot ulcers (DFU) on which less emphasize is seen on routine medical practice. The aim of this study was to emphasize on healing effect of this off-loading method and to study the possible influence of variants on the healing rate of this technique.
Methods: In this cohort study, 92 diabetic patients with complaint of plantar foot ulcer grade 0, 1 and 2 according to Wagner classification had participated in Shahid Beheshti Hospital, Babol City, Iran, from March 2014 to February 2016. The demographic and biochemical information along with dimensions of foot ulcers were carefully recorded. After the primary cleansing, surgical debridement and dressing, TCC was applied on foot by the specialist and they were requested to return weekly for changing the TCC and re-evaluation of ulcers. The healing rate was calculated as decline in ulcer surface area per week.
Results: 92 patients of study sample with mean age of 63.9±10.56 year consisted of 76 patients with DM type 2 with BMI of 31.16±3.8 kg/m² and 58 male patients. The average healing rate of ulcers treated with TCC was 0.406 ±0.168 cm²/week. The duration of diabetes on average was 17.23±6.93 years. Most of the patients (n=45) had an ulcer on the forefoot and the healing rate of midfoot ulcers was slower. The average amount of baseline HbA1c was 8.2±0.19%. There was no relation between smoking history (P=0.94) and anti-diabetic regimen used by patients (P=0.754) with the healing rate.
Conclusion: The healing rate is slower in elderly patients and those with longer duration of diabetes. So in these two groups, TCC is to be applied for a longer duration in order to achieve complete healing.
Maria Zahiri , Khalil Pourkhalili , Sadegh Darvishi , Hossein Heydari , Zahra Akbari,
Volume 77, Issue 10 (1-2020)
Abstract
Background: Aphanizomenon flos-aquae (AFA) is a type of blue-green algae and contains a source of biological compounds. These microalgae have many beneficial health effects. Recently, fucoidan, known sulfated polysaccharide component of AFA algae, has been claimed to stimulate stem-cell mobilization in animal models. Stem cells play an essential role in tissue repair process. In this study, we use excisional full thickness wound model to investigate the effectiveness of trademark AFA extract on skin wound repair process.
Methods: In this experimental study, 21 adult male Wistar rats (weighing 200-250 g) were used and under general anesthesia (intraperitoneally with a ketamine/xylazine solution), two round excisional wounds were created under sterile conditions by a 6 mm punch on the dorsum (paravertebral area) of all rats. Animals were randomly assigned into 3 groups. In groups 1 and 2 (SE-200, SE-400), StemEnhance© (StemTech Health Sciences Inc. British Columbia, Canada) were given respectively 200 or 400 mg/kg by oral gavage once daily and in group 3 (Sham), distilled water (DW) was given to all subjects. Post-wounding gavage of StemEnhance or DW started from 1st day and continued to 7th day. The wound surface area was monitored daily by digital camera and assessed by Image Tool™ software, version 3.5 (UTHSCSA, San Antonio, TX, USA). At 9th day post-wounding animals were sacrificed and repaired tissues were harvested by and assessed by a 8 mm punch. Repaired skin areas were processed for hematoxylin and eosin (H&E). Histopathological parameters of healing including inflammatory cell infiltration, angiogenesis, and fibroblast count were assessed by pathologist. Our study was conducted in the Physiology Department of Medical School, Bushehr University of Medical Sciences, Iran, from October 2016 to March 2016.
Results: Macroscopic imaging of wound area revealed that there was statistically significant difference in wound area reduction between SE-200 group and sham group on day 6 post wounding (P=0.032). Moreover, histological findings showed that the number of neutrophils, macrophages, fibroblasts, and microvessel density decreased in both StemEnhace-treated groups. There were no significant differences between two treatment groups.
Conclusion: According to the obtained results it seems that the extract of Aphanizomenon flos-aquae algae positively affects wound healing process by ameliorating inflammatory response in early healing phases.
Vahid Hatami, Hamed Tavan, Sajad Hatami , Ali Delpisheh, Mina Mamizadeh,
Volume 79, Issue 10 (1-2022)
Abstract
Background: Healing involves complex processes that are not yet fully known. The wound healing process consists of three stages. In all these stages, normal wound healing requires platelet activation, release of cytokines and growth hormones, and chemotaxis and cell differentiation. Platelets play a key role in homeostasis and wound healing and growth factor production of more than 30 carried out by them. Platelets regulate the healing process with their chemotactic effect. Antilogous PRP platelet count in about 3 to 5 times increase and consequently also increases the number of growth factors, for this reason, they are being used in surgical procedures and clinical therapy.
Methods: At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared.
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Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05.
Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.
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Tahere Abbasi Moayyer, Aziz Ghahhari,, Tayebeh Rastegar, Fateme Malek, Farzane Rezaei Yazdi, Kamyar Ghaffari Dafchahi, Nasrin Takzaree,
Volume 80, Issue 3 (6-2022)
Abstract
Background: One of the most important issues in medical science is the healing of burn wounds. The use of medicinal plants has been common for many years and today cell therapy offers new approaches to the management of skin wound healing. The present study aimed to evaluate the the combination treatment of lotion containing honey, Aloe, and propolis with BM-MSCs in the healing of second-degree burns in animal models.
Methods: this experimental study from October 2020 to November 2020, was performed in the animal house of Tehran University of Medical Sciences. 72 rats with an age range of 3-4 months and a weight of about 200-250 gr, after burns were randomly divided into 6 groups of 12 with study periods of 7, 14 and 21 days. The groups were as following: control (no treatment), Positive control (SSD1%), First experimental (Stem cells), Second experimental(lotion), Third experimental(Stem cells and lotion), and Fourth experimental (DMEM). To measure the percentage of healing from the wound surface on days 0, 4, 7, 10, 14, 17, and 21 photos were taken and the wound surface area was calculated by Image J software. After sacrificing rats, tissue samples were taken on days 7, 14 and 21 after burning induction. Samples were prepared for staining H&E and Trichrome Masson’s, as well as RT-PCR examination. The results were analyzed using Graph Pad Prism8 software and Tukey and one-way variance tests.
Results: Treatment preference was with the combination therapy group and then with the lotion group. According to macroscopic and microscopic images of H&E and Trichrome Mason, the highest amount of wound coverage and the presence of mature collagen fibers were also observed in the combination therapy group. The results of statistical analysis and scoring also showed increased epithelization, granulation tissue formation, collagen deposition, angiogenesis and fibroblast cell proliferation, and decreased inflammation in the combination therapy group. The combination therapy group also had the highest expression of the TGF-β gene. (P<0/05)
Conclusion: Due to its epithelialization, anti-inflammatory and angiogenesis properties, the lotion has healing properties in second-degree burn wounds and its simultaneous use with mesenchymal stem cells leads to healing and acceleration of burn wound healing.
