Successful treatment of pyoderma gangrenosum with granulocyte and monocyte adsorption apheresis
ABSTRACT Pyoderma gangrenosum is a neutrophilic dermatosis clinically characterised by the presence of painful skin ulcerations with erythematous and undetermined borders and histologically by the presence of neutrophilic infiltrates in the dermis. Granulocyte and monocyte adsorption apheresis, also called granulocytapheresis, is a therapeutic strategy for extracorporeal immunomodulation that selectively removes activated granulocytes and monocytes/macrophages from the peripheral blood. Here, we report a case of a 73‐year‐old patient affected by a severe form of pyoderma gangrenosum presenting with multiple painful ulc...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Irene Russo, Serena Miotto, Anna Colpo, Piero Marson, Tiziana Tison, Anna Ferrazzi, Mauro Alaibac Tags: CASE REPORT Source Type: research

Epidermal grafting for wound healing: a review on the harvesting systems, the ultrastructure of the graft and the mechanism of wound healing
Abstract Epidermal grafting for wound healing involves the transfer of the epidermis from a healthy location to cover a wound. The structural difference of the epidermal graft in comparison to the split‐thickness skin graft and full‐thickness skin graft contributes to the mechanism of effect. While skin grafting is an epidermal transfer, little is known about the precise mechanism of wound healing by epidermal graft. This paper aims to explore the evolution of the epidermal graft harvesting system over the last five decades, the structural advantages of epidermal graft for wound healing and the current hypotheses on th...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Muholan Kanapathy, Nadine Hachach ‐Haram, Nicola Bystrzonowski, John T Connelly, Edel A O'Toole, David L Becker, Afshin Mosahebi, Toby Richards Tags: REVIEW ARTICLE Source Type: research

Management of extremely hard ‐to‐heal extremity wounds with severe life‐threatening complications
We present a series of four patients with soft tissue sarcoma of the thigh undergoing tumour removal and reconstruction of the defect after neoadjuvant radiotherapy. The post‐operative outcome depended on the total dose of radiation used as well as the closing technique of the resulting wound. Major wound complications occurred when the irradiated skin was closed directly over the resection cavity or when local skin flaps were used. In one case, severe radiation‐induced life‐threatening multiple bleeding events occurred, which led to multiple flap failures. Even if the skin cover is not a problem, we propose a combin...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Aijia Cai, Anja M Boos, Andreas Arkudas, Raymund E Horch Tags: ORIGINAL ARTICLE Source Type: research

Skin property can predict the development of skin tears among elderly patients: a prospective cohort study
Abstract The aim of this study was to identify skin properties that may be used to predict the development of a skin tear (ST) among elderly patients. A prospective cohort study was conducted among elderly patients aged 65 and older (N = 149) at a long‐term medical facility in Japan over an 8‐month period. Skin properties at baseline were measured on the forearm using a 20‐MHz ultrasound scanner, which measured the thickness of the dermis layer and low‐echogenic pixels, and skin blotting method, which evaluated the levels of collagen type IV, matrix metalloproteinase‐2 and tumour necrosis factor‐a...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Yuiko Koyano, Gojiro Nakagami, Shinji Iizaka, Junko Sugama, Hiromi Sanada Tags: ORIGINAL ARTICLE Source Type: research

Development of bullous pemphigoid during the haemodialysis of a young man: case report and literature survey
Abstract Haemodialysis is the most frequent form of renal replacement therapy (RRT) in patients with end‐stage renal disorder (ESRD). Patients with ESRD frequently develop skin problems, mainly xerosis, pruritus and hyperpigmentation, as well as bullous diseases, mainly porphyria or pseudoporphyria and, in some cases, bullous pemphigoid (BP). BP is the most common autoimmune sub‐epidermal blistering disease, and it predominantly affects elderly people. Clinically, BP is characterised by generalised pruritic, bullous eruptions and urticaria‐like lesions. Usually, BP is an idiopathic disorder; however, in some cases, u...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Katarzyna Osipowicz, Agnieszka Kalinska ‐Bienias, Cezary Kowalewski, Katarzyna Wozniak Tags: CASE REPORT Source Type: research

Risk factors for ulceration over tophi in patients with gout
Abstract Ulceration over tophi in patients with gout usually causes a number of clinical problems. The aim of this study was to investigate the risk factors for ulceration of tophi in patients with gout. Patients with gout who had tophi with or without ulceration were prospectively recruited and underwent a comprehensive clinical assessment. Clinical factors independently associated with the presence of ulceration were analysed using logistic regression models. Of the 113 participants, 18 (13·7%) had clinically apparent ulceration over tophi. In univariate analysis, ulceration over tophi correlated with age, tophus ...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Jianjun Xu, Cai Lin, Peng Zhang, Jianghui Ying Tags: ORIGINAL ARTICLE Source Type: research

The care of transmetatarsal amputation in diabetic foot gangrene
Abstract Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre‐ and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene. Studies were identified by searching the MEDLINE, Scopus and Science ...
Source: International Wound Journal - September 30, 2016 Category: Surgery Authors: Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano Franciscis, Raffaele Serra Tags: INVITED REVIEW Source Type: research

Deconstructing negative pressure wound therapy
Abstract Since its introduction 20 years ago for the treatment of chronic wounds, negative pressure wound therapy use has expanded to a variety of other wound types. Various mechanisms of action for its efficacy in wound healing have been postulated, but no unifying theory exists. Proposed mechanisms include induction of perfusion changes, microdeformation, macrodeformation, exudate control and decreasing the bacterial load in the wound. We surmise that these different mechanisms have varying levels of dominance in each wound type. Specifically, negative pressure wound therapy is beneficial to acute open wounds because it ...
Source: International Wound Journal - September 29, 2016 Category: Surgery Authors: Shadi Lalezari, Christine J Lee, Anna A Borovikova, Derek A Banyard, Keyianoosh Z Paydar, Garrett A Wirth, Alan D Widgerow Tags: ORIGINAL ARTICLE Source Type: research

A not ‐so‐sweet diagnosis – leukocytoclastic vasculitis masquerading as squamous cell carcinoma
We report the case of a 75‐year‐old man with a history of a previously completely excised and grafted squamous cell carcinoma (SCC) on the dorsum of his hand, who presented with an acutely swollen, erythematous and ulcerated lesion adjacent to the graft site. A shave biopsy failed to definitively exclude SCC recurrence. He was referred to the Plastics team who initially suspected Sweet's syndrome but could not rule out SCC recurrence. The patient underwent formal mapping incisional biopsies that later diagnosed LCV. He was managed conservatively and made an excellent recovery. We present clinical photographs and histol...
Source: International Wound Journal - September 28, 2016 Category: Surgery Authors: Mussa Mensa, Zita M Jessop, Nick Wilson ‐Jones, Iain S Whitaker Tags: ORIGINAL ARTICLE Source Type: research

Squamous cell carcinoma complicating a chronic lesion of hidradenitis suppurativa: a case report and review of the literature
We present a case of HS of the perineum and buttocks complicated by SCC, requiring multiple extensive surgical resections. Adjuvant radiotherapy was withheld initially because of concern for poor healing of the surgical wound but was eventually initiated after a second recurrence was identified. The patient ultimately expired 4 years after the initial diagnosis of SCC. We also review 80 cases of SCC complicating HS found in the English literature. Case reports and mechanistic studies suggest the possibility that human papilloma virus and smoking may be risk factors associated with SCC in HS. Despite the majority of ...
Source: International Wound Journal - September 28, 2016 Category: Surgery Authors: Natanel Jourabchi, Alexander H Fischer, Ashley Cimino ‐Mathews, Kevin M Waters, Ginette A Okoye Tags: CASE REPORT Source Type: research

Calendar
(Source: International Wound Journal)
Source: International Wound Journal - September 12, 2016 Category: Surgery Tags: CALENDAR OF EVENTS Source Type: research

News and views
(Source: International Wound Journal)
Source: International Wound Journal - September 12, 2016 Category: Surgery Tags: NEWS AND VIEWS Source Type: research

The ‘Olympics’ of wound care arrives in Europe
(Source: International Wound Journal)
Source: International Wound Journal - September 12, 2016 Category: Surgery Authors: Keith Harding, Douglas Queen Tags: EDITORIAL Source Type: research

Issue Information – Aims and Scope
(Source: International Wound Journal)
Source: International Wound Journal - September 12, 2016 Category: Surgery Tags: ISSUE INFORMATION Source Type: research

Issue Information – JIP
(Source: International Wound Journal)
Source: International Wound Journal - September 12, 2016 Category: Surgery Tags: ISSUE INFORMATION Source Type: research

Effect of total contact cast in non ‐healing diabetic foot ulcers in Lebanese patients
ABSTRACT The aim of this study was to evaluate the effectiveness of total contact casting (TCC) in treating non‐healing diabetic foot ulcers in Lebanese diabetic patients. Twenty‐three diabetic patients were treated with TCC, and relevant data were collected retrospectively. Sixteen patients were analysed; the average duration of casting was 6 weeks, and 75% of the patients achieved complete ulcer closure without recurrence during one year of follow‐up and without any complications. TCC appears to be an effective treatment of diabetic foot ulcers. (Source: International Wound Journal)
Source: International Wound Journal - September 8, 2016 Category: Surgery Authors: Marie Merheb, Elie Gharios, Alaa Younes, Mohamad Al Cheikh, Toufic Chaaban Tags: ORIGINAL ARTICLE Source Type: research

An avoidable adverse drug reaction: Nicolau syndrome
(Source: International Wound Journal)
Source: International Wound Journal - September 8, 2016 Category: Surgery Authors: Duygu Gulseren, Emine Buket Sahin, Onder Bozdogan, Ferda Artuz Tags: LETTER TO THE EDITOR Source Type: research

Trauma management in Homer's Iliad
Abstract Homer's Iliad is one of the highest intellectual products of the early ancient Greek civilisation. A plethora of medical information lies within Iliad's 24 rhapsodies, and a total of 147 injuries are described. The present study records and evaluates all cases of trauma management included in this epic poem. Not only Iliad's original text but also all myths related to Iliad from the five‐volume Greek Mythology by Ioannis Kakridis were meticulously studied to locate the injured person, the type of trauma, the care provider and the type of given care as well as the outcome of each case. A total of 21 cases were fo...
Source: International Wound Journal - September 8, 2016 Category: Surgery Authors: Christos Koutserimpas, Kalliopi Alpantaki, George Samonis Tags: ORIGINAL ARTICLE Source Type: research

Retrospective observational analysis of the use of an architecturally unique dermal regeneration template (Derma Pure ®) for the treatment of hard‐to‐heal wounds
Abstract The purpose of this analysis was to evaluate the use of DermaPure, a decellularised human skin allograft, in the treatment of a variety of challenging wounds. This retrospective observational analysis reviewed a total of 37 patients from 29 different wound clinics across the USA. Each patient received one application of DermaPure which was followed until complete closure. A statistical analysis was performed with the end point being complete healing. All wounds on average, had a duration of 56 weeks and healed in an average time of 10·58 weeks. Individual wound categories included diabetic foot ulcer...
Source: International Wound Journal - August 31, 2016 Category: Surgery Authors: Kimmel Howard, Gittleman Haley Tags: ORIGINAL ARTICLE Source Type: research

Accelerated wound healing after wide excisions in Hidradenitis Suppurativa using autologous split ‐thickness skin grafting and platelet‐rich plasma
(Source: International Wound Journal)
Source: International Wound Journal - August 31, 2016 Category: Surgery Authors: Allard RJV Vossen, Hessel H Zee, Errol P Prens Tags: LETTER TO THE EDITOR Source Type: research

Epidermal skin grafting
Abstract Autologous skin grafts, such as full‐ and split‐thickness, have long been part of the reconstructive ladder as an option to close skin defects. Although they are effective in providing coverage, they require the need for a trained surgeon, use of anaesthesia and operating room and creation of a wound at the donor site. These drawbacks can be overcome with the use of epidermal skin grafts (ESGs), which can be harvested without the use of anaesthesia in an office setting and with minimal to no scarring at the donor site. ESGs consist only of the epidermal layer and have emerged as an appealing alternative to oth...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Ingrid Herskovitz, Olivia B Hughes, Flor Macquhae, Adele Rakosi, Robert Kirsner Tags: REVIEW ARTICLE Source Type: research

Epidermal skin grafting in vitiligo: a pilot study
Abstract Vitiligo is a multifactorial acquired dermatosis characterised by achromic or hypochromic macules and by the absence of functioning melanocytes. Treatment depends on the extent of the affected areas and on disease activity. Surgical techniques have proven to be effective in stable cases but can be time‐consuming and, in some cases, aesthetically unsatisfying or painful for the patients. The aim of the study was to assess the clinical safety and effectiveness of a new automatic epidermal skin harvesting device in patients with stable localised vitiligo over a minimum 12‐month period. This new system (CELLUTOME&...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Agata Janowska, Valentina Dini, Salvatore Panduri, Michela Macchia, Teresa Oranges, Marco Romanelli Tags: ORIGINAL ARTICLE Source Type: research

The impact of surgical site occurrences and the role of closed incision negative pressure therapy
Abstract Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews (‘SSI’, ‘deep sternal wound infections’ (DSWI), ‘closed incision negative pressure wound therapy’ (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a ‘snowball’ method of continued searches of the references in the identified publications. Search cr...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Christian Willy, Michael Engelhardt, Marcus Stichling, Onnen Grauhan Tags: ORIGINAL ARTICLE Source Type: research

Management of the open abdomen: clinical recommendations for the trauma/acute care surgeon and general surgeon
Abstract Traditionally, the surgical approach to managing abdominal injuries was to assess the extent of trauma, repair any damage and close the abdomen in one definitive procedure rather than leave the abdomen open. With advances in medicine, damage control surgery using temporary abdominal closure methods is being used to manage the open abdomen (OA) when closure is not possible. Although OA management is often observed in traumatic injuries, the extension of damage control surgery concepts, in conjunction with OA, for the management of the septic patient requires that the general surgeon who is faced with these challeng...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Luis G Fern ández Tags: ORIGINAL ARTICLE Source Type: research

A solution for complex wounds: the evidence for negative pressure wound therapy with instillation
ABSTRACT Negative pressure wound therapy with instillation and dwell time (NPWTi‐d) is an adjunctive therapy that can be used in the management of complex wounds with infection. NPWTi‐d incorporates the intermittent instillation of a topical solution to the wound in a programmed manner. Unlike standard negative pressure wound therapy, NPWTi‐d delivers topical wound solutions directly to the wound, allows the solution to dwell over the wound bed, and removes the solution during the negative pressure phase. The authors review the evidence for using NPWTi‐d and the role it may potentially play in helping to reduce hos...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Ersilia L Anghel, Paul J Kim, Christopher E Attinger Tags: ORIGINAL ARTICLE Source Type: research

Use of negative pressure wound therapy in burn patients
Abstract According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less‐compliant patients. We propose an enhanc...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Shou ‐Cheng Teng Tags: ORIGINAL ARTICLE Source Type: research

Wound bed preparation: TIME for an update
We present an up‐to‐date literature review of the most important recent aspects of wound bed preparation. While there are many novel therapies that are available to the treating clinician, often, there are limited data on which to assess their clinical value, and a lack of appreciation for adequate wound bed preparation needed before expensive therapy is used to heal a wound. (Source: International Wound Journal)
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Rhiannon L Harries, David C Bosanquet, Keith G Harding Tags: ORIGINAL ARTICLE Source Type: research

Use of advanced technologies across the wound care spectrum: prologue
Abstract The growing trends of ageing populations and increasing prevalence of diabetes have given rise to an expanding number of problematic acute and chronic wounds. Over the past two decades, the use of negative pressure wound therapy (NPWT) with and without instillation of topical wound solutions has expanded to include treatment of a large variety of wounds. Additionally, the use of NPWT specifically designed for use over closed surgical incisions has been associated with favourable results. The recent introduction of an automated epidermal harvesting system, which neither creates a donor site wound nor requires the u...
Source: International Wound Journal - August 21, 2016 Category: Surgery Authors: Robert S Kirsner, Marco Romanelli Tags: ORIGINAL ARTICLE Source Type: research

Issue Information
(Source: International Wound Journal)
Source: International Wound Journal - August 21, 2016 Category: Surgery Tags: ISSUE INFORMATION Source Type: research

Cutaneous malakoplakia masquerading as pyoderma gangrenosum
We report a case of cutaneous malakoplakia in a 77‐year‐old male with pyoderma gangrenosum and a 2‐year history of a non‐healing malleolar ulcer treated successfully with cotrimoxazole. (Source: International Wound Journal)
Source: International Wound Journal - August 14, 2016 Category: Surgery Authors: Mariam Smith ‐Pliego, Jose Contreras‐Ruiz, Siobhan Ryan, R Gary Sibbald, Wedad Hanna, Rodrigo Roldan‐Marin Tags: ORIGINAL ARTICLE Source Type: research

Does cryotherapy improve skin circulation compared with compression and elevation in preventing venous leg ulcers?
Abstract This trial compared skin blood flow, temperature and incidence of venous leg ulcers in patients with chronic venous disease using compression wraps and elevation pillows. Patients with CEAP C4 skin damage and C5 history of ulcers were randomly assigned to a cryotherapy intervention (n = 138) or placebo cuff control (n = 138) applied to the lower legs over 9 months. The time the ulcers healed prior to enrollment in the study for the cryotherapy group ranged from 1 to 2218 days (n = 8, median = 32 days); for the control group, the range was 24 to 489 days (n = 6, median = 390 days). There were no statistically signi...
Source: International Wound Journal - August 9, 2016 Category: Surgery Authors: Teresa J Kelechi, Martina Mueller, Mohan Madisetti, Margie A Prentice, Mary J Dooley Tags: ORIGINAL ARTICLE Source Type: research

Use of customised pressure ‐guided elastic bandages to improve efficacy of compression bandaging for venous ulcers
Abstract Compression bandaging is a major treatment of chronic venous ulcers. Its efficacy depends on the applied pressure, which is dependent on the skill of the individual applying the bandage. To improve the quality of bandaging by reducing the variability in compression bandage interface pressures, we changed elastic bandages into a customised version by marking them with circular ink stamps, applied when the stretch achieves an interface pressure between 35 and 45 mmHg. Repeated applications by 20 residents of the customised bandage and non‐marked bandage to one smaller and one larger leg were evaluated by measuring...
Source: International Wound Journal - August 8, 2016 Category: Surgery Authors: Nuttawut Sermsathanasawadi, Choedpong Chatjaturapat, Rattana Pianchareonsin, Nattawut Puangpunngam, Chumpol Wongwanit, Khamin Chinsakchai, Chanean Ruangsetakit, Pramook Mutirangura Tags: ORIGINAL ARTICLE Source Type: research

The CelluTome epidermal graft ‐harvesting system: a patient‐reported outcome measure and cost evaluation study
This study aimed to compare ESG with SSG by evaluating patient‐related outcome measures (PROMs) and the cost implications of both. Twenty patients answered a graft satisfaction questionnaire that evaluated: donor/graft site noticeability, aesthetic concerns, adverse problems and patient satisfaction. Cost/patient was calculated based on total operative expenses and five clinic follow‐ups. In 100% of the ESG cases, there were no DS noticeability or adverse problems compared to 25% in the SSG group. Complete satisfaction with DS appearance was observed in 100% of the ESG cases (50% SSG). Noticeability, adverse problems a...
Source: International Wound Journal - August 3, 2016 Category: Surgery Authors: Oliver J Smith, Sarah ‐Jayne Edmondson, Nicki Bystrzonowski, Nadine Hachach‐Haram, Muholan Kanapathy, Toby Richards, Ash Mosahebi Tags: ORIGINAL ARTICLE Source Type: research

The MEEK technique: 10 ‐year experience at a tertiary burn centre
This study was carried out at the Bogenhausen Hospital Burn Unit, Munich, Germany from 2006 to 2015. There were a total of 148 skin grafting operations. The modified MEEK technique was performed on 67 patients. Patients included 34 males and 33 females, with an average age of 39·6 years. The mean percentage body surface burned was 65%, and full‐thickness injury occurred in 52%. The mean area graft per procedure was 20%. The viability of the graft as assessed between the 7th and 10th day was generally in the range of 60–90%. The average number of operations required was 2·21. The mean length of stay wa...
Source: International Wound Journal - August 3, 2016 Category: Surgery Authors: Abdulaziz Almodumeegh, Paul I Heidekrueger, Milomir Ninkovic, Johannes Rubenbauer, Ektoras Hadjipanayi, P Niclas Broer Tags: ORIGINAL ARTICLE Source Type: research

A cost ‐effectiveness analysis of optimal care for diabetic foot ulcers in Australia
This study developed a Markov model to analyse the cost‐effectiveness of implementing optimal care in comparison with the continuation of usual care for diabetic patients at high risk of DFUs in the Australian setting. The model results demonstrated overall 5‐year cost savings (AUD 9100·11 for those aged 35–54, $9391·60 for those aged 55–74 and $12 394·97 for those aged 75 or older) and improved health benefits measured in quality‐adjusted life years (QALYs) (0·13 QALYs, 0·13 QALYs and 0·16 QALYs, respectively) for high‐risk patients receiving optimal car...
Source: International Wound Journal - August 3, 2016 Category: Surgery Authors: Qinglu Cheng, Peter A Lazzarini, Michelle Gibb, Patrick H Derhy, Ewan M Kinnear, Edward Burn, Nicholas Graves, Rosana E Norman Tags: ORIGINAL ARTICLE Source Type: research

The impact of lower limb chronic oedema on patients' quality of life
This study aimed to explore patients' perceptions regarding the impact that lower limb chronic oedema has on their quality of life (QoL). A quantitative descriptive design was used to collect data from patients with lower limb chronic oedema. A condition‐specific validated questionnaire was distributed to a purposive sample (n = 122) through manual lymphatic drainage/vascular/health clinics in Ireland. Results indicated that patients with lower limb chronic oedema experience a wide range of physical problems such as limb heaviness (74%, n = 66), weakness (44%, n = 40) and pain (38%, n = 34). Additionally, difficulties wi...
Source: International Wound Journal - August 3, 2016 Category: Surgery Authors: Adelene Greene, Pauline Meskell Tags: ORIGINAL ARTICLE Source Type: research

Heel ulcers do heal in patients with diabetes
Abstract A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes. Seven hundred and sixty‐eight patients [median age 73 (17–98)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed‐up until final outcome. Fifty‐eight per cent of the patients healed primarily; 7% healed after major debridement; ...
Source: International Wound Journal - August 3, 2016 Category: Surgery Authors: Hedvig Örneholm, Jan Apelqvist, Jan Larsson, Magnus Eneroth Tags: ORIGINAL ARTICLE Source Type: research

Acellular dermal matrix reduces capsule formation in two ‐stage breast reconstruction
Abstract Acellular dermal matrix (ADM) is commonly employed to create an inferior pocket for the tissue expander in two‐stage breast reconstruction. The authors sought to determine whether placement of ADM during the first stage of reconstruction decreases the amount of capsule formation at implant exchange. Patients who underwent mastectomy and tissue expander reconstruction were included in this study. Two biopsies were obtained at the time of implant exchange, one from the pocket adjacent to the ADM and the other from the area adjacent to the pectoralis muscle. Pathology analysis was performed on each sample. Ten pati...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Karan Chopra, Bryan Buckingham, Jamil Matthews, Jennifer Sabino, Kashyap K Tadisina, Ronald P Silverman, Nelson H Goldberg, Sheri Slezak, Devinder P Singh Tags: ORIGINAL ARTICLE Source Type: research

Does cyrotherapy improve skin circulation compared with compression and elevation in preventing venous leg ulcers?
Abstract This trial compared skin blood flow, temperature and incidence of venous leg ulcers in patients with chronic venous disease using compression wraps and elevation pillows. Patients with CEAP C4 skin damage and C5 history of ulcers were randomly assigned to a cyrotherapy intervention (n = 138) or placebo cuff control (n = 138) applied to the lower legs over 9 months. The time the ulcers healed prior to enrollment in the study for the cyrotherapy group ranged from 1 to 2218 days (n = 8, median = 32 days); for the control group, the range was 24 to 489 days (n = 6, median = 390 days). There were no statistically signi...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Teresa J Kelechi, Martina Mueller, Mohan Madisetti, Margie A Prentice, Mary J Dooley Tags: ORIGINAL ARTICLE Source Type: research

Validation of an algorithm to predict reulceration in amputation patients with diabetes
Abstract The aim of this article was to assess the ability to predict reulceration in people with diabetes and a history of minor amputation according to the formula proposed by Miller et al. A retrospective study was performed on 156 consecutive records of patients with a recent history of simple or multiple forefoot amputation. The sample was divided according to Miller's formula into patients at low risk of reulceration and those at high risk; those were further divided into two subgroups according to whether or not the first segment of the forefoot had been amputated. Forty‐eight (47·1%) individuals suffered f...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Ra úl J Molines‐Barroso, José L Lázaro‐Martínez, Francisco J Álvaro‐Afonso, Irene Sanz‐Corbalán, José L García‐Klepzig, Javier Aragón‐Sánchez Tags: ORIGINAL ARTICLE Source Type: research

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox ®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement
This study provides sound evidence that analgesia with topically administered 5% lidocaine/prilocaine cream is superior to the use of inhaled 50% N2O/O2 gas premix in chronic leg ulcer debridement. (Source: International Wound Journal)
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Juerg Traber, Ulrike Held, Maria Signer, Tobias Huebner, Stefan Arndt, Thomas A Neff Tags: ORIGINAL ARTICLE Source Type: research

A case series and a review of the literature on foreign modelling agent reaction: an emerging problem
This study involved 23 patients whose ages ranged from 22 to 67 years with higher proportion of women and homosexual men. The most commonly injected sites were the buttocks (38·5%), legs (18%), thighs (15·4%) and breasts (11·8%). Mineral oil (39%) and other unknown substances (30·4%) were the most commonly injected. The latency period ranged from 1 week to 17 years. Complications included several skin changes such as sclerosis and ulceration as well as systemic complications. FMAR is a severe syndrome that may lead to deadly complications, and is still very common in Latin America. (Source: Inte...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Ashley A Mart ínez‐Villarreal, Daniel Asz‐Sigall, Daniela Gutiérrez‐Mendoza, Thomas E Serena, Adriana Lozano‐Platonoff, Lourdes Y Sanchez‐Cruz, Sonia Toussaint‐Caire, Judith Domínguez‐Cherit, Lirio A López‐García, Andrea Cárdenas‐S Tags: ORIGINAL ARTICLE Source Type: research

A prospective, multicentre, open ‐label, single‐arm clinical trial for treatment of chronic complex diabetic foot wounds with exposed tendon and/or bone: positive clinical outcomes of viable cryopreserved human placental membrane
We report the results of a prospective, multicentre, open‐label, single‐arm clinical trial to establish clinical outcomes when vCHPM is applied weekly to complex DFUs with exposed deep structures. Patients with type 1 or type 2 diabetes and a complex DFU extending through the dermis with evidence of exposed muscle, tendon, fascia, bone and/or joint capsule were eligible for inclusion. Of the 31 patients enrolled, 27 completed the study. The mean wound area was 14·6 cm2, and mean duration was 7·5 months. For patients completing the protocol, the primary endpoint, 100% wound granulation by week 16, was met ...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Robert G Frykberg, Gary W Gibbons, Jodi L Walters, Dane K Wukich, Farrell C Milstein Tags: ORIGINAL ARTICLE Source Type: research

The versatility of the medial thigh lift for defect coverage in the genito ‐perineal region
Abstract Soft tissue defects in the genito‐perineal region are predominantly because of trauma, infections, neoplasms or iatrogenic causes. As a result of the region's urological, reproductive and gastrointestinal function, defects in this area may cause devastating physical and psychological consequences as well as diminished sexual functioning. The purpose of this study was to examine the efficacy of implementing a medial thigh lift for defect coverage in the perineal region. A retrospective analysis of all medial thigh lift procedures for defect coverage in the genito‐perineal region between November 2010 and March ...
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Gabriel Djedovic, Barbara Del Frari, Johannes Matiasek, David Schiltz, Timm O Engelhardt, Gerhard Pierer, Ulrich M Rieger Tags: ORIGINAL ARTICLE Source Type: research

Candida albicans colonisation, continence status and incontinence ‐associated dermatitis in the acute care setting: a pilot study
Abstract Candida albicans is the most prevalent human fungal commensal organism and is reported to be the most frequent aetiological organism responsible for infection associated with incontinence‐associated dermatitis. However, it remains unclear whether incontinence predisposes a patient to increased Candida colonisation or whether incontinence acts as a trigger for Candida infection in those already colonised. The purpose of this observational cross‐sectional study was to estimate colonisation rates of C. albicans in continent, compared to incontinent patients, and patients with incontinence‐associated dermatitis....
Source: International Wound Journal - July 31, 2016 Category: Surgery Authors: Jill L Campbell, Fiona M Coyer, Alison M Mudge, Ivan M Robertson, Sonya R Osborne Tags: ORIGINAL ARTICLE Source Type: research

Persistent cutaneous ulcers after Yttrium ‐90 synovectomy, an unusual complication: two case reports and a review of the literature
We report two patients with knee osteoarthritis treated with intra‐articular injection of Yttrium‐90 who developed persistent cutaneous ulcers secondary to radiation necrosis. (Source: International Wound Journal)
Source: International Wound Journal - July 22, 2016 Category: Surgery Authors: Lidia Garc ía‐Colmenero, Gemma Martin‐Ezquerra, Jordi Monfort, Ramon M Pujol Tags: ORIGINAL ARTICLE Source Type: research

Unusual cause of breast wound: postoperative pyoderma gangrenosum
In this report, we emphasise the importance of considering pyoderma gangrenosum (PG) as one of the differential diagnoses of breast ulcers after surgical procedures. Careful clinical assessment may establish an early diagnosis and prevent potential serious complications. (Source: International Wound Journal)
Source: International Wound Journal - July 20, 2016 Category: Surgery Authors: Bahareh Abtahi ‐naeini, Fahimeh Bagheri, Mohsen Pourazizi, Mohammad Forozeshfard, Ali Saffaei Tags: CASE REPORT Source Type: research

Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions
Abstract In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218...
Source: International Wound Journal - July 19, 2016 Category: Surgery Authors: Sue Min Kim, Kyung Hoon Cook, Il Jae Lee, Dong Ha Park, Myong Chul Park Tags: ORIGINAL ARTICLE Source Type: research

Efficacy and safety of triamcinolone acetonide alone and in combination with 5‐fluorouracil for treating hypertrophic scars and keloids: a systematic review and meta‐analysis
Abstract Pathological scars, such as keloids and hypertrophic scars, readily cause physical and psychological problems. Combination 5‐fluorouracil (5‐FU) with triamcinolone acetonide (TAC) is presumed to enhance the treatment of pathological scars, although supportive evidence is lacking. We aimed to compare the efficacy and safety of TAC alone and in combination with 5‐FU for the treatment of hypertrophic scars and keloids. Five databases (PubMed, Medline, Cochrane databases, Embase and CNKI) were searched with the limitations of human subjects and English‐language text. Mean differences (MDs), odds ratios (ORs) a...
Source: International Wound Journal - July 18, 2016 Category: Surgery Authors: YiMing Ren, XianHu Zhou, ZhiJian Wei, Wei Lin, BaoYou Fan, ShiQing Feng Tags: ORIGINAL ARTICLE Source Type: research

Efficacy and safety of triamcinolone acetonide alone and in combination with 5 ‐fluorouracil for treating hypertrophic scars and keloids: a systematic review and meta‐analysis
Abstract Pathological scars, such as keloids and hypertrophic scars, readily cause physical and psychological problems. Combination 5‐fluorouracil (5‐FU) with triamcinolone acetonide (TAC) is presumed to enhance the treatment of pathological scars, although supportive evidence is lacking. We aimed to compare the efficacy and safety of TAC alone and in combination with 5‐FU for the treatment of hypertrophic scars and keloids. Five databases (PubMed, Medline, Cochrane databases, Embase and CNKI) were searched with the limitations of human subjects and English‐language text. Mean differences (MDs), odds ratios (ORs) a...
Source: International Wound Journal - July 17, 2016 Category: Surgery Authors: YiMing Ren, XianHu Zhou, ZhiJian Wei, Wei Lin, BaoYou Fan, ShiQing Feng Tags: ORIGINAL ARTICLE Source Type: research