Background: Hepatic ischemia-reperfusion injury (IRI) is a complex process involving multiple mediators that initiate inflammatory responses, ultimately leading to cell necrosis and apoptosis. During hepatic IRI, various inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), and reactive oxygen species (ROS) exacerbate liver injury. Infliximab is an antibody that neutralizes TNF-α, and suppression of TNF-α activity with infliximab treatment can protect the liver from IRI. Splenectomy also alleviates hepatic IRI by decreasing neutrophil infiltration, reducing the release of ROS into the hepatic sinusoids, and suppressing TNF-α release. This study aimed to evaluate the effects of infliximab on hepatic IRI based on inflammatory responses, oxidative stress, and apoptosis, and to compare these effects with those of splenectomy. Methods: Twenty-four rats were randomly assigned to the following four groups: (1) sham, (2) hepatic ischemia-reperfusion (IR), (3) hepatic IR with 10 mg/kg infliximab, and (4) hepatic IR with splenectomy. Each group consisted of six rats. Hepatic ischemia was induced for 30 minutes, followed by 2 hours of reperfusion injury. Infliximab was administered intraperitoneally 1 hour before surgery and splenectomy was performed immediately before hepatic ischemia. Results: Infliximab and splenectomy downregulated the levels of liver enzymes (aspartate aminotransferase [p<0.001 for all] and alanine aminotransferase [p<0.001 for all]), a prooxidant (malondialdehyde [p=0.006 for infliximab; p<0.001 for splenectomy]), inflammatory cytokines (TNF-α and nuclear factor kappa B [p<0.001 for all]), and an apoptotic mediator (caspase-3 [p=0.005 for infliximab; p=0.004 for splenectomy]) compared with those with hepatic IR alone. Conclusion Infliximab treatment and splenectomy mitigated hepatic IRI. These protective effects are likely mediated via anti-inflammatory, antioxidative, and antiapoptotic pathways within the pathophysiology of hepatic IRI.

Wound pain is a common issue during wound care procedures such as dressing changes and debridement, significantly affecting patient comfort and recovery. Effective pain management is essential, not only for enhancing quality of life but also for promoting healing and minimizing complications. Factors like resting pain intensity, expected pain, and type of dressing have been identified as key predictors of severe wound pain during these procedures, helping clinicians manage pain more effectively by enabling early intervention. The Wound Pain Management Model was developed to guide healthcare professionals in managing chronic wound pain through steps like wound assessment, local treatment, and systemic management when necessary. While opioids are a common treatment, concerns over dependence and side effects have led to the exploration of alternatives. Virtual reality (VR) has emerged as a promising non-pharmacological approach, reducing pain through distraction, particularly in burn and chronic wound care. However, variability in study designs limits the current understanding of VR’s overall effectiveness. This review examines both pharmacological and non-pharmacological approaches to wound pain management, with a focus on VR. Further research with larger, more consistent studies is needed to better assess VR’s long-term benefits across different patient groups and wound types.