Gene expression analysis in scars treated with silicone cream: a case series.

BACKGROUND: In contrast to fetal scar tissue, adult scar tissue presents with visible scarring. Topical silicone creams have been shown to improve the appearance of scars. This case series compares the genetic expression of post-surgical scar tissues that received topical scar treatment with silicone cream, SKN2017B, or no treatment. SKN2017B is a recently formulated silicone-based scar cream that contains selective synthetic recombinant human growth factors, hyaluronic acid, and vitamin C. We hypothesise that scars treated with silicone-based scar creams have a more favourable genetic expression resembling a well-healing scar. METHODS: Women who had undergone an abdominoplasty were included in this investigation and randomly assigned to treat part of the scar with topical silicone, another part with SKN2017B, and to leave a third part untreated. After four weeks, punch biopsies were taken and the RNA sequenced. Healthy abdominal skin was biopsied as baseline data. Genes of interest were identified and median values were calculated for the samples. RESULTS: SKN2107B-treated scars demonstrated the lowest collagen type I to collagen type III ratio. Other key genes of interest in wound healing showed the lowest (favourable) expression of fibroblast activation protein alpha, lysyl oxidase and cartilage oligomeric matrix protein; the highest (favourable) expression of fibronectin type III domain containing 1 and matrix metallopeptidase 9 were found in scars treated with SKN2017B. CONCLUSION: The results of this small case series demonstrate a trend that those scars treated with topical silicone cream, notably SKN2017B, display the most favourable gene expression for wound healing.

Acute carpal tunnel syndrome from burns of the hand and wrist.

Acute median nerve compression usually occurs from increased pressure within the carpal tunnel and forearm compartments. Although the hyperesthesia from burns may mimic symptoms of acute compression neuropathy, clinical diagnosis should be made from history, clinical signs and symptoms. Early recognition and decompression of the carpal tunnel either as part of the burn excision or along with escharotomy usually leads to full recovery.

Closure of massive abdominal wall defects: a case report using the abdominal reapproximation anchor (ABRA) system.

Closure of massive abdominal wounds can be a challenging surgical problem. Presented here is a novel technique for reconstitution of the abdominal wall after severe internal injuries complicated by sepsis required a prolonged period of open abdominal dressing changes. By using an innovative and effective progressive tension band system, the fascial edges could be reapproximated over time allowing primary wound closure. This system is recommended as an effective instrument to accomplish closure of these difficult wounds.

Reconstruction of a transmetatarsal amputation stump using a salvaged peroneal artery fasciocutaneous flap from the opposite leg: A case report.

During lower extremity amputation, the objective is to provide a functional residual limb that permits maximum patient mobility and independence. Preservation of length of the fore part of the foot using salvageable tissue from the amputated part in young patients prevents equines deformity and revision of amputation to a higher level. This can be achieved using tissue available from the amputated part. The spare part concept in reconstructive surgery should be integrated into the trauma algorithm to avoid additional donor site morbidity. Reported here is a young adult patient with crush injuries to both feet, which resulted in amputations. A fasciocutaneous flap raised from one extremity was used to facilitate transmetatarsal amputation stump length preservation of the other extremity.

Pendant l'amputation de l'extrémité inférieure, l'objectif consiste à obtenir un membre résiduel fonctionnel qui assure la mobilité et l'indépendance maximales du patient. Chez les jeunes patients, la préservation de la longueur de la partie avant du pied à l'aide de tissu récupérable de la partie amputée permet d'éviter les malformations équines et la révision de l'amputation à un niveau plus élevé. Le concept de pièce de rechange en chirurgie reconstructive devrait être intégré à l'algorithme du traumatisme pour éviter la morbidité additionnelle au foyer du donneur. Est exposé le cas d'un jeune patient adulte ayant des lésions par écrasement aux deux pieds, qui ont provoqué des amputations. Un lambeau fasciocutané prélevé sur une extrémité a facilité la préservation de la longueur du moignon de l'amputation transmétatarsienne de l'autre extrémité.

Use of groin flap in the closure of through and through defect of a forearm: A case report.

The groin flap is a vascularized axial flap based on the superficial circumflex iliac artery arising from the femoral artery just below the inguinal ligament. It is used regularly by many reconstructive surgeons for covering soft tissue defects of the hand. Although the development of various fasciocutaneous free flaps during the 1980s decreased the attractiveness of the groin flap, these flaps can be used in reconstructing significant defects of the forearm and hand where free tissue transfer is not feasible.

Le lambeau inguinal est un lambeau axial vascularisé basé sur l'artère iliaque circonflexe, rameau de l'artère fémorale, juste sous le ligament inguinal. Les chirurgiens qui travaillent en reconstruction l'utilisent régulièrement pour corriger les anomalies affectant les tissus mous de la main. Bien que le développement de divers lambeaux libres fasciocutanés au cours des années 1980 ait rendu le lambeau inguinal moins attrayant, ce dernier peut néanmoins être utilisé pour la reconstruction d'anomalies importantes à l'avant-bras et à la main où il est impossible de transférer des tissus libres.

Lymphedema of the upper extremity following circumferential burns.

Lymphedema is characterized by edema of the extremity due to the inability of the lymphatic system to remove lymph into the circulation. This condition can result from destruction of the superficial lymphatics from burn injury and recurrent infection of the extremity. Due to its rare occurrence, two cases of upper extremity lymphedema following burns are reported.

Le lymphoedème se caractérise par l'œdème d'un membre en raison de l'incapacité du système lymphatique d'écouler la lymphe dans la circulation sanguine. Le problème de drainage peut résulter de la destruction des vaisseaux lymphatiques de surface par des brûlures ou des infections récidivantes. Comme ce genre d'événement se produit rarement, nous avons inclus dans le présent article la description de deux cas de lymphoedème des membres supérieurs, secondaire à des brûlures.