This document summarizes new wound management techniques and products. It discusses how selecting appropriate wound care can positively influence repair by understanding repair mechanisms. During the inflammatory phase, debridement and dressings can accelerate healing by enhancing inflammation. Products like Solcoseryl and hydrogels can stimulate early repair but may prolong inflammation later. Sugar, honey, and ketanserin can activate macrophages and improve inflammation. Chronic wounds get "stuck" in inflammation; treatments aim to identify and remove obstacles and create a healing environment. Later, growth factors and dressings that release them can enhance proliferation while limiting scarring.
High density chitosan membranes were produced via a novel manufacturing process involving casting, freezing, neutralizing, and applying compression and dehydration. The resulting membranes have densities as high as 1.6 g/cm3 and superior physical properties compared to commercial collagen membranes. They exhibit biocompatibility and are resorbable in vivo, demonstrating potential as surgical barrier membranes, tissue scaffolds, wound dressings, or drug delivery devices.
This document describes PalinGen Flow, an allograft derived from human amniotic membrane and fluid that is processed and cryopreserved for use in regenerative medicine and wound healing. It contains growth factors, collagen and other proteins that promote tissue repair. Studies show it provides antimicrobial, anti-inflammatory and anti-adhesion properties useful for orthopedic, neuro, spinal, and other surgical applications to aid healing and reduce scarring. The amniotic membrane and fluid are obtained from screened and consenting pregnant donors undergoing C-sections and processed at an accredited tissue bank in compliance with FDA regulations.
This document discusses the use of skin substitutes in treating burns and bone regeneration through bioengineering approaches. It describes various temporary and permanent skin substitutes derived from cadaver skin, amniotic membrane, or xenografts. Issues with immune rejection and disease transmission are discussed. The use of cultured keratinocytes and fibroblasts seeded onto scaffolds is also summarized. For bone regeneration, the document outlines how mobilized stem cells, growth factors, and a biomimetic scaffold can promote endogenous bone repair by mimicking the natural process. Uncontrolled bone growth in diseases like fibrodyplasia ossificans progressiva is also briefly mentioned.
This document discusses local drug delivery for the treatment of periodontitis. It begins by introducing periodontitis and current nonsurgical treatments. It then discusses the rationale for localized drug delivery directly into periodontal pockets, including achieving higher drug concentrations at the site of infection while reducing systemic exposure. Several routes of local delivery are described, including mouth rinses, subgingival irrigation, and local drug delivery systems like fibers, films, and injectable gels. The document covers the development of local delivery devices, indications and contraindications for their use, advantages and disadvantages, and various drug delivery systems that have been investigated.
9 managegement of maxillofacial injuriesEphrem Tamiru
This document provides an overview of the management of maxillofacial injuries. It discusses the anatomy of the facial skeleton, common causes of maxillofacial injuries, examination of patients, clinical examination techniques, radiological examination, management of airway and bleeding, soft tissue injury management, fracture management principles of reduction, fixation and immobilization, and supportive care considerations.
The document is about the Institute for Innovative HRM Development (IIHRMD), which was established to impart lifelong HR education. It provides information about IIHRMD's vision, locations, programs offered, and faculty. The key programs discussed include a certification course in corporate HR practices offered on weekends or through distance learning. The document promotes IIHRMD's programs and faculty while providing details about courses, schedules, eligibility, and fees.
High density chitosan membranes were produced via a novel manufacturing process involving casting, freezing, neutralizing, and applying compression and dehydration. The resulting membranes have densities as high as 1.6 g/cm3 and superior physical properties compared to commercial collagen membranes. They exhibit biocompatibility and are resorbable in vivo, demonstrating potential as surgical barrier membranes, tissue scaffolds, wound dressings, or drug delivery devices.
This document describes PalinGen Flow, an allograft derived from human amniotic membrane and fluid that is processed and cryopreserved for use in regenerative medicine and wound healing. It contains growth factors, collagen and other proteins that promote tissue repair. Studies show it provides antimicrobial, anti-inflammatory and anti-adhesion properties useful for orthopedic, neuro, spinal, and other surgical applications to aid healing and reduce scarring. The amniotic membrane and fluid are obtained from screened and consenting pregnant donors undergoing C-sections and processed at an accredited tissue bank in compliance with FDA regulations.
This document discusses the use of skin substitutes in treating burns and bone regeneration through bioengineering approaches. It describes various temporary and permanent skin substitutes derived from cadaver skin, amniotic membrane, or xenografts. Issues with immune rejection and disease transmission are discussed. The use of cultured keratinocytes and fibroblasts seeded onto scaffolds is also summarized. For bone regeneration, the document outlines how mobilized stem cells, growth factors, and a biomimetic scaffold can promote endogenous bone repair by mimicking the natural process. Uncontrolled bone growth in diseases like fibrodyplasia ossificans progressiva is also briefly mentioned.
This document discusses local drug delivery for the treatment of periodontitis. It begins by introducing periodontitis and current nonsurgical treatments. It then discusses the rationale for localized drug delivery directly into periodontal pockets, including achieving higher drug concentrations at the site of infection while reducing systemic exposure. Several routes of local delivery are described, including mouth rinses, subgingival irrigation, and local drug delivery systems like fibers, films, and injectable gels. The document covers the development of local delivery devices, indications and contraindications for their use, advantages and disadvantages, and various drug delivery systems that have been investigated.
9 managegement of maxillofacial injuriesEphrem Tamiru
This document provides an overview of the management of maxillofacial injuries. It discusses the anatomy of the facial skeleton, common causes of maxillofacial injuries, examination of patients, clinical examination techniques, radiological examination, management of airway and bleeding, soft tissue injury management, fracture management principles of reduction, fixation and immobilization, and supportive care considerations.
The document is about the Institute for Innovative HRM Development (IIHRMD), which was established to impart lifelong HR education. It provides information about IIHRMD's vision, locations, programs offered, and faculty. The key programs discussed include a certification course in corporate HR practices offered on weekends or through distance learning. The document promotes IIHRMD's programs and faculty while providing details about courses, schedules, eligibility, and fees.
CRM involves identifying, establishing, maintaining, and enhancing relationships with customers through understanding their needs and providing customized experiences. It aims to maximize long-term customer value through collaborative relationships rather than one-time transactions. CRM systems utilize customer data, analytical tools, and customer interactions to improve customer retention and acquire new customers. The key components of a CRM system include operational, analytical, and collaborative CRM, and technology plays an important role in enabling personalized CRM approaches at scale.
Stress is the body's response to demands placed on it and can have psychological, behavioral, and mental effects. Psychologically, stress can cause feelings of depression, anxiety, worry, and forgetfulness. Behaviorally, stress may lead to smoking, overeating, aggression, and lack of initiative. Mentally, stress can result in difficulty concentrating, confusion, and negative self-talk. The document recommends finding ways to relax the mind through activities like music, art, or writing.
Stress is the body's response to demands placed on it and can have psychological, behavioral, and mental effects. Psychologically, stress can cause feelings of depression, anxiety, worry, and forgetfulness. Behaviorally, stress may lead to smoking, overeating, aggression, and lack of initiative. Mentally, stress can result in difficulty concentrating, confusion, and negative self-talk. The document recommends finding ways to relax the mind through activities like music, art, or writing.
Nurture Talent Academy provides training and mentoring programs to help budding entrepreneurs start their own ventures. It helps students and startups convert ideas into viable businesses by teaching skills like business planning, finance, marketing, and technology. The document describes TECHUNT 2013, a program that trains and mentors technology students and professionals to become entrepreneurs by solving societal problems using technology and mobile applications. Students will learn skills like idea generation, Android development, mobile prototyping, and marketing to develop their own Android app and participate in a business competition.
Am Art As A Gateway Part II - Lesson Plan ExampleTanya Efremova
- Flamingos are gregarious shorebirds that are typically found in large flocks near bodies of water. They feed by filtering food from the water and mud with their webbed feet.
- Flamingos are typically pink or red in color due to carotenoids in their diet, and a healthy flamingo will appear more vibrantly colored. Their color can appear pale if they are unhealthy or malnourished.
- Although flamingo populations were once thriving, scientists have discovered that flamingos are now dying by the thousands in the Great Rift Valley lakes of East Africa. Habitat loss and environmental threats have endangered several flamingo species.
Wound Ballistics and Body Armor Paper PresentationSam Spurlin
Wound ballistics provided the scientific basis for the development of body armor. However, other factors like weight, comfort, cost of production, and bureaucracy became more important over time in influencing the development of body armor. Key developments included Kocher's studies of gunshot wounds in the 1870s, WWII casualty surveys which showed the potential for body armor, and armor designs from the Civil War through Vietnam which struggled with issues of weight and ballistic effectiveness.
This document discusses maxillofacial injuries, focusing on the importance of the "Golden Hour" period for treatment. It describes how maxillofacial injuries can impact functions like breathing, speaking, and eating. The document outlines the steps for examining and diagnosing maxillofacial trauma, including inspecting and palpating the extra-oral and intra-oral areas as well as ordering radiographs. Primary management goals are described as controlling pain, preventing infection, and surgical planning. The classification of fracture types is also detailed. The overarching message is the time sensitivity of treating maxillofacial injuries to address airway issues, bleeding, and prevent long-term complications.
The advancements in military starts from the study of basics that relate to Ballistics, any object that uses ballistics to shape its design attains edge diversification in its functionality. In retrospect ballistics are negligible because of its use in shaping projectile bodies, later with advancements in Science and Technology resulted in computerization of the whole concept. In the given presentation the study related to Ballistics and its growth from the start is specified at its best.
Hadoop is an open-source framework for distributed storage and processing of large datasets across clusters of commodity hardware. It addresses problems with traditional systems like data growth, network/server failures, and high costs by allowing data to be stored in a distributed manner and processed in parallel. Hadoop has two main components - the Hadoop Distributed File System (HDFS) which provides high-throughput access to application data across servers, and the MapReduce programming model which processes large amounts of data in parallel by splitting work into map and reduce tasks.
project report on working capital management at jindal saw ltd.Naaz Ali
The document provides an overview of Jindal Saw Ltd., an Indian company that manufactures steel pipes and tubes. It details the company's objectives, research methodology, limitations, products, locations, clients, milestones, financial performance over the past 5 years, and balance sheet data. Jindal Saw is a leading manufacturer of steel pipes and tubes in India with integrated facilities across multiple locations. It produces pipes for oil, gas, water transportation and other industrial applications.
This document summarizes cholinergic drugs including their mechanisms, clinical uses, and side effects. It discusses:
1. Cholinergic agonists like methacholine and pilocarpine that directly activate muscarinic receptors. Their uses include lowering blood pressure and treating glaucoma. Side effects include increased secretions.
2. Acetylcholinesterase inhibitors like physostigmine and neostigmine that indirectly activate cholinergic receptors by inhibiting acetylcholine breakdown. They are used for conditions like myasthenia gravis and as antidotes for organophosphate poisoning.
3. Anticholinergic drugs like atropine that competitively block mus
Removal partial denture considerations in maxillofacial prostheticsBibin Bhaskaran
Removal partial denture considerations in maxillofacial prosthetics discusses interim, definitive, and surgical considerations for prosthetics following maxillofacial defects. Interim prosthetics aim to separate oral and nasal cavities and improve swallowing/speech. Definitive prosthetics restore function after tissue healing. Surgical preservation of teeth and tissues benefits prosthetics by providing support and retention. Mandibular reconstruction challenges include soft tissue bulk and bone placement impacting function.
Maxillofacial trauma requires aggressive airway management and preliminary care. The document outlines the steps for preliminary care which include:
1) Initial assessment of the patient using ABCDE to evaluate airway, breathing, circulation, disability and exposure.
2) Securing the airway through basic maneuvers like jaw thrust or advanced techniques like endotracheal intubation if needed.
3) Assessing breathing and managing thoracic injuries.
4) Controlling hemorrhage through circulation management and fluid resuscitation to restore perfusion.
5) Conducting a full secondary survey to identify all injuries.
Advanced Composite Materials & Technologies for DefenceDigitech Rathod
This document discusses advanced composite materials and technologies for defense applications. It covers composites for armor applications, including novel ceramic materials and modeling of material response to high-rate loading. It discusses fibers and resins used in ballistic armor composites. Different threats are outlined and the technical requirements for armor are discussed. Body armor design considerations around weight, flexibility and cost are presented.
This document discusses terminal ballistics and kinetic energy theory. It defines ballistics and kinetic energy, and describes the anatomy of bullets, including types of rounds. The kinetic energy formula is provided, and kinetic energy is explained as the energy of motion. Bullet impacts are demonstrated, showing how bullets can lacerate, cause cavitation, and shock waves in tissue. Future innovations may allow disruption of bullet kinetic energy or dodging bullets using external devices.
We saw the infamous 26/11 at Mumbai, India. We lost some brave-hearts. Hence, we look into the forensics behind firearm injuries. We shall also discuss the JFK assassination case in brief. I would recommend downloading the presentation and view it in power point 2010 or above to see all the effects flawlessly.
This document discusses wound management and healing. It covers the goals of wound care including facilitating hemostasis, decreasing tissue loss, promoting healing, and minimizing scarring. The three main types of wound healing - primary, secondary, and tertiary intention - are described. Factors that affect wound healing like diabetes, infection, drugs, nutrition, tissue necrosis and hypoxia are summarized. The basics of wound evaluation, preparation, closure, and aftercare are outlined, including debridement, reducing bioburden, optimizing blood flow and oxygen supply, and using dressings appropriately.
This document summarizes recent advances in the management of oral and maxillofacial injuries. Key points include:
1) Minimally invasive endoscopic techniques are being used more for fractures of the mandibular condyle, zygomatic complex, orbit, and frontal sinus to limit incisions and improve visualization.
2) Computer-assisted surgery is being used to assist with preoperative planning, intraoperative guidance, and postoperative evaluation for oral and maxillofacial procedures.
3) Advances have been made in the treatment of many specific facial fractures including mandibular, midfacial, orbital, nasal, frontal, and temporomandibular joint fractures through the use of new techniques,
A series of case studies showed that an integrated approach using Dialklycaramoyl chloride (DACC) to control bacteria and inflammation combined with a new bioactive native collagen scaffold to control excess MMPs addressed challenges in healing chronic wounds. Specifically:
- Case 1 involved a surgical wound in a diabetic female that was treated with DACC followed by the collagen scaffold, resulting in granulation and re-epithelialization.
- Cases 2-3 involved poorly controlled diabetics with amputations that were also treated with the two-step DACC then collagen scaffold approach, improving granulation tissue formation.
- Cases 4-6 involved other chronic wounds treated with the collagen scaffold alone or in combination with other
This document discusses medicated dressings for healing diabetic wounds. It begins with an introduction to wound pathogenesis and the wound healing process. It then describes different types of dressings, focusing on those suitable for diabetic wounds. These include hydrocolloid dressings, hydrogel dressings, alginate dressings, foam dressings, and silver-coated dressings. Polymer-based dressings using materials like cellulose, chitosan, collagen and hyaluronic acid are also discussed. The document concludes by stating that advanced dressings that inhibit bacteria, manage exudate, and promote re-epithelialization while maintaining a moist environment can help ensure rapid healing of diabetic foot ulcers.
CRM involves identifying, establishing, maintaining, and enhancing relationships with customers through understanding their needs and providing customized experiences. It aims to maximize long-term customer value through collaborative relationships rather than one-time transactions. CRM systems utilize customer data, analytical tools, and customer interactions to improve customer retention and acquire new customers. The key components of a CRM system include operational, analytical, and collaborative CRM, and technology plays an important role in enabling personalized CRM approaches at scale.
Stress is the body's response to demands placed on it and can have psychological, behavioral, and mental effects. Psychologically, stress can cause feelings of depression, anxiety, worry, and forgetfulness. Behaviorally, stress may lead to smoking, overeating, aggression, and lack of initiative. Mentally, stress can result in difficulty concentrating, confusion, and negative self-talk. The document recommends finding ways to relax the mind through activities like music, art, or writing.
Stress is the body's response to demands placed on it and can have psychological, behavioral, and mental effects. Psychologically, stress can cause feelings of depression, anxiety, worry, and forgetfulness. Behaviorally, stress may lead to smoking, overeating, aggression, and lack of initiative. Mentally, stress can result in difficulty concentrating, confusion, and negative self-talk. The document recommends finding ways to relax the mind through activities like music, art, or writing.
Nurture Talent Academy provides training and mentoring programs to help budding entrepreneurs start their own ventures. It helps students and startups convert ideas into viable businesses by teaching skills like business planning, finance, marketing, and technology. The document describes TECHUNT 2013, a program that trains and mentors technology students and professionals to become entrepreneurs by solving societal problems using technology and mobile applications. Students will learn skills like idea generation, Android development, mobile prototyping, and marketing to develop their own Android app and participate in a business competition.
Am Art As A Gateway Part II - Lesson Plan ExampleTanya Efremova
- Flamingos are gregarious shorebirds that are typically found in large flocks near bodies of water. They feed by filtering food from the water and mud with their webbed feet.
- Flamingos are typically pink or red in color due to carotenoids in their diet, and a healthy flamingo will appear more vibrantly colored. Their color can appear pale if they are unhealthy or malnourished.
- Although flamingo populations were once thriving, scientists have discovered that flamingos are now dying by the thousands in the Great Rift Valley lakes of East Africa. Habitat loss and environmental threats have endangered several flamingo species.
Wound Ballistics and Body Armor Paper PresentationSam Spurlin
Wound ballistics provided the scientific basis for the development of body armor. However, other factors like weight, comfort, cost of production, and bureaucracy became more important over time in influencing the development of body armor. Key developments included Kocher's studies of gunshot wounds in the 1870s, WWII casualty surveys which showed the potential for body armor, and armor designs from the Civil War through Vietnam which struggled with issues of weight and ballistic effectiveness.
This document discusses maxillofacial injuries, focusing on the importance of the "Golden Hour" period for treatment. It describes how maxillofacial injuries can impact functions like breathing, speaking, and eating. The document outlines the steps for examining and diagnosing maxillofacial trauma, including inspecting and palpating the extra-oral and intra-oral areas as well as ordering radiographs. Primary management goals are described as controlling pain, preventing infection, and surgical planning. The classification of fracture types is also detailed. The overarching message is the time sensitivity of treating maxillofacial injuries to address airway issues, bleeding, and prevent long-term complications.
The advancements in military starts from the study of basics that relate to Ballistics, any object that uses ballistics to shape its design attains edge diversification in its functionality. In retrospect ballistics are negligible because of its use in shaping projectile bodies, later with advancements in Science and Technology resulted in computerization of the whole concept. In the given presentation the study related to Ballistics and its growth from the start is specified at its best.
Hadoop is an open-source framework for distributed storage and processing of large datasets across clusters of commodity hardware. It addresses problems with traditional systems like data growth, network/server failures, and high costs by allowing data to be stored in a distributed manner and processed in parallel. Hadoop has two main components - the Hadoop Distributed File System (HDFS) which provides high-throughput access to application data across servers, and the MapReduce programming model which processes large amounts of data in parallel by splitting work into map and reduce tasks.
project report on working capital management at jindal saw ltd.Naaz Ali
The document provides an overview of Jindal Saw Ltd., an Indian company that manufactures steel pipes and tubes. It details the company's objectives, research methodology, limitations, products, locations, clients, milestones, financial performance over the past 5 years, and balance sheet data. Jindal Saw is a leading manufacturer of steel pipes and tubes in India with integrated facilities across multiple locations. It produces pipes for oil, gas, water transportation and other industrial applications.
This document summarizes cholinergic drugs including their mechanisms, clinical uses, and side effects. It discusses:
1. Cholinergic agonists like methacholine and pilocarpine that directly activate muscarinic receptors. Their uses include lowering blood pressure and treating glaucoma. Side effects include increased secretions.
2. Acetylcholinesterase inhibitors like physostigmine and neostigmine that indirectly activate cholinergic receptors by inhibiting acetylcholine breakdown. They are used for conditions like myasthenia gravis and as antidotes for organophosphate poisoning.
3. Anticholinergic drugs like atropine that competitively block mus
Removal partial denture considerations in maxillofacial prostheticsBibin Bhaskaran
Removal partial denture considerations in maxillofacial prosthetics discusses interim, definitive, and surgical considerations for prosthetics following maxillofacial defects. Interim prosthetics aim to separate oral and nasal cavities and improve swallowing/speech. Definitive prosthetics restore function after tissue healing. Surgical preservation of teeth and tissues benefits prosthetics by providing support and retention. Mandibular reconstruction challenges include soft tissue bulk and bone placement impacting function.
Maxillofacial trauma requires aggressive airway management and preliminary care. The document outlines the steps for preliminary care which include:
1) Initial assessment of the patient using ABCDE to evaluate airway, breathing, circulation, disability and exposure.
2) Securing the airway through basic maneuvers like jaw thrust or advanced techniques like endotracheal intubation if needed.
3) Assessing breathing and managing thoracic injuries.
4) Controlling hemorrhage through circulation management and fluid resuscitation to restore perfusion.
5) Conducting a full secondary survey to identify all injuries.
Advanced Composite Materials & Technologies for DefenceDigitech Rathod
This document discusses advanced composite materials and technologies for defense applications. It covers composites for armor applications, including novel ceramic materials and modeling of material response to high-rate loading. It discusses fibers and resins used in ballistic armor composites. Different threats are outlined and the technical requirements for armor are discussed. Body armor design considerations around weight, flexibility and cost are presented.
This document discusses terminal ballistics and kinetic energy theory. It defines ballistics and kinetic energy, and describes the anatomy of bullets, including types of rounds. The kinetic energy formula is provided, and kinetic energy is explained as the energy of motion. Bullet impacts are demonstrated, showing how bullets can lacerate, cause cavitation, and shock waves in tissue. Future innovations may allow disruption of bullet kinetic energy or dodging bullets using external devices.
We saw the infamous 26/11 at Mumbai, India. We lost some brave-hearts. Hence, we look into the forensics behind firearm injuries. We shall also discuss the JFK assassination case in brief. I would recommend downloading the presentation and view it in power point 2010 or above to see all the effects flawlessly.
This document discusses wound management and healing. It covers the goals of wound care including facilitating hemostasis, decreasing tissue loss, promoting healing, and minimizing scarring. The three main types of wound healing - primary, secondary, and tertiary intention - are described. Factors that affect wound healing like diabetes, infection, drugs, nutrition, tissue necrosis and hypoxia are summarized. The basics of wound evaluation, preparation, closure, and aftercare are outlined, including debridement, reducing bioburden, optimizing blood flow and oxygen supply, and using dressings appropriately.
This document summarizes recent advances in the management of oral and maxillofacial injuries. Key points include:
1) Minimally invasive endoscopic techniques are being used more for fractures of the mandibular condyle, zygomatic complex, orbit, and frontal sinus to limit incisions and improve visualization.
2) Computer-assisted surgery is being used to assist with preoperative planning, intraoperative guidance, and postoperative evaluation for oral and maxillofacial procedures.
3) Advances have been made in the treatment of many specific facial fractures including mandibular, midfacial, orbital, nasal, frontal, and temporomandibular joint fractures through the use of new techniques,
A series of case studies showed that an integrated approach using Dialklycaramoyl chloride (DACC) to control bacteria and inflammation combined with a new bioactive native collagen scaffold to control excess MMPs addressed challenges in healing chronic wounds. Specifically:
- Case 1 involved a surgical wound in a diabetic female that was treated with DACC followed by the collagen scaffold, resulting in granulation and re-epithelialization.
- Cases 2-3 involved poorly controlled diabetics with amputations that were also treated with the two-step DACC then collagen scaffold approach, improving granulation tissue formation.
- Cases 4-6 involved other chronic wounds treated with the collagen scaffold alone or in combination with other
This document discusses medicated dressings for healing diabetic wounds. It begins with an introduction to wound pathogenesis and the wound healing process. It then describes different types of dressings, focusing on those suitable for diabetic wounds. These include hydrocolloid dressings, hydrogel dressings, alginate dressings, foam dressings, and silver-coated dressings. Polymer-based dressings using materials like cellulose, chitosan, collagen and hyaluronic acid are also discussed. The document concludes by stating that advanced dressings that inhibit bacteria, manage exudate, and promote re-epithelialization while maintaining a moist environment can help ensure rapid healing of diabetic foot ulcers.
Wound healing is an important concern these days and there are lots of various medications for it.
One of the most effective methods is Applying Acellular Matrices to the wound bed.
In this presentation, It was tried to explain the application of these products as well as the complications of usage.
I wish it be useful for anyone.
It would be appreciated if you let me know your comments on my presentation.
sincerely,
S. Mohammad Zargar
Contact me: s.mohammad.zargar@gmail.com
This document discusses the phases and cellular processes involved in wound healing. It describes three phases - inflammatory, proliferative, and maturation. The inflammatory phase involves hemostasis, recruitment of inflammatory cells, and production of growth factors. The proliferative phase involves angiogenesis, fibroplasia, and re-epithelialization to form granulation tissue. The maturation phase involves remodeling of scar tissue and collagen. Local and systemic factors that can impact wound healing are also discussed.
Full length paper - Treatment of skin Scars and wound of healing-1.docxSneha Pandey
This document provides an overview of skin scarring and wound healing problems. It discusses the cellular and molecular processes involved in normal wound healing and scar formation. Recent advances in understanding the roles of stem cells and fibroblasts in regeneration and scarring are described. Both traditional and novel potential treatments for preventing and reducing scarring are reviewed, including dressings, topical treatments, surgical revision, injection therapies, pressure therapy, laser treatments, dermabrasion, radiation, and cryotherapy. However, truly effective anti-scarring treatments that make use of specific molecular or cellular targets are still needed.
Wound healing is a complex process involving three overlapping phases: inflammation, proliferation, and remodeling. During the inflammatory phase, blood vessels are disrupted causing bleeding and a fibrin clot forms. Inflammatory cells are recruited to the wound to remove debris and prevent infection. In the proliferative phase, new tissue such as granulation tissue, blood vessels and epithelium form. Finally, in the remodeling phase, the wound undergoes scarring and strengthening as collagen is remodeled over several months. Factors like infection, smoking, and malnutrition can disturb the healing process, while proper wound care including debridement, dressings and management of bioburden can optimize healing.
Acellular Matrices for the Treatment of WoundsGNEAUPP.
This document summarizes an expert working group's review of acellular matrices for treating wounds. It defines what acellular matrices are and how they aim to mimic the extracellular matrix to aid wound healing. The document outlines different types of acellular matrices and how they are classified. It also discusses the role of the extracellular matrix in wound healing and the need for products that can help replace or stimulate the matrix. The working group aimed to help clinicians understand how to select and use appropriate acellular matrix products for different wound types.
The document discusses wound healing and repair, providing definitions of wounds and the healing process. It describes the phases of wound healing as regeneration, repair, granulation tissue formation, and wound contraction. There are two main types of wound healing: primary intention (healing by first intention) and secondary intention (healing by second intention). Several factors can affect wound healing, including infection, chronic diseases, and age. Complications include infection, scarring issues, and hernias. The strength of healed wounds increases over time but may never reach the strength of unwounded skin. Materials used in endodontics like calcium hydroxide and MTA can promote healing. Recent advancements include regenerative endodontics using scaffolds and growth
This document discusses early complications that can occur within the first 2 months after penetrating keratoplasty (PK). It summarizes several common complications including wound-related issues like leaks and epithelial defects, infections, suture-related problems, and inflammation-related issues like elevated intraocular pressure and anterior synechia formation. Management strategies are provided for each complication, emphasizing the importance of promptly recognizing and treating any complications to prevent graft failure and loss of vision.
Madridge Journal of AIDS (ISSN: 2638-1958); The placenta is an important blood-placental barrier organ that plays an important part during the time of pregnancy by allowing the selective exchange of molecules and gases.
This document discusses debridement and the role of enzymes in wound bed preparation. It defines necrotic tissue and explains that debridement is important to remove barriers to healing like necrotic tissue and bacteria. There are five main methods of debridement: surgical, enzymatic, autolytic, mechanical, and biologic. For chronic wounds that accumulate necrotic tissue, debridement should be viewed as a ongoing process rather than a single intervention to continuously remove barriers to healing.
Wound healing [including healing after periodontal therapy]Jignesh Patel
The document discusses wound healing and periodontal wound healing in particular. It describes the processes of regeneration and repair. Regeneration involves renewal of tissues through growth of same tissue type, while repair involves replacement of tissues through scar formation. The molecular biology of wound healing is explained, including roles of fibrin clot, growth factors, matrix degradation and connective tissue formation. Healing by primary and secondary intention is also defined. Healing processes following various periodontal procedures like scaling, root planing, flap surgery and implant placement are outlined. Factors influencing wound healing and potential complications are briefly mentioned.
Stem cells can help treat third-degree burns through tissue regeneration. Skin grafting is commonly used to treat third-degree burns but has limitations like limited donor skin availability, pain, and scarring. Stem cells can aid all phases of wound healing and promote tissue growth. Mesenchymal stem cells in particular can migrate to damaged tissue, reduce inflammation, and enhance cell proliferation and differentiation. Delivery of stem cells using lipid nanoparticles applied directly to the skin or through transdermal patches could help treat burns and reduce scarring. Coacervates, which are lipid spheres that protect therapeutic molecules, show potential for sustained release of growth factors like TGF-β3 and IL-10 that could synergistically reduce scar formation during
This document proposes a hypothesis for a targeted drug delivery system to reduce scarring after glaucoma surgery. It suggests encapsulating the antifibrotic drug mitomycin C (MMC) in LDL receptor-targeting chitosan nanoparticles. These nanoparticles could be delivered via hyaluronic acid film to activated human Tenon's capsule fibroblasts at the surgical site, which overexpress the LDL receptor. This would allow the MMC to be taken up by the targeted cells via receptor-mediated endocytosis, reducing toxicity while increasing effectiveness in preventing excessive scarring. Testing is needed to confirm the low cytotoxicity of the chitosan-based drug carrier and its ability to gradually release the nanoparticles at the surgical site. If
Austin Tissue Engineering is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Tissue Engineering.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Tissue Engineering. Austin Tissue Engineering accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Tissue Engineering.
Austin Tissue Engineering strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
physiology of wound healing / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Debridement is an important component of the wound bed preparation (WBP) management Model.
Cause of the wound and patient-centered concerns, debridement is a necessary step in local wound care.
Debridement is the removal of necrotic tissue, exudate, bacteria, and metabolic waste from a wound in order to improve or facilitate the healing process
This document discusses proteases and their role in wound diagnostics and healing. It begins with an overview of proteases and their functions in normal wound healing. Elevated or prolonged protease activity can impair healing by damaging new tissue formation. While protease activity is important in healing, too much can prevent wounds from progressing. Current methods for assessing protease activity include laboratory analysis of wound fluid and clinical assessment, but clinical signs alone do not always predict high protease levels. The development of an easy-to-use point-of-care protease test could help clinicians determine when wounds may have healing problems earlier and guide treatment.
This document summarizes a study comparing the healing of partial-thickness skin graft donor sites treated with two different moist dressings: Tegaderm, a semipermeable membrane dressing, and MEBO, a burn ointment that provides a moist environment without an occlusive dressing. The study found that donor sites treated with MEBO healed anatomically faster than those treated with Tegaderm. Physiologic barrier recovery, as measured by transepidermal water loss, also occurred significantly earlier with MEBO. Finally, MEBO treatment resulted in better scar quality compared to Tegaderm. The findings suggest that MEBO is an effective alternative to conventional occlusive dressings for treating partial-thickness wounds.
2. experimentally that inflammation in horses is weak
but protracted4
and that horse leukocytes produce
fewer reactive oxygen species essential to bacterial
killing.5
They also produce lower levels of other
mediators required to reinforce the inflammatory
response and to induce tissue formation and wound
contraction.5
In view of these facts, it may be wise
to facilitate a strong, early inflammatory response to
injury.
Debridement is an important step in the initial
treatment of a wound, particularly when necrosis,
exposed cortical bone, or frayed tendons are present;
it can be achieved through surgical, enzymatic,
wound dressing, laser, and biosurgical means. De-
bridement of non-viable tissue reduces the duration of
the inflammatory phase. After thorough debride-
ment, it is advisable to dress the wound briefly in an
effort to accelerate biological processes. Bandaging
can be combined with topical therapy to enhance the
inflammatory response.
Wilmink et al.6
recently investigated the use of a
protein-free dialysate of calf blooda
in deep wounds
of horses. In the first 4 wk after injury, Solcoseryl
stimulated repair by provoking greater inflammatory
response, faster contraction, and faster formation of
granulation tissue. Subsequently, it inhibited repair
by delaying epithelialization and prolonging inflam-
mation. The author recommends its use in the treat-
ment of deep wounds during the initial phase of repair
by second intention; treatment should cease when ep-
ithelialization predominates.
Dart et al.7
examined the efficacy of a hydrogelb
on
second intention wound healing in horses. Hydro-
gels are made from materials such as gelatin or
polysaccharide that are cross-linked with a polymer
to form a sheet or gel. By enhancing the moisture
content of necrotic tissue and increasing collagenase
production within the wound, hydrogels facilitate
autolytic debridement. Contrary to expectations,
the hydrogel investigated in this study did not pro-
duce beneficial effects on healing of small full-thick-
ness skin wounds on the limb of horses. A b,1–4
acetylated mannan,c
commercially available as a hy-
drogel, is likewise touted to enhance macrophage
activity; it seems beneficial in the management of
dog foot-pad wounds8
but has not been investigated
in the horse.
A general strategy for improving wound repair
may be through any molecule that can recruit or
activate macrophages during the acute inflamma-
tory phase. The trend of applying sugar or honey to
open wounds dates back a long time and has recently
acquired some scientific merit.9
Both products are
chemoattractant for tissue macrophages and when ap-
plied to contaminated or infected wounds, may have
antibacterial properties. Indeed, the stimulatory ef-
fect of honey may be imparted through up-regulation
of various inflammatory cytokines within mono-
cytes.10
Both sugar and honey have been shown to
enhance fibroplasia as well as epithelialization. A
synthetic form of sugar, Maltodextrin N.F.,d
is com-
mercially available. On application, Intracell works
by mixing with wound exudate to form a semi-perme-
able barrier, and thus, it maintains moisture while
protecting the wound from environmental contami-
nants. Furthermore, it attracts endothelial cells, fi-
broblasts, and epithelial cells to minimize scarring and
reduce the incidence of proud flesh. Although anec-
dotal evidence is encouraging, no scientific studies
have been conducted to evaluate the efficacy of natural
or synthetic sugar in the management of horse
wounds.
Ketanserin,e
a serotonin receptor, is the active
ingredient in Vulketan gel. Macrophage activation
may be suppressed by serotonin present in the early
inflammatory phase; ketanserin antagonizes this se-
rotonin-induced suppression and thus, allows a
strong and effective inflammatory response to occur
within wounds. This should translate into a supe-
rior control of infection and a better orchestration of
Fig. 1. Phases of wound repair.
266 2006 ր Vol. 52 ր AAEP PROCEEDINGS
IN-DEPTH: CURRENT CONCEPTS IN WOUND MANAGEMENT
3. the later phases of repair when growth factors re-
leased by the activated macrophage play an impor-
tant role. Vulketan gel was clinically tested
against an antiseptic and a desloughing agent in
equine limb wounds. Vulketan gel was 2–5 times
more likely to result in successful closure, because it
reduced infection and the development of exuberant
granulation tissue.11
Many wounds located on the distal limb of horses
exhibit signs of chronic inflammation, regardless of
whether or not they are infected. Chronic wounds
seem to be “stuck” at some critical stage of repair,
probably during inflammation or cell proliferation.
Current emphasis of chronic wound management
focuses on three main issues: (1) identification of
the obstruction to healing, (2) removal of the ob-
struction by debridement, (3) creation of a favorable
environment at the wound site. Suggested therapy
for chronic wounds includes a combination of pro-
teinase inhibitors and anti-inflammatory agents fol-
lowed by the application of growth factors.
An oxidized regenerated-cellulose (ORC)/collagen
dressingf
has been developed for wounds that have
not progressed beyond the inflammatory phase.
It is designed to modify the chronic wound environ-
ment by decreasing the activity of key matrix met-
alloproteinases (MMPs) in the wound fluid. A study
in diabetic rats found faster epithelialization of
wounds treated with ORC/collagen than with hydro-
colloid dressing alone; this was accompanied by higher
levels of various growth factors.12
Promogran con-
sists of a sterile, freeze-dried matrix composed of col-
lagen and ORC that is formed into a sheet. In the
presence of wound exudate, the matrix absorbs liquid
and forms a soft, conformable, biodegradable gel that
physically binds and inactivates MMPs. The gel also
binds naturally occurring growth factors within the
wound; this protects them from degradation by pro-
teinases by releasing them back into the wound in an
active form as the gel is slowly broken down. To the
best of my knowledge, the use of this product has not
been described in veterinary literature.
3. Therapy During the Proliferative Phase
The proliferative phase of repair involves epithelial-
ization, fibroplasia, and angiogenesis. The thera-
peutic goal during this phase is to enhance cell
migration and proliferation and limit the activity of
synthetic fibroblasts to avoid excessive deposition of
extracellular-matrix (ECM) components. Assum-
ing that inflammation is now resolved, one might
wish to continue with chemoattractant agents (spe-
cific to endothelial and epithelial cells as well as
fibroblasts) and provide a scaffold for migration
should the natural one be lacking.
The horse activates wound-collagen formation to a
greater extent and earlier during repair than do
other species,13
pre-disposing it to the formation of
exuberant granulation tissue with subsequent re-
tardation of contraction and epithelial migration.
In most species, fibroplasia and epithelialization are
favored by the moist wound environment provided
by certain bandages, whereas in the horse, fully
occlusive dressings significantly prolong healing
times and favor the production of excess wound ex-
udate and granulation tissue.14,15
A notable excep-
tion is achieved with the use of amnion, a biological
occlusive wound dressing.16,17
Proud flesh has been the topic of many new stud-
ies; some focus on its pathophysiology, and others
discuss the prevention of its development. It has
recently been documented in horses that cytokines
and growth factors are key players in the repair
process. In particular, members of the transform-
ing growth factor-beta (TGF-) family have been
incriminated in the fibrotic response to trauma
noted in horse limb wounds.18–20
Because problematic wound repair, including
chronicity and fibrosis, may result from excessive
inflammation and an abnormal cytokine profile, in-
vestigators have attempted to alter this balance to
ameliorate the quality of wound repair in the horse.
Topical application of TGF- improves wound repair
in a variety of species, especially in models of
chronic, impaired wound healing. A study by Steel
et al.21
tested the recombinant growth factor, found
to be effective in laboratory animals, on full-thick-
ness wounds located on the limb of horses. There
were no beneficial effects on total amount of granu-
lation tissue and epithelialization area or on clinical
assessments of wound biopsies. Conversely, Ohne-
mus et al.22
achieved promising results by topically
applying the anti-fibrotic isoform TGF-3 to wounds
on the limbs of horses. Granulation tissue had a
healthier appearance and did not become exuberant
in treated wounds, despite the use of bandages.
Numerous companies now promote products
based on their bioactive molecule (cytokine/growth
factor) content. For example, an all-natural,
equine-specific wound healantg
is currently mar-
keted in the United States. The company claims
that a gel containing activated platelets and their
released growth factors induces wound repair in in-
juries previously deemed untreatable.23
Because
application of a single growth factor does not mimic
natural processes and should not improve healing
unless impairment was caused by the relative lack
of that single protein, a cocktail approach, such as
motivating the use of platelet-rich plasma, might
indeed impart benefit.
Along those same lines, we recently accelerated
wound repair in diabetic rats with topical applica-
tion of elk velvet-antler extracts.24
Velvet antler
contains various growth factors and a soluble ex-
tract that stimulates dermal fibroblast growth in
vitro. According to the premise that slow growth of
dermal fibroblasts from equine limbs may contribute
to the poor healing characteristics of wounds of the
distal aspect of the limbs of horses,25
we suggest
that this extract may be an economical adjunct to
the treatment of full-thickness wounds in this loca-
tion on horses.
AAEP PROCEEDINGS ր Vol. 52 ր 2006 267
IN-DEPTH: CURRENT CONCEPTS IN WOUND MANAGEMENT
4. Therapy During the Remodeling Phase
We recently investigated the efficacy of a silicone-gel
dressingh
in the treatment of proud flesh in limb
wounds of horses. This therapy is successful in
reversing hypertrophic scarring in human burn pa-
tients, apparently by exerting pressure on the mi-
crovasculature of the scar and altering levels of
various growth factors, notably pro-fibrotic TGF-.
The anoxic fibroblasts undergo apoptosis rather
than proliferating and secreting ECM. In our
study, the silicone-gel dressing surpassed a conven-
tional dressing in preventing formation of exuberant
granulation tissue and improving tissue quality in
horse wounds. Microvessels were occluded signifi-
cantly more often in wounds dressed with the sili-
cone gel.26
Thus, we recommend integrating the
silicone dressing into a management strategy de-
signed to improve the repair of limb wounds in
horses.
Tissue engineering is used to develop methods for
the repair and restoration of injured or missing body
parts. ECM is at the heart of most scaffold-based
therapies, because it represents a collection of mole-
cules organized in a three-dimensional ultrastructure,
unique for each tissue/organ. The components are
principally collagen, proteoglycans, glycoproteins, and
growth factors secreted by resident cells that provide,
in addition to the structural framework, a source of
information that contributes to cell phenotype and be-
havior.27
ECM does not cause perfect regeneration
but will accelerate wound closure and improve tissue
quality. The healed, remodeled tissue is associated
with differentiated cell and tissue types with minimal
scar tissue.
A natural biocompatible collagen matrix derived
from porcine small-intestinal submucosai
or uri-
nary-bladder submucosaj
and containing a plethora
of proteins and growth factors is available to veter-
inarians. A recent study determined that porcine
small intestinal submucosa offers no apparent ad-
vantage over a non-biological dressing for treatment
of small, granulating wounds of the distal limb of
horses.28
Indeed, no differences were detected in
bacterial proliferation, inflammatory reaction, vas-
cularization of the graft, and overall healing be-
tween the biological dressing and the non-biological,
non-adherent synthetic pad. This said, ECM scaf-
folds are not intended for applications in which nat-
ural healing results in normal or near-normal tissue
structure and function. Porcine urinary bladder
submucosa has been on the market for a shorter
period of time and has not been evaluated exten-
sively. The perceived best use for this product is in
large avulsion injuries of the distal extremity in
which ECM bioscaffolds provide not only a protec-
tive barrier against dehydration but also a first line
of antibacterial defense, a source of angiogenic and
mitogenic growth factors, and a favorable surface for
accelerated epithelial coverage. The Veterinary
Wound Management Society has planned a multi-
center trial for porcine urinary bladder submucosa
in traumatic wounds of both horses and small
animals.
4. Conclusions
In conclusion, acceleration and improvement of re-
pair may not prove as simple as applying a single
treatment to the wound. A more precise under-
standing of the mechanisms of dermal repair and
scarring in the horse is needed before reasoned ther-
apeutic approaches can be implemented. The abil-
ity to directly influence the repair process is a
powerful impetus to drive research into aspects of
impaired healing, such as that frequently occurring
in the horse.
References and Footnotes
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spective study of primary intention healing and sequestrum
formation in horses compared to ponies under clinical circum-
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2. Theoret CL. Update on wound repair. Clin Tech Equine
Pract 2004;3:110–122.
3. Business Communications Company, Inc. Advanced Wound
Care Business to Cross $3 Billion by 2005. Available online
at http://bccresearch.com/editors/RC-077N.html. Accessed
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in second-intention wound healing between horses and po-
nies: histological aspects. Equine Vet J 1999;31:61–67.
5. Wilmink JM, Veenman JN, van den Boom R, et al. Differ-
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2003;35:561–569.
6. Wilmink JM, Stolk PW, van Weeren PR, et al. The effec-
tiveness of the haemodialysate Solcoseryl for second-inten-
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glycol hydrogel (Solugel) on second intention wound healing
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8. Swaim SF, Vaughn DM, Kincaid SA, et al. Effect of locally
injected medications on healing of pad wounds in
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9. Molan PC. The role of honey in the management of wounds.
J Wound Care 1999;8:415–418.
10. Tonks AJ, Cooper RA, Jones KP, et al. Honey stimulates
inflammatory cytokine production from monocytes. Cyto-
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11. Engelen M, Besche B, Lefay MP, et al. Effects of ketanserin
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12. Jeschke MG, Sandmann G, Schubert T, et al. Effect of oxi-
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Rep Regen 2005;13:324–331.
13. Chvapil M, Pfister T, Escalada S, et al. Dynamics of the
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14. Howard RD, Stashak TS, Baxter GM. Evaluation of occlu-
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15. Berry DB, Sullins KE. Effects of topical application of anti-
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16. Bigbie RB, Schumacher J, Swaim SF, et al. Effects of am-
nion and live yeast cell derivative on second-intention healing
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5. 17. Goodrich LR, Moll DH, Crisman MV, et al. Comparison of
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18. Theoret CL, Barber SM, Moyana TN, et al. Expression of
transforming growth factor b1, b3, and basic fibroblast
growth factor in full-thickness skin wounds of equine limbs
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20. van den Boom R, Wilmink JM, O’Kane S, et al. Transform-
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rh-TGF-b1 on second intention wound healing in horses. Aust
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23. Carter CA, Jolly DG, Worden CE, et al. Platelet-rich plasma
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24. Mikler J, Theoret CL, Haigh J. Effect of topical elk antler
velvet administration on cutaneous wound healing in an an-
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Altern Complement Med 2004;10:835–840.
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26. Ducharme-Desjarlais M, Lepault E´ , Ce´leste C, et al. Deter-
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a
Solcoseryl Solco Basle Ltd, Birsfelden, Switzerland.
b
Solugel, Johnson & Johnson Medical Products, Markham,
Canada L3R 0T5.
c
Carravet Veterinary Products Laboratories, Phoenix, AZ
85067.
d
Intracell Macleod Pharmaceutical, Fort Collins, CO 80525.
e
Vulketan gel, Janssen Animal Health, Beerse, Belgium.
f
Promogran, Johnson & Johnson Medical Products, Markham,
Canada L3R 0T5.
g
Lacerum BeluMedX, Little Rock, AK 72212.
h
Cicacare, Smith Nephew, Hull, UK HU3 2BN.
i
Vet BioSISt, Cook Veterinary Products, Bloomington, IN
47404.
j
ACell Vet, Jessup, MD 20794.
k
Carrasorb, Carrington Laboratories, Irving, TX 75038.
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IN-DEPTH: CURRENT CONCEPTS IN WOUND MANAGEMENT