Assessing antibacterial efficacy of a polyhexanide hydrogel versus alginate-based wound dressing in burns.

Objective: Burn injuries pose a heightened risk of infection, which is primarily responsible for increased morbidity and mortality. Factors such as extensive skin damage and compromised immunity exacerbate this vulnerability. and are frequently identified in burns, with Gram-negative often resistant to antibacterial agents.

[One Health: a perspective of the informal ministerial network : "What if the One Health approach became the guiding theme of cooperation at the national, European and global level?"].

In the view of the German government, the One Health approach is a pioneering compass for inter- and transdisciplinary thinking, networking, and action. To protect the health of humans, animals, plants, and ecosystems, it should always receive attention at all its interfaces and activities. The One Health approach has gained political importance in recent years and is being taken into account in several strategies.

A single-stage bilayered skin reconstruction using Glyaderm® as an acellular dermal regeneration template results in improved scar quality: an intra-individual randomized controlled trial.

Background: Absence of almost the entire reticular dermal layer is inherent to the use of autologous split-thickness skin grafting (STSG) to close full-thickness wounds, often resulting in hypertrophic scars and contractures. Many dermal substitutes have been developed, but unfortunately most have varying results in terms of cosmetic and/or functional improvement as well as patient satisfaction, in addition to high costs. Bilayered skin reconstruction using the human-derived glycerolized acellular dermis (Glyaderm®) has been reported to result in significantly improved scar quality using a two-step procedure.

Pressure therapy for scars: Myth or reality? A systematic review.

Background: Hypertrophic scarring is a deviate occurrence after wound closure and is a common burn sequela. The mainstay of scar treatment consists of a trifold approach: hydration, UV-protection and the use of pressure garments with or without extra paddings or inlays to provide additional pressure. Pressure therapy has been reported to induce a state of hypoxia and to reduce the expression pattern of transforming growth factor-β1 (TGF-β1), therefore limiting the activity of fibroblasts.

Occlusion and hydration of scars: moisturizers versus silicone gels.

Background: The mainstay of non-invasive scar management, consists of pressure therapy with customized pressure garments often combined with inlays, hydration by means of silicones and/or moisturizers as well as UV protection. It is generally accepted that scar dehydration resulting from impaired barrier function of the stratum corneum and expressed by raised trans epidermal water loss (TEWL) values, can lead to increased fibroblast activity and thereby hypertrophic scar formation. However, we have reached no consensus on exactly what optimal scar hydration is nor on barrier function repair: by means of silicone sheets, liquid silicone gels or moisturizers.

Enzymatic debridement: past, present, and future.

Introduction: Early surgical debridement of the deep second and third-degree burns is still the standard of care (SOC) to prepare the wound bed for skin grafting. However, this technique has some drawbacks that explain the growing interest in enzymatic debridement as an alternative. In this article, we provide a historic overview as well as the current state-of-the-art and future prospective of this type of non-surgical debridement.

The use of fluid silicone gels in the prevention and treatment of hypertrophic scars: a systematic review and meta-analysis.

Background: Silicone products, either as a sheet or in fluid form, are universally considered as the first line therapy in the prevention and treatment of hypertrophic scars and keloids. However, the study results have been questioned by different authors and there has never been a large systematic synopsis published on the efficacy of fluid silicone gels. This systematic review aims to elucidate the available evidence of the results obtained by fluid silicone gels and present a complete and comprehensive overview of the available literature as well as a meta-analysis of the pooled data.

The process to obtain reimbursement for enzymatic debridement in clinically deep burns.

Introduction: Burn eschar removal by enzymatic debridement with NexoBrid (EDNX) results in a maximum preservation of all viable tissue, which is the main advantage over traditional tangential excision. The authors participated in a marketing authorization holder process to obtain reimbursement from the national health authorities in Belgium.

Material And Methods: The reimbursement process consisted of three phases, as specified by the reimbursement regulations required by the Belgian National Institute for Health and Disability Insurance (NIHDI).

Evidence Based Burn Depth Assessment Using Laser-Based Technologies: Where Do We Stand?

Early clinical assessment of burn depth and associated healing potential (HP) remains extremely challenging, even for experienced surgeons. Inaccurate diagnosis often leads to prolonged healing times and unnecessary surgical procedures, resulting in incremental costs, and unfavorable outcomes. Laser Doppler imaging (LDI) is currently the most objective and accurate diagnostic tool to measure blood flow and its associated HP, the main predictor for a patient's long-term functional and aesthetic outcome.

Injuries associated with electronic nicotine delivery systems: A systematic review.

Background: Since its introduction on the market in 2007, the number of reports on injuries caused by the overheating, ignition, or explosion of electronic nicotine delivery systems (ENDSs) has increased significantly. These injuries appear to have different causes, the most important one being lithium-ion battery overheating to the point of ignition or explosion.

Methods: A literature search for all relevant studies concerning ENDS-related traumatic injuries of all kinds was conducted, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol.

Phase II study of helical tomotherapy in the multidisciplinary treatment of oligometastatic colorectal cancer.

Background: Complete metastasectomy provides a real chance for long-term survival in patients with oligometastatic colorectal cancer (CRC). For inoperable patients, we evaluated in this study intensity-modulated and image-guided radiotherapy (IMRT-IGRT) by helical tomotherapy.

Methods: Twenty-four CRC patients with ≤ 5 metastases were enrolled, receiving a dose of 50 Gy in fractions of 5 Gy.

Pattern of failure after helical tomotherapy in head and neck cancer.

Background And Purpose: Helical tomotherapy (HT, Hi-Art TomoTherapy(®)) is a recently developed radiation device delivering highly conformal dose with a rotational gantry resulting in more uniform target doses and better avoidance of organs at risk. Treatment failure patterns in head and neck cancer (HNC) patients treated with HT were analyzed.

Patients And Methods: 63 patients with a biopsy-proven HNC were treated with HT.

The effect of tomotherapy imaging beam output instabilities on dose calculation.

A radiotherapy treatment plan is based on an anatomical 'snapshot' of the patient acquired during the preparation stage using a kVCT (kilovolt computed tomography) scanner. Anatomical changes will occur during the treatment course, in some cases requiring a new treatment plan to deliver the prescribed dose. With the introduction of 3D volumetric on-board imaging devices, it became feasible to use the produced images for dose recalculation.

Helical tomotherapy with simultaneous integrated boost for high-risk and lymph node-positive prostate cancer: early report on acute and late toxicity.

The use of whole pelvic radiotherapy (WPRT) for high-risk and lymph node-positive prostate cancer (PC) remains controversial. The purpose of this study was to evaluate the acute toxicity associated with helical tomotherapy in the treatment of high-risk and lymph node-positive prostate cancer. To do so, twenty-eight patients were treated to a dose of 54 Gy in daily fractions of 1.

Dosimetric assessment of static and helical TomoTherapy in the clinical implementation of breast cancer treatments.

Background And Purpose: Investigation of the use of TomoTherapy and TomoDirect versus conventional radiotherapy for the treatment of post-operative breast carcinoma. This study concentrates on the evaluation of the planning protocol for the TomoTherapy and TomoDirect TPS, dose verification and the implementation of in vivo dosimetry.

Materials And Methods: Eight patients with different breast cancer indications (left/right tumor, axillary nodes involvement (N+)/no nodes (N0), tumorectomy/mastectomy) were enrolled.

Preoperative helical tomotherapy and megavoltage computed tomography for rectal cancer: impact on the irradiated volume of small bowel.

Purpose: Preoperative (chemo)radiotherapy is considered to be standard of care in locally advanced rectal cancer, but is associated with significant small-bowel toxicity. The aim of this study was to explore to what extent helical tomotherapy and daily megavolt (MV) CT imaging may reduce the irradiated volume of small bowel.

Methods And Materials: A 3D-conformal radiotherapy (3D-CRT) plan with CTV-PTV margins adjusted for laser-skin marks (15, 15, and 10 mm for X, Y, and Z directions, respectively) was compared with helical tomotherapy (IMRT) using the same CTV-PTV margins, and to helical tomotherapy with margins adapted to daily MV-CT imaging (IMRT/IGRT; 8, 11, 7, and 10 mm for X, Y(ant), Y(post) and Z resp.

The use of molecular imaging to evaluate radiation fields in the adjuvant setting of breast cancer: a feasibility study.

Purpose: To evaluate standard radiation fields in locally advanced breast cancer using the information of a preoperative FDG-PET showing lymph node involvement.

Patients And Methods: In 15 consecutive patients, referred for postoperative radiotherapy, a standard simulation was performed. Planning CT was fused semiautomatically with preoperative FDG-PET, and thoracic wall/breast (clinical target volume [CTV]), lungs, and location(s) of axillary nodal involvement on FDG-PET (PET(ax)) were delineated.

[Conformal radiotherapy: tomotherapy].

Conformal radiation therapy allows the possibility of delivering high doses at the tumor volume whilst limiting the dose to the surrounding tissues and diminishing the secondary effects. With the example of the conformal radiation therapy used at the AZ VUB (3DCRT and tomotherapy), two treatment plans of a left ethmoid carcinoma will be evaluated and discussed in detail. The treatment of ethmoid cancer is technically difficult for both radiation therapy and surgery because of the anatomic constraints and patterns of local spread.

Citizen Involvement in Waste Management: An Application of The STOPER Model via an Informed Consensus Approach.

/ Waste management planning and implementation is not only a technological issue, but a social and political one as well. In this paper, we discuss a proposal to rethink certain aspects about waste management planning and implementation. Specifically, we present a framework whereby the ordinary citizen can proactively and constructively participate in the decision-making process.