For burn patients, topical treatment is as important as systemic treatment. Reasonable and timely wound treatment will influence the homeostatic equilibrium, and the progression, the prognosis, and the outcome of the disease. The therapeutic principle should be varied for wounds with different depth of injury. But avoiding or at least alleviating infection, and accelerating healing period, were the common principles. In common, the medication for local wound treatment includes: topical antiseptic, surgical dressing products, artificial skins, and so on. Ideal topical antiseptic should have the following characteristics: the antimicrobial spectrum is broad, including Pseudomonas aeruginosa and MRSA; be able to penetrate necrotic tissue; does not induce drug resistance easily; no local irritating effect and not painful; no side effect to body;can be applied easily; low cost. The functions of surgical dressing include: protect the wounds, keep the microcirculation open, and accelerate wound healing. Artificial skin has been used as the autoskin carrier in skin transplantation operation for large burn area to protect the autoskin grafts, accelerate wound healing, and cover the wounds temporarily. Burns therapy has developed for 50 years in China, the study of local treatment for burn wounds has also experienced a tortuous path of trial and error. This review might contribute some ideas future research.
Anti-Infective Agents, Local ; therapeutic use ; Bandages ; Burns ; drug therapy ; Humans ; Skin Transplantation ; Skin, Artificial ; Wound Healing

OBJECTIVETo evaluate the therapeutic effect of silver nitrate ointment on partial-thickness burn wounds, and observe its side-effects.

METHODSMulti-center, randomized, positive drug paralleled self-controlled trial was carried out. Eighty patients with superficial partial-thickness burns, and 40 with deep-partial thickness burns were randomized into AgNO3 group and SD-Ag group according to drug topically applied to the wounds. The wound healing time, wound healing rate and bacterial culture of the wound, the effect and safety of the drug, as well as drug irritation to the wounds were studied in these two groups.

RESULTSFor the patients with superficial partial-thickness burn wounds, the wound healing time in silver nitrate group was (9.5 +/- 2.7) days, which was obviously shorter than that in SD-Ag group [(10.8 +/- 3.4) days, P <0.01]. The wound healing rate in silver nitrate group on 7 post-burn day ( PBD) was (77.9 +/- 20.5)%, which was obviously higher than that in SD-Ag group [(67.3 +/- 22.6) %, P < 0.01]. For those with deep-partial thickness burn wounds, the wound healing time in silver nitrate group was (21.5 +/- 4.8) days, which was evidently shorter than that in SD-Ag group [(23.3 +/- 6.4) days, P <0.01]. The wound healing rate in silver nitrate group on 20 PBD was (86.6 +/- 15.9)%, which was evidently higher than that in SD-Ag group [(78.5 +/- 17.7)%, P < 0.01]. Silver nitrate ointment has the same antibacterial effect as 1% SD-Ag cream, but it was less painful when applied to the open wounds.

CONCLUSIONSilver nitrate ointment is an effective and safe medicament for the clinical management of partial-thickness burn wounds.

Adolescent ; Adult ; Anti-Infective Agents, Local ; therapeutic use ; Burns ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Silver Nitrate ; therapeutic use ; Silver Sulfadiazine ; therapeutic use ; Wound Healing

To investigate the clinical effect of cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment in the treatment of pregnancy with otitis externa mycotica.From May 2015 to May 2017,16 cases of pregnant patients(19 ears)with otitis externa mycotica were divided into two groups:pure cleaning up group and cleaning up combined with medication group.In the pure cleaning up group,external auditory canal were only cleaned up under otoendoscope conventionally in 9 patients(11 ears),while in the cleaning up combined with medication group,Clotrimazole Ointment was topically applied after cleaning up the external auditory canal under otoendoscope in 7 patients(8 ears).After treatment of 2 weeks,the clinical curative effect,adverse reaction and average time interval to take effect were compared at the end of treatment.The total effective rate(100%)in cleaning up combined with medication group's was significantly better than that in pure cleaning up group's(81.81%)(<0.05);The average time interval to take effect in cleaning up combined with medication groupwas significantly shorter than that in pure cleaning up group's[(2.71±0.70)d vs(5.40±1.96)d,<0.05].After the two-week treatment,there was a four-week follow-up.Only one patient in pure cleaning up group relapsed.After two-week treatment by Clotrimazole Ointment,this patient was cured.Cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment is effective and safe for the treatment of otitis externa mycotica in pregnant women.The addition of topical application of Clotrimazole Ointment further improve the therapeutic efficacy,as compared to the conventional method of cleaning up the external auditory canal under otoendoscope.We suggest clinical application of this method.
Anti-Infective Agents, Local ; therapeutic use ; Clotrimazole ; therapeutic use ; Ear Canal ; Female ; Humans ; Mycoses ; therapy ; Otitis Externa ; therapy ; Pregnancy ; Pregnancy Complications, Infectious ; therapy ; Sensitivity Training Groups

OBJECTIVETo observe the effects of combined FE enzymes on the infection of the granulation burn wound during late postburn stage in controlling burn wound infection caused by common antibiotic resistant bacteria.

METHODSThirty patients in our burn ward were enrolled and were randomly divided into A [treated with combined FE enzymes (50 ml dissolved in 0-150 ml normal saline to reach the final concentration of 1-3 U/ml)] and B (treated with gentamicin) groups, with 15 patients in each group. Several layers of gauze, either soaked with combined FE enzyme in A or gentamicin in B group, were used to cover the burn wounds once to twice a day. Bacterial culture from the burn wound exudation before and after drug administration was done before the application of the agents. The bacteria in the burn wounds and their susceptibility to antibiotics were identified. The healing time of the burn wounds was recorded. Furthermore, the healing rate of the burn wound was recorded on the 3rd, 5th, 8th, 10th and 12th post skin grafting days (PSGD).

RESULTSThe dominating bacteria in the burn wounds in both groups were Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae and MRSA. The susceptibility rate of bacteria ( MRSA, Staphylococcus epidermidis, Staphylococcus saprophyte, Pseudomonas aeruginosa, Escherichia coli and Enterobacter cloacae) to combined FE enzyme was 93.8%, 100.0%, 100.0%, 100.0%, 100.0% and 95.0% respectively, which were much higher than those in B group (17.6%, 31.3%, 28.6%, 44.0%, 33.3%, 28.0% respectively, P < 0.1. The wound healing time after skin grafting in A group (10.6 +/- 1.5 days) was significantly shorter than that in B group (15.3 +/- 1.7 days, P < 0.01). The wound healing rate on 10 PSGD in A group was (85.4 +/- 2.4)%, and which was only (51.3 +/- 1.5% in B group (P < 0.01)

CONCLUSIONCombined FE enzyme can effectively control burn wound infection, so that the interval between skin grafting and wound healing can be shortened and success rate of skin grafting be improved.

Adolescent ; Adult ; Aged ; Anti-Infective Agents, Local ; therapeutic use ; Bacteria ; isolation & purification ; Burns ; microbiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Muramidase ; therapeutic use ; Wound Infection ; prevention & control

Adult ; Anti-Infective Agents, Local ; therapeutic use ; Female ; Fissure in Ano ; drug therapy ; Humans ; Male ; Middle Aged ; Povidone-Iodine ; therapeutic use ; Pregnancy ; Pregnancy Complications ; Treatment Outcome

OBJECTIVETo explore the influence of silver nanoparticle dressing on prevention of infection and healing of the second degree burn wound.

METHODSOne hundred and ninety-one burn patients with second degree including superficial and deep burn wound were randomly divided into three groups. Group A including 65 cases was treated by silver nanoparticle dressing on wounds, and group B (63 cases) and group C (63 cases) were treated by 1% silver sulfadiazine cream and vaseline gauze on their wounds, respectively. Dressing was changed daily, and wound swab bacterial cultures were performed before and after dressing change, and also wound healing times were recorded in each patient.

RESULTSGroup A and B were similar in their bacterium colonizations on wound after treatment with the silver nanoparticle dressing and 1% silver sulfadiazine cream, and they had a similar effect on reducing bacterium colonization on wound after treatment, while in vaseline gauze group bacterium colonization on wound increased after treatment. In group A the wound healing time of superficial second degree was significantly shorter than those in group B and group C (P < 0.01). In deep second degree wounds the healing time in group A was much shorter than that in group C (P < 0.01), but had no significant difference when compared with group B (P > 0.05).

CONCLUSIONSilver nanoparticle dressing can be used on second degree burn wound and can decrease the risk of wound infection and accelerate wound healing.

Adult ; Anti-Infective Agents, Local ; therapeutic use ; Bandages ; Burns ; therapy ; Female ; Humans ; Male ; Particle Size ; Petrolatum ; therapeutic use ; Silver ; therapeutic use ; Silver Sulfadiazine ; therapeutic use ; Surgical Sponges ; Wound Healing ; drug effects ; Wound Infection ; prevention & control

OBJECTIVETo investigate the effect of antibiotics on postoperative inflammatory complications after surgical extraction of the impacted mandibular third molar.

METHODSNinety-Six patients had their bilateral third molars removed through a split-mouth, double-blind, controlled, clinical trial in two visits. On one side amoxicillin (or clindamycin) was used (antibiotics group) from 1 h pre-operation to 3 d post-operation. On the other side, placebo was used (placebo group) the same time. Postoperative inflammatory complications including alveolar osteitis (AO), surgical site infection (SSI), pre-buccal site infection and anterior isthmus faucium space infection were monitored and recorded 2 d and 10 d after the surgery. The pain, swelling, and trismus were also recorded.

RESULTSAll 96 patients completed the study. Two AO (2.1%), one SSI (1.0%) and seven other infections were observed in the treatment group. Also three AO (3.1%), one SSI (1.0%) and eleven other infections were observed in the placebo group. However, no statistically significant differences were found in the incidence of various postoperative inflammatory complications and reactions between the groups (P > 0.05). There was no significant difference on the postoperative reaction, except pain on 10 d. Patients who had inflammatory infection recovered well with symptomatic anti-infection treatment.

CONCLUSIONSThe use of amoxicillin (or clindamycin) cannot effectively prevent and reduce the postoperative inflammatory complications after surgical extraction of the impacted mandibular third molar.

Amoxicillin ; therapeutic use ; Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Clindamycin ; therapeutic use ; Double-Blind Method ; Dry Socket ; Edema ; Humans ; Molar ; Molar, Third ; Surgical Wound Infection ; prevention & control ; Tooth Extraction ; Tooth, Impacted ; surgery

Anti-Infective Agents, Local ; therapeutic use ; Biosensing Techniques ; Chlorhexidine ; therapeutic use ; Chlorine Compounds ; therapeutic use ; Chromatography, Gas ; Dehydroascorbic Acid ; therapeutic use ; Dental Disinfectants ; therapeutic use ; Halitosis ; diagnosis ; therapy ; Humans ; Hydrogen Peroxide ; therapeutic use ; Mouthwashes ; therapeutic use ; Odorants ; prevention & control ; Oils, Volatile ; therapeutic use ; Oral Hygiene ; instrumentation ; Oxides ; therapeutic use ; Sodium Bicarbonate ; therapeutic use ; Sulfur Compounds ; analysis

OBJECTIVETo evaluate the wound healing potential of fractions from ethanol extract of Martynia annua (M. annua) Linn leaves.

METHODSEthanol extract of M. annua Linn leaves was fractionate into three different fractions (MAF-A, MAF-B and MAF-C) which were screened for wound healing potential using two models: excision and incision on rats. The thin layer chromatography (TLC) profile of all fractions were analyzed and TLC of luteolin was also done. The Povidone-Iodine Ointment was used as reference for comparision. Excision and incision wounds were created on dorsal portion of rats for study. Wound contraction, biochemical parameters (protein level and hydroxyproline level) and histopathological study were performed in excision wound model whereas incision model was used for determination of tensile strength.

RESULTSThe wound contraction and tensile strength of skin tissues were observed significantly greater in MAF-C fraction treated group than other two fractions (P<0.01). In excision wound method (on day 18) protein content and hydroxyproline were found significantly higher in MAF-C group than control group (P<0.01). Histopathological study also showed better angiogenesis, matured collagen fibres and fibroblast cells as compared with the control group.

CONCLUSIONSIn conclusion, our findings suggest that fraction MAF-C from ethanol extract of M. annua leaves is found most effective in wound healing.

Animals ; Anti-Infective Agents, Local ; isolation & purification ; therapeutic use ; Female ; Growth Substances ; isolation & purification ; therapeutic use ; Male ; Plant Extracts ; isolation & purification ; therapeutic use ; Plant Leaves ; chemistry ; Rats, Wistar ; Tracheophyta ; chemistry ; Treatment Outcome ; Wound Healing ; drug effects

Effective final irrigation regimen is an important step in order to achieve better disinfection and ensure residual antimicrobial effects after root canal preparation. The aim of this study was to compare the residual antimicrobial activity of 0.2% cetrimide, and 0.2% and 2% chlorhexidine in root canals infected with Enterococcus faecalis. Biofilms of E. faecalis were grown on uniradicular roots for 4 weeks. After root canal preparation, root canals were irrigated with 17% ethylenediaminetetraacetic acid (EDTA) to remove the smear layer. The roots were randomly divided into three experimental groups (n=26) according to the final irrigating solution: Group I, 5 mL 0.2% cetrimide; Group II, 5 mL 0.2% chlorhexidine; and Group III, 5 mL 2% chlorhexidine. Samples were collected for 50 days to denote the presence of bacterial growth. The proportion of ungrown specimens over 50 days was evaluated using the nonparametric Kaplan-Meier survival analysis. Differences among groups were tested using the log-rank test and the level of statistical significance was set at P<0.05. The highest survival value was found with 2% chlorhexidine, showing statistically significant differences from the other two groups. At 50 days, E. faecalis growth was detected in 69.23% specimens in Groups I and II, and in 34.61% specimens of Group III. There were no significant differences between 0.2% cetrimide and 0.2% chlorhexidine. Final irrigation with 2% chlorhexidine showed greater residual activity than 0.2% chlorhexidine and 0.2% cetrimide in root canals infected with E. faecalis.
Anti-Infective Agents, Local ; administration & dosage ; therapeutic use ; Bacterial Load ; drug effects ; Biofilms ; drug effects ; Cetrimonium Compounds ; therapeutic use ; Chlorhexidine ; administration & dosage ; therapeutic use ; Dental Pulp Cavity ; microbiology ; Edetic Acid ; therapeutic use ; Enterococcus faecalis ; drug effects ; Gram-Positive Bacterial Infections ; drug therapy ; Humans ; Microscopy, Electron, Scanning ; Root Canal Irrigants ; administration & dosage ; therapeutic use ; Root Canal Preparation ; methods ; Smear Layer ; Time Factors