International wound journal
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Ionic silver has a long history as an antimicrobial in human health care. This article is a review of the published literature on how ionic silver may enter the body from exposure to silver-containing wound care products and its eventual metabolic fates, in an assessment of the safety during normal use of these products in wound care. Following the application to breached skin, there appears to be little evidence of localised or systemic toxicity, and this is borne out by the continuous use of silver sulfadiazine formulations for more than 50 years. Consequently, following normal use, the risk of silver ion toxicity locally and systemically is considered to be low or negligible.
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Despite extensive researches in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), current pharmacological therapies and respiratory support are still the main methods to treat patients with ALI and ARDS and the effects remain limited. Hence, innovative therapies are needed to decrease the morbidity and mortality. ⋯ Numerous documents demonstrate that MSCs can exert multiple functions, such as engraftment, differentiation and immunoregulation, but now the key researches are concentrated on paracrine factors secreted by MSCs that can mediate endothelial and epithelial permeability, increase alveolar fluid clearance and other potential mechanisms. This review aimed to review the current researches in terms of the effects of MSCs on ALI and ARDS and to analyse these paracrine factors, as well as to predict the potential directions and challenges of the application in this field.
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Causative agents of wound infections and the routes by which they access surgical incision sites have been recognised for more than a century. Despite knowledge of the factors that influence the risks of surgical site infections (SSIs) and the means to prevent and/or control them, surgical patients still get infections. Traditional systems of classifying and diagnosing SSIs and the diversity of microbial flora reported in contemporary SSIs will be described. Strategies available to prevent and control SSIs will be critically reviewed and the need to develop alternative approaches will be discussed.
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Review Case Reports
Reconstruction of infected and denuded scrotum and penis by combined application of negative pressure wound therapy and split-thickness skin grafting.
Trauma to the genital region and perineum can leave behind lifelong sequelae and pose significant challenges to surgeons in the restoration of functional ability and aesthetic status. Effective methods and techniques are indispensable during the treatment period. Negative pressure wound therapy (NPWT) is a widely accepted technique that is becoming a commonplace treatment in many clinical settings. ⋯ After debridement, we adopted NPWT during the postoperative dressing changes and the application of meshed STSG. The outcomes showed that combination of NPWT and split-thickness skin grafts is safe, well-tolerated and efficient in the reconstruction of penoscrotal defects. This could be a versatile tool for reconstruction after perineal and penoscrotal trauma.
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To systematically assess published reports on the efficacy of electrophysical therapy in the treatment of diabetic foot ulcers, including electrical stimulation, low-level laser therapy, therapeutic ultrasound and electromagnetic therapy. Databases searched included MEDLINE, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1966 to 2011. Studies reviewed included only randomised controlled trials (RCTs) on treatment with electrophysical modalities compared with sham, conventional treatment or other electrophysical modalities. ⋯ The pooled estimate of the number of healed ulcers of the three studies on electrical stimulation compared to the control or sham electrical stimulation showed statistical significance [mean difference of 2·8 (95% CI = 1·5-5·5, P = 0·002] in favour of electrical stimulation. The results indicated potential benefit of using electrophysical therapy for managing diabetic foot ulcers. However, due to the small number of trials ever conducted, the possibility of any harmful effects cannot be ruled out, and high-quality trials with larger sample sizes are warranted.