Purpose:Juice from Salvia nilotica fresh leaves is traditionally used for the treatment of wounds in Ethiopia; yet, such a claim has not been scientifically verified so far. Therefore, this study aimed to evaluate the wound-healing properties of S. nilotica leaf extract and solvent fractions using excision and incision wound models in mice. Methods:About 80% methanolic crude extract and its solvent fractions (chloroform, butanol, and aqueous) were formulated as an ointment. Incision and excision models were used to assess the wound-healing effect of the crude extract, whereas the solvent fractions were tested in the excision model. In the excision model, wound contraction, epithelialization, and histopathological changes were measured, whereas tensile strength was measured in the incision model. Results:The crude extract of S. nilotica significantly promoted wound healing (P < 0.05), which was evident with increased wound contraction, enhanced tensile strength, and reduced epithelialization period when compared with the negative control groups. All solvent fractions have also enhanced the wound-healing process similarly. The histopathological examination results also confirmed the positive effects of the plant extract on wound healing as the extract has increased collagen deposition, fibroblast proliferation, and vascularization of the wound site. Conclusion:The findings of this study showed the wound-healing potential of S. nilotica leaf extracts, which in turn may partly justify the traditional use of the plant material for wound-healing purposes.
Introduction:Scars present repercussions beyond physical appearance, affecting emotional well-being and social interactions. Few studies have compared how different scar types, including keloids (K), hypertrophic scars (HS), and post-burn scars (BS), relate to psychosocial outcomes. Objective:Assess body appreciation and screening indicators of anxiety and depression in patients with scars of different etiologies. Methods:We conducted an exploratory cross-sectional study including 42 patients with scars allocated to three groups: K, HS, and BS. Body image perception was measured using the Body Appreciation Scale (BAS), and anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Mean BAS and HADS scores were compared across groups, and associations with clinical features were explored. Results:The combined prevalence of anxiety and depression symptoms increased descriptively from HS (0%) to K (5.9%) to BS (20%) (p = 0.11). Higher odds of combined anxiety and depression symptoms were associated with facial involvement (p = 0.017; OR = 19.8, 95% CI 1.70-229.65), and functional impairment (p = 0.039; OR = 18.0, 95% CI 1.59-202.95) features more frequent among burn patients, although confidence intervals were wide. BAS scores did not differ significantly among groups (p = 0.78), indicating moderate-to-high body appreciation across scar types (mean BAS: 3.68 burns, 3.77 hypertrophic, 3.85 keloids). Anxiety (p = 0.57) and depression (p = 0.43) scores were similar. Conclusion:Different scar types were associated with broadly similar psychosocial outcomes. Emotional vulnerability among patients with burn scars appears more closely related to scar-related features, such as facial location and functional impairment, than to scar etiology alone. Findings should be interpreted cautiously and regarded as hypothesis-generating. Lay Summary:This study examined how different types of scars, including burns, hypertrophic scars, and keloids, may affect emotional well-being and body image. Adults with these scars completed questionnaires assessing body appreciation, anxiety, and depression. Overall, levels of body appreciation were similar across groups, suggesting that many people can adapt to visible or symptomatic scars over time.Participants with burn scars showed a tendency toward higher levels of anxiety and depressive symptoms. However, these emotional difficulties were more strongly associated with features such as facial involvement and functional limitations than with the type of scar itself. This highlights the importance of considering the broader clinical and social context in which scars occur.As this was an initial study with a relatively small number of participants, the findings should be interpreted as exploratory rather than definitive conclusions. Overall, the results suggest that while many people adapt well to scars, those accompanied by greater visibility or functional impact may be linked to emotional vulnerability. Comprehensive scar management should therefore address not only physical and psychological support but also promote recovery that considers the person as a whole.
Background:NovoSorb® Biodegradable Temporising Matrix (BTM) is a synthetic polyurethane bilayer matrix, used in trauma and burns reconstruction. However, there is little evidence of its use for paediatric limb ischaemia. We present a review of literature and three paediatric cases of sepsis-induced ischaemic limb injuries, reconstructed using BTM. Methods:Data were collected on demographics, management and outcomes of three patients cared for by the senior author and plastic surgery service. The operative regimen and challenges faced are discussed.Three children, aged 1-8 years, were managed between 2022 and 2024. The first case had an immune-mediated reaction after bronchiolitis, and two cases had group A streptococcus sepsis. The first case required debridement of both lower limbs, covered with BTM, to improve scar quality and limb length. The second child had bilateral upper limb ischaemia, necessitating left below-elbow and right trans-metacarpal amputations, with BTM applied bilaterally to optimise residual limb length and stump quality. The third child underwent a right above-knee amputation and had significant soft tissue necrosis from the plantar surface of the left foot to the knee; BTM was applied to the left leg as a limb-salvage strategy. Results:All cases required multiple surgical debridements, followed by early BTM application and subsequent split-thickness skin grafting. Follow-up of 1 year showed good outcomes in scar quality and preservation of limb length. Conclusion:BTM has not been reported in wounds of this aetiology in the paediatric population. These cases demonstrate BTM as a valuable adjunct in reconstruction of complex wounds secondary to sepsis-induced critical limb ischaemia. Lay summary:Occasionally, serious infections in children can severely reduce blood flow to parts of the arms or legs. This can cause tissue damage, often leading to amputations. Treating these injuries is difficult, especially when the aim is to save as much of the limb as possible. NovoSorb® Biodegradable Temporising Matrix (BTM) is a man-made dressing that helps the body form and organise new tissue before a skin graft is applied. It is already used for burns and other injuries, but its use in children with infection-related limb damage has been rarely reported.Question: Can BTM help rebuild and maintain residual length in children's limbs after severe infection causes loss of blood supply?Work conducted: This study reported three children, aged 1-8 years, treated between 2022 and 2024.What we did: Each child had life-threatening infections that damaged parts of their arms or legs. Surgeons removed the dead tissue in stages, utilised BTM early to protect the wounds and help new tissue organise, then later added thin skin grafts. After at least one year, all children had good scar quality and movement of the limb, and, where possible, preserved more of the affected limb.Learning points of this study: We saw promising results using BTM in these rare and complex cases. It appeared to achieve good healing and maintain residual limb length, but we do not know for sure how it compares to other treatments. Larger studies are needed to confirm these findings and guide best practice.
Objective:Evolution in the use of Biodegradable Temporising Matrix (BTM) in our adult burn service prompted an evaluation of our therapy guidelines. Method:We conducted a retrospective case note review of adult burn patients who received BTM between March 2022 and September 2024. Data collected included commencement timing of range of motion (ROM) and ambulation after BTM application, burn and BTM total body surface area (%TBSA) and reason for any BTM loss. Results:The study included 22 patients (23 procedures). Overall, median burn TBSA was 30% with median BTM TBSA of 22% (BTM range 0.1%-70% TBSA). All patients had BTM crossing at least one upper limb (UL) or lower limb (LL) joint. Median time to ROM initiation after BTM was 4.5 days for UL and 2.0 days for LL. Median time to ambulation was 1.0 day overall. Among LL BTM patients intubated for < 7 days, ambulation commenced at a median of 1.5 days. Larger LL BTM areas (>10% TBSA) were slower to mobilise than smaller (<10% TBSA) areas (median 2.5 vs 1.0 days). Partial BTM loss occurred in six cases (26%), though none were attributed to therapy interventions. Conclusion:Therapy guidelines in our burns unit now recommend initiating gentle ROM within 3-5 days after BTM application, and ambulation from day 2-3, even in patients with large LL BTM areas, without negatively impacting BTM integration or timing to SSG.
Introduction:Experiences of seeing an altered appearance for the first time can have an important influence on an individual's psychological wellbeing, their body image and their adjustment. Existing research has explored this experience in individuals with breast cancer and facial burns, but limited research has been conducted in other appearance altering conditions. The aim of this study was to explore patient's initial experiences viewing themselves after acquiring an appearance altering condition, including distress, preparedness and social support. Methods:Participants (n = 64) with a surgical scar, burn injury or amputation completed a mixed methods online survey. This survey included questions about practical elements of the experience, the support they received, their expectations, distress, and preparedness; as well as open questions regarding participant's feelings, fears, support and suggested improvements to the experience. Data analysis included statistical analysis and inductive content analysis. Discussion:Participants reported a variety of initial experiences. Some felt adequately prepared and supported, whilst others felt this could have improved. A strong correlation was found between perceived support and distress (rs = -.66, p = <.001) and preparedness and distress (rs = -.66, p = <.001). No significant differences in preparedness, distress or support were found according to gender, age, or condition. Conclusions:Whilst many participants reported satisfaction with viewing their appearance for the first time, some participants reported significant distress and a need for further support around this experience. This suggests an important role for healthcare providers in discussing expectations and providing appropriate patient support following injury or treatment.
