Unveiling the language of scars: A patient-centric themed framework for comprehensive scar morphology.

Background: Scarring, a pervasive issue spanning across medical disciplines, lacks a comprehensive terminology for effective communication, patient engagement, and outcome assessment. Existing scar classification systems are constrained by specific pathologies, physician-centric features, and inadequately account for emerging technologies. This study refrains from proposing yet another classification system and instead revisits the foundational language of scar morphology through a theme analysis of primary patient complaints.

Sharps and needlestick injuries within the operating room: Risk prone procedures and prevalence meta-analysis.

Background: Sharps and needlestick injuries pose a serious risk to operating theatre personnel with considerable morbidity, mortality and healthcare implications. The cost of prophylaxis and post-exposure treatment is a significant institutional economic burden.

Aim: The aim of the review was to identify the prevalence of sharps and needlestick injury within the operating theatre and to establish the most common critical steps.

Augmented reality for teaching anatomy.

Successive waves of the coronavirus (COVID-19) pandemic lockdowns resulted in significant reduction in face-to-face teaching, with an adverse effect especially on sectors requiring direct skill acquisition. Despite the fact that augmented reality (AR) presents an equitable, cost-effective solution which reduces crowding in the confined spaces of the dissection theater, the benefits of AR-supported undergraduate medical education have been poorly investigated. We conducted a validated survey to explore the value of AR in the dissection theater and assess its impact from the learner's perspective.

Picosecond laser versus historical responses to Q-switched lasers for tattoo treatment.

BackgroundTattooing is increasingly common among adolescents and young adults. This study explores the clinical efficacy of picosecond laser for the correction of tattoos. Literature suggests that 25-47% of the population have had a tattoo at some point in their life (1).

Value of clinical, ultrasonographic and MRI signs as diagnostic differentiators of non-benign lipomatous tumours.

Suspicion of malignant change within a lipoma is a common and increasing workload within the UK Sarcoma multidisciplinary team (MDT) network, and a source of considerable patient anxiety. Currently, there is no lipoma-specific data, with regard to which clinical or radiographic features predict non-benign histology, or calculate an odds-ratio specific to a lipomatous lesion being non-benign. We performed a 9-year, double-blind, unmatched cohort study, comparing post-operative histology outcomes (benign versus non-benign) versus 15 signs across three domains: Clinical (size of tumour, depth, growth noticed by patient, previous lipoma, patient felt pain), Ultrasonographic (size, depth, vascularity, heterogenous features, septae) and MRI (size, depth, vascularity, heterogenous features, septae, complete fat signal suppression).

Cutaneous laser surgery for secondary burn reconstruction: Cost benefit analysis.

Thermal disease presents a major burden to individual patient morbidity, healthcare cost as well as to over all economy. Burns also also represent a significant per-patient utlilisation of finite healthcare resources. Secondary complications in these patients, such as multiple drug resistant organisms, may have a devastating effect.

New Developments for Fractional Co Resurfacing for Skin Rejuvenation and Scar Reduction.

Fractional CO procedures are an established, safe and effective armamentarium for managing skin rejuvenation and scarring. Very short-pulse-duration devices offer a very high ablated volume/ablated surface ratio, inducing a controlled thermal damage. With this kind of device, each procedure can be customized on the features of the skin of each patient.

Measuring coagulation in burns: an evidence-based systematic review.

Introduction: Dynamic monitoring of coagulation is important to predict both haemorrhagic and thrombotic complications and to guide blood product administration. Reducing blood loss and tailoring blood product administration may improve patient outcome and reduce mortality associated with transfusion. The current literature lacks a systematic, critical appraisal of current best evidence on which clinical decisions may be based.

Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars.

The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for patient and physician alike.

Chromophores in operative surgery: Current practice and rationalized development.

Background: Chromophore-containing molecules feature extensively in surgical practice, with synthetic dyes gaining popularity over endogenous optical adjuncts. New applications for chromophores in diagnostics and operative treatment exploit unique chemical structures suited for illuminating target tissues beyond the visual spectrum, ranging from ultraviolet (UV) to near-infrared (NIR). This review outlines the rationale for surgical chromophore application, the weaknesses and risks in each class of these compounds, and areas of foreseeable potential for employment of specialized contrast agents.

Polymer therapeutics in surgery: the next frontier.

Polymer therapeutics is a successful branch of nanomedicine, which is now established in several facets of everyday practice. However, to our knowledge, no literature regarding the application of the underpinning principles, general safety, and potential of this versatile class to the perioperative patient has been published. This study provides an overview of polymer therapeutics applied to clinical surgery, including the evolution of this demand-oriented scientific field, cutting-edge concepts, its implications, and limitations, illustrated by products already in clinical use and promising ones in development.

Polyaniline-graphene based α-amylase biosensor with a linear dynamic range in excess of 6 orders of magnitude.

α-amylase is an established marker for diagnosis of pancreatic and salivary disease, and recent research has seen a substantial expansion of its use in therapeutic and diagnostic applications for infection, cancer and wound healing. The lack of bedside monitoring devices for α-amylase detection has hitherto restricted the clinical progress of such applications. We have developed a highly sensitive α-amylase immunosensor platform, produced via in situ electropolymerization of aniline onto a screen-printed graphene support (SPE).

Clinical applications of amylase: Novel perspectives.

Background: Amylase was the first enzyme to be characterized, and for the previous 200 years, its clinical role has been restricted to a diagnostic aid. Recent interface research has led to a substantial expansion of its role into novel, viable diagnostic, and therapeutic applications to cancer, infection, and wound healing. This review provides a concise "state-of-the-art" overview of the genetics, structure, distribution, and localization of amylase in humans.

Development and validation of an in vitro pharmacokinetic/pharmacodynamic model to test the antibacterial efficacy of antibiotic polymer conjugates.

This study describes the use of a novel, two-compartment, static dialysis bag model to study the release, diffusion, and antibacterial activity of a novel, bioresponsive dextrin-colistin polymer conjugate against multidrug resistant (MDR) wild-type Acinetobacter baumannii. In this model, colistin sulfate, at its MIC, produced a rapid and extensive drop in viable bacterial counts (<2 log10 CFU/ml at 4 h); however, a marked recovery was observed thereafter, with regrowth equivalent to that of control by 48 h. In contrast, dextrin-colistin conjugate, at its MIC, suppressed bacterial growth for up to 48 h, with 3 log10 CFU/ml lower bacterial counts after 48 h than those of controls.

Dextrin-colistin conjugates as a model bioresponsive treatment for multidrug resistant bacterial infections.

Polymer therapeutics offer potential benefits in the treatment of multidrug resistant (MDR) infections; affording targeted delivery of biologically active agents to the site of inflammation, potential decreases in systemic toxicity, and the retention of antimicrobial activity at the target site. As a prototype model, these studies developed and characterized a library of dextrin-colistin conjugates (dextrin molecular weight: 7500-48,000 g/mol) as a means of targeting the delivery of colistin. Optimum colistin release kinetics (following dextrin degradation by physiological concentrations of amylase (100 IU/L)) were observed in conjugates containing low molecular weight (∼7500 g/mol) dextrin with ∼1 mol % succinoylation (∼80% drug release within 48 h, compared to ∼33% from sodium colistin methanesulfonate (CMS, Colomycin)).

Gram negative wound infection in hospitalised adult burn patients--systematic review and metanalysis-.

Background: Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres.

Application of topical negative pressure (vacuum-assisted closure) to split-thickness skin grafts: a structured evidence-based review.

Introduction: Significant controversy surrounds the effectiveness of negative pressure wound therapy although it has been in use for decades. Although many clinicians favor this modality in relation to its practicality, ease of use especially in complex wounds, it has faced the same challenges as other dressings in relation to evidence base of efficacy in relation to a number of outcome measures. In view of the current financial pressures on health care systems worldwide, this structured review systematically challenges the evidence for perioperative application of topical negative pressure (TNP) to split-thickness skin grafts (STSGs) through evidence-based critical appraisal, and extrapolate the mechanisms of action on the mechanisms through which TNP may aid wound healing.

The enhanced permeability retention effect: a new paradigm for drug targeting in infection.

Multidrug-resistant, Gram-negative infection is a major global determinant of morbidity, mortality and cost of care. The advent of nanomedicine has enabled tailored engineering of macromolecular constructs, permitting increasingly selective targeting, alteration of volume of distribution and activity/toxicity. Macromolecules tend to passively and preferentially accumulate at sites of enhanced vascular permeability and are then retained.

Clostridium histolyticum collagenase in the treatment of Dupuytren's contracture.

Dupuytren's disease is a common, costly and recurrent health issue. This review compares Clostridium histolyticum collagenase with current operative treatments. Collagenase management is an effective non-surgical alternative associated with lower risks of serious adverse events, but higher incidence of non-serious adverse events.

Colistin in burn intensive care: back to the future?

Colistin is a venerable antibiotic whose fortunes have been revived by its excellent activity, the diminishing output of novel clinically effective antibiotics and the increasing importance of MDR infection in burn surgery, both in the civilian and military arenas. This review synthesizes current evidence on the usage of colistin in burn surgery including the structure-activity relationship; dosing, pharmacokinetics/pharmacodynamic (PK/PD), analytic methods, resistance and current research efforts into the redevelopment of this antibiotic, to distil recommendations for future research and clinical efficacy.

Colistin past and future: a bibliographic analysis.

Objective: Colistin is a venerable drug that has found renewed interest because of multidrug resistance (MDR) and the shortfall of effective antibiotics. We present a synthesis of publication trends on MDR infection, colistin, and its adverse events, as a measure of the medical-academic community's interest, to inform current redevelopment strategies.

Design: This was a multidatabase electronic search over 50 years with back- and forward-referencing through Web of Knowledge.

The efficacy of medicinal leeches in plastic and reconstructive surgery: a systematic review of 277 reported clinical cases.

Background: Although there are numerous case reports and small case series describing the experiences of leech therapy in various circumstances, there are relatively few large studies evaluating the effectiveness of leeching to relieve venous congestion. The therapeutic value of leeching is illustrated by these reports but the current literature lacks a cohesive summary of previous experiences.

Methods: An electronic search of PubMed, the Cochrane library and the Centre for Reviews and Dissemination between 1966 and 2009 was used to retrieve human studies published in the English language evaluating outcomes following leech therapy.