Abstract: Keloids remain a major problem for patients who have suffered deep injuries. The pathophysiology underlying keloid formation may be driven by the biological activity of transforming growth factor beta1 (TGF-b1). Decorin is a human proteoglycan that inactivates the effect of TGF-b1 and therefore displays a beneficial effect of antifibrosis in various tissues, such as kidney, muscle, and lung. Keloids are fibroproliferative disorders of the dermis that occur following wounding. This study investigated the effects of decorin on cell proliferation, TGF-b1 production, and collagen synthesis in keloid fibroblasts. Fibroblasts were extracted from explants of operative specimens obtained from keloid tissue and cultured in vitro with serial, diluted decorin concentrations (10, 50, 100, 200 nM) for 48 hours. The cell proliferation rates were measured by MTT [3-(4,5-dimethylthiazol-2-yl)-2,5 -diphenyltetrazolium bromide] colorimetric determination, and cell cycle distributions were anal

Abstract: Chronic ulcers constitute a major health problem of which the epidemiological impact in Spain is still unknown. For this reason, the Spanish advisory panel on chronic wounds, Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP), contemplated the possibility of conducting 2 national prevalence studies: one on pressure ulcers and the other on leg ulcers. Materials and methods: The authors conducted a nationwide point-prevalence survey based on an intentional sample. A specific questionnaire was prepared and distributed to all GNEAUPP members. The study on pressure ulcers was conducted between November and December 2001, and the leg ulcer study was conducted between October and December 2002. Results: During the research period, a total of 458 questionnaires were received for the pressure ulcer study and 353 for the leg ulcer study. The questionnaires received allowed the authors to estimate an 8.25% average pressure ulcer prevalence

Abstract: Debridement of the ulcer bed is a preliminary, essential step in promoting healing of necrotic and sloughy ulcers. This study reports the authors’ experience in ulcer debridement with a new hydrosurgery device based on fluidjet technology (Versajet™ Hydrosurgery System, Smith & Nephew, Hull, UK). From November 2003 to May 2005, 142 inpatients, from a setting of 469 patients affected by chronic leg ulcers, were treated with the hydrosurgery device; the remaining 327 patients were treated with moist dressings (control). In 108 cases, an adequately debrided wound bed was achieved with 1 operative procedure; 2 and 3 procedures were required in 27 and 7 patients, respectively. The mean time per procedure was 5.9 ± 3.6 minutes, and the time to complete ulcer debridement (on average 1.3 ± 0.6 days) was considerably shorter than with traditional treatment with moist dressings, thereby producing an equivalent decrease of in-hospital stay. When used by an experienced surgeon, the hydro

Abstract: A persistent dilemma exists about how to treat pain and ulceration in patients with vascular disease whose stenosis or occlusion cannot be reconstructed by angioplasty, stenting, or bypass. These patients are prone to infection, amputation, and narcotic addiction. Therefore, to prevent these complications, the blood supply to the extremity must be increased by medication that produces vasodilatation. L-arginine fits this description, as it is a precursor to nitric oxide and a potent vasodilator. L-arginine is now readily available in 2 different products (RESOURCE® Arginaid® EXTRA, Novartis Medical Nutrition, Fremont, Mich, and JUVEN®, Ross Products, Columbus, Ohio). In this study, 6 patients with nonreconstructable vascular disease were given L-arginine (RESOURCE Arginaid EXTRA), 2 packs daily, for a 2-week period. In all cases, the reported pain was reduced and the ulcers either healed or reduced in size. Those patients with renal compromise showed no elevation in creatinin