Tissue-engineered skin is a significant advance in the field of wound healing. It has mainly been developed because of limitations associated with the use of autografts and allografts where the donor site suffers from pain, infection, and scarring. Recently, tissue-engineered skin replacements have been finding widespread application, especially in the case of burns, where the major limiting factor is the availability of autologous skin. The development of a bioartificial skin facilitates the treatment of patients with deep burns and various skin-related disorders. The present review gives a comprehensive overview of the developments and future prospects of scaffolds as skin substitutes for tissue repair and regeneration.
In this study, the potential of cryogel bilayer wound dressing and skin regenerating graft for the treatment of surgically created full thickness wounds was evaluated. The top layer was composed of polyvinylpyrrolidone-iodine (PVP-I) cryogel and served as the antiseptic layer, while the bottom regenerative layer was made using gelatin cryogel. Both components of the bilayer showed typical features of a cryogel interconnected macropore network, rapid swelling, high water uptake capacity of about 90%. Both PVP and gelatin cryogel showed high tensile strength of 45 and 10 kPa, respectively. Gelatin cryogel sheets were essentially elastic and could be stretched without any visible deformation. The antiseptic PVP-I layer cryogel sheet showed sustained iodine release and suppressed microbial growth when tested with skin pathogens (zone of inhibition ∼2 cm for sheet of 0.9 cm diameter). The gelatin cryogel sheet degraded in vitro in weeks. The gelatin cryogel sheet supported cell infiltration, attachment, and proliferation of fibroblasts and keratinocytes. Microparticles loaded with bioactive molecules (mannose-6-phosphate and human fibrinogen) were also incorporated in the gelatin cryogel sheets for their role in enhancing skin regeneration and scar free wound healing. In vivo evaluation of healing capacity of the bilayer cryogel was checked in rabbits by creating full thickness wound defect (diameter 2 cm). Macroscopic and microscopic observation at regular time intervals for 4 weeks demonstrated better and faster skin regeneration in the wound treated with cryogel bilayer as compared to untreated defect and the repair was comparable to commercial skin regeneration scaffold Neuskin-F. Complete skin regeneration was observed after 4 weeks of implantation with no sign of inflammatory response. Defects implanted with cryogel having mannose-6-phosphate showed no scar formation, while the wound treated with bilayer incorporated with human fibrinogen microparticles showed early signs of skin regeneration; epidermis formation occurred at 2 weeks after implantation.
Introduction: Diagnosis of fungal infection is mostly relied on clinical skills assisted by array of diagnostic methods. Culture and molecular testing are specific but lacks sensitivity and are labour intensive, time consuming, expensive and not readily available. Direct examination using Potassium Hydroxide (KOH) mount is most often practiced but lacks contrast and requires a skilled eye to interpret. Chicago Sky Blue 6B (CSB) stain has shown a promising result providing coloured contrast and better sensitivity and specificity. Aim: To evaluate the rapid diagnosis of fungal infections using CSB stain over conventional KOH mounts. Materials and Methods: This cross-sectional analytical study was done at RIMS, Raipur catering to rural and tribal population in Chhattisgarh in Central India over a period of 10 months after due approval from Institutional Ethics Committee. Clinically, suspected cases of mycosis belonging to all ages of either gender attending Outpatient Department (OPD) of Dermatology and Ophthalmology Department, who were advised mycological evaluation by physician but not on treatment were included in study. The samples were processed with KOH mount and CSB stain and were observed by two independent observers. The data was managed in Microsoft office Excel and was analysed using tests of proportion and Pearson’s Chi-square test for significance. Results: A total of 128 participants were involved in the study with a male preponderance of 96/128 (75%) as against 32/128 (25%). A total of 110 patients were diagnosed using CSB 6B stain whereas 80 patients were diagnosed using KOH mount. CSB 6B was evaluated against the conventional KOH mount using a Chi-square test and was found to be highly significant with Chi-square value of 39.74 with 1 degree of freedom and p-value of <0.001. Conclusion: This study brought out the significance of CSB 6B stain over conventional KOH mount with better sensitivity, specificity, Negative Predictive Value (NPV) and Positive Predictive Value (PPV) and ease and rapidity of diagnosis with better colour contrast helping clinicians with prompt initiation of treatment with a laboratory confirmation.
Background Salivary gland tumors constitute about 3% of all head and neck tumors. We present a series of 104 cases of various salivary gland pathologies and the various modalities of surgeries done between January 2007 and July 2017. Materials and methods Total 104 patients with salivary gland tumors were included in this study, of which 76 patients had parotid tumors and 28 were submandibular gland tumors. The presence or absence of coexisting salivary gland stones, involvement or noninvolvement of ducts were all considered. Preoperatively, patients underwent fine needle aspiration cytology (FNAC) and imaging studies along with routine blood investigations. Results All patients underwent surgery and subsequent histopathological examination (HPE). The preoperative FNAC and postoperative HPE were not correlating in 6.5% of parotid tumors and in 3.5% of submandibular gland tumor. Anomalies in the fasciovenous planes were seen in 3% of the patients, which caused intraoperative difficulties. Postoperatively, five patients had salivary leak and three patients had neuropraxia, which was managed conservatively and the patients recovered subsequently between 3 months and 6 months postoperatively. Conclusion Surgery for salivary gland tumors has its own threats due to the close proximity of nerve, vessels, and ducts. Postoperative complications like nerve palsy is seen more common in malignant tumors in both parotid and submandibular gland tumors. A proper methodical assessment and awareness of the various anatomical anomalies intraoperatively may give good surgical outcomes in surgeries of salivary gland tumors. In our study, various anomalies were encountered and dealt appropriately. How to cite this article Vemuru T, Mohanty S, Manimaran V, et al. Clinical Outcomes of Salivary Gland Tumor Surgery: A 10-year-chart View. Int J Head Neck Surg 2021;12(1):11–14.
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