ACELAGRAFT™ (Celgene Cellular Therapeutics, Cedar Knolls, NJ) was developed as a decellularized and dehydrated human amniotic membrane product (DDHAM). The product has demonstrated potential as a wound healing product with several ongoing preclinical and clinical studies in the area of acute and chronic ulcers. Although the mechanism of action of such a decellularized product has not been examined, a detailed study of the ability of fibroblasts to interact with DDHAM and subsequent cellular responses are presented. These studies indicate that the composition of DDHAM is that of an extracellular matrix (ECM)-like material with high collagen content, retaining key bioactive molecules, such as fibronectin, laminin, glycosaminoglycans (GAGs), and elastin. No cytokines or growth factors were identified as one might expect in a nondecellularized amniotic membrane product. Cell assays show that fibroblasts can recognize fibronectin in DDHAM and bind to it via typical integrin-fibronectin

Microbial virulence and host resistance are the determinants of the surgical infections. Bacteria are responsible for the majority of cases, but fungi are rare. The aim of this study was to evaluate the fungi causing surgical infections and discuss host factors predisposing the infection. Methods. A total of 824 surgical wound specimens had been evaluated. The specimens were cultured using 5% sheep blood, Sabouraud Dextrose, and Eosin methylene blue agars and the isolates were identified by classical methods and API identification system. Results. Growth was obtained in 455 (55.2%) out of 824 specimens. Nine (2%) of the agents of surgical infections were yeasts: Candida albicans was isolated in 5 (55.6%), C tropicalis in 3 (33.3%), and C glabrata in 1 (11.1%) specimen(s). Examining the characteristics of the patients, fungal infection could be explained with the presence of at least 1 predisposing factor. Immunosuppression was closely related with fungal growth. Conclusion.

Aeromonas hydrophila infection has been described as the cause of necrotizing fasciitis in patients with suppressed immune systems,burns, and trauma in an aquatic setting. The following presents a case in which severe necrotizing fasciitis and myonecrosis of the lower extremity, as well as toxic shock, developed as a result of wound infection from direct contact with brackish water. Mixed aerobic and anaerobic bacteria, including Aeromonas hydrophila, were isolated from the wound culture. This case illustrates that an infection with Aeromonas hydrophila can cause severe necrotizing fasciitis and myonecrosis. Early and aggressive surgical intervention should be implemented immediately after necrotizing fasciitis is diagnosed.

Due to the development of vacuum-assisted closure therapy (V.A.C.® Therapy™, KCI, San Antonio, Tex), chronic wound care has taken a step forward. Vacuum-assisted closure has proven to be effective in the treatment of chronic and acute wounds. Although most complications are rare, localized superficial skin irritation is the most common complication reported in the literature. Further complications involve pain, infection, bleeding, and fluid depletion. The authors present a case of a chronic fistula 5 years after vacuum-assisted closure therapy as a result of a piece of foam dressing that was left inside a wound. The retainment of vacuum-assisted closure dressings is a serious complication that can easily be prevented when proper precautions are taken during dressing changes.