Carboxymethylchitosan, alginate and tulle gauze wound dressings: a comparative study in the treatment of partial-thickness wounds.

Background: Carboxymethylchitosan is a chitosan-derivative obtained from the carboxymethylation of chitin with chloroacetic acid in alkaline solution. It has shown its potential in animal model studies as an accelerator of wound healing. Materials and methods: Prospective, comparative clinical trials of traditional tulle gauze, alginate membrane, and carboxymethylchitosan sponge were carried out in the treatment of partial- thickness skin graft donor sites. Between June 2005 and March 2006, 70 donor sites from 44 patients were randomly treated by these three different wound dressing materials. Each wound was treated until it was completely healed, and a visual analogue scale was used for the pain evaluation. Results: The results showed that the donor sites dressed with carboxymethylchitosan or alginate healed more rapidly than those treated with tulle gauze. There was no significant difference in the healing rate between carboxymethylchitosan and alginate. The pain scores evaluated among these three dressing groups did not significantly differ. Conclusion: Carboxymethylchitosan is as efficacious as traditional tulle gauze or alginate membrain in the treatment of partial thickness skin graft donor sites.

The epidemiology of mandibular fractures treated at Chiang Mai University Hospital: a review of 198 cases.

BACKGROUND: Mandibular fractures constitute a substantial proportion of maxillo-facial trauma cases in Chiang Mai. The present study investigated the prevalence, sex, age group, alcohol consumption, crash helmet use, causes, site, treatment, and postoperative result of mandibular fractures at Chiang Mai University Hospital, Thailand. MATERIAL AND METHOD: The medical records and radiographs of 198 patients treated for mandibular fracture at Chiang Mai University Hospital over a 1.5 year period (from 1 January 2005 to 30 June 2006) were reviewed Data on the patients' age, sex, alcohol and helmet use, mechanism of injury, site of fracture, treatment modality, and post-operative result were recorded and assessed. RESULTS: Men of 21 to 30 years of age sustained the most mandibular fractures. The ratio of males to females was 5:1. Most fractures were caused by motorcycle accidents (MCA) (75.75%), followed by body assault (13.63%), and falls (4.54%). Alcohol consumption was a contributing factor at the time of injury in 79% of fractures according to the information available. The most common fracture sites were, in descending order the parasymphysis (45.3%), angle (19.51%), condyle (15.68%), symphysis (13.24%), body (3.83%), and ramus (2.09%). Nearly 3/4 of all cases were treated by open reduction (76%). CONCLUSION: The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment.

Comparison among Op-site, polyvinyl chloride film and tulle gauze in the treatment of skin graft donor sitet.

A prospective analytic study was performed at the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Chulalongkorn Memorial University Hospital and the Department of Surgery, Chiang Mai University Hospital to compare among Polyvinyl chloride film (PVC film), Op-site and tulle gauze in the treatment of skin graft donor site. From October 1998 to January 2000, 81 donor sites in the same number of patients were treated by three different methods; tulle gauze (26 patients), Op-site (27 patients) and PVC film (28 patients). Each wound was followed until it was completely healed and visual analogue scale was used for pain evaluation. Donor site dressed with PVC film had a healing time of 10.44 days which was not different from Op-site (10.54 days) but significantly faster (p<0.001) than tulle gauze (17.84 days). Pain as measured with visual analogue scale in the group of PVC film (1.48) was not different from Op-site (1.34) but significantly less than (p<0.001) tulle gauze (5.45). There was no difference in the rate of infection between each group. In conclusion, the authors found no difference between Op-site and PVC film in healing time and pain. Both of them were better than tulle gauze. The results demonstrate the usefulness of PVC film as a donor site dressing as it promises relatively rapid healing, less pain and is inexpensive.