METHODS: 1.5% (w/v) chitosan films with Chrysanthemum morifolium essential oil (0% to 6% (v/v)) were produced through homogenization, the casting of a film solution in a petri dish and convection drying. The edible film was evaluated in terms of its physical (color, thickness, water vapor permeability), mechanical (puncture strength, tensile strength, elongation at break) and chemical properties (antioxidant assay, Fourier Transform Infrared Spectroscopy (FTIR)).
RESULTS: With an increasing concentration of Chrysanthemum morifolium in the chitosan film, the test values of physical properties such as tensile strength, puncture force, and elongation at break declined significantly. However, the thickness, water permeability, and color profile (L*, a*, b*) values of the chitosan film increased. Similarly, the scavenging effect of antioxidant assay increased (from 4.97% to 18.63%) with a rise in Chrysanthemum morifolium concentration. 2%, 3%, and 4% of Chrysanthemum morifolium in the chitosan film showed a significant inhibition zone ranging from 2.67 mm to 3.82 mm against Staphylococcus aureus, a spoilage bacterium that is commonly found in chicken and beef products. The storage and pH tests showed that 4% of Chrysanthemum morifolium in the film maintained pH level (safe to consume), and the shelf life was extended from 3 days to 5 days of meat storage.
CONCLUSIONS: This study demonstrated that the incorporation of 4% (v/v) Chrysanthemum morifolium extract into 1.5% (w/v) chitosan film extends the storage duration of raw meat products noticeably by reducing Staphylococcus aureus activity. Therefore, it increases the quality of the edible film as an environmentally friendly food packaging material so that it can act as a substitute for the use of plastic bags. Future studies will be conducted on improving the tensile strength of the edible film to increase the feasibility of using it in the food industry. In addition, the microstructure and surface morphology of the edible film can be further determined.
Case presentation: We experience a 47-year-old lady who developed an unrecognised EVI after being admitted for sepsis. The EVI turned out to be a huge and sloughy skin ulcer. A series of wound debridement with vacuum dressing were conducted until the wound was able to be closed.
Discussion: The EVI can be categorised according to Amjad EVI grading and Loth and Eversmann's EVI classification. Adult EVI tends to be overlooked, especially during critical care because patients cannot complain upon sedation and ventilation. In order to prevent EVI, firstly prevention is better than cure. Secondly, if EVI is recognised early, infusion should be stopped immediately. Thirdly, analgesia is mandatory. Finally, the plastic team needs to be engaged if it is deemed required.
Conclusion: Prevention and early intervention before the occurrence of progressive tissue damage is the key to treatment. Early radical wound debridement and immediate or delayed wound coverage with skin graft or skin flap are indicated in full thickness skin necrosis, persistent pain, and chronic ulcer.