Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
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Controlled Clinical Trial
CO2 insufflation influences the temperature of the open surgical wound.
In open surgery, heat is lost due to radiation and evaporation through the wound. Hypothermia causes tissue hypoxia and impairs various cellular immune functions that increases the risk for postoperative wound infections and delayed wound healing. The patient's body is usually well protected with heating arrangements, but the open wound is left unprotected and until now no practical method has been available to protect it thermically. ⋯ The temperature of the area distant to the diffuser increased by 1.2 degrees C (p<0.01) whereas in the area close to the diffuser it decreased by 1.8 degrees C (p<0.01). In conclusion, short-term insufflation of dry room temperature carbon dioxide in an open wound increases the surface temperature significantly. Although a small increase, it may reduce the incidence of postoperative wound infections in the future.
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Progress in wound healing is primarily quantified by the rate of change of the wound's surface area. The most recent guidelines of the Wound Healing Society suggest that a reduction in wound size of <40% within 4 weeks necessitates a reevaluation of the treatment. However, accurate measurement of wound size is challenging due to the complexity of a chronic wound, the variable lighting conditions of examination rooms, and the time constraints of a busy clinical practice. ⋯ The simplicity of our method combined with its robustness suggests that it can be a valuable tool in clinical wound evaluations. The basic challenge of our method is in deep wounds with very small surface areas where color-based detection can lead to erroneous results and which could be overcome by texture-based detection methods. The authors are willing to provide the developed MATLAB code for the work discussed in this paper.
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Editorial Biography Historical Article
H. Paul Ehrlich, PhD: 2010 recipient of the Wound Healing Society's Lifetime Achievement Award.