<p>A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India</p>

Abstract

Purpose: To analyze the demographic, clinical, and microbiological profile of patients presenting to our unit with chronic wounds of various etiologies with an intent to give a current overview of chronic wounds. Patients and Methods: We performed a prospective observational study of patients presenting with chronic wounds from October 2018 to September 2019. The study was conducted at the Department of Burns and Plastic Surgery of a tertiary care institute in a nonmetropolitan city in Central India. A total of 103 patients were included in the study. Data collected from the patients included demographic details, history, clinical features, and relevant laboratory reports. Wound swabs obtained by Levine's technique were sent for culture and sensitivity studies. Treatment was instituted according to the clinical picture and modified if necessary. Progress was monitored until the wound healed, either by conservative management or by surgical intervention. Patients were followed up for six months thereafter. Results: Most of the patients presented with lower limb wounds (n=81, 78.64%). Swab specimens from 103 wounds were cultured. Among the isolates, gram-negative organisms were more common than gram-positive organisms. Staphylococcus aureus was the most common species isolated, followed by Pseudomonas aeruginosa. The frequency of infections caused by other gram-negative organisms like Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis was on the rise. There were significant differences in the patterns of antimicrobial resistance in our patients. Sharp debridements were required in almost all cases for wound preparation. Most of the patients (n=74, 71.84%) underwent surgical intervention for achieving wound closure. Split-thickness skin grafting (STSG) was the most common surgical intervention performed (n=45, 43.68% patients), followed by local and distant flaps. Conclusion: Our study gives a current overview of the causes, clinical presentation, prevalent microbial flora, and their antibiotic susceptibilities prevalent in chronic wounds presenting to our unit. Treatments administered are discussed with emphasis on the different reconstructions performed.

Evaluation of antibacterial and wound‐healing activities of alcoholic extract of Boswellia carterii, in vitro and in vivo study

“…The most common microorganisms in healthy skin and wounds are bacteria, which can delay or prevent wound healing 7 . Today, the prevalence of multidrug‐resistant bacteria such as methicillin‐resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa is increasing in infections associated with a variety of skin lesions, including chronic wounds 8,9 . This may lead to increased morbidity, mortality, and medical costs.…”

“…7 Today, the prevalence of multidrug-resistant bacteria such as methicillinresistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa is increasing in infections associated with a variety of skin lesions, including chronic wounds. 8,9 This may lead to increased morbidity, mortality, and medical costs. Hence, the development of new drugs from medicinal herbs has long been considered as an approach to combat antibiotic resistance in bacteria.…”

Single-Stage Extensor Digitorium Tendon Reconstruction, Including Overlying Soft Tissue Defects of the Foot Dorsum with a Composite-Free Anterolateral Thigh Flap

“…A massive in-depth injury in the foot dorsum, including loss of the extensor tendon with overlying soft tissue deficiency, brings difficulties to the reconstruction that demands the wound not only be covered but also be functional. 1 2 The management of each component can be achieved by single- or multistages, depending on the injury level and the surgeon's experience. Due to the complexity of the damage, it is sometimes tricky for conventional local or pedicle flaps to meet the requirement, and free tissue transfer is a reasonable choice for coverage of foot dorsum defects.…”