dressings for radiotherapy wounds

Radiation dermatitis severity was reduced in patients with breast cancer radiotherapy after prophylactic use of Hydrofilm (Paul Hartmann AG, Heidenheim, Germany) compared with control (Schmeel et al., 2019). The pathophysiological variations in RSI consist of erythema and desquamation that occur shortly, as well as chronic skin atrophy, ulcers, telangiectasias and fibrosis [6, 7]. For example, DFU can cause severe and persistent infections and, in extreme cases, lead to amputation. Topical management of acute radiation dermatitis in breast cancer patients: a systematic review and meta-analysis. ALLEVYN Non-Adhesive(Smith & Nephew Healthcare, London, UK) exhibited the lowest pressure, while DuoDERM Extra Thin CGF (ConvaTec Inc., Princeton, NJ, USA)showed the highest pressure (Matsuzaki and Kishi, 2015). The results indicated that the UrgoStart Contact dressing is linked to good tolerance and acceptability, which can effectively promote the healing of neuropathic DFU (Richard et al., 2012). Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Hydrogels have a three-dimensional structure composed of hydrophilic substances (Tsang and Bhatia, 2004). Compared with skin damage that is attributed to other factors, RSI is characterized by incubation period, timeliness, potentiality, progress and persistence. Selection of Appropriate Wound Dressing for Various Wounds Biomaterial Wound Dressing Market Size to Hit USD 7.87 - GlobeNewswire Another retrospective study reported the effectiveness of Mepilex Ag dressings in preventing stress injuries in children after thoracotomy. Any evaluation of future interventions for the healing of compression ulcers should focus on the dressings most widely used by health professionals. The site is secure. IP-10 inhibits epidermal growth factor-induced motility by decreasing epidermal growth factor receptor-mediated calpain activity. used adipose-derived stem cells (ADSCs) as seed cells and HA as a carrier to prepare stem cell complexes to treat radiation-induced skin damage in rats [101]. demonstrated topical corticosteroids to be effective to reduce eczema peeling, reduce the frequency of serious skin toxicity and delay the occurrence of grade 3 dermatitis [79]. (2003). Sustained silver-releasing dressing in the treatment of diabetic foot ulcers. JW and YS conceived and coordinated this project. Nearly 90% of patients having received radiation therapy underwent moderate-to-severe skin reactions, severely reducing patients' quality of life and adversely affecting their disease treatment. Metabolic oxidation/reduction reactions and cellular responses to ionizing radiation: a unifying concept in stress response biology. Unlike the aforementioned types of wounds, VLU in the lower extremities requires treatment of lower extremity edema to promote wound healing. This manuscript also contains authors' consensus. Hydrogel blends of chitin/chitosan, fucoidan and alginate as healing-impaired wound dressings. Management of diabetic foot ulcers with a TLC-NOSF wound dressing. Lozano Sanchez F. S., Marinel lo Roura J., Carrasco Carrasco E., Gonzalez-Porras J. R., Escudero Rodriguez J. R., Sanchez Nevarez I., et al.. (2014). Wound Dressings During Radiotherapy for Cancer: A Survey of Practice Authors: Siby Elizabeth J. Thomas Sheryl Reimer-Kirkham Trinity Western University Rosemary Kohr University of New Brunswick. Reproduced with permission from Harding et al. A comparative study between hydrofiber dressing, povidone dressing in diabetic foot ulcers, Biochemical analysis of acute and chronic wound environments. National Library of Medicine It is one of the clinical manifestations of chronic venous insufficiency at the most severe stage. A clinical study investigated the effects of film dressings 3M Cavilon No Sting Barrier Film (3M, Minneapolis, MN, USA), and topical corticosteroids on skin exposed to radiotherapy and compared the effects of the two methods in preventing radiation dermatitis. Titanium wound chambers for wound healing research. It is worth noting that these systematic reviews included a very small number of studies and were performed several years ago. DFUs as a common type of non-healing or chronic wounds are attracting considerable attention in the medical field (Khanolkar et al., 2008). Excessive pain may severely affect the patient's mental and physiological state. Thus, a question is raised that whether it is effective to be applied bevacizumab again. The skin graft donor site is a type of surgical wound; therefore, it is less likely to be infected than the aforementioned types of wounds. Brennan M. B., Hess T. M., Bartle B., Cooper J. M., Kang J., Huang E. S. (2017). For instance, superoxide dismutase and its mimetics down regulated ROS levels and RSI. Wound Dressings During Radiotherapy for Cancer: A Survey of Practice The integrated results of the study were reviewed with five clinical experts to make recommendations for research, practice, leadership, and policy. The beneficial role of corticosteroids in preventing RSI has been verified [78]. Kerstein M.D. However, several shortcomings limit their application, such as difficulty to maintain the wound bed moist and proneness to adhesion to granulation tissue (Moore and Webster, 2013). With the gradual acknowledgment of wound healing theories, the development of wound dressings also evolved considerably. Although the above studies have concluded that the use of modern dressings and growth factors can improve radiation dermatitis, there is a lack of evidence-based, randomized, controlled trials comparing different types of these dressings. A study evaluated the efficacy of hydrofiber dressings and wound healing in DFUs, comparing the safety, final outcome, and patient compliance. A multifunctional pro-healing zwitterionic hydrogel for simultaneous optical monitoring of pH and glucose in diabetic wound treatment, Frontiers in Bioengineering and Biotechnology, Three-dimensional network of hydrophilic polymers, Moisturizing, removal of necrotic tissue, and monitoring of the wound without removing the dressing, Pressure ulcers, surgical wounds, burns, radiation dermatitis, Hydrogel mixed with synthetic rubber and sticky materials, Consists of polysaccharides derived from brown seaweed, Excellent exudate absorption properties, hemostasis, Infected and non-infected wounds with a large amount of exudate, Consists of polyurethane or is silicone-based, Semipermeability, thermal insulation, antimicrobial activity, Consists of adhesive, porous, and thin transparent polyurethane, Autolytic debridement properties, impermeable to liquids and bacteria, Epithelializing wounds and superficial wounds with limited exudate, Caused by neuropathy and lower extremity vascular disease, Lack of supply of oxygen and blood in the wound bed; long-term stagnation in the inflammatory phase, Silver ion foam dressing, hydrofiber dressing, UrgoStart Contact dressing, Mepilex, A local injury to the skin or subcutaneous soft tissue occurring at the site of the bone prominence or the compression of the medical device, Foam dressing, hydrocolloids dressing, multi-layered soft silicone foam dressings, polyurethane film, Mepilex, A large amount of exudate; prone to infection; severe cases can injure subcutaneous and submucosal tissues, Caused by high pressure of the blood in the leg veins, Lack of blood supply to the wound; a large amount of necrotic tissue and abnormal exudate on the surface of the ulcer, accompanied by multiple bacterial infections, Slow cell proliferation; decreased cytokine activity; decreased collagen content, Film dressing (Airwall), silver-containing hydrofiber, film dressing (3M Cavilon, Hypertrophic scars; hypopigmentation; hyperpigmentation, Polyurethane foam (ALLEVYN), calcium alginate (Kaltostat. Therefore, appropriate management of the donor site after the collection of SSG is essential. The site is secure. The therapeutic effect of modern wound dressings in the clinical management of wounds is documented. A study evaluated the effectiveness and safety of Contreet Foam, a dressing with sustained release of silver, in the management of chronic VLU with moderate and high exudation. Characterization of human skin-derived mesenchymal stem cell proliferation rate in different growth conditions. Reports showed a marked reduction in itching and a lower RTOG radiation dermatitis score in moderate soap and water washing compared with no washing [43]. Biomaterial Wound Dressing Market Trends and Insights by Product type (Alginate Dressing, Hydrocolloids, Skin Substitutes), Application (Burns, Wounds, Ulcers) and Region (Americas, Europe, Asia . (C) Epidermal thickness in different treatment groups at days 14 and 21. Basic fibroblast growth factor suppresses radiation-induced apoptosis and TP53 pathway in rat small intestine. The therapeutic effect of modern wound dressings in the clinical management of wounds is documented. Applying all kinds of irritating drugs or cosmetics is strictly prohibited. Comparing the efficacies of alginate, foam, hydrocolloid, hydrofiber, and hydrogel dressings in the management of diabetic foot ulcers and venous leg ulcers: a systematic review and meta-analysis examining how to dress for success. In this review, we summarized the mechanisms of wound healing, traditional and modern wound dressings, and the advantages and disadvantages of both types of dressings. Graumlich J. F., Blough L. S., McLaughlin R. G., Milbrandt J. Studies have reported that stem cells are a promising way to treat refractory skin damage. ROS synthesis may hinder the use of BH4 for the oxidation of BH4 to dihydrobiopterin (BH2). The .gov means its official. Accelerated full-thickness wound healing via sustained bFGF delivery based on a PVA/chitosan/gelatin hydrogel incorporating PCL microspheres. Zhang Q, Fong CC, Yu WK, Chen Y, Wei F, Koon CM, Lau KM, Leung PC, Lau CB, Fung KP, Yang M. Herbal formula astragali radix and rehmanniae radix exerted wound healing effect on human skin fibroblast cell line Hs27 via the activation of transformation growth factor (TGF-) pathway and promoting extracellular matrix (ECM) deposition. Wound healing after radiation therapy: Review of the literature The .gov means its official. performed a local injection of ADSCs covered with artificial skin to treat an elderly woman having developed chronic radiationinduced skin ulcers after radiotherapy of uterine cancer 40 years ago, achieving good results [102]. FUNDING: Xiaojing Yang is the recipient of a grant from Shanghai Jiao Tong University Affiliated Sixth People's Hospital (contract grant number: ynlc201807) and a grant from Shanghai Municipal Health Commission (20184Y0229). reported the effectiveness and safety of M. tenuiflora cortex extract (MTC-2G) in patients with VLU. A study reported the pain-reducing function of a silver dressing (AQUACEL Ag) in patients with partial thickness burns. Last, systematic review and meta-analysis of DFU and pressure ulcers is slightly lagging, and it is recommended to include research in recent years for timely updates to provide reliable evidence for decision. Microparticles loaded with pentoxifylline and succinate D--tocopherol act as a novel topical formulation that locally targets inflammatory cytokines and oxidation pathways, which are applied to the skin after local laser ablation [68]. Verbelen J., Hoeksema H., Heyneman A., Pirayesh A., Monstrey S. (2014). Bassetto F, Bosco G, Brambullo T, Kohlscheen E, Tocco Tussardi I, Vindigni V, Tiengo C. Hyperbaric oxygen therapy in plastic surgery practice: case series and literature overview. The results indicated that, in the subgroup with enlarging ulcers, there were significantly more healed ulcers in the LyphoDerm group vs. the control group (Harding et al., 2005). If you have any questions or concerns about your skin, you can contact your GP/District Nurse, or you can call the radiotherapy department on: Patient information Histopathological results confirm that both prophylactic and therapeutic dermaprazole have anti-inflammatory and anti-fibrotic effects. CONFLICTS OF INTEREST: The authors declare no conflicts of interest. The use of modern dressings in countries and regions where health insurance systems are not well-established involves a significant cost, especially for those with low- or average-income levels. VEGF refers to a marker of neovascularization. Federal government websites often end in .gov or .mil. It usually occurs at the site of bone prominence or compression of the medical device (Webb, 2017). 2002; 15:216-224. doi: 10.1097 . Catechin is a natural phenolic compound. Inclusion in an NLM database does not imply endorsement of, or agreement with, Trolamine acts as a nonsteroidal anti-inflammatory drug by recruiting macrophages and stimulating granulation tissue [83]. The results indicated that the average pain score and wound healing time in the Askina Calgitrol Ag group was significantly lower/shorter than those reported in the silver sulfadiazine group (Opasanon et al., 2010). At the same time, the role of polyurethane foam dressings and conventional treatments or hydrocolloids in the prevention of pressure ulcers was also compared. Treatment of donor site wounds after SSG is an important clinical issue because patients generally report greater pain at the donor site than at the graft receiving site (Voineskos et al., 2009). According to the types and stages of wounds, dressings can be applied to their surface and promote healing. Existing studies reported that a combination of pentoxifylline and alpha-tocopherol mitigates fibrosis for at least 6 months [67]. It is capable of expediting the healing of second-degree burn wounds and improving scar quality [39]. They can comprehensively evaluate the skin in the radiotherapy area prior to radiotherapy and use film dressings or liquid dressings to protect the skin. Existing studies revealed that cytokines are directly or indirectly involved in radiation-induced damage [34]. On the whole, statins are adopted to treat hypercholesterolemia and prevent heart disease. More cost-effective protective measures exerting fewer side effects should be developed to effectively protect the interests of patients, ensure smooth chemotherapy, as well as improving the quality of life of patients. They also have immunomodulatory, anti-inflammatory, metabolic, antioxidant and antibacterial characteristics [80]. Michaels J. In the presence of infection, superficial and partial thickness wounds can deteriorate into deeper burns. Alginate dressings, hydrocolloid dressings, and foam dressings are used in this setting. Compared with triethanolamine, it exhibits no major discrepancy to treat grade 2 and grade 3 dermatitis. applied a silicone border foam dressing to the tibia region of patients in the ICU. Particularly, they may play a role in avoiding wound contact with external bacteria and effectively prevent cross-infection (Murakami et al., 2010; Horn, 2012). Health related quality of life in burn patientsa review of the literature. Overview and classification]. Skin lipids have a radioprotective role. Furthermore, film dressings possess autolytic debridement properties (Thomas, 1990; Fletcher, 2003), and are suitable for use on epithelializing wounds and superficial wounds with few exudates (Imran et al., 2004). Based on these characteristics, hydrogels are primarily used on pressure ulcers, surgical wounds, burns, radiation dermatitis, etc. Progressive endometritis occurs for gradual occlusion of the microvasculature and hypoxia attributed to fibrosis. Use of Hydrogel for Radiotherapy Patients The results showed significant differences in the incidence of pressure injuries between the two groups (10%). Furthermore, Walsh et al. Also, the use of ice or heat should prohibited. A randomized controlled trial investigated the role of Mepilex Border Sacrum and Mepilex Heel dressings in preventing stress injuries in critically ill patients prior to transfer to the intensive care unit (ICU). Harding K. G., Krieg T., Eming S. A., Flour M. L. (2005). Vascular endothelial growth factor (VEGF) and VEGF receptor inhibitors in the treatment of renal cell carcinomas. The underlying causes of the disease are venous valve incompetence and calf muscle pump insufficiency, leading to venous stasis and hypertension (Gianfaldoni et al., 2017). A factorial, randomized trial of pentoxifylline or placebo, four-layer or single-layer compression, and knitted viscose or hydrocolloid dressings for venous ulcers. Topical granulocyte-macrophage colony-stimulating factor for radiation dermatitis of the vulva. Foam dressings provide thermal insulation and maintain moisture to the wound, and prevent damage to the wound at the time of removal. Timely and effective communication can alleviate patients internal stress, and the patients can have a more relaxed attitude towards treatment. compared the efficacy of Mepilex Lite Dressings (Mlnlycke Health Care, Gothenburg, Sweden) with Vaseline Gauze in the treatment of DFU. The excellent physical properties of this hydrogel and the action of aspiration drainage promote healing of burn wounds (Li Z. et al., 2018). Moreover, the quality of life of patients with chronic VLU is severely affected (Salome et al., 2016). TGF- is combined with its receptor to form a trimeric complex, causing tissue fibrosis [20]. Karlsmark T., Agerslev R. H., Bendz S. H., Larsen J. (2018). Radio-modulatory effects of green tea catechin EGCG on pBR322 plasmid DNA and murine splenocytes against gamma-radiation induced damage. As demonstrated by Abbas et al., the incidence of RTOG grade 3 dermatitis was down-regulated in patients with squamous cell carcinoma of the head and neck using triethanolamine emulsions [86]. It can be seen that inhibiting the expression of inflammatory factors can promote skin repair. Interleukin-12 preserves the cutaneous physical and immunological barrier after radiation exposure. HA-az-F127 hydrogel promotes healing of burn wounds. In this case, it might be better to have a dressing that you can . Modern Dressings in Prevention and Therapy of Acute and Chronic and transmitted securely. It is suggested that how to promote wound healing in a home and nursing home should be studied in the future. Nitric oxide (NO) is critical to the homeostasis of the functioning of the skin and has become the target of treatment for specific skin diseases [27]. Unlike ordinary burns and ulcers, radiation directly damages the skin as well as its deep tissue cells, causing dryness, loss of elasticity, pigmentation, soft tissue fibrosis, capillary dilatation, and radiation dermatitis in irradiated areas. DFU is a prevalent and serious global health issue. (2009). Akita et al. Radiation-Induced Skin Injury: A Challenging Issue in the Outpatient Traditional and ethnobotanical dermatology practices in Romania and other Eastern European countries. FOIA In diabetics, the incidence of DFUs is approximately 510%. Allergy Drug Discov. A randomised controlled trial. Zhong W. H., Tang Q. F., Hu L. Y., Feng H. X. Hemati S, Asnaashari O, Sarvizadeh M, Motlagh BN, Akbari M, Tajvidi M, Gookizadeh A. Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast cancer. The mentioned research can be deepened. Moreover, triethanolamine mitigated patient discomfort compared with -sitosterol [56]. Acosta J. Given the mentioned information, bevacizumab as a novel type of drug to treat radiation brain injury exhibits a higher overall treatment efficiency, and it may be more in-depth thinking and exploration in the future. Under decreased angiogenesis and increased transforming growth factor- (TGF-) levels, blood vessels show variations, causing increased endothelial fibrosis; subsequent occlusion of the vascular lumen causes tissue hypoxia. Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC skin toxicity study group. Moreover, for the same patients, dense fibrosis with thick fibers was commonly identified in post-radiation tissues. A recent systematic review evaluated the effectiveness of silver-containing foam dressings and traditional SDD dressings in treating partial thickness burns. Asai J, Takenaka H, Hirakawa S, Sakabe J, Hagura A, Kishimoto S, Maruyama K, Kajiya K, Kinoshita S, Tokura Y, Katoh N. Topical simvastatin accelerates wound healing in diabetes by enhancing angiogenesis and lymphangiogenesis. Amelioration of radiation-induced skin injury by adenovirus-mediated heme oxygenase-1 (HO-1) overexpression in rats. PTX refers to a competitive nonselective phosphodiesterase inhibitor. The therapeutic effects of traditional dry dressings and modern wet dressings in the clinical management of wounds are documented. They are used on skin that is red, tender, sore, or weepy. Patient education should consist of daily skin and wound care management and topical medications. A case review of wound bed preparation in an infected venous leg ulcer utilizing novel reticulated open cell foam dressing with through holes during negative pressure wound therapy with instillation. They are insoluble in water and subsequently absorb water from 10% to thousands fold their equivalent weight (Goodwin et al., 2016). Phase III study of silver leaf nylon dressing vs standard care for reduction of inframammary moist desquamation in patients undergoing adjuvant whole breast radiation therapy. Ferreira EB, Ciol MA, Vasques CI, Bontempo PS, Vieira NN, Silva LF, Avelino SR, Dos Santos MA, Dos Reis PE. Burns, generally caused by heat (i.e., hydrothermal fluids, vapors, hot gases, flames, hot metal liquids or solids) cause tissue damage, mainly on the skin and mucous membranes. PDF Using PolyMem dressing - Royal United Hospital Serra R., Grande R., Buffone G., Molinari V., Perri P., Perri A., et al.. (2016). Rapid healing of wounds and the prevention of hyperplasia of scars in advanced stages of healing are important aspects for patients with burns. At the meantime, a network meta-analysis show that silver-containing dressings can increase the likelihood of VLU healing, but because of the small number of related studies and high risk of bias, the most effective treatment is still not determined (Norman et al., 2018). The results showed that the incidence of hospital-acquired pressure injury in the ICU decreased from 12.5% in 2009 to 7% in 2010, and the number of sacral pressure injury cases decreased from 50 to 13, respectively (Walsh et al., 2012). Wound healing after radiation therapy: review of the literature. Thus, treatment of the wound surface is also necessary. Endogenous electric fields (EFs) are capable of regulating the behaviors of skin cells in wound healing. Silver-containing foam dressings with Safetac: a review of the scientific and clinical data. Numerous advanced radiotherapy technologies for tumors have developed rapidly and been progressively applied in clinics. Cleanse the area with liquid medicinal soap with a pH between 4 and 6. shredding. Cioffi WG Jr, Burleson DG, Jordan BS, Becker WK, McManus WF, Mason AD Jr, Pruitt BA Jr. No use, distribution or reproduction is permitted which does not comply with these terms. studied the regeneration function of PRP by locally irradiating the back skin of mice. Mature adipocytes promote the migration of co-cultured keratinocytes and fibroblasts, but do not promote their proliferation. Facilitated synthesis and deposition of ECM and accumulation of fibroblasts are considered the characteristics of skin fibrosis. Wounds are classified as acute or chronic wounds. Acute wound pain has been shown to increase patient stress and subsequently negatively affect quality of life and lead to delayed wound healing (Broadbent et al., 2003). Berbe M, Fu Q, Kumar KS, Hauer-Jensen M. Novel strategies to ameliorate radiation injury: a possible role for tetrahydrobiopterin. (2017). Therefore, most of the dressings (e.g., Ag foam dressings) have the ability of osmotic absorption and prevention of infection. Salome G. M., de Almeida S. A., de Jesus Pereira M. T., Massahud M. R., Jr., de Oliveira Moreira C. N., de Brito M. J., et al.. (2016). Hydrogel wound dressing s aid in the healing process by providing a moist environment and non-adherent pain relief. Nevertheless, very few studies have focused on this aspect. The various types of dressings described above have their own characteristics; thus, the selection of the dressing should be based on the specific conditions of the wound. Low levels of VEGF after radiotherapy indicated that targeted VEGF treatment enhanced vascular repair. Trauma to Skin The alginate dressing absorbs large amounts of exudate and is also suitable for the treatment of VLU. Gel of chamomile vs. urea cream to prevent acute radiation dermatitis in patients with head and neck cancer: a randomized controlled trial. The study found that the polyurethane film patch effectively prevented the occurrence of erythema in the sacral area immediately after surgery (Imanishi et al., 2006). Silver clear nylon dressing is effective in preventing radiation-induced dermatitis in patients with lower gastrointestinal cancer: results from a phase III study. This manuscript also contains authors' consensus. PlGF refers to a member of the VEGF family and is involved primarily in pathological angiogenesis, including cancer. Despite the increasing accuracy of radiation therapy, normal tissues are still unavoidably exposed. Human fetal skin-derived stem cell secretome enhances radiation-induced skin injury therapeutic effects by promoting angiogenesis. Leakage of blood and fluid is also common. Innovative approaches in wound healing: trajectory and advances. Cell proliferation is suppressed in irradiated wounds. Haruna et al. Li Z., Zhou F., Li Z., Lin S., Chen L., Liu L., et al.. (2018). . At the same time, more high-quality research is needed in order to obtain more definitive evidence-based evidence in order to provide reliable decision-making basis for decision makers. Interestingly, a study investigated the modes of action preventing the occurrence of pressure ulcer, such as shear and friction force redistribution, and pressure distribution. Fatty acidbinding protein 4 can be incorporated into skin cells and promote the repair of DNA damage in irradiated skin fibroblasts. B., Timaran C. (2014). Ho et al. Accessibility Corticosteroids have anti-inflammatory effects. Hydrocolloid dressings for healing diabetic foot ulcers. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Data analysis of a multicentre surveillance network (IVDK) and review of the literature. Another study compared the wound healing efficacy of AQUACEL Ag dressing and Urgotul (Laboratoires Urgo, Chenove, France) Silver dressing for the treatment of venous ulcers at risk of infection. Almendral JM, Sommer D, Macdonald-Bravo H, Burckhardt J, Perera J, Bravo R. Complexity of the early genetic response to growth factors in mouse fibroblasts. Acute RSIs involve dry and wet desquamation, skin necrosis, ulcers, as well as bleeding [3]. A basic fibroblast growth factor improves lower extremity wound healing with a porcine-derived skin substitute. In addition, dressings with horizontal fabric structures transferred load over a greater area (Call et al., 2015). The results showed that both silver dressings were effective in the healing of venous ulcers (Harding et al., 2012). Studies have also demonstrated their role in fixation of skin grafts and protecting skin from radiation-induced reactions during radiotherapy for malignancy [ 10 , 11 . Bioactive dressings are a good choice for the repair of diabetic wounds.
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