摘要：Objective The present study aims to explore the individualized treatment options for multisite pressure ulcer (PU) at various stages in elderly patients with multiple medical conditions. Methods Stages 1 and 2 PU at 146 sites were treated with closed negative pressure suction combined with continuous micro-oxygen perfusion and the local application of foam dressings, silver ion dressings, and moist burn cream. Stages 3 and 4 PU in the sacrococcygeal region were treated with skin or myocutaneous flap transplantation. Results Stages 1 and 2 PU healed after treatment with closed negative pressure suction combined with continuous micro-oxygen perfusion and dressing changes. One case died during hospitalization due to an illness. Skin or myocutaneous flap repair was conducted in 34 cases of stage 3 or 4 PU in the sacrococcygeal area. Of these cases, 28 achieved primary healing, and 6 required two or three surgeries, 5 of which received micro-skin implantation. In addition, 10 small deep PU at other sites were repaired by direct excision and suturing or local flap repair. Seven cases were transferred to other departments or hospitals due to concomitant diseases or were discharged automatically without surgical treatment. Conclusion Home care for geriatric patients is difficult. PU often occur at multiple sites because of the duration of various pressures, and different sites may demonstrate different stages because of varying degrees of pressure. When actively treating stages 3 and 4 PU, the trauma management of stages 1 and 2 PU should not be neglected.

摘要：Background and Aim: Natural topical products have been used to enhance wound healing, especially in immunocompromised animals. The aims of this study were to evaluate and to compare the effects of moist exposed burn ointment (MEBO) and honey on the healing of full-thickness skin wounds in immunocompromised dogs. Materials and Methods: The study was conducted using 12 adults, apparently healthy mongrel dogs. Immunosuppression was induced in six dogs by oral administration of prednisone (2 mg/kg) and azathioprine (2 mg/kg), once a day for 21 days. On each dog, a total of 9, 1.5 cm in diameter full-thickness skin circular wounds were created aseptically in the thoracolumbar area under general anesthesia using customized skin punch biopsy kit. In a random fashion, three wounds in each dog were treatment using MEBO (contains b-sitosterol, baicalin, and berberine as active ingredients in a base of beeswax and sesame oil), honey or no treatment (control), once per day for 21 days. Wounds were grossly evaluated once a day for signs of inflammation or infection. In addition, biopsy specimens and digital imaging data of each wound were obtained on days 7, 14, and 21 for histopathological evaluation of the healing process. Results: Wounds in immunocompromised dogs appeared to heal significantly in a slower fashion than in non-immunocompromised counterparts. Digital analysis data showed that MEBO-treated wounds expressed better epithelialization area, faster contraction, and smaller wound area percentage when compared with honey-treated wounds. Histopathological analysis showed significantly higher angiogenesis scores in MEBO-treated wounds when compared with other treatments. Conclusion: Results of this study showed that MEBO resulted in significant enhancement of wound healing in both healthy and immunocompromised dogs. However, when compared to honey, the wound healing effect of MEBO was superior to that of honey.

摘要：Toxic epidermal necrolysis (TEN) is a rare condition that was described by Lyell in 1956. It is a severe, acute, adverse, primarily drug-induced, potentially fatal, cutaneous reaction that is characterized by large areas of skin desquamation and sloughing, similar in many aspects to second-degree burns. The treatment of cutaneous drug reactions rests essentially on immediate diagnosis and recognition of the disease process, accurate history, thorough physical examination, prompt discontinuation of the offending drug, and supportive care. TEN patients are best managed in specialized burn units. Nevertheless, the management remains very much individualized, based on the clinical setting. Topical wound care remains an essential factor in the treatment of burn-like syndromes and is a main determining parameter for morbidity and mortality. As the value of moist environment in wound healing is being fully appreciated, we report on the use of a newly introduced ointment, the Moist Exposed Burn Ointment (Julphar; Gulf Pharmaceutical industries, Ras El-Khaymah, United Arab of Emirutes), a moisture-retentive ointment, in the successful management of a case of TEN.

摘要：Introduction The purpose of this manuscript is to investigate the treatment of skin soft tissue embolization or vascular occlusion after the injection of hyaluronic acid (HA) for Injection Rhinoplasty (IR) in Asians with a special interest in the time occurrence of the occlusion. Methods A total of 35 cases were evaluated after receiving HA injections for IR who presented with a vascular occlusive event. They were divided into three stages based on the time to embolization. Immediate, ≤5 hours; early, ≤3 days; and late, >3 days. There were two cases of immediate, 28 deemed early, and five late. Methods to prevent tissue necrosis are reviewed in the manuscript based on these stages. Results Skin color gradually recovered to normal after 11 treatments in 11 patients with mild embolization. No ischemic aggravation or skin necrosis was observed in 19 patients with moderate embolization; red scarring was seen in two and hypertrophic scar with uneven skin color in one patient. The five patients in the severe category had longer healing, more red scars, and more hypertrophic scarring. Conclusion The treatment of skin soft tissue embolization or vascular occlusion after HA IR in Asians can be effected by identifying the stage and degree of embolization and treating appropriately with the outlines presented in this manuscript.