Kamonwan Jenwitheesuk

A Prospective Randomized, Controlled, Double-Blind Trial of the Efficacy Using Centella Cream for Scar Improvement

Objective This study was performed to evaluate the efficacy of Centella asiatica extract in cream, a preparation for the prevention of scar development of the split-thickness skin graft (STSG) donor site. Methods A prospective randomized, double-blind control study was performed to evaluate the efficacy of Centella cream in 30 patients who underwent a STSG operation. Both Centella cream and placebo were applied equally to the donor site at least 2 weeks after epithelialization was completed. A scar assessment using the Vancouver Scar Scale (VSS) was taken at 4, 8, and 12 weeks. Results Of the original 30 patients, 23 patients completed evaluation. There were significant differences in pigmentation parameter of VSS and comparative total VSS scores between 4 and 12 weeks in Centella cream group. Conclusion The effect of Centella cream on scar development of a STSG operation may be attainable in terms of better pigmentation. By means of objective measurements and longer follow-up times, Centella cream may prove to be an alternative product for hypertrophic scar amelioration.

Degree of improvement after hyperbaric oxygen therapy for compromised flap and graft: A case series

Objective: To determine the treatment outcome of hyperbaric oxygen therapy (HBOT) in compromised graft/flap. Method: A retrospective study was conducted to identify patients who had undergone ischemic compromised graft and flap and received hyperbaric oxygen therapy at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, between 2012 and 2017. Wound improvement was the primary outcome. Results: Eleven patients with ischemic graft/flaps were enrolled in the study (9 adults; 2 children). The results showed that the treatment outcome for all patients undergoing skin flap/graft was improved. Patients classified as grade 3 and 4 (7 flaps in total) had improved wound healing without other adjunctive therapies whereas 4 patients-classified as grades 1 and 2-experienced partial wound healing and required surgical debridement with skin graft or flap reconstruction. Conclusion: In flap or graft ischemia, HBOT represented an additional medical treatment that can enhance wound healing resulting in a satisfactory treatment outcome.

Efficacy of Adjunctive Hyperbaric Oxygen Therapy in Osteoradionecrosis

Abstract Osteoradionecrosis (ORN) is a common consequence resulting from radiation in patients with cancer. Presently, hyperbaric oxygen therapy (HBOT) is proposed to have a role in improving wound healing in ORN patients. There is no strong scientific evidence to confirm the benefits of HBOT for treatment of ORN as an adjunctive treatment. This study aimed to determine the benefits of adjunctive treatment of HBOT in ORN. A retrospective study was conducted at the Srinagarind Hospital, the Faculty of Medicine, Khon Kaen University, Thailand, between 2011 and 2017. The patients diagnosed with ORN, who received adjunctive HBOT before the operation, were enrolled. Complete healing of wounds was the primary outcome. There were 84 ORN patients with a mean age of 58.78 years; 54.76% were male and 45.24% were female. HBOT had a role significant in improving wound healing of ORN patients with stages 1 and 2. Poisson regression analysis showed that stage 3 of ORN negatively correlated with the number of HBOT dives (p = 0.001, incidence rates ratio = 0.85). In conclusion, HBOT improved wound healing of ORN patients with stages 1 and 2. In addition, stage 2 of ORN patients significantly required the highest number of HBOT dives compared to other types of ORN to promote wound healing, whereas stage 3 patients, who underwent bone debridement combined with HBOT, initiated to success of treatment process and required a smaller number of dives.