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Jorge Berlangaacosta - One of the best experts on this subject based on the ideXlab platform.
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intralesional administration of epidermal growth factor based formulation heberprot p in chronic diabetic foot ulcer treatment up to complete Wound Closure
International Wound Journal, 2009Co-Authors: Jose I Fernandezmontequin, Elizeth Garciaiglesias, Blas Y Betancourt, Gisselle Leyvagonzalez, Ernesto L Mola, Katia Galannaranjo, Mayte Ramireznavas, Sergio Bermudezrojas, Felix Rosales, Jorge BerlangaacostaAbstract:Previous studies have shown that an epidermal growth factor-based formulation (Heberprot-P) can enhance granulation of high-grade diabetic foot ulcers (DFU). The aim of this study was to explore the clinical effects of this administration up to complete Wound Closure. A pilot study in 20 diabetic patients with full-thickness lower extremity ulcers of more than 4 weeks of evolution was performed. Mean ulcer size was 16·3 ± 21·3 cm2. Intralesional injections of 75 μg of Heberprot-P three times per week were given up to complete Wound healing. Full granulation response was achieved in all 20 patients in 23·6 ± 3·8 days. Complete Wound Closure was obtained in 17 (85%) cases in 44·3 ± 8·9 days. Amputation was not necessary in any case and only one relapse was notified. The most frequent adverse events were tremors, chills, pain and ardour at site of administration and local infection. The therapeutic scheme of intralesional Heberprot-P administration up to complete Closure can be safe and suitable to improve the therapeutic goal in terms of healing of chronic DFU.
Jose I Fernandezmontequin - One of the best experts on this subject based on the ideXlab platform.
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granulation response and partial Wound Closure predict healing in clinical trials on advanced diabetes foot ulcers treated with recombinant human epidermal growth factor
Diabetes Care, 2013Co-Authors: Carmen M Valenzuelasilva, Angela D Tueroiglesias, Elizeth Garciaiglesias, Odalys Gonzalezdiaz, Amaurys Del Riomartin, Isis Belkis Yera Alos, Jose I Fernandezmontequin, Pedro LopezsauraAbstract:OBJECTIVE To determine if partial Wound Closure surrogate markers proposed for neuropathic, small diabetic foot ulcers (DFUs) can be extended to advanced lesions and if the development of granulation tissue can be used to predict complete healing. RESEARCH DESIGN AND METHODS Data from two multicenter, double-blind, randomized clinical trials (one of them placebo controlled) that used intralesional recombinant human epidermal growth factor (rhEGF) to promote granulation and healing were used. For confirmation in a larger sample from common clinical practice, the results of an active postmarketing surveillance of rhEGF treatment of DFUs in 60 healthcare units was included. The surrogates evaluated were percent area change, log healing rate, ratio of log areas, and percent of granulation tissue covering the Wound area. The tests used were surrogate final end point correlation, receiver operating characteristic curves to discriminate healers from nonhealers, validation tests using logistic regression models, and the proportion-mediated estimation. RESULTS Two weeks >50% granulation, end of treatment >75% granulation, and 16.1% area change showed significant predictive value (>70% correct classification) for final Wound Closure. The granulation-based variables fulfilled the criterion that the effect of rhEGF treatment on Wound Closure was mediated by the surrogate. CONCLUSIONS This work provides the first evidence for the use of granulation tissue development as a predictor of Wound healing in advanced DFUs. These results can be useful for clinical trial design, particularly during the exploratory phase of new products.
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intralesional administration of epidermal growth factor based formulation heberprot p in chronic diabetic foot ulcer treatment up to complete Wound Closure
International Wound Journal, 2009Co-Authors: Jose I Fernandezmontequin, Elizeth Garciaiglesias, Blas Y Betancourt, Gisselle Leyvagonzalez, Ernesto L Mola, Katia Galannaranjo, Mayte Ramireznavas, Sergio Bermudezrojas, Felix Rosales, Jorge BerlangaacostaAbstract:Previous studies have shown that an epidermal growth factor-based formulation (Heberprot-P) can enhance granulation of high-grade diabetic foot ulcers (DFU). The aim of this study was to explore the clinical effects of this administration up to complete Wound Closure. A pilot study in 20 diabetic patients with full-thickness lower extremity ulcers of more than 4 weeks of evolution was performed. Mean ulcer size was 16·3 ± 21·3 cm2. Intralesional injections of 75 μg of Heberprot-P three times per week were given up to complete Wound healing. Full granulation response was achieved in all 20 patients in 23·6 ± 3·8 days. Complete Wound Closure was obtained in 17 (85%) cases in 44·3 ± 8·9 days. Amputation was not necessary in any case and only one relapse was notified. The most frequent adverse events were tremors, chills, pain and ardour at site of administration and local infection. The therapeutic scheme of intralesional Heberprot-P administration up to complete Closure can be safe and suitable to improve the therapeutic goal in terms of healing of chronic DFU.
David E E Holck - One of the best experts on this subject based on the ideXlab platform.
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comparison of postoperative eyelid position using fibrin sealant versus suture for Wound Closure in muller s muscle conjunctiva resection ptosis repair
Plastic and Reconstructive Surgery, 2011Co-Authors: Craig N Czyz, Julian D. Perry, Nicole Rich, Jill A Foster, Marsha C Kavanagh, David E E HolckAbstract:Background: The purpose of this study was to compare postoperative eyelid position using fibrin sealant versus suture for Wound Closure in Muller's muscle–conjunctiva resection ptosis repair. Methods: One hundred ninety-six patients (367 eyelids) who underwent Muller's muscle–conjunctiva resection ptosis repair were divided into two groups: Wounds closed with suture and those closed with fibrin sealant. Preoperative and postoperative eyelid measurements were compared statistically using appropriate t tests. Complications, eyelid symmetry, and revision rates were analyzed using a two-tailed Fisher's exact test. Results: Suture was used for Wound Closure on 53 eyelids of 39 patients and fibrin sealant was used on 314 eyelids of 157 patients. There was no statistically significant difference (p = 0.49) when comparing the change from preoperative to postoperative margin-to-reflex distance 1 between the two groups. Postoperative symmetry within 0.5 mm was achieved in 87 percent of patients in the suture group and in 96 percent of patients in the fibrin sealant group (p = 0.06). The percentage of patients requiring additional ptosis adjustment was 2 percent in both groups (p = 1.0). Major complications were more common in the suture group (p = 0.0001). Conclusions: Muller's muscle–conjunctiva resection ptosis repair using fibrin sealant for Wound Closure offers equivalent lid position and symmetry as compared with suture Wound Closure. There is also a reduction in major postoperative complications when using fibrin sealant.
Henrik Husted - One of the best experts on this subject based on the ideXlab platform.
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tissue adhesive for Wound Closure reduces immediate postoperative Wound dressing changes after primary tka a randomized controlled study in simultaneous bilateral tka
Clinical Orthopaedics and Related Research, 2019Co-Authors: Kirill Gromov, Anders Troelsen, Sofie Raaschou, Hakon Sandhold, Christian Skovgaard Nielsen, Henrik Kehlet, Henrik HustedAbstract:AbstractBackgroundProlonged Wound drainage after TKA is associated with increased risk of infection. To decrease Wound drainage, tissue adhesive has been suggested as an adjunct to Wound Closure after TKA; however, no studies of which we are aware have investigated the effect of tissue adhesive in a
Mary Evans - One of the best experts on this subject based on the ideXlab platform.
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abdominal Wound Closure a trial of nylon polyglycolic acid and steel sutures
British Journal of Surgery, 2005Co-Authors: D J Leaper, A V Pollock, Mary EvansAbstract:Failures after abdominal Wound Closure (early dehiscences and late incisional hernias) are due to breakage of sutures, slippage of knots or tearing out of sutures from the tissues. The suture-holding capacity of the entire thickness of muscle and aponeurosis is nearly twice that of the anterior rectus sheath, and deep bites (1·0 cm from the cut edges) are nearly twice as secure as bites of 0·5 cm. In a random controlled clinical trial of 357 major laparotomies, Closure with either layered monofilament nylon or mass polyglycolic acid or steel resulted in 2 burst abdomens (0·56 per cent), 10 incisional hernias due to suture failure (3·4 per cent) and 8 incisional hernias caused by deep sepsis (2·7 per cent). There were no statistically significant differences among the treatment groups, but 1 patient in the nylon and 3 in the steel groups had persistent sinuses until their sutures were removed.
