chondroitin-sulfates and Pain--Postoperative

The use of platelet-rich fibrin (PRF) has attracted great interest in the treatment of oral and maxillofacial procedures, gingival recessions, and bone healing. However, PRF has been reported hardly to prepare wound bed before skin grafting. This randomized clinical study sought to identify the effect of PRF as an alternative adjunct to tendon-exposed wound healing.. Thirty-six patients with tendon-exposed wounds were treated by applying Integra or PRF (n=18 per group). The take rate of Integra or PRF and pain levels assessed with the four-point verbal rating scale (VRS-4) for the first 5days after application were measured for each condition. Data of texture change analysis were assessed and recorded for a duration of 3 months postoperatively.. The take rate was less in the Integra group than in the PRF group (92.39 vs 97.83 P<0.001). After surgery, compared to the Integra group, the patients in the PRF group reported significantly lower pain scores (P<0.001). Texture changes from the Integra group were rated higher than those from the PRF (P<0.001).. The use of PRF could be an option for tendon exposed areas where the wound is unfit for standard skin grafting or flap transfer.

Topics: Adult; Chondroitin Sulfates; Collagen; Female; Humans; Male; Middle Aged; Pain Management; Pain, Postoperative; Platelet-Rich Fibrin; Skin Transplantation; Tendons; Wound Healing; Wounds and Injuries; Young Adult

To investigate the effectiveness and safety of instilling highly concentrated hyaluronic acid (HA)/chondroitin sulphate (CS) on ureteric stent-related pain, urinary symptoms, and quality of life (QoL) of patients who underwent ureteroscopic lithotripsy for ureteric stones followed by ureteric stent placement.. Eligible patients were randomly allocated to receive intravesical instillation with HA/CS or normal saline just after ureteric stent placement. Just before stent removal on postoperative day 7, the patients completed the Ureteric Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS) QoL question, and a pain visual analogue scale (VAS).. In total, 92 patients (46 each in the treatment and control arms) completed the study. The groups did not differ in terms of age or stent indwelling time. Compared with the control group, the treatment group had significantly lower USSQ urinary symptom domain scores (24.6 vs 32.5; P < 0.001), better IPSS QoL scores (3.5 vs 4.4, P = 0.018), and lower VAS pain scores (2.0 vs 3.2; P < 0.001). They also had lower total body pain subscores (16.7 vs 22.0; P = 0.01) and lower additional pain subscores due to urinary tract infections (2.1 vs. 3.2; P = 0.01) in the USSQ.. Highly concentrated HA/CS effectively improved urinary symptoms and pain, and reduced the need for additional medication or procedures after ureteric stent placement.

Topics: Administration, Intravesical; Adult; Chondroitin Sulfates; Female; Humans; Hyaluronic Acid; Lithotripsy; Lower Urinary Tract Symptoms; Male; Middle Aged; Pain Measurement; Pain, Postoperative; Pilot Projects; Stents; Ureter; Ureteroscopy; Urinary Calculi; Urological Agents

Reduction mammaplasty is a common procedure performed by plastic and reconstructive surgeons to relieve chronic back and neck pain associated with macromastia, with the added benefit of an improvement in the aesthetic contour of the ptotic breast. Complications related to this procedure are fortunately uncommon, but include hematoma, infection, and wound breakdown. The authors report an interesting case of reduction mammaplasty complicated postoperatively by pyoderma gangrenosum (PG), which is a rare inflammatory disorder leading to progressive skin necrosis. The destructive process, which involved both breast incisions, was managed successfully with immunosuppressive therapy and intensive wound care, followed by a novel method of coverage with a dermal regeneration template and subsequent epidermal autograft that led to stable coverage of the open wounds. PG is frequently misdiagnosed as a necrotizing infection, leading to improper debridement with exacerbation of the disease process. The mainstay of therapy for PG is still nonoperative and focuses on immunosuppressive medications and local wound care, which allows healing in most cases. However, there are a few indications for surgical intervention, including significantly large wounds that are refractory to medical management. It is important for plastic surgeons and other clinicians to be cognizant of this entity, as a delay in diagnosis and management of PG can lead to serious consequences, with considerable soft tissue loss and disfigurement of the breast.

Topics: Bandages; Chondroitin Sulfates; Collagen; Debridement; Female; Humans; Immunosuppressive Agents; Mammaplasty; Middle Aged; Pain, Postoperative; Postoperative Complications; Pyoderma Gangrenosum; Skin Transplantation