The Change of Surface Temperature in Healing Process of Wound and Burn in Porcine Model

PURPOSE: The goal of wound managements are to prevent further tissue injury during dressing changes, and absorb the excessive exudates, provide moist condition, reduce the infection. But the usual dressing methods have several limitations to serve the information about wound surface environment. Moist, pressure, temperature, pH are the important factors that give us the information about the healing process phase, speed of healing, & the risk of infection. METHODS: We made full thickness wounds & burn on porcine model, then assessed the surface temperature intermittently until repithelialization were completed, and size measurement were done with Image Pro Plus 6.0. RESULTS: In wound areas, the surface temperature was lowest at post operation #1 day, then slightly increased till POD #21 days, and again down slope curvature. In burn area, the surface temperature was highest at POD #1 day, then slightly decreased till POD # 21 days, and more fall curvature. Modern sensing technology along with wireless radio frequency communication technology is posed to make significant advances in wound management. Our result will be a basic data for the future researches about the surface temperature monitor to detect the early infection and the intervention to modulate the surface temperature to increase the rate of epithelialization. CONCLUSION: The result of the correlation between the surface temperature and area reduction have weak or moderate negative Pearson correlation coefficient.

Comparison of Wound Healing Process between Burn and Skin Defect in a Porcine Model

PURPOSE: The purpose of this study was to develop porcine full thickness skin wound healing model of thermal burn and skin defect and to compare wound healing process between them. METHODS: Twelve thermal burns and 12 skin defect wounds were created on the back of 3 domestic pigs. A round shaped heated electric iron was contacted for 30 seconds to develop full thickness burn. Appropriate dressings were applied for 30 days after wounding. Full thickness skin biopsies were obtained for histologic analysis by a pathologist. The amount of wound discharge, the surface area of each wound, and wound culture results were compared between skin defect and burn wound. RESULTS: Of 12 burn wound sections, 7 (58%) were identified to full thickness dermal injury. Complete wound reepithelialization was seen between postburn days 21 and 28 in both wounds. The initial wound area was smaller in burn than skin defect (P<0.001, 14.4+/-0.8 cm2 vs 22.8+/-3.4 cm2). The wound area of both burn and skin defect was slightly increased for 9 days after wounding and rapidly decreased after that time. The linear advancement length of wound edge was significantly slower in burn (P=0.009, 1.06+/-0.28 vs 1.48+/-0.42 cm). The amount of wound discharge was greater in skin defect than burn (P=0.002, 35.1+/-8.3 vs 49.5+/-11.2 g). CONCLUSION: We developed a porcine model of both thermal burn and skin defect. Time for complete reepithelialization was similar but the linear advancement length of wound edge was slower in burn than skin defect wound.

Management of Split Thickness Skin Graft Donor Sites: Comparison of Four Different Dressing Materials

PURPOSE: Split thickness skin graft is a frequently used reconstructive technique in burn wound, but the ideal dressing material of the donor site is yet to be developed. The donor sites have been managed with various dressing materials. The aim of this study is to compare four different dressing materials for management of the donor site in a prospective trial. METHODS: This study is based on 85 patients who had undergone split thickness skin graft from September 2011 to February 2012. The grafts harvested with a same manner and the donor sites were managed with one of the four dressing materials: Aquacel Ag(R), Mepitel(R), Bactigra(R), Op-Site(R). We compared post-operative pain scale, the time required epithelialization, ease of application, post-operative infection and number of dressings. RESULTS: Aquacel Ag(R) was the more painless dressing materials in post-operative day 1, 4, 7, 10 than Mepitel(R), Bactigra(R), Op-Site(R). Number of dressings was more lower for Aquacel Ag(R) with Mepitel(R). Ease of application was more higher for Aquacel Ag(R) with Mepitel(R). But Aquacel Ag(R) was not earliest epithelialization. The incidence of infection was not low in Aquacel Ag(R). CONCLUSION: Aquacel Ag(R) dressing is better than other dressing materials for split thickness skin graft donor site in the number of dressings, ease of application, post-operative pain.

Management of Split Thickness Skin Graft Donor Sites: Comparison of Different Dressing Materials

PURPOSE: The purpose of management of the donor is to maintain a moist condition that promotes healing process and prevents pain, infection. We have performed a prospective study to compare the usefulness between Aquacel Ag(R) and Mepitel(R). METHODS: 36 consecutive patients, in whom STSG was performed, were included into the study. STSG are harvested as a usual manner and the donor site are dressed with Aquacel Ag(R) or Mepitel(R), alternatively. The usefulness are compared with re-epithelialization, pain, frequency to change the second dressing, and ease of application. RESULTS: There are no differences in the days of re-epithelialization, pain perception of patients, but significantly differences in frequency to change the second dressing, and ease of application. Aquacel Ag(R) is better than Mepitel(R). CONCLUSION: We concluded that Aquacel Ag(R) dressing is better than Mepitel(R) for STSG donor site just in the frequency to change the second dressing and ease of application.

Concomitant Splenectomy during Hepatectomy in Patients with Liver Cirrhosis and Thrombocytopenia / 한국간담췌외과학회지

BACKGROUND/AIMS: Resection of hepatocellular carcinoma in patients with liver cirrhosis and thrombocytopenia is risky. The benefit of concomitant splenectomy in cirrhotic patients is controversial. METHODS: To evaluate the efficacy of concomitant splenectomy in patients with liver cirrhosis and thrombocytopenia, 13 cirrhotic patients with thrombocytopenia (platelet count< or =80,000/mm3) were divided by two groups (Group I: the patients without concomitant splenectomy during hepatectomy, Group II: the patients with concomitant splenectomy). Intraoperative and postoperative parameters were retrospectively reviewed. RESULTS: Group II patients needed less amount of postoperative blood transfusion (Group I: 178.3+/-150 ml PRC in 3 patients, Group II: 107.1+/-100 ml in 2 patients, p=0.012, p= 0.041) and the platelet count was elevated to above 250,000/mm3 (p=0.003) and showed lower serum bilirubin level (p=0.037) within 1 week of operation in group II patients. CONCLUSION: The concomitant splenectomy during in patients of liver cirrhosis with thrombocytopenia may improve liver function and elevate platelet count.

Clinical Value of CEA, CA15-3 and TPS in Recurrent Breast Cancer

PURPOSE: The survival of patients with metastatic breast cancer has not substantially improved during the last decade. Serum tumor markers, such as carcinoembryonic antigen (CEA), the mucin associated cancer antigen (CA15-3) and the tissue polypeptide specific antigen (TPS) have been used for monitoring and detecting recurrences in patients with diagnosed breast cancer. However, their precise role in the management of patients with breast carcinoma has not yet been firmly established. METHODS: CEA, CA15-3 and TPS were measured serially in a consecutive series of 136 patients (56 patients with recurrent cases and 70 patients with no evidence of recurrence) with breast cancer. Relationships between tumor marker levels and sites of recurrent disease were evaluated. The mean follow-up period was 38 months. RESULTS: Among the recurrent patients, local recurrences accounted for 16 cases (28.6%), bone metastasis for 10 cases (21.4%) and multiple metastasis for 18 cases (32.2%). Tumor markers in cases of organ or multiple metastases were higher than in cases of local recurrence. The sensitivity and the specificity of the tumor markers in patients with breast carcinomas were 44.6 and 94% for CEA, 51.8 and 99% for CA15-3, and 66.07 and 94% for TPS, respectively. CONCLUSION: Serial measurements of plasma CEA, CA15-3 and TPS are a cost-effective method to detect recurrence in breast carcinoma patients.