Conectar
Diabetic foot ulcers (DFUs) present significant challenges due to their associated amputation rates, mortality, treatment complexity and excessive costs. Our earlier work introduced a wound surgical integrated treatment (WSIT) for DFUs, yielding promising outcomes. This study focuses on a specific WSIT protocol employing antibiotic-loaded bone cement (ALBC) in the first Stage, and free vastus lateralis muscle-sparing (VLMS) flaps and split-thickness skin grafts (STSGs) in the second stage to repair non-weight-bearing DFUs. From July 2021 to July 2023, seven DFU patients (aged 47–71 years) underwent this treatment. Demographic data, hospital stay and repair surgery times were collected. Histological and immunohistochemical analyses assessed angiogenesis, collagen deposition and inflammation. SF-36 questionnaire measured pre- and postoperative quality of life. Preoperative ultrasound Doppler showed that the peak blood flow velocity of the recipient area artery was significantly >30 cm/s (38.6 ± 6.8 cm/s) in all patients. Muscle flap sizes varied from 8 × 3.5 × 1 to 18 × 6 × 2 cm. The operation time of the repair surgery was 156.9 ± 15.08 minutes, and the hospital stay was 18.9 ± 3.3 days. Histological analysis proved that covering DFUs with ALBC induced membrane formation and increased collagen, neovascularization and M2 macrophages fraction while reducing M1 macrophages one. All grafts survived without amputation during a 7- to 24-month follow-up, during which SF-36 scores significantly improved. A combination of ALBC with free VLMS flaps and STSGs proved to be safe and effective for reconstructing non-weight-bearing DFUs. It rapidly controlled infection, enhanced life quality and foot function, and reduced hospitalization time. We advocate integrating this strategy into DFU treatment plans.
Postoperative wound infections (PWIs) following open reduction and internal fixation (ORIF) for elbow fractures can significantly affect patient outcomes. Identifying associated risk factors is crucial for improving clinical practices and patient care. A retrospective analysis (June 2020–June 2023) at our institution involved 90 patients who underwent elbow ORIF. Thirty patients developed PWIs (case group), compared to 60 who did not (control group). Variables like anaemia, operation duration, hospital stay, blood loss, body mass index (BMI), age, hypoalbuminemia, smoking status, diabetes mellitus and open fractures were examined. Univariate and multivariate analyses determined the impact of these variables on PWI incidence, with statistical significance set at p < 0.05. The main pathogens identified were Escherichia coli among Gram-negative bacteria (59.46%) and Staphylococcus aureus among Gram-positive bacteria (40.54%). In the univariate analysis, hypoalbuminemia, anaemia, and lifestyle factors such as smoking showed higher prevalence in patients with PWIs. However, age and length of hospital stay did not significantly influence infection rates. The multivariate analysis further elucidated that anaemia, smoking, diabetes mellitus and open fractures were independent, significant predictors of PWIs. These findings highlight the complexity of factors influencing infection risk post-ORIF, underscoring the importance of both individual health conditions and surgical complications in patient outcomes. Anaemia, smoking, diabetes mellitus and open fractures significantly increase the risk of PWI after elbow ORIF. Early identification and management of these risk factors are imperative to reduce infection rates and improve postoperative recovery.
The risk of pressure ulcers in stroke patients is a significant concern, impacting their recovery and quality of life. This systematic review and meta-analysis investigate the prevalence and risk factors of pressure ulcers in stroke patients, comparing those in healthcare facilities with those in home-based or non-clinical environments. The study aims to elucidate how different care settings affect the development of pressure ulcers, serving as a crucial indicator of patient care quality and management across diverse healthcare contexts. Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Embase, Web of Science and the Cochrane Library. Inclusion criteria encompassed studies on stroke patients in various settings, reporting on the incidence or prevalence of pressure ulcers. Exclusion criteria included non-stroke patients, non-original research and studies with incomplete data. The Newcastle–Ottawa scale was used for quality assessment, and statistical analyses involved both fixed-effect and random-effects models, depending on the heterogeneity observed. A total of 1542 articles were initially identified, with 11 studies meeting the inclusion criteria. The studies exhibited significant heterogeneity, necessitating the use of a random-effects model. The pooled prevalence of pressure injuries was 9.53% in patients without family medical services and 2.64% in patients with medical services. Sensitivity analysis confirmed the stability of these results, and no significant publication bias was detected through funnel plot analysis and Egger's linear regression test. The meta-analysis underscores the heightened risk of pressure injuries in stroke patients, especially post-discharge. It calls for concerted efforts among healthcare providers, policymakers and caregivers to implement targeted strategies tailored to the specific needs of different care environments. Future research should focus on developing and evaluating interventions to effectively integrate into routine care and reduce the incidence of pressure injuries in stroke patients.
Peritoneal dialysis(PD) is one of the most efficient methods in end-stage kidney disease, and it is very important for PD to perform well. No research has been conducted to evaluate the effect of various types of PD catheters on the prognosis of post-operative wound complications. While recent meta-analyses are in favour of straight tubing, there is still uncertainty as to whether direct or coiled PD is beneficial. The purpose of this meta-analysis was to compare the efficacy of direct and coiled PD catheters on the incidence of post-operative wound infection, bleeding and peritonitis. A comprehensive search was carried out on three databases, including PubMed and Embase, and a manual search was carried out on the links in the paper. The results showed that the incidence rate of bleeding after operation and the degree of infection among the straight and coiled pipes were compared. The results showed that there were no statistically significant differences in the incidence of post-operative wound infection among straight PD patients with coiled PD (OR, 0.79; 95% CI, 0.58–1.08 p = 0.13). No statistical significance was found in the case of PD with coiled tubing compared with that of straight PD group in wound leakage (OR, 1.17; 95% CI, 0.71–1.93 p = 0.55). No statistically significantly different rates of post-operative peritonitis were observed for coiled tubing compared with straight ones in PD patients (OR, 1.06; 95% CI, 0.78–1.45 p = 0.7). There is no statistical significance on the rate of wound infection, wound leakage and peritonitis among coiled and straight tube in PD.
Sacrospinous ligament fixation (SSLF) is widely applied to the treatment of female pelvis organ prolapsed. Contradictory findings have already been reported in the comparison of sacrocolpopexy (SC) with SSLF. The objective of this study is to evaluate the efficacy of SC versus SSLF in treating pelvis organ prolapsed after operation. We conducted a meta-analysis of both operative approaches, including PubMed, Embase, and Cochrane Library. In this research, 822 articles were chosen from three databases, 201 were copied, and 10 were included. Among them, 7248 cases were operated on the prolapsed pelvis. It was found that SSLF surgery could significantly decrease the rate of postoperative wound infection after operation (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.42–0.82; p = 0.001). No statistical significance was found among the SSLF and the SC surgery for the post-operation haemorrhage of the patient (OR, 0.81; 95% CI, 0.23–2.83; p = 0.75). No statistical significance was found among the SSLF and the SC surgery for the postoperative period of the patient's operation (mean difference, −15.46; 95% CI, −52.87 to 21.94; p = 0.42). Applying SSLF surgery to treat pelvic prolapse in women may benefit from a reduction in the number of post-operative wound infections. However, SSLF had no statistical significance with respect to the amount of haemorrhage after operation or operation time.
This meta-analysis aims to systematically investigate the clinical efficacy of Chinese herbal compound dressings in treating patients with diabetic foot ulcers (DFUs). A comprehensive computerised search was conducted in databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases, from database inception to November 2023, to identify randomised controlled trials (RCTs) concerning the use of Chinese herbal compound dressings in patients with DFU. Two researchers independently screened the literature, extracted data, and assessed the quality based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. Overall, 18 RCTs involving 1405 DFU patients were included. The analysis indicated that compared to the control group, the group treated with Chinese herbal compound dressings had significantly shorter ulcer healing time (standardised mean difference [SMD] = −2.49, 95% confidence interval [CI]: −3.53 to −1.46, p < 0.001), reduced ulcer surface area (SMD = −3.38, 95% CI: −4.67 to −2.09, p < 0.001), and higher healing rates (odds ratio [OR] = 2.24, 95% CI: 1.72–2.92, p < 0.001) as well as overall effectiveness rates (OR = 4.56, 95% CI: 3.10–6.71, p < 0.001). This study demonstrates that the external application of Chinese herbal compound dressings in patients with DFU can significantly shorten the ulcer healing time and improve wound healing rates.
Emergency craniotomy in patients with traumatic brain injury poses a significant risk for surgical site infections (SSIs). Understanding the risk factors and pathogenic characteristics of SSIs in this context is crucial for improving outcomes. This comprehensive retrospective analysis spanned from February 2020 to February 2023 at our institution. We included 25 patients with SSIs post-emergency craniotomy and a control group of 50 patients without SSIs. Data on various potential risk factors were collected, including demographic information, preoperative conditions, and intraoperative details. The BACT/ALERT3D Automated Bacterial Culture and Detection System was utilized for rapid bacterial pathogen identification. Statistical analyses included univariate and multivariate logistic regression to identify significant risk factors for SSIs. The study identified Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus as the most prevalent pathogens in SSIs. Significant risk factors for SSIs included the lack of preoperative antibiotic use, postoperative drainage tube placement, diabetes mellitus, and the incorporation of invasive procedures, all of which showed a significant association with SSIs in the univariate analysis. The multivariate analysis further highlighted the protective effect of preoperative antibiotics and the increased risks associated with anaemia, diabetes mellitus, postoperative drainage tube placement, and the incorporation of invasive procedures. Our research underscores the critical role of factors like insufficient preoperative antibiotics, postoperative drainage, invasive techniques, anaemia, and diabetes mellitus in elevating the risk of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy. Enhanced focus on these areas is essential for improving surgical outcomes.
Traumatic haemorrhage is a prevalent clinical condition, and effective and timely haemostasis is crucial for the preservation of patients' lives. In recent years, injectable hemostatic materials have gained significant attention due to their excellent hemostatic efficacy, biocompatibility, and biodegradability, making them widely applied in the treatment of incompressible traumatic haemorrhage. Systematic analysis of injectable hemostatic materials is crucial for research in this area. This article provides a comprehensive review of the development and research trends of injectable hemostatic materials over the past 20 years using visualization techniques. Analysis of collaboration and co-citation networks revealed localized research collaboration networks, highlighting the need for enhanced international collaboration in the field of injectable hemostatic materials. Current research focuses primarily on hemostatic materials, hemostatic processes, and hemostatic mechanisms. Injectable hemostatic materials with excellent performance offer promising strategies for wound healing. This review provides a comprehensive and systematic summary of injectable hemostatic materials, offering valuable guidance for the development and clinical application of novel injectable hemostatic materials. Additionally, visualized methodology and mapping analysis are effective data mining methods that provide approaches and strategies for clear knowledge network analysis. These methods facilitate better understanding and interpretation of research dynamics in the field of injectable hemostatic materials, thereby guiding and inspiring future research.
This study compared the ankle-brachial index (ABI) with transcutaneous oxygen pressure (TcPO2) in assessing peripheral vascular disease (PVD) prevalence in 100 diabetic foot ulcer (DFU) patients. Patients were categorized into vascular or nonvascular reconstruction groups and underwent both ABI and TcPO2 measurements four times over 6 months. Predictive validity for PVD diagnosis was analysed using the area under the receiver-operating characteristic curve (AUC). The study found TcPO2 to be a superior predictor of PVD than ABI. Among the DFU patients, 51 with abnormal TcPO2 values underwent vascular reconstruction. Only TcPO2 values showed significant pretreatment differences between the groups and increased post-reconstruction. These values declined over a 6-month follow-up, whereas ABI values rose. For those with end-stage renal disease (ESRD), TcPO2 values saw a sharp decrease within 3 months. Pre-reconstruction TcPO2 was notably lower in amputation patients versus limb salvage surgery patients. In conclusion, TcPO2 is more effective than ABI for evaluating ischemic limb perfusion and revascularization necessity. It should be prioritized as the primary follow-up tool, especially for ESRD patients.
The meta-analysis aimed to assess and compare diabetic foot wound ulcer management by vacuum sealing drainage. Using dichotomous or contentious random- or fixed-effects models, the outcomes of this meta-analysis were examined, and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Twenty-three examinations from 2000 to 2023 were enrolled for the present meta-analysis, including 1928 individuals with diabetic foot ulcers. Vacuum sealing drainage had significantly lower wound healing (OR, 2.35; 95% CI, 1.79–3.08, p < 0.001), lower duration of therapy (MD, −6.19; 95% CI, −10.06 to −2.32, p = 0.002), higher wound size reduction (MD, 4.22; 95% CI, 0.87–7.56, p = 0.01) and lower complication (OR, 0.32; 95% CI, 0.13–0.80, p = 0.01) compared with standard therapy in patients with diabetic foot ulcers. The examined data revealed that vacuum sealing drainage had significantly lower wound healing, duration of therapy and complication rates, as well as higher wound size reduction, compared with standard therapy in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size.
Oral carcinoma, a prevalent malignancy of the oral cavity, often results in surgical site wounds post-resection. The therapeutic efficacy of platelet-rich fibrin (PRF) in wound healing and scar formation has garnered significant attention. This meta-analysis aimed to evaluate the role of PRF in promoting surgical site wound healing and reducing scar formation following oral carcinoma resection. A systematic search, adhering to PRISMA guidelines, was conducted across multiple databases. The primary outcomes assessed were the Landry, Turnbull and Howley (LTH) wound healing index and the Manchester scar scale (MSS). Statistical evaluations were performed using RevMan 5.4 software. Six studies were incorporated, involving 93 patients treated with PRF and 97 in the control group. For the LTH index, significant improvements in wound healing were observed in the PRF group with I 2 = 74%, (Random: SMD: 3.70, 95% CIs: 2.66 to 4.75, p < 0.01). The Manchester scar scale assessment, which included 60 PRF-treated patients and 60 controls, indicated a significant reduction in scar formation in the PRF group I 2 = 79%, (Random: SMD: 9.13, 95% CIs: 6.06 to 12.20, p < 0.01). PRF demonstrates promising therapeutic potential in enhancing surgical site wound healing and reducing scar formation post oral carcinoma resection. The application of PRF has been associated with improved wound healing metrics and diminished scar severity. However, further high-quality studies are warranted to confirm these findings.
The meta-analysis aims to evaluate and compare the sternal wound infections following internal mammary artery grafts for a coronary bypass. Examinations comparing bilateral internal mammary artery to single internal mammary artery for coronary artery bypass grafting were among the meta-analyses from various languages that met the inclusion criteria. Using dichotomous random- or fixed-effect models, the results of these investigations were examined, and the Odd Ratio (OR) with 95% confidence intervals (CIs) was computed. A total of 31 examinations from 2001 to 2023 were recruited for the current analysis including 181 503 personals with coronary artery bypass grafting. Bilateral internal mammary artery had significantly higher sternal wound infection (OR, 1.51; 95% CI, 1.37–1.68, p < 0.001), superficial sternal wound infection (OR, 1.72; 95% CI, 1.16–2.56, p = 0.007), deep sternal wound infection (OR, 1.62; 95% CI, 1.41–1.86, p < 0.001), sternal wound infection in diabetics (OR, 1.48; 95% CI, 1.16–1.90, p = 0.002), sternal wound infection in elderly (OR, 1.38; 95% CI, 1.22–1.57, p < 0.001), sternal wound infection in pedicled preparation (OR, 1.70; 95% CI, 1.30–2.23, p < 0.001) and sternal wound infection in skeletonized preparation (OR, 1.40; 95% CI, 1.09–1.81, p = 0.009) compared to single internal mammary artery in personals with coronary artery bypass grafting. Bilateral internal mammary artery grafting is linked to a higher risk of impaired wound healing, particularly in diabetic individuals, elderly, pedicled preparation, and skeletonized preparation. Nevertheless, caution should be exercised while interacting with its values since examinations were performed by different surgeons with different skills on different types of personals.
This study aims to investigate whether the current wound classifications were valid for the treatment prognosis of subjects treated for limb-threatening diabetic foot ulcers (LTDFU). A total of 1548 patients with LTDFU and infection were studied, with wounds recorded using the Wagner, Texas, PEDIS and WIfI classifications while major lower extremity amputations (LEAs) or in-hospital mortality incidences were defined as poor outcomes. Among them, 153 (9.9%) patients received major LEAs and 38 (2.5%) patients died. After adjustments, the Wagner classification and Texas stage as well as clinical factors such as comorbidity with major adverse cardiac events (MACE), being under dialysis and having serum levels of C-reactive protein (CRP) and albumin were independent factors for prognosis. For patients without dialysis, Wagner and Texas stage stood out independently for prognosis. For patients on dialysis, only levels of CRP (odds ratio [OR] = 2.2 in Wagner, OR = 2.0 in WIfI, OR = 2.2 in Texas, OR = 2.3 in PEDIS) and albumin (OR = 0.4 in four classifications) were valid predictors. The Wagner system and Texas stage were valid for predicting prognosis in treatment for LTDFUs, suggesting a role of vascular perfusion. MACE history, levels of CRP and albumin level should assist in prediction; more significantly, only levels of CRP and albumin appeared valid for those subjects undergoing dialysis.
Surgical site infections (SSIs) following ankle fracture fixation pose significant challenges in patient recovery and healthcare management. Identifying risk factors contributing to SSIs can aid in developing targeted prevention and treatment strategies. This systematic review and meta-analysis were conducted according to the PRISMA guidelines and the PICO framework. A comprehensive literature search across major databases, including PubMed, Embase, Web of Science and the Cochrane Library, was completed on September 26, 2023. The inclusion criteria encompassed peer-reviewed studies of various designs that investigated risk factors for SSIs post-ankle fracture fixation. Quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analyses assessed heterogeneity and calculated combined effect sizes using fixed- or random-effects models, depending on the heterogeneity observed. The initial search yielded 1250 articles, with seven meeting the inclusion criteria after rigorous screening and full-text review. The included studies, conducted between 2006 and 2019, predominantly utilized case–control designs. The meta-analysis identified diabetes, open fractures, smoking, age, alcohol consumption, ASA score ≥3, high BMI, contaminated incisions, fracture dislocation and heart disease as significant risk factors for postoperative SSIs. Publication bias assessment showed no significant bias across studies. The identification of key risk factors such as diabetes, open fractures, smoking, advanced age, alcohol consumption, high ASA score, elevated BMI, contaminated incisions, fracture dislocation and heart disease is essential in managing SSIs post-ankle fracture fixation. Targeted interventions addressing these risk factors are crucial to reduce the incidence of SSIs and improve overall patient outcomes.
This study was to verify whether the severity of pressure injuries (PIs) in intensive care unit (ICU) patients plays a mediating role in the relationship between severity of their illnesses and risk of death. I examined adult patients admitted to the ICUs between 1 January 2014 and 31 August 2021. The average follow-up period was 11.34 months. A total of 390 ICU patients suffered from PIs. The influences of the APACHE II score of the ICU patients on the mediating variable ‘unstageable & DTPIs vs. Stage 1&2 PIs’ and on risk of death were significant. After controlling the influence of APACHE II score on risk of death, the influences of mediating variables ‘Stage 3&4 PIs vs. Stage 1&2 PIs’ and ‘unstageable & DTPIs vs. Stage 1&2 PIs’ on risk of death were also significant. The regression coefficient of APACHE II score of the ICU patients declined after the severity of PIs was included. The Sobel test on the indirect effects also reached the level of significance. The severity of illnesses is a factor that is beyond my control, severe PIs should still be prevented to lower the risk of death.
The morphology of facial scars shows a wide variation in terms of texture and colour. To date, there are no reliable predictors of aberrant scarring. We conducted a retrospective analysis to identify factors associated with specific scar features and types. Photographs and medical records of 428 patients with facial scars were retrospectively reviewed. Patients with keloids were excluded. The mean age of the patients was 45.43 ± 23.13 years with a male-to-female ratio of 1:1.36. Atrophic scars were the most common (42.8%), followed by flat scars (38.7%) and hypertrophic scars (18.5%). Scars on the forehead were more likely to be atrophic, whereas scars on the chin/jaw and around the mouth were more likely to be hypertrophic. Hypopigmentation was significantly more common in scars located on the forehead. Redness (erythema) was significantly more common in scars located on the chin/jaw. Old scars were less likely to be erythematous, and hypertrophic. Atrophic scars were more common in younger patients. Scars caused by dermatologic conditions, such as acne, were more likely to be atrophic, whereas surgical scars had the lowest risk of being atrophic or hypertrophic. In conclusion, the location, onset, and cause of facial scars were associated with specific features of scars.
There are many debates regarding the risk factors of surgical site infection (SSI) following posterior cervical surgery in previous studies. And, till now there is no such a study to examine cervical laminoplasty surgery. From January 2011 through October 2021, a total of 405 patients who were treated with unilateral open-door laminoplasty surgeries were enrolled in this study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analysis were performed to determine the risk factors. Of the 405 patients, 20 patients had SSI. The rate of SSI found to be 4.93%. There were significant differences between groups in the thicker subcutaneous fat thickness (FT) (p < 0.001), the higher ratio of subcutaneous FT to muscle thickness (MT) (p < 0.001), the higher preoperative Japanese Orthopaedic Association (JOA) Scores (p < 0.003), the decreased preoperative serum albumin (p < 0.001), the more postoperative drainage (p < 0.05) and the longer time of draining (p < 0.001). Logistic regression analysis of these differences showed that the higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining were significantly related to SSI (p < 0.05). The higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining are identified as the independent risk factors of SSI in cervical laminoplasty. Identification of these risk factors could be useful in reducing the SSI incidence and patients counselling.
Distal tibial fracture is the most commonly seen type of fracture of the lower extremities. Both intramedullary nail fixation (INF) and plate fixation (PF) have been used to treat distal tibial fractures, but the best way to treat them is still in dispute. The purpose of this meta-analysis is to compare INF versus PF fixation with respect to the incidence of injury. For studies that have been published between inception and June 2023, a systematic review has been carried out on PubMed, Embase, Cochrane Library and Web of Scientific databases. All of the trials that looked at INF and PF-related complications were enrolled. Data from the 13 primary results were analysed with RevMan 5.3. The meta-analyses comprised 13 randomized controlled trials (RCTs). INF indicates that there is a tendency for patients with distal tibia fractures to reduce the risk of operative site infection (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.40, 3.13; p = 0.0003) after surgery compared with PF. INF resulted in a reduction in total wound complications (OR, 14.20; 95% CI, 1.81, 111.57; p = 0.01) but shortened operation time (mean difference, 13.03; 95% CI, 2.08, 23.99; p = 0.02). In view of these findings, INF seems to be a preferred method of surgery for the treatment of distal tibial fractures with respect to the reduction of post-operative wound complications.
Light-emitting diode (LED) lights produce a variety of wavelengths that have demonstrable efficacy in therapeutic and aesthetic fields. However, a repetitive treatment regimen is required to produce treatment outcomes, which has created a need for portable LED devices. In this study, we aimed to develop a portable therapeutic LED device and investigate its healing effect on excisional wounds in a rat model. The 35 × 35 mm-sized LED device was used on a total of 30 rats with full-thickness wounds that were divided into two groups depending on radiation intensity (11.1 and 22.2 mW/cm2 group). LED irradiation was performed every 24 h for 30 min, over 14 days, in direct contact with the wound. Percentage wound closure was measured by photographic quantification and was assessed histologically using haematoxylin and eosin (H&E) and Masson's Trichrome staining, and immunohistochemistry for Vascular endothelial growth factor (VEGF) and CD31. Percentage wound closure was significantly higher in 22.2 mW/cm2 irradiated wounds than that in the control wounds on days 7 and 10. The area of collagen deposition was remarkably larger in 22.2 mW/cm2 irradiated wounds than that in the control, with more horizontally organized fibres. CD31 immunostaining confirmed a significant increase in the number of microvessels in 22.2 mW/cm2 irradiated wounds than that in the control wounds, although there was no difference in VEGF immunostaining. Our novel portable LED device accelerates wound healing in a rat model, raising the possibility that portable LED devices can combine convenience with accessibility to play an innovative role in wound dressing.
Dexmedetomidine has been demonstrated to be effective in the management of pain in total knee replacement (TKA). Nevertheless, a combination of a local anaesthetic and a dose of dexmedetomidine might be a better choice for post-operative pain management of TKA. The aim of this research is to determine if the combination of a local anaesthetic with dexmedetomidine during a knee replacement operation can decrease the post-operation pain. Furthermore, the effectiveness and security of dexmedetomidine combined with topical anaesthetic were evaluated for the management of post-operative TKA. Based on the research results, the author made a research on the basis of four big databases. The Cochrane Handbook on Intervention Systems Evaluation has also evaluated the quality of the literature. Seven randomized controlled trials have been established from this. It was found that the combination of local anaesthesia and dexmedetomidine had a greater effect on postoperative pain in 4 h (mean difference [MD], −0.9; 95% CI, −1.71, −0.09; p = 0.03), 8 h (MD, −0.52; 95% CI, −0.66, −0.38; p < 0.0001), 12 h (MD, −0.72; 95% CI, −1.04, −0.40; p < 0.0001), 24 h (MD, −0.49; 95% CI, −0.83, −0.14; p = 0.006), 48 h (MD, −0.51; 95% CI, −0.92, −0.11; p = 0.01). Nevertheless, because of the limited number of randomized controlled trials covered by this meta-analysis, caution should be exercised with regard to data treatment. More high quality research will be required to confirm the results.
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