Conectar
Faecal contamination of sacral pressure ulcers occurs frequently, so, theoretically, faecal diversion using colostomies is a useful procedure. We retrospectively analysed the data of adult patients for whom colostomies were created to enhance wound healing and compared patients with sacral pressure ulcers who received colostomies and those who did not during the same period. Patients' characteristics analysed included age, gender, comorbidities, WBC count, serum CRP level and microbial profile (before creating colostomy). Additionally, we examined whether the wound was closed, the recurrence rate after wound closure, and mortality outcomes. Regression analysis indicated that colostomy creation was associated with fewer species of gut microbiota cultured and lower rates of wound dehiscence after closure; no association was found between colostomy and mortality. Colostomies help promote wound healing of sacral pressure ulcers after closure by eradicating wound infection, and do not increase patients' mortality rates.
We aimed to compare the scar quality and recovery rate of joint activity for patients with joint-involved burn injuries receiving either artificial dermis (AD) with split-thickness skin graft (STSG) or full-thickness skin graft (FTSG) for reconstruction. The primary outcomes were %skin graft (SG) take. Secondary outcomes included complications such as the infection rate and donor site morbidity, 12-month scar quality evaluated using the Vancouver scar scale (VSS), recovery rate of joint activity and incidence of scar contracture requiring further revision. Twenty-eight patients between 1 August 2021, and 1 August 2023, were enrolled. Twelve patients received AD-STSG while the other 16 patients underwent FTSG for reconstruction. The median %SG take was 95.0% (interquartile range [IQR] 6.3%) and 96.0% (IQR 10.0%) for the AD-STSG and FTSG groups (p = 0.71). The FTSG group had significantly better 12-month scar quality (median VSS 4.0 [IQR 1.3] vs. 6.0 [IQR1.5], p < 0.01) and recovery rate of joint activity (median 82.5% [IQT 15.0%] vs. 70.0% [IQR 7.5%], p < 0.01) compared with AD-STSG group. However, two patients in the FTSG group (12.5%) suffered partial wound dehiscence of the donor site, whereas no patients experienced donor site morbidity in the AD-STSG group (p = 0.49). The incidence of scar contracture requiring further revision was 25.0% (3/12) in the AD-STSG group and 12.5% (2/16) in the FTSG group (p = 0.62). In conclusion, AD-STSG could be an alternative treatment over FTSG for larger joint-involved burn wounds (>200 cm2) owing to lesser donor site morbidity with admissible cosmetic outcomes and functional recovery.
We evaluated the primary application of crushed prednisolone combined with hydrocolloid powder for clinically diagnosed peristomal pyoderma gangrenosum (PPG). We present our data on this cohort and follow-up of our previous patients. Of the 23 patients who were commenced on this regime, 18 healed (78%). Twenty-two patients commenced on this regime as the primary treatment for their PPG, and for one, it was a rescue remedy after failed conventional therapy. Four patients with significant medical comorbidities failed to heal and one had their stomal reversal surgery before being fully healed. The proposed treatment regime for PPG is demonstrated to be effective, inexpensive and able to be managed in the patient's usual home environment. In vitro drug release analysis was undertaken, and data are presented to provide further insights into the efficacy of this regime.
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