July, 2005

Dear Readers,

In the first article of this issue, Junko et al. (Pressure-induced ischemic wound healing with bacterial inoculation in the rat) report on a new animal model for pressure ulcers. There have been other publications of animal models for pressure ulcers, and the authors discuss these studies. In the present report, the effects of bacterial contamination and subsequent infection are studied in pressure-induced rat wounds. Compared to the pressure-wound-only control group, the inoculated group showed greater tissue necrosis and slower healing. It is suggested by the findings “…that bacterial invasion may interact with pressure-induced ischemia to generate ulceration.” The study of acute wounds in animals served as a basis to understanding wound healing in man. However, it has become clear that chronic wounds do not always follow the path known for the acute wound. As animals do not suffer from decubitus ulcers, each attempt to model this chronic wound offers some insight into the nature of pressure ulcers. In this report, the role of bacteria is shown. In the clinic, there are many other variables in a likely debilitated patient that will not be present in an otherwise healthy experimental animal. Sorting through some of these variables in the model presented may yield a better understanding of the challenges in treating these wounds.

Huljev and Kucisec-Tepes present a case study on the presentation, possible causes, and treatment course of necrotizing fasciitis in a patient (Necrotizing fasciitis of the abdominal wall as a post-surgical complication: a case report). They discuss several predisposing factors that could have led to the necrotizing infection, which followed routine surgery in this patient. The importance of early recognition and prompt and intensive treatment for this condition is discussed.

Yamada et al. (Quality of life of individuals with chronic venous ulcers) employed the Ferrans and Powers Quality of Life Index (QLI) in analyzing a population of 89 Brazilian venous ulcer patients. The results “…showed good levels of QOL, mainly in the family and psychological/spiritual subscales.”

Brett (Chlorophyllin—A healer? A hypothesis for its activity) reviews the literature on chlorophyll and its derivatives and focuses on the biological activities reported therein. As chlorophyllin has been included in some enzymatic debriding agents to control odor and possibly healing, the author presents a long list of how these molecules may play an active role in wound therapy.

In Diagnostic Dilemmas (Bullous pemphigoid with atypical presentation), Dasgeb et al. describe an unusual case that was diagnosed on the basis of histopathology, direct immunofluorescence, and indirect immunofluorescence. The authors discuss these techniques, the basis for the tests, and how the diagnosis of bullous pemphigoid was confirmed. The treatment and results are presented.