Spontaneous clostridial myonecrosis after pregnancy - emergency treatment to the limb salvage and functional recovery: a case report.

Clostridial myonecrosis (CM) is a rare, life threatening necrotizing infection of a skeletal muscle caused by Clostridium perfringens in the majority of cases. The diagnosis may be difficult because of few diagnostic and cutaneous signs early in its course. Standard therapy involves surgical debridements of a devitalized tissue and high-dose organism-specific antibiotic therapy. The hyperbaric oxygen has also showed its usefulness in the treatment of these infections. Autograft systems as tissue replacement, based on bioengineered materials, have been demonstrated to be safe and effective treatments for chronic wounds and a suitable physiotherapy is recommended for the recovery of functional impairments of upper extremities. We present a rare case of CM of right upper limb treated with a combination of standard treatments and new techniques.

Tissue regeneration in loss of substance on the lower limbs through use of platelet-rich plasma, stem cells from adipose tissue, and hyaluronic acid.

BACKGROUND: Platelet-rich plasma (PRP) induces wound regeneration and tissue repair through cell proliferation and differentiation, promoting tissue healing and also acting as an autologous scaffold. With a small quantity of blood, it is possible to obtain the necessary optimal volume of PRP to treat the loss of substance in the lower limb. It has been demonstrated that mesenchymal stem cells are present in the adipose tissue (thus accelerating the effect of the PRP). METHODS: The analysis involved 30 patients with lesions ranging from ulcerative, dystrophic, with substance loss, with differentiating etiopathogenesis all localized on the inferior limb, and to those treated with PRP and autologous fat grafts. The wounds were covered with a 3-dimensional, polymerized hyaluronic acid medicated biologic dressing. The authors' protocol consists of a general checkup; wound examination; instrumental, microbiological, and immunohistochemical diagnostic examinations; and acquisition of photographic images with follow-up at 0, 1, 2, and 3 weeks; 1, 3, and 6 months; and 1 year. RESULTS: The results show an improvement from minor to moderate in 100% of patients after 3 weeks, healing in less than 6 weeks in 47% of patients, and complete wound healing in 57% of patients within 3 months. CONCLUSIONS: The authors' data demonstrate the ability of the combination of PRP and autologous adipose graft to regenerate tissue and epithelialization with wound closure, with a significant healing-time reduction. Furthermore, the minimally invasive technique is well accepted by patients, with a noteworthy improvement of the quality of life along with cost reduction due to the fewer number of medications.

Hyalomatrix PA in burn care practice: results from a national retrospective survey, 2005 to 2006.

Results of a national retrospective survey on Hyalomatrix PA in burn patients are reported.A total of 11 burn centers were contacted.A total of 57 patients were available. Hyalomatrix PA was used on young and adult patients, mainly in deep partial thickness and full thickness burns. In most cases, Hyalomatrix PA was applied immediately after the wound cleaning (wound debridement or escharectomy for adults, dermabrasion or debridement in young patients). After 7 days, reepithelization processes were more frequent in deep partial thickness burns. One-half of the patient population underwent grafting. After 29 days, complete closure was achieved in almost all patients. The Vancouver Scar Scale showed better values for adults, while no differences were observed for burn depth or patients undergoing grafting. No adverse reactions were recorded.Hyalomatrix PA is used in young and adults, in deep partial thickness and full thickness burns, as a temporary coverage before grafting or alone for wound healing.