Conectar
This study aims to evaluate the effectiveness of a rotating-leg prepper (intervention) compared with a rolled gauze bandage (control) in reducing pressure injury and preventing surgical site infection in the legs of patients undergoing heart surgery. The paired-matched, open, randomised controlled trial was conducted from September 2022 to July 2024. The participants were composed of the patient and the staff groups. Sixty patients were paired-matched to the intervention and control groups. Before painting the resting area with an antiseptic, the ankle presented non-blanchable erythema, which was recorded as a pressure injury. The intervention group showed significantly lower pressure injury (0% vs. 76.6%, p = 0.001) than the control group, with a relative risk of 5.29 (95% CI: 2.71–10.30). Both groups exhibited no significant difference in surgical site infection. However, the relative risk of surgical site infection in the control group was 2.03 (95% CI: 1.57–2.64). Thirty staff participants were purposively sampled to evaluate the effects of both leg lifting methods and assess their satisfaction with the leg prepper. The overall satisfaction with the rotating-leg prepper was 4.87 ± 0.22. Rotating-leg preppers can reduce pressure injury and prevent surgical site infections in patients' legs during heart surgery.
Topical keloid therapy is performed with triamcinolone acetonide (TA) intralesional injection. However, the recurrence rate is high with various side effects. Mesenchymal stem cells (MSCs) have high proliferative abilities and reduce the activity and proliferation of fibroblast cells in keloids. To overcome the costs and limitations, conditioned medium (CM) is used. This study aims to evaluate feasibility of intralesional injection of umbilical cord MSC (UC-MSC) and conditioned medium (UC-CM) compared to TA for keloid therapy. Twenty-four patients with keloids who met the inclusion criteria were included, randomized into three treatment groups and then got assessed for the sociodemographic data, keloid volume, histopathology (type 1:3 collagen ratio), interleukin-10 (IL-10) levels and Patient and Observer Scar Assessment Scale (POSAS) score during visits. Largest volume regression occurred in the UC-MSC group, followed by UC-CM and then the TA group (UC-MSC: 45.32% ± 2.61%; UC-CM: 43.61% ± 3.67%; TA: 28.34% ± 3.81%; p = 0.003). Similar pattern was also observed in increase in IL-10 levels, the decrease in POSAS scores and the reduction of type 1:3 collagen ratio. Hence, UC-MSC and UC-CM are promisingly more effective than TA for keloid therapy, showcasing their superiority in reducing keloid volume, symptoms and type 1:3 collagen ratio, as well as increasing the levels of IL-10.
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