Journal of Plastic Surgery and Transplantation

Wound infections represent a persistent challenge in clinical practice, contributing to delayed healing, increased healthcare costs, and greater patient morbidity. The global rise in antimicrobial resistance has renewed interest in topical antiseptics as adjuncts to standard wound care. Octenidine dihydrochloride (OCT), a bispyridine-type cationic surfactant, has emerged as a promising agent owing to its broad-spectrum antimicrobial activity, rapid action, and minimal potential for resistance development. This review critically examines the current evidence on the use of octenidine in wound management. We discuss its mechanism of action, which involves disruption of microbial membranes and biofilms, and highlight its applications across acute and chronic wound types. Comparative studies evaluating octenidine against other antiseptics and standard solutions suggest its effectiveness, particularly in complex and critically colonised wounds. Octenidine’s favourable safety profile, with low cytotoxicity and minimal systemic absorption, supports its use even in vulnerable populations such as neonates and pregnant women. Future research is needed to define further its role within standardised wound care protocols and antimicrobial stewardship strategies.

Background: Individuals who spend long periods seated without repositioning are at increased risk of developing pressure ulcers over the ischial tuberosity. Aim: To describe the management of an ischial pressure injury using a hatchet flap. Objectives: To reduce wound-related morbidity, improve quality of life, and prevent recurrence of pressure injuries. Material: A 22-year-old male developed a Grade IV ischial pressure ulcer six months after sustaining paraplegia from a fall. Although his neurological status improved gradually, the ulcer persisted and became recurrently infected. Staged wound debridement and hatchet flap coverage were performed. Result: The flap healed uneventfully, and there was no recurrence after the patient resumed mobilization. Conclusion: The random-pattern hatchet flap is a reliable option for the management of pressure sores of limited size, with minimal complications.

Heparin possesses anti-inflammatory, antihistaminic, anti-allergic, serotoninblocking, and proteolytic enzyme-inhibiting properties. Topical forms of heparin have been used in burn care to prevent burn wound extension, minimize skin tissue loss, promote faster healing with fewer contractures, relieve pain, reduce tissue edema and exudation, prevent infection, and support revascularization, granulation, and epithelialization of deeply burned tissue. Similarly, topical lignocaine in gel form has been applied to raw burn areas and post-skin graft sites, showing significant effectiveness in pain relief. In addition to analgesia, lignocaine has also been shown to reduce edema and post-burn ischemia. In this case report, we discuss the combined use of topical heparin and local anesthetic as part of burn wound management.

Diabetic foot ulceration (DFU) remains a leading cause of morbidity, amputation, and health care expenditure worldwide. Nurses occupy a pivotal position in the multidisciplinary management of DFU, from risk stratification and early detection to wound bed preparation, infection control, off loading, and patient education. This paper synthesises contemporary evidence (2018 2024) on nursing interventions that improve ulcer healing, prevent recurrence, and reduce amputation rates. A narrative review methodology was employed, drawing on peer reviewed journals, clinical practice guidelines (International Working Group on the Diabetic Foot IWGDF; American Diabetes Association – ADA), systematic reviews, and meta analyses. Findings reveal that a structured, protocol driven nursing care pathway incorporating comprehensive assessment, validated risk scoring tools, advanced wound care technologies (e.g., moist dressings, growth factor therapy, negative pressure wound therapy), and rigorous patient centred education significantly enhances outcomes. Gaps in the literature pertain to long term adherence to off loading devices and the cost effectiveness of emerging technologies in low resource settings. The paper concludes with practical recommendations for nursing practice, policy, and future research.

Surgical wounds represent a common source of postoperative morbidity, contributing to prolonged hospital stays, increased health care costs, and diminished patient quality of life. Nursing care is pivotal across the continuum from intra operative preparation to community discharge yet practice variation persists despite robust clinical guidelines. This paper synthesizes current evidence (2010 2024) regarding assessment, prevention of infection, dressing selection, pain management, and education in surgical wound nursing care. A systematic literature search of PubMed, CINAHL, Cochrane Library, and WHO/ CDC guideline repositories identified 112 peer reviewed studies, of which 68 met inclusion criteria for quantitative synthesis. Findings underscore the superiority of multimodal strategies that combine aseptic technique, risk stratified prophylaxis, advanced moist healing dressings, and patient centered education. Gaps remain in standardizing outcome metrics, integrating tele health follow up, and tailoring interventions for high risk populations such as diabetics and the immunocompromised. Recommendations for clinical practice, policy, and future research are presented.