Diabetes is a growing public health problem that can lead to serious complications for the pa-tient such as foot ulcers and amputations. For affected patients the foot ulcers causes suffer-ing, pain and impaired health. The foot ulcers also contribute to major costs to the society and affects healthcare resources hard. A large part of the district nurse's work consists of wound care. Therefore it is important that the district nurse possess adequate knowledge of wound dressings to promote wound healing and thereby shorten the wound healing time. The aim of the study was to examine the wound healing time due to treatment with antiseptic or non-antiseptic dressings in elderly patients with diabetes and foot ulcers. The method used was a quantitative register study with a retrospective and descriptive design. Patients included in the study were 241 men and women aged ≥ 65 years with diabetes and healed foot ulcers. Men were represented by 68 % (n=164) and women by 32 % (n=77). The results showed no signif-icant difference in wound healing time due to treatment with antiseptic or non-antiseptic dressings. The most common non-antiseptic dressing used was polyurethane foam and the most common antiseptic dressing used was silver dressing. More research to compare wound healing time between non-antiseptic and antiseptic dressings in elderly patients with diabetes and foot ulcers are needed. District nurses need to increase their knowledge within different dressings and its positive and negative effects.

Submitted in partial compliance with the requirements of the Master’s Degree in Technology: Homoeopathy, Department of Homeopathy, Durban University of Technology, Durban, South Africa, 2016. / Introduction This research study investigated the efficacy of a homoeopathic protocol in the post-surgical wound management of medical male circumcision (MMC) in the KwaZulu-Natal region. The study had 30 male participants from 10 of the 11 district municipalities of the KwaZulu-Natal province. The study consultations took place at the Durban University of Technology Health Sciences Clinic. Aim of the study The aim of the study was to determine the efficacy of a topical application of a homoeopathic protocol using; Calendula officinalis (mother tincture (M.T.)), Hypericum perforatum (M.T.) and Delphinum staphysagria 30CH (orally) as an adjunct to the standard care of the post-surgical effects of circumcision and to assess the wounds post-surgically in terms of time taken to heal and associated signs and symptoms. Methodology The data for this study was collected from 30 male participants who had undergone MMC from various hospitals within KwaZulu-Natal. The participants were aged between 18 to 30 years. All participants underwent a medical examination and were given a pain rating scale and a pain and sleep diary. They were instructed to keep a daily record using the data collection tools mentioned above for the study period of six weeks. Descriptive statistics were employed in the form of tables and graphs. The data analysis methods used in the study are: independent samples t-test and the non-parametric Spearman’s Correlation test. Results Group statistics in relation to ‘time to heal’ showed a statistically significant reduction in the time taken for the group on the homoeopathic protocol. Analysis of ‘time to heal’ by group shows that on average, Group 1 (active group: homoeopathic protocol + standard care) (M = 31.4, SD = 7.49) healed in a significantly shorter time than Group 2 (control group: standard care) (M = 38.6667, SD = 1.99), t (28) = -2.617, p=.014. There was no other statistical significance noted except for the results of the Spearman’s rho, where table 4.8 shows there is a significant positive correlation between average quality sleep until healing and the proportion of days across healing NOT feeling refreshed (rho = .676, p<.0005). / M

published_or_final_version / abstract / Dentistry / Master / Master of Dental Surgery

No description available.

A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirement for the degree of Master of Science in Medicine in the branch of Plastic and Reconstructive Surgery / Introduction: Chronic wounds are commonly associated with biofilms and exaggerated inflammation resulting in non-healing: “Bioflammacides” are a recently described group of compounds used in the treatment of chronic and recalcitrant wounds.“Bioflammacides” target biofilms and inflammation aiding a change in the wound environment enabling cutaneous wound healing. Aim: This study aims to evaluate the effects of two targeted “active” topical dressings: a bioflammacide gel (Flavonix®), and a nanocrystalline silver sheet (Acticoat®), on the wound healing events in an in vivo rat chronic wound model. 
Methods: A chronic wound model was created in 128 Sprague-Dawley rats, modifying previously described methods by combining burn and excisional wounds. Wounds were inoculated with a bacteria broth (Pseudomonas
aeruginosa 
and
 Staphylococcus 
aureus) on POD 7; Flavonix®, Acticoat® 
and a negative control. An additional non-inoculated control group (no bacterial or other broth) was included. Eight animals were assigned to each group at each time point.The study was conducted over 21 days and the categorical variables assessed were epithelial gap, cellular proliferation at the wound edge at days 10,14 and 21 semi-quantitative culture for bacterial load at Days 10 and 21: Both Acticoat® and Flavonix®
showed improved wound healing compared to the control group. Epithelial gap distances were significantly different between the Acticoat® group and the negative control group at Day 21 (p
=
0.0350) (8mm
vs.
12.8mm).
Cellular profileration profiles were most modulated in the Flavonix®
treated group at Day 21 in iii comparison to the negative control group (p=0.013) (1.45
vs.
8.65). Bacterial load based on semi-quantitative culture showed significant differences in Pseudomonas aeruginosa counts at POS 21 with all treatment groups except Acticoat® but failed to show a significant change with the Staphylococcus aureus counts in any groups Conclusion: Flavonix® and Acticoat®
both demonstrated similar effects on wound healing events in our chronic wound model with significant differences being noted between the treated groups and negative controls n epithelial gap reduction and cellular proliferation profiles. Bacterial burden in the form of a mixed species biofilm was not convincingly altered by any of the treatment groups, but this did not alter the wound in its ability to close suggesting that inflammatory balance plays an important role as a common pathway in cutaneous healing

O cuidado com as áreas doadoras de enxertos de pele merece constante atenção, visto que desencadeia desconforto por dor e restrição de movimentos. Existem evidências de que a estimulação elétrica pode acelerar a cicatrização de feridas e produzir analgesia, e que diferentes parâmetros físicos podem interferir nas respostas apresentadas. O objetivo do estudo foi avaliar o efeito da polaridade da corrente na cicatrização e na dor. Para tanto foram comparados os efeitos da estimulação elétrica de alta voltagem (EAV), polarizada, e a estimulação elétrica nervosa transcutânea (ENT), despolarizada, no tratamento das áreas doadoras de pacientes queimados. Para tanto, foram avaliados 48 voluntários do sexo masculino randomizados em três grupos: submetidos à estimulação elétrica de alta voltagem (GEAV), média idade de 34,2(±9,8) anos, n=17; submetidos à estimulação elétrica nervosa transcutânea (GENT), com 34(±9,5) anos, n= 16; e não submetido à estimulação elétrica ou grupo controle (GC) média de idade 35(±9,5 anos), n= 15. Os procedimentos terapêuticos foram aplicados nas extremidades da área doadora, no primeiro pós-operatório, até a epitelização completa. As variáveis avaliadas foram avaliação clínica, o tempo (dias) de epitelização, estimado pelo desprendimento do curativo primário sobre a lesão, avaliação da dor pela escala numérica de dor, a temperatura cutânea pela termografia infravermelha, qualidade da cicatriz (book de fotos, escala ® Vancouver, software Image J ). Após a análise dos dados, foi aplicado o teste de Shapiro-Wilk, em seguida o comportamento pré e pós-intervenção intragrupo foi aplicado o teste Wilcoxon. Para comparação entre os grupos foi efetuado teste de Kruskal-Wallis seguido de post-hoc de Dunn, em todos os casos foi utilizado o nível de significância de 5% (p<0,05). Os achados apontam que o tempo de desprendimento do curativo Rayon das áreas doadoras foi significativamente menor para GEAV apresentando (p<0,033). Houve redução significativa da dor (p<0,05) para o GEAV e para o GENT, quando comparado ao GC. A quantidade relacionada a solicitação de analgésicos foi reduzida para os grupos estimulados, com diferença significativa do GEAV versus GC (p<0,002) e GENT versus GC (p<0,001). Não houve diferença significativa na temperatura cutânea entre os grupos. Não houve diferença significativa no escore final da escala Vancouver e nem quantidade de crostas entre os grupos. A polaridade da corrente pode ter influenciado no tempo de epitelização, porém não interferiu na dor e na qualidade da área doadora. / The cares with donor areas of skin grafts deserve constant attention, since it triggers discomfort due to pain and movement restriction. There are evidences that electric stimulation may accelerate wound healing and produce pain relief. The objective of this study was to evaluate the effect of electric current polarity on the healing and pain. Therefore, the effects of stimulation on high voltage pulsed current (HVPC) and nervous transcutaneous stimulation (TENS) were compared in the treatment of donor areas of burns victims. Therefore, 48 volunteers of the male sex were randomized between three groups: submitted to high voltage pulsed current stimulation (GHVPC), with 34.2 (± 9.8) years, n=17; submitted to nervous transcutaneous stimulation (GTENS), with 34 (±9.5) years, n=16; and nonsubmitted to stimulation group, or control group (GC), average age of 35 (± 9,5) years, n=15. The therapeutic procedures were applied on the edges of the donor area, at the first postoperative, until complete healing. The evaluated variables were ephitelization time (days), estimated by the unfastening of the primary curative on the wound, evaluation of pain by numerical scale of pain, skin temperature by infrared thermography, scar quality (photo book, Vancouver scale and Image J® software). After data analysis, the Shapiro-Wilk test was applied, and the Wilcoxon test was applied to the before and after intervention. Kruskal-Wallis test followed by Dunn post-hoc was used to compare the groups. In all cases, the significance level of 5% (p<0.05) was used. The findings indicate that the time of release of the Rayon dressing from the donor sites was significantly reduced for GEAV (p <0.033). A reduction of pain relief was significant (p<0.05) for the GEAV and for the GENT, when compared to the GC. Amount the number of solitation for analgesic drugs was decreased for the groups stimulated with significant difference of the GEAV verse GC (p<0.002) and GENT verse GC (p <0.001). Change in cutaneous temperature was not significant between groups. There was no difference significant in score of Vancouver scale and in the number of crusts in the groups. The polarity of the current might have influenced the healing time, however not the pain nor the quality of the donor site.

Orientador: Rosemary Adriana Chierici Marcantonio / Banca: Luís Carlos Spolidório / Banca: Letícia Theodoro / Resumo: O laser cirúrgico de Er,Cr:YSGG (érbio, impregnado por cromo: ítrio, scandio, gálio, garnet) tem sido utilizado no tratamento cirúrgico periodontal, embora poucos estudos histológicos sejam encontrados na literatura. O objetivo deste estudo foi comparar histologicamente a utilização do laser de Er-Cr: YSGG em tecido mole e ósseo em relação à técnicas cirúrgicas convencionais. Foram utilizados 20 ratos, divididos aleatoriamente em 3, 7, 15 e 30 dias, com 5 animais por período. Em cada animal foram realizados os procedimentos (P) nas regiões de dorso e calota, respectivamente: PI) Incisão no dorso com bisturi de lâmina no 15; PII) Incisão no dorso com Laser Er,Cr:YSGG (150mJ de energia, 2.0W de potência), PIII) Defeito ósseo na calota com fresa diamantada esférica em baixa rotação sob refrigeração; PIV) Defeito ósseo na calota com Laser Er,Cr:YSGG (150mJ de energia, 3.0W de potência). Os procedimentos foram randomicamente distribuídos entre lado direito e esquerdo de cada animal. A análise histológica foi avaliada de acordo com a intensidade da resposta inflamatória, presença de áreas necróticas e processo de regeneração tecidual. A análise histométrica dos defeitos ósseos foi confirmada pelo teste estatístico paramétrico ANOVA e complementado pelo teste Bonferroni. Para os procedimentos na região de dorso pode-se observar que nos períodos iniciais houve melhor resposta histológica para o PI, embora no período de 30 dias os procedimentos I e II apresentavam resultados semelhantes. A análise histométrica confirmou uma maior formação óssea na calota com o uso do laser de Er,Cr:YSGG aos 30 dias (79.96±10.30%) em relação ao procedimento com fresa aos 15 (62.05±4.84%) e 30 dias (58.23±9.99%). Na análise histológica em tecido duro, observou-se necrose óssea superficial... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The Er,Cr:YSGG (Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet) surgical laser has been demonstrated as an useful instrument on dentistry since its wavelength (2,78μm) is strongly absorbed by water and hydroxyapatite. The aim of this study was to histologically compare the in vivo healing process that occurs in soft and hard tissues incisions made by Er,Cr:YSGG laser or conventional periodontal surgeries techniques. Twenty rats were used and divided into 4 groups of 5 different periods. On each animal was performed the following procedures (P) in the soft and hard tissue: PI) dorsum incision with scalpel number 15; PII) dorsum irradiation with 2.0W Er,Cr:YSGG laser; PIII) skull defect made by a diamond spherical bur with water refrigeration; PIV) skull defect created by 3.0W Er,Cr:YSGG laser. The procedures were randomly distributed into right and left side of each animal. After sacrifice 3, 7, 15 and 30 days post-surgery the histological examinations were performed. Histometric analysis of the bone defects was confirmed by the parametric statistic test ANOVA and complemented by the Bonferroni test. In the first periods, the histological findings in the dorsum were better in the PI group, although by day 30 PI and PII showed similar healing response. The procedures in the skull revealed superficial necrosis in all periods in the PIV group, although this group had much more evidence of bone formation at day 30 than PIII. The histometric analysis also confirmed a better tissue response for laser application in the skull than conventional techniques, with 79.96±10.30% bone formation by day 30 with Er,Cr:YSGG laser and 62.05±4.84% by day 15 and 58.23±9.99% by day 30 with bur. The utilization of Er,Cr:YSGG laser in soft tissue caused a minimal delay in the healing initial periods but the... (Complete abstract, click electronic access below) / Mestre

Orientador: Carlos Alberto Hussni / Coorientador: Carlos Roberto Teixeira / Banca: Marcos Jun Watanabe / Banca: Rogério Loesch Zacariotti / Resumo: As lesões cutâneas em répteis possuem diferentes causas e decorrem em cicatrizes e disecdise, predispondo a dermatites futuras, indesejáveis, podendo determinar a retirada do animal da exposição e levar ao abandono destes quando criados domesticamente. Com o objetivo de comparar diferentes produtos tópicos e procedimentos na busca da cicatrização da pele, foram utilizados doze lagartos adultos, machos, da espécie Tupinambis merianae. Em cada animal foram produzidas quatro lesões circulares na pele do dorso, dispostas em quadrilátero. Compostos três grupos de quatro animais, o Grupo 1 compreende o comparativo entre solução fisiológica e policresuleno; no Grupo 2, tintura de iodo a 2% e o não tratamento, considerado como controle; o Grupo 3 clorexidine e o enxerto autólogo de pele. As lesões do lado direito destinaram-se à análise macroscópica diária, com planimetria a cada sete dias e observação do tempo total de cicatrização. Das lesões esquerdas, foram coletadas amostras para biópsias e conseqüentes exames histopatológicos, a cada sete dias. Os lagartos apresentaram processo cicatricial semelhante aos mamíferos, notoriamente mais lento, entretanto. O enxerto não se mostrou vantajoso neste experimento, sofrendo necrose nos quatro animais. O policresuleno destacou-se por impermeabilizar a ferida em 4 dias, enquanto que os demais grupos obtiveram o mesmo efeito entre 8 e 12 dias. As lesões se mostraram completamente epitelizadas entre 40 e 53 dias, não havendo diferença entre os grupos quanto ao tempo total de cicatrização, retração tecidual e aparência da cicatriz / Abstract: Skin lesions in reptiles are caused by different factors and result in scarring and dysecdysis, predisposing to dermatitis. It may let the animal out of exhibitions or lead to the abandonment when created as pets. In order to compare different topical products and procedures for skin repair, twelve adult male tegu lizards (Tupinambis merianae) were used. Four circular square arranged skin lesions were created at the dorsum of each animal. Animals were divided in three groups (four animals/group) and each group was treated with two medications. In Group 1, animals were treated with saline and policresulen, in Group 2, with tincture of iodine and untreated (control group), and in Group 3, chlorhexidine and autologous skin graft. The lesions on the right side were macroscopicaly evaluated daily and the planimetry was realized every seven days. The left lesions were sampled every seven days for histopathological examination. The lizards showed healing process similar to mammals; however, it was notably slower. In this experiment, the skin graft showed no advantage, undergoing necrosis in all four animals. Policresulen closed the wounds in four days, while other groups had the same effect between 8 and 12 days. The lesions were completely epithelialized between 40 and 53 days, with no difference between groups regarding the total time of healing, tissue retraction and appearance of the scar / Mestre

Orientador: Alexandre Lima de Andrade / Coorientador: Suely Regina Mogami Bomfim / Banca: Paulo César Ciarlini / Banca: Regina Kiomi Takahira / Resumo:Biotécnicas como o plasma rico em plaquetas (PRP) vêm sendo amplamente utilizadas na reparação e regeneração teciduais, objetivando acelerar a cicatrização de feridas. O potencial do PRP para diminuir o tempo de recuperação dos traumas depende da concentração plaquetária, de sua função, e de seus fatores de crescimento. A escassez de protocolos para obtenção do PRP em cães, aliada às variações dos mesmos, dificulta o emprego desta biotécnica. O objetivo deste estudo foi testar três diferentes protocolos para obtenção do PRP e verificar sua eficácia na espécie canina. Foram colhidos 15 mL de sangue de 20 cães sadios, sendo as amostras submetidas aos protocolos para obtenção do PRP segundo Anitua, Sonnleitner e Vendramin. As concentrações médias de plaquetas proporcionadas por cada protocolo foram de 247%, 351% e 439%, respectivamente. O protocolo de Vendramin se sobressaiu em relação aos demais, com melhor concentração plaquetária no PRP, e apresentou boa reprodutibilidade / Abstract:Biotechnology as the platelet-rich plasma (PRP) have been widely used in tissue repair, aiming to accelerate the healing of wounds. The potencial of PRP to reduce the recovery time of injuries depends on the concentration of platelets, its function and their growth factors. The lack of protocols for obtaining PRP in dogs, combined with variations of the same, hinders the use of biotech. The aim of this study was to test three different protocols for obtaining PRP and verify effectiveness in dogs. 15 mL were collected blood of 20 healthy dogs, and the samples were subjected to protocols to obtain PRP second Anitua, Sonnleitner and Vendramin. The mean concentrations of each protocol provided by platelets were 247%, 351% and 439% respectively. The protocol Vendramin stood in relation to other, better platelet count in PRP, and has good reproducibility / Mestre

Orientador: Andrigo Barboza De Nardi / Banca: Mônica Vicky Bahr Arias / Banca: Geórgia Modé Magalhães / Resumo: A enxertia cutânea é uma técnica cirúrgica simples e bastante útil para o reparo de feridas, principalmente nas quais existe dificuldade da aplicação do fechamento primário, ou de outras técnicas reconstrutivas. Entretanto, para a sobrevivência do enxerto, é necessário que o leito da ferida esteja saudável e com a presença de um tecido de granulação exuberante. O objetivo deste trabalho foi avaliar a aplicação da membrana amniótica e da laserterapia como potenciais estimulantes da cicatrização em enxertos aplicados em feridas sem tecido de granulação. Para isso, foram utilizados 42 coelhos divididos em quatro grupos de tratamento, grupo controle (GC), grupo membrana (GM), grupo laser (GL) e grupo membrana e laser (GML), submetidos a avaliações macro e microscópicas dos enxertos. Na avaliação macroscópica foi possível notar que os pacientes dos grupos onde a membrana amniótica foi utilizada com o intuito de estimular a reepitelização (GM e GML) apresentaram acentuada reação inflamatória, falha de integração do enxerto e consequente necrose do mesmo. Já os pacientes do grupo GL apresentaram melhor aspecto do enxerto no último dia de avaliação. Na análise microscópica, observou-se intensa integração do enxerto à derme, reepitelização acentuada e escassas células inflamatórias no local do enxerto nos pacientes do grupo GL. O oposto foi observado nos pacientes dos grupos GM e GML, onde aparentemente a presença da membrana amniótica induziu resposta inflamatória bastante consistente na região adjacente à membrana e ao enxerto, resultando em rejeição da membrana. Por último, a formação de colágeno não se correlaciona com outros fatores como inflamação e necrose, em nenhum dos grupos de tratamento. Desta forma, é possível afirmar que a laserterapia mostrou ser efetiva, contribuindo para o processo cicatricial e integração do enxerto. Já a membrana amniótica canina não deve ser... / Abstract: Skin grafting is a simple surgical technique and useful to repair wounds, especially those where there is a difficulty to apply primary closure skin or other reconstructive techniques. However, for the graft survival it is necessary that the healthy wound bed and the presence of an exuberant granulation tissue. This study aimed to evaluate the application of amniotic membrane and laser therapy as potential stimulating healing in grafts applied in wounds without granulation tissue. For this, we used 42 rabbits divided into four treatment groups, control group (CG), membrane group (MG), laser group (LG) and membrane and laser group (MLG), submitted to macroscopic and microscopic evaluation. The macroscopic examination was possible to note that the patients of the groups where the amniotic membrane was used in order to stimulate re-epithelialization (MG and MLG) presented evidences associated with severe inflammatory reaction, graft integration failure and consequent necrosis. In LG patients apparently had the best aspect of the graft in the last valuation date. On the microscopic examination, there was intense integration of the graft to the dermis, high reepithelialization level and scarce inflammatory cells in the graft site of LG group patients. The opposite was observed in patients in the MG and MLG groups, where apparently the presence of amniotic membrane seems to have induced very consistent inflammatory response in the region adjacent to the membrane and the graft, evincing that there was a rejection of the membrane. Finally, the collagen formation does not correlated with other factors such as inflammation and necrosis in any of the treatment groups. We can conclude that laser therapy was effective, contributing to the healing process and integration of the graft. Thus, the canine amniotic membrane should not be used for this purpose because it causes intense inflammatory reaction besides to avoid graft nutrition / Mestre