SlideShare a Scribd company logo
Negatively Charged Microspheres
Technology for the Treatment of Post
Aesthetic Surgery Complications
Josef Haik MD MPH, Eyal Winkler MD, Nimrod Farber
MD, Moti Harats MD, Oren Weissman MD
Department of Plastic and Reconstructive Surgery
and The Burn Unit, Sheba Medical Center
ISRAEL
Background
• Complications following aesthetic procedures such as
lower T-junction wound dehiscence following breast
reduction surgery, or flap necrosis following a facelift
procedure are vexing and grievous complications both to
the patient and the surgeon.
• Treatment modalities that can actively expedite wound
healing and re-epithelialization rates are highly craved.
• Objectives - To assess wound healing and re-
epithelialization rates of open wounds due to dehiscence
following breast reduction surgery or flap necrosis
following a facelift procedure.
Methods
• Eight patients with wounds of the aforementioned
types (5 breast reduction patients and 3 facelift
patients) were treated with daily dressing with NCM
soaked dressings.
• Wound closure rates were documented daily.
Results
• Treatment duration averaged 10 days in the facelift
cases and 33 days for breast cases.
• Wounds showed both accelerated granulation
tissue formation, and re-epithelialization rates.
• Average wound epithelialization rate was 1.9
millimeters per day for breast cases and 1
millimeters per day for the facelift cases.
• In these cases, NCM treatment helped patients
avoid additional surgery such as skin grafting. No
complications or side effects were encountered.
Patient’s Results
• Female, 29 year old
• Wound etiology: Post bilateral breast reduction, postoperative wound dehiscence
• Wound duration: 29 days
• Previous treatment: Povidone iodine soaked dressings, AG hydrofiber dressings
Prior to treatment Day 5 of treatment Day 12 of treatment Day 24 of treatment
Patient’s Results
• Female, 52 year old
• Wound etiology: Post bilateral breast reduction, postoperative wound dehiscense
• Wound duration: 19 days
• Previous treatment: Silver sulfadiazine, AG hydrofiber dressings
Prior to treatment Day 5 of treatment Day 10 of treatment Day 17 of treatment
Patient’s Results
• Female, 31 year old
• Wound etiology: Post unilateral facelift due to regressed hemangioma,
postoperative flap necrosis
• Wound duration: 32 days
• Previous treatment: Silver sulfadiazine, surgical debridement, AG hydrofiber
dressings
Prior to treatment 1 Week of treatment 2 Weeks of treatment
Discussion
• CPM may offer a new and efficacious way to expedite
the healing of open wounds of various etiologies,
including resistant wounds that failed to heal despite
deploying a multitude of treatment modalities including
surgery.
• CPM seems to expedite both the formation of
granulation tissue (including over bones, cartilages
and tendons) as well as epithelialization rates.
• Further research with larger patient volumes are still
needed to verify these findings.

More Related Content

Viewers also liked

Summer Research Poster 2014 V.3.0
Summer Research Poster 2014 V.3.0Summer Research Poster 2014 V.3.0
Summer Research Poster 2014 V.3.0Ben Peterson
 
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
Jeff Fried
 
Examen1
Examen1Examen1
Le Bulldog, agence de communication
Le Bulldog, agence de communicationLe Bulldog, agence de communication
Le Bulldog, agence de communication
lebulldog
 
Moodle
MoodleMoodle
Tipos de imágenes y formatos
Tipos de imágenes y formatosTipos de imágenes y formatos
Tipos de imágenes y formatos
david leandro millan benavides
 
Share point 2013 new and improved
Share point 2013 new and improvedShare point 2013 new and improved
Share point 2013 new and improved
Eric Shupps
 
Survey on amazon
Survey on amazonSurvey on amazon
Survey on amazon
saif ahamad
 
Suraj project
Suraj projectSuraj project
Suraj project
Suraj Kapri
 
Fisiologia de la deshidratación
Fisiologia de la deshidratación   Fisiologia de la deshidratación
Fisiologia de la deshidratación
Christian Dzul
 
Social crm
Social crm Social crm
Social crm
Oscar Russo
 
Rev Your Engines - SharePoint Performance Best Practices
Rev Your Engines - SharePoint Performance Best PracticesRev Your Engines - SharePoint Performance Best Practices
Rev Your Engines - SharePoint Performance Best Practices
Eric Shupps
 
Gdpr - L'approccio aubay al mascheramento dei dati
Gdpr -  L'approccio aubay al mascheramento dei datiGdpr -  L'approccio aubay al mascheramento dei dati
Gdpr - L'approccio aubay al mascheramento dei dati
Oscar Russo
 
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
Eric Shupps
 
Regulament sesiune referate
Regulament sesiune referateRegulament sesiune referate
Regulament sesiune referate
Cimpeanemese
 

Viewers also liked (15)

Summer Research Poster 2014 V.3.0
Summer Research Poster 2014 V.3.0Summer Research Poster 2014 V.3.0
Summer Research Poster 2014 V.3.0
 
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
Succeeding with Hybrid SharePoint (includes new Cloud SSA material)
 
Examen1
Examen1Examen1
Examen1
 
Le Bulldog, agence de communication
Le Bulldog, agence de communicationLe Bulldog, agence de communication
Le Bulldog, agence de communication
 
Moodle
MoodleMoodle
Moodle
 
Tipos de imágenes y formatos
Tipos de imágenes y formatosTipos de imágenes y formatos
Tipos de imágenes y formatos
 
Share point 2013 new and improved
Share point 2013 new and improvedShare point 2013 new and improved
Share point 2013 new and improved
 
Survey on amazon
Survey on amazonSurvey on amazon
Survey on amazon
 
Suraj project
Suraj projectSuraj project
Suraj project
 
Fisiologia de la deshidratación
Fisiologia de la deshidratación   Fisiologia de la deshidratación
Fisiologia de la deshidratación
 
Social crm
Social crm Social crm
Social crm
 
Rev Your Engines - SharePoint Performance Best Practices
Rev Your Engines - SharePoint Performance Best PracticesRev Your Engines - SharePoint Performance Best Practices
Rev Your Engines - SharePoint Performance Best Practices
 
Gdpr - L'approccio aubay al mascheramento dei dati
Gdpr -  L'approccio aubay al mascheramento dei datiGdpr -  L'approccio aubay al mascheramento dei dati
Gdpr - L'approccio aubay al mascheramento dei dati
 
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
From Zero to Hero: A Real World Guide to Building High Availability SharePoin...
 
Regulament sesiune referate
Regulament sesiune referateRegulament sesiune referate
Regulament sesiune referate
 

Similar to EWMA 2013 - Ep555 - Negatively Charged Microspheres- (NCM) Technology for The Treatment of Post Aesthetic Surgery Complications

Surgical treatment of pilonidal disease
Surgical treatment of pilonidal diseaseSurgical treatment of pilonidal disease
Surgical treatment of pilonidal disease
MohamedTag14
 
day care surgery.pptx 1st year resident##
day care surgery.pptx 1st year resident##day care surgery.pptx 1st year resident##
day care surgery.pptx 1st year resident##
jamesshah9
 
Introduction to Perioperative Course
Introduction to Perioperative CourseIntroduction to Perioperative Course
Introduction to Perioperative Course
Mohamed M. Abdilahi
 
Introduction to Perioperative Course
Introduction to Perioperative  CourseIntroduction to Perioperative  Course
Introduction to Perioperative Course
Mohamed M. Abdilahi
 
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
EWMA
 
ROHIT HEMORRHOIDECTOMY JOURNAL.pptx
ROHIT HEMORRHOIDECTOMY JOURNAL.pptxROHIT HEMORRHOIDECTOMY JOURNAL.pptx
ROHIT HEMORRHOIDECTOMY JOURNAL.pptx
drpnkj
 
Day care surgery by manjusb
Day care surgery by manjusbDay care surgery by manjusb
Day care surgery by manjusb
manjusb61
 
Ebs hfs + an
Ebs hfs + anEbs hfs + an
Ebs hfs + an
MQ_Library
 
Hemorrhoidectomy
HemorrhoidectomyHemorrhoidectomy
Hemorrhoidectomy
Bashir BnYunus
 
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMAConference
 
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA
 
Mx of Wound Healing.pptx
Mx of Wound Healing.pptxMx of Wound Healing.pptx
Mx of Wound Healing.pptx
MohammedMujtaba38
 
Experience with semi occlusive dressing in fingertip injuries
Experience with semi occlusive dressing in fingertip injuriesExperience with semi occlusive dressing in fingertip injuries
Experience with semi occlusive dressing in fingertip injuries
CAMILA AZOCAR
 
Day Case Surgery by dr bhipi (2).pptx
Day Case Surgery by dr bhipi (2).pptxDay Case Surgery by dr bhipi (2).pptx
Day Case Surgery by dr bhipi (2).pptx
BhipiChandraRay
 
Day Care Surgery.pptx
Day Care Surgery.pptxDay Care Surgery.pptx
Day Care Surgery.pptx
GUNABHIDAS1
 
doudenal blow out mgt as a complication of gastric surgery ppt final-1.pptx
doudenal blow out mgt as a complication of gastric surgery ppt  final-1.pptxdoudenal blow out mgt as a complication of gastric surgery ppt  final-1.pptx
doudenal blow out mgt as a complication of gastric surgery ppt final-1.pptx
surafelfekadu777
 
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
Addis3
 
Breast Liposuction (Female vs. Male).pptx
Breast Liposuction (Female vs. Male).pptxBreast Liposuction (Female vs. Male).pptx
Breast Liposuction (Female vs. Male).pptx
Osama Moawad
 

Similar to EWMA 2013 - Ep555 - Negatively Charged Microspheres- (NCM) Technology for The Treatment of Post Aesthetic Surgery Complications (20)

Surgical treatment of pilonidal disease
Surgical treatment of pilonidal diseaseSurgical treatment of pilonidal disease
Surgical treatment of pilonidal disease
 
day care surgery.pptx 1st year resident##
day care surgery.pptx 1st year resident##day care surgery.pptx 1st year resident##
day care surgery.pptx 1st year resident##
 
Introduction to Perioperative Course
Introduction to Perioperative CourseIntroduction to Perioperative Course
Introduction to Perioperative Course
 
Introduction to Perioperative Course
Introduction to Perioperative  CourseIntroduction to Perioperative  Course
Introduction to Perioperative Course
 
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
EWMA 2014 - EP454 EXPERIENCES WITH USING A COLLAGEN WOUND MATRIX* ON RECALCIT...
 
ROHIT HEMORRHOIDECTOMY JOURNAL.pptx
ROHIT HEMORRHOIDECTOMY JOURNAL.pptxROHIT HEMORRHOIDECTOMY JOURNAL.pptx
ROHIT HEMORRHOIDECTOMY JOURNAL.pptx
 
Day care surgery by manjusb
Day care surgery by manjusbDay care surgery by manjusb
Day care surgery by manjusb
 
Ebs hfs + an
Ebs hfs + anEbs hfs + an
Ebs hfs + an
 
Cicatrix cream summary 2008
Cicatrix cream summary 2008Cicatrix cream summary 2008
Cicatrix cream summary 2008
 
Hemorrhoidectomy
HemorrhoidectomyHemorrhoidectomy
Hemorrhoidectomy
 
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
 
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
EWMA 2013 - Ep476 - Treatment of Split Thickness Skin Graft Donor Sites with ...
 
Mx of Wound Healing.pptx
Mx of Wound Healing.pptxMx of Wound Healing.pptx
Mx of Wound Healing.pptx
 
Experience with semi occlusive dressing in fingertip injuries
Experience with semi occlusive dressing in fingertip injuriesExperience with semi occlusive dressing in fingertip injuries
Experience with semi occlusive dressing in fingertip injuries
 
Day Case Surgery by dr bhipi (2).pptx
Day Case Surgery by dr bhipi (2).pptxDay Case Surgery by dr bhipi (2).pptx
Day Case Surgery by dr bhipi (2).pptx
 
Keloids
KeloidsKeloids
Keloids
 
Day Care Surgery.pptx
Day Care Surgery.pptxDay Care Surgery.pptx
Day Care Surgery.pptx
 
doudenal blow out mgt as a complication of gastric surgery ppt final-1.pptx
doudenal blow out mgt as a complication of gastric surgery ppt  final-1.pptxdoudenal blow out mgt as a complication of gastric surgery ppt  final-1.pptx
doudenal blow out mgt as a complication of gastric surgery ppt final-1.pptx
 
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
wound_complication_after_cs.pdfPublic Health Questions and Answers for Studen...
 
Breast Liposuction (Female vs. Male).pptx
Breast Liposuction (Female vs. Male).pptxBreast Liposuction (Female vs. Male).pptx
Breast Liposuction (Female vs. Male).pptx
 

More from EWMAConference

EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
EWMAConference
 
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
EWMAConference
 
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
EWMAConference
 
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
EWMAConference
 
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case reportEWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
EWMAConference
 
EWMA 2013 - Ep575 - A case of diabetic hand wound
EWMA 2013 - Ep575 - A case of diabetic hand woundEWMA 2013 - Ep575 - A case of diabetic hand wound
EWMA 2013 - Ep575 - A case of diabetic hand wound
EWMAConference
 
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
EWMAConference
 
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
EWMAConference
 
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
EWMAConference
 
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
EWMAConference
 
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
EWMAConference
 
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
EWMAConference
 
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigationEWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
EWMAConference
 
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
EWMAConference
 
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
EWMAConference
 
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
EWMAConference
 
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
EWMAConference
 
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
EWMAConference
 
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
EWMAConference
 

More from EWMAConference (20)

EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
EWMA 2013 - Ep590 - HOLIDAY FEET: MANAGING A SUNBURNT FOOT USING THE RIGHT DR...
 
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
EWMA 2013 - Ep589 - COST BENEFITS IN USING A MICROFIBER DEBRIDEMENT PAD IN TH...
 
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
EWMA 2013 - Ep 587 - TREATMENT OF DIABETIC FOOT WITH COMBINATION OF TOPICAL N...
 
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
EWMA 2013 - Ep580 - Treatment with negative pressure and drainage sheet for p...
 
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case reportEWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
 
EWMA 2013 - Ep575 - A case of diabetic hand wound
EWMA 2013 - Ep575 - A case of diabetic hand woundEWMA 2013 - Ep575 - A case of diabetic hand wound
EWMA 2013 - Ep575 - A case of diabetic hand wound
 
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
EWMA 2013 - Ep574 - SOFT SILICONE AND LINOLEIC ACID TO TREAT CHONICAL WOUND I...
 
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
EWMA 2013 - Ep573 - INCIDENCE OF EPIDERMOLYIS BULLOSA AMONG COUPLES WITH CONS...
 
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
EWMA 2013 - Ep570 - WHEN PERCEPTION IS NOT REALITY – LEG ULCER TREATMENT OF A...
 
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
EWMA 2013 - Ep566 - SEQUENTIAL TREATMENT OF CHRONIC WOUNDS WITH HYDRO-DESLOUG...
 
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
EWMA 2013 - Ep565 - TREATMENT OF PRESSURE ULCERS IN TOES WITH A NEW HYDRO-DES...
 
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
EWMA 2013 - Ep564 - DEVELOPING A TIME CONCEPT TREATMENT IN A POST-TRAUMATIC W...
 
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigationEWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
EWMA 2013 - Ep563 - A new anti-biofilm dressing: in vivo investigation
 
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
EWMA 2013 - Ep562 - MANAGEMENT OF AN ATYPICAL VASCULAR ULCER WITH TLC-NOSF DR...
 
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
EWMA 2013 - Ep559 - OUR EXPERIENCE IN THE HEALING OF TRAUMATIC WOUNDS WITH A ...
 
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
EWMA 2013 - Ep558 - USE OF A NEW HYDRO-DESLOUGHING ABSORBENT DRESSING* IN A N...
 
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
EWMA 2013 - Ep556 - A CASE OF MULTIPLE CUTANEOUS ESCHARS FROM PYODERMA GANGRE...
 
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
EWMA 2013 - Ep552 - THE USE OF URINARY BLADDER MATRIX (ACELL) IN THE TREATMEN...
 
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
EWMA 2013 - Ep547 - European wound-registry (EWR) -characteristics and method...
 
Ep453 ewma p
Ep453 ewma pEp453 ewma p
Ep453 ewma p
 

Recently uploaded

Are There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdfAre There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdf
Little Cross Family Clinic
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
Anurag Sharma
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
KafrELShiekh University
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
NEHA GUPTA
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
Levi Shapiro
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
Shweta
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Prof. Marcus Renato de Carvalho
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
NephroTube - Dr.Gawad
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Sapna Thakur
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
i3 Health
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 

Recently uploaded (20)

Are There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdfAre There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdf
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
 
Evaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animalsEvaluation of antidepressant activity of clitoris ternatea in animals
Evaluation of antidepressant activity of clitoris ternatea in animals
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeNovas diretrizes da OMS para os cuidados perinatais de mais qualidade
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
 
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.GawadHemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 

EWMA 2013 - Ep555 - Negatively Charged Microspheres- (NCM) Technology for The Treatment of Post Aesthetic Surgery Complications

  • 1. Negatively Charged Microspheres Technology for the Treatment of Post Aesthetic Surgery Complications Josef Haik MD MPH, Eyal Winkler MD, Nimrod Farber MD, Moti Harats MD, Oren Weissman MD Department of Plastic and Reconstructive Surgery and The Burn Unit, Sheba Medical Center ISRAEL
  • 2. Background • Complications following aesthetic procedures such as lower T-junction wound dehiscence following breast reduction surgery, or flap necrosis following a facelift procedure are vexing and grievous complications both to the patient and the surgeon. • Treatment modalities that can actively expedite wound healing and re-epithelialization rates are highly craved. • Objectives - To assess wound healing and re- epithelialization rates of open wounds due to dehiscence following breast reduction surgery or flap necrosis following a facelift procedure.
  • 3. Methods • Eight patients with wounds of the aforementioned types (5 breast reduction patients and 3 facelift patients) were treated with daily dressing with NCM soaked dressings. • Wound closure rates were documented daily.
  • 4. Results • Treatment duration averaged 10 days in the facelift cases and 33 days for breast cases. • Wounds showed both accelerated granulation tissue formation, and re-epithelialization rates. • Average wound epithelialization rate was 1.9 millimeters per day for breast cases and 1 millimeters per day for the facelift cases. • In these cases, NCM treatment helped patients avoid additional surgery such as skin grafting. No complications or side effects were encountered.
  • 5. Patient’s Results • Female, 29 year old • Wound etiology: Post bilateral breast reduction, postoperative wound dehiscence • Wound duration: 29 days • Previous treatment: Povidone iodine soaked dressings, AG hydrofiber dressings Prior to treatment Day 5 of treatment Day 12 of treatment Day 24 of treatment
  • 6. Patient’s Results • Female, 52 year old • Wound etiology: Post bilateral breast reduction, postoperative wound dehiscense • Wound duration: 19 days • Previous treatment: Silver sulfadiazine, AG hydrofiber dressings Prior to treatment Day 5 of treatment Day 10 of treatment Day 17 of treatment
  • 7. Patient’s Results • Female, 31 year old • Wound etiology: Post unilateral facelift due to regressed hemangioma, postoperative flap necrosis • Wound duration: 32 days • Previous treatment: Silver sulfadiazine, surgical debridement, AG hydrofiber dressings Prior to treatment 1 Week of treatment 2 Weeks of treatment
  • 8. Discussion • CPM may offer a new and efficacious way to expedite the healing of open wounds of various etiologies, including resistant wounds that failed to heal despite deploying a multitude of treatment modalities including surgery. • CPM seems to expedite both the formation of granulation tissue (including over bones, cartilages and tendons) as well as epithelialization rates. • Further research with larger patient volumes are still needed to verify these findings.