Negative pressure wound therapy (NPWT) is a technique using vacuum dressing to promote wound healing in complicated wound. However, for many patients, the application and removal of the NPWT is source of procedural pain. The authors hypothesized that administering cold sterile water into the NPWT sponge would decrease pain during dressing changes. A prospective randomized controlled study was conducted on 27 patients who were undergoing 81 NPWT wound dressing changes (n = 81) at a single institution between October 2016 and September 2017. Each patient had 3 NPWT dressing changes. Cold sterile water (5.74 °C), room temperature sterile water (26.89 °C), and nothing were randomized and administered in the NPWT tubing into the sponge 10 minutes before changing the dressing in each and every procedure. Pain scores were assessed using a 0 to 10 numeric pain scale. Patients administered with cold water reported less pain than those administered with room temperature sterile water during the dressing change (4 vs 5.67; P < .003), and much less pain than those with nothing instilled before dressing change (4 vs 6.59; P < .001). There is no statistically significant difference in pain score between using the room temperature sterile water group and the control group that instilled nothing (5.67 vs 6.59; P = .065). This study has shown that cold water administered through the suction tubing before the dressing change had a better reduction in pain score than using room temperature sterile water and the control group.

The accumulation of DNA damage in burn wounds delays wound healing. DNA methylation by short interspersed nuclear element (SINE) small interfering (si) RNA prevents DNA damage and promotes cell proliferation. Therefore, SINE siRNA may be able to promote burn wound healing. Here, a SINE B1 siRNA was used to treat burn wounds in rats. Second-degree burn wounds were introduced on the backs of rats. The rats were then divided into three groups: a B1 siRNA-treated, saline-treated control, and saline + calcium phosphate-nanoparticle-treated control group (n=15/group). The wounds were imaged on days 0, 7, 14, 21 and 28 post-injury. The tissue sections were processed for methylation, histological and immunohistochemical examination, and scored based on the overall expression of histone H2AX phosphorylated on serine 139 (γH2AX) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Burn wound closure improved in the B1 siRNA-treated group compared with that in the control group, especially from days 14-28 post-injury (P<0.001). The overall pathological score and degree of B1 methylation in the B1 siRNA-treated group improved significantly at days 14-28 post-injury, with the maximum improvement observed on day 14 (P<0.01) compared with the NSS and Ca-P nanoparticle groups. Immunohistochemical staining revealed lower expression of γH2AX and 8-OHdG in the B1 siRNA-treated group than in the control groups at days 14-28 post-injury; the maximum improvement was observed on days 14 and 21. These data imply that administering SINE siRNA is a promising therapeutic option for managing second-degree burns.

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Background: The BRAF V600E mutation in the Thai population has been identified in a considerable percentage of people with cutaneous melanoma. The objectives of this study were to determine the prevalence of this mutation in cutaneous melanomas, conduct a clinicopathological association analysis with the BRAF V600E mutation, and develop a treatment strategy for patients with this mutation that would take advantage of the medications currently available to treat them. Methods: Anti-BRAF V600E (clone VE1) immunohistochemistry was performed on 50 pathological samples of cutaneous melanoma after excluding the samples with a low amount of pathologic tissue, a lack of clinical data‚ and poor follow-up. BRAF V600E expression DNA sequencing was performed to confirm the results of several cases. Results: Anti-BRAF V600E antibody positivity was noted in 56% (28/50) of cutaneous melanoma cases. DNA sequencing results were consistent with immunohistochemistry results. In cutaneous melanoma, the BRAF V600E mutation was significantly associated with adverse prognosis of patients, including reduced overall survival and disease-free survival. Conclusions: An increased prevalence of the BRAF V600E mutation was determined in a collection of cutaneous melanomas in the Thai population, implying that BRAF-targeted therapy may be a promising strategy for patients with BRAF-mutated cutaneous melanoma. This study revealed an association between the clinicopathological aspects of cutaneous melanoma and overall survival, disease-free survival, and overall mortality. A treatment with anti-BRAF-targeted therapy, which incorporates the already available medications‚ is being researched and developed.

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