Wound Healing

WEDNESDAY, March 6, 2024 -- For patients with sutured wounds, application of 2-octyl cyanoacrylate (2-OCA) tends to be preferred by patients and observers, although there are no significant differences in scar cosmesis, according to a study published in the March issue of the Journal of the American Academy of Dermatology.Zachary Kwapnoski, M.D., from the University of California Davis School of Medicine in Sacramento, and colleagues compared the cosmetic outcome and patient wound care satisfaction for an intermediate suture closure and for an intermediate suture closure followed by the application of 2-OCA in a randomized split-scar study involving 50 patients. Following intermediate sutured closure of a surgical defect, one side of the wound received an additional application of 2-OCA. The scar was assessed using the Patient and Observer Assessment Scale (POSAS) tool after three months; wound care preferences were reported by patients.The researchers found that the mean sum of observer POSAS was 12.80 and 12.40 for sutured closure alone and sutured closure followed by 2-OCA, respectively. Both patients and observers tended to favor the 2-OCA treated side in a majority of POSAS components. This trend was also seen for the wound care questionnaire. For most components of wound care, patients favored the use of additional 2-OCA, although the trends were not significant."Our study did not find statistically significant differences in wound care," the authors write. "However, all but one of our wound care questions (comfortability of dressing) tended to favor the 2-OCA treated side."

No significant difference seen in scar cosmesis; patients favored 2-OCA for most components of wound care, although trends were not significant

Patients, Observers Tend to Favor 2-OCA Added to Wound Suture

WEDNESDAY, July 5, 2023 (HealthDay News) -- Lower extremities have the highest rates of surgical site infections following Mohs micrographic surgery (MMS), according to a research letter published online June 24 in the Journal of the American Academy of Dermatology.Ailynna Chen, M.D., M.P.H., from the University of Iowa Carver College of Medicine in Iowa City, and colleagues conducted a systematic review to provide a quantitative estimate of SSI rates across different MMS closure techniques with stratification by body site.Based on 27 included reports, the researchers identified 2,252 flap/graft closures; 3,818 primary closures; and 1,434 secondary intention healing cases. The researchers observed a significant difference between body sites, with lower extremities having the highest SSI rates across all closure types. For head and neck, the pooled SSI rates were 0.01 for flap/graft closures, &lt;0.01 for primary closure, and &lt;0.01 for secondary intention healing; for lower extremity SSI, the corresponding rates were 0.11, 0.05, and 0.04. Except for one study with high risk of bias, studies had low-to-moderate risk of bias."While previous studies suggest that heightened sterility practices (i.e., sterile gloves, single-use instruments, antibiotic prophylaxis) are generally unnecessary for MMS, closure type, body site, and other patient characteristics should also be considered," the authors write.

Findings especially for flap and graft closures

Lower Extremities Have Highest Surgical Site Infection Rates With Mohs Surgery

Thermal images taken in home settings at week 0 can differentiate between healed and unhealed wounds on venous leg ulcers, according to a study published online Oct. 26 in
 
 Scientific Reports
 
 .




 Quoc Cuong Ngo, Ph.D., from RMIT University in Melbourne, Australia, and colleagues used wound data for 56 older participants with venous leg ulcers over 12 weeks. Thermal images of the wounds were collected in their homes and labeled as healed or not healed. Textural information was extracted from the thermal images at week 0, with higher variation of gray tones distribution for thermal images of unhealed wounds.




 The researchers noted that the first three principal components of the textural features from one timepoint can be used as an input to a Bayesian neural network, which can discriminate healed from unhealed wounds. The classification results showed 78.57 and 60.00 percent sensitivity and specificity, respectively, using the optimal Bayesian neural network.




 "Our new work that identifies chronic leg wounds during the first visit is a world-first achievement," a coauthor said in a statement. "This means that specialized treatment for slow-healing leg ulcers can begin up to four weeks earlier than the current gold standard."




 
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Thermal images taken in home settings at week 0 can discriminate healed from unhealed leg venous ulcer wounds

Thermal Images Differentiate Healed From Unhealed Wounds

One-centimeter suture spacing is not associated with improved cosmetic outcomes compared with 2-centimeter suture spacing on wounds, according to a study published online April 27 in the
 
 British Journal of Dermatology
 
 .




 Karin Eshagh, M.D., from the UCLA Medical Center in Los Angeles, and colleagues compared cosmetic outcomes for suturing with 1-cm versus 2-cm interval subcuticular sutures. Fifty patients were enrolled in a randomized split-wound trial where half the wound was repaired with sutures spaced 1 cm apart and half with sutures spaced 2 cm apart. The scar was evaluated by blinded observers and patients three months after surgery using the validated Patient and Observer Scar Assessment Scale (POSAS) assessment instrument.




 The researchers observed no significant difference at three months in the total mean POSAS score for observers for the sides that received 1- and 2-cm interval subcuticular sutures. Furthermore, there was no significant difference between the sides in the patient assessment scale score at three months.




 "Our results do not support the use of increased subcuticular suture use for improvement of cosmetic outcomes on the face and neck, at least for the suture intervals we studied," the authors write.




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No significant difference seen in total mean Patient and Observer Scar Assessment Scale score assessed by patients, observers

Cosmetic Outcome Comparable With 1-, 2-cm Suture Spacing

Nearly 1 million Fitbit Ionic smartwatches sold in the United States have been recalled because they pose a burn hazard, the U.S. Consumer Product Safety Commission (CPSC) said Wednesday. About 693,000 of the smartwatches were also sold in other countries.

 The lithium-ion battery in the Ionic smartwatch can overheat and cause burns, and consumers should immediately stop using them, the CPSC said in a statement.

 Fitbit has received at least 115 reports in the United States and 59 reports from other countries of the battery in the watch overheating. There have been 78 reports of Ionic-related burn injuries in the United States, including two reports of third-degree burns and four reports of second-degree burns. There have been 40 reports of Ionic-related burn injuries from other countries, according to the CPSC.




 The Ionic smartwatches have the model number FB503 on the back of the device near where the band attaches, and Fitbit is printed on the front of the watches. They were sold at Best Buy, Kohl's, Target, and other stores nationwide and online at Amazon.com and Fitbit.com from September 2017 through December 2021. Fitbit stopped production of the Ionic in 2020.




 Consumers with Ionic smartwatches should contact Fitbit to receive prepaid packaging to return the device. After receiving the device, the company will issue each consumer a refund of $299. Fitbit will also provide consumers who return their Ionic smartwatches with a discount code for 40 percent off select Fitbit devices. For more information, consumers can call Fitbit toll-free at 888-925-1764, 24 hours a day, seven days a week or can go to the company's website.




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The lithium-ion battery in the Ionic smartwatch can overheat and cause burns

Fitbit Recalls More Than 1 Million Ionic Smartwatches Due to Burn Hazard

For patients undergoing surgical procedures, continuing biologic disease-modifying antirheumatic drugs (bDMARDs) is associated with a decrease in the risk for disease flares and statistically nonsignificant increases in the risks for surgical site infections and wound complications, according to a review published online Feb. 17 in the
 
 Journal of Bone &amp; Joint Surgery
 
 .




 Bernard H. van Duren, M.B.Ch.B., D.Phil., from the University of Leeds in the United Kingdom, and colleagues conducted a systematic review to compare the risk for infection, delayed wound healing, and disease flares associated with the use of bDMARDs in patients undergoing orthopedic surgical procedures. Eleven studies were included, with data for 7,344 patients: 2,385 who continued and 4,959 who withheld their bDMARDs perioperatively.




 The researchers found that compared with withholding bDMARDs, continuing bDMARDs was associated with a lower risk for disease flares (odds ratio, 0.22; 95 percent confidence interval, 0.05 to 0.95; P = 0.04). The risks for surgical site infections (odds ratio, 1.11; 95 percent confidence interval, 0.82 to 1.49; P = 0.49) and wound complications (odds ratio, 2.16; 95 percent confidence interval, 0.48 to 9.85; P = 0.32) were increased in association with continuing bDMARDs, but the differences were not statistically significant.




 "A significant increase in disease flares was noted among patients who withheld their bDMARDs," the authors write. "Despite capturing data on a large number of patients, we remain cautious regarding the reliability of these data because of the variable quality of the available studies and the lack of randomized controlled trials."




 Two authors disclosed financial ties to the pharmaceutical and medical device industries.




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Limited evidence suggests that continuing biological DMARDs may lower risk for disease flares without increasing risk for postop complications

Evidence Weighed for Perioperative Use of bDMARDs

James Del Rosso, DO talks with Zoe Diana Draelos, MD about topical management of common skin wounds encountered in office practice, formulation characteristics, some basic do&rsquo;s and don&rsquo;ts, and details about data with Aquaphor.

In this episode, James Del Rosso, DO talks with Zoe Diana Draelos, MD about topical management of common skin wounds encountered in office practice, formulation characteristics, some basic do&rsquo;s and don&rsquo;ts, and details about data with Aquaphor. &nbsp; Financial Disclosures: James Del Rosso, DO CONSULTANT/ADVISOR Abbvie, Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), BioFrontera, BioPharmX, Bristol-Myers-Squibb, Cassiopea, Dermata, Dermavant, Encore, EPI Health, Evommune, Ferndale, Galderma, Incyte, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), MC2, Novan, Pfizer, Regeneron, Sanofi-Genzyme, SolGel, Sonoma (IntraDerm), Sun Pharma, Trevi, UCB, Verrica, Vyne (Foamix; Menlo) SPEAKER BUREAU Aclaris, Almirall, Amgen, Arcutis, Bausch Health (Ortho Dermatology), EPI Health, Ferndale, Galderma, Genentech, JEM Health, Leo Pharma, La Roche Posay, Lilly (Dermira), Pfizer, Regeneron, Sanofi-Genzyme, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo)
RESEARCH INVESTIGATOR Aclaris, Almirall, Amgen, Anaptys Bio, Arcutis, Athenex, Bausch Health (Ortho Dermatology), BioPharmX, Biorasi, Botanix, Brickell, Cara Therapeutics, Cassiopea, Dermavant, EPI Health, Ferndale, Galderma, Incyte, Leo Pharma, Lilly (Dermira), Novan, Pfizer, Ralexar, Regeneron, SolGel, Sun Pharma, UCB, Verrica, Vyne (Foamix; Menlo).
 Zoe Diana Draelos, MD Consultant and Research Activities I am or have been a consultant and researcher to the following companies: Aclaris, Aesthetics Biomedical, Aivita, Allergan, Almirall, Amderma, Amgen, AOBiome, Arcutis, Bausch, Bayer, Biopelle, Boehringer Ingelheim, Boots, Botanix, Brickell Biotech, Burt's Bees, Carpe, Chattem, Chlorox, Clark Pharmaceuticals, Clay-Parks Laboratories, Colgate-Palmolive, Coloplast, Combe, DelArrivo, Dermavant, Dermira, Dial, Dr. Reddy's, Estee Lauder, ET Browne, Evolus, Ferndale Laboratories, Foamix, Galderma, Genetech, General Mills, Glaxo, Glenmark, Helix Biomedix, Henkel, Hovione, International Specialty Products, Johnson &amp; Johnson, Kamedis, Kao, LaRoche Posay, Leo, Lilly, L&rsquo;Oreal, Lululemon, Maruho, Menlo, Merck, Milliken, NicePak, Novartis, Nu Skin, Perricone MD, Perrigo, Pfizer, Pharmanet, Proctor &amp; Gamble, Reckitt Benkiser, Regenerist, Revance, Rodan &amp; Fields, Roviant, Sanofi, Schick, SkinCeuticals, Symrise, TEVA Pharmaceuticals USA, Taro, Teoxane, Tolmar, Topix, Vanda, Verrica, Warner-Chilcott, WellSpring, Ya-Man, ZO Skin Health.

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