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- Annersten Gershater, Magdalena, et al.
(författare)
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Re-ulceration is common in persons with diabetes and healed foot ulcer after participant-driven education in group : A randomized controlled trial.
- 2022
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Ingår i: Advances in wound care. - : Mary Ann Liebert. - 2162-1918 .- 2162-1934. ; 12:3, s. 117-126
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the number of ulcer-free days during 24 months in persons with diabetes and a healed foot ulcer below the ankle provided with adjusted therapeutic shoes who were given standard information and participated in participant-driven group education compared with standard information alone.METHOD: A randomized controlled trial was designed to evaluate the number of ulcer-free days after participant-driven group education in addition to standard information compared to standard information alone. The number needed to treat (N=174) was not met, as only n=138 persons with diabetes and previously healed foot ulcer were recruited (age median 63 years [34-79], 101 male/37 female).RESULT: 138 persons were recruited, of whom 107 (77.5%) completed the study, 7 (5%) dropped out, and 12 (9%) became deceased. No statistically significant difference was found between the intervention group compared to the control group after 6, 18, or 24 months. After 12 months, more patients in the intervention group had developed ulcers. Seventy-seven participants (56%) developed new foot ulcers, irrespective of side and site. Development of one ulcer appeared in 36 participants, two ulcers in 19, and 22 participants developed three ulcers. Forty-eight participants remained ulcer-free (35%) during the 24-month follow-up. Median ulcer-free days until first ulceration were 368 (4-720); until second ulceration, 404 (206-631); and until third ulceration, 660 (505-701). The participants wore prescribed therapeutic shoes during 88% of the follow-up visits.CONCLUSION: One third of the participants remained ulcer free for 24 months. Patient-driven education in groups did not give better results than standard information in this underpowered study. The present study illustrates the challenges to perform comparative preventive studies in this group of patients with extensive comorbidity. Further studies are needed to evaluate interventions on ulceration in persons with a healed foot ulcer.
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- Dabas, Mai, et al.
(författare)
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Application of artificial intelligence methodologies to chronic wound care and management : A scoping review
- 2023
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Ingår i: Advances in wound care. - : Mary Ann Liebert. - 2162-1918 .- 2162-1934. ; 12:4, s. 205-240
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Forskningsöversikt (refereegranskat)abstract
- SIGNIFICANCE: As the number of hard-to-heal wound cases rises with the aging of the population and the spread of chronic diseases, healthcare professionals struggle to provide safe and effective care to all their patients simultaneously. This study aimed to provide an in-depth overview of the relevant methodologies of artificial intelligence (AI) and their potential implementation to support these growing needs of wound care and management.RECENT ADVANCES: MEDLINE, Compendex, Scopus, Web of Science and IEEE databases, were all searched for new AI methods or novel uses of existing AI methods for diagnosis or management of hard-to-heal wounds. We only included English peer-reviewed original articles, conference proceedings, published patent applications or granted patents (not older than 2010) where the performance of the utilized AI algorithms was reported. Based on these criteria, a total of 75 studies were eligible for inclusion. These varied by the type of the utilized AI methodology, the wound type, the medical record/database configuration and the research goal.CRITICAL ISSUES: AI methodologies appear to have a strong positive impact and prospect in the wound care and management arena. Another important development that emerged from the findings is AI-based remote consultation systems utilizing smartphones and tablets for data collection and connectivity.FUTURE DIRECTIONS: The implementation of machine learning algorithms in the diagnosis and management of hard-to-heal wounds is a promising approach for improving the wound care delivered to hospitalized patients, while allowing healthcare professionals to manage their working time more efficiently.
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- Gefen, Amit, et al.
(författare)
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How should clinical wound care and management translate to effective engineering standard testing requirements from foam dressings? Mapping the existing gaps and needs
- 2023
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Ingår i: Advances in wound care. - : Mary Ann Liebert. - 2162-1918 .- 2162-1934. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- SIGNIFICANCE: Wounds of all types remain one of the most important, expensive and common medical problems, e.g., up to approximately two-thirds of the work time of community nurses is spent on wound management. Many wounds are treated by means of dressings. The materials used in a dressing, their microarchitecture and how they are composed and constructed form the basis for the laboratory and clinical performances of any advanced dressing. Recent Advances: The established structure-function principle in material science is reviewed and analyzed in this article in the context of wound dressings. This principle states that the microstructure determines the physical, mechanical, and fluid transport and handling properties, all of which are critically important for, and relevant to the adequate performances of wound dressings.CRITICAL ISSUES: According to the above principle, once the clinical requirements for wound care and management are defined for a given wound type and etiology, it should be theoretically possible to translate clinically-relevant characteristics of dressings into physical test designs resulting specific metrics of materials, mechanical, and fluid transport and handling properties, all of which should be determined to meet the clinical objectives and be measurable through standardized bench testing.FUTURE DIRECTIONS: This multidisciplinary review article, written by an International Wound Dressing Technology Expert Panel, discusses the translation of clinical wound care and management into effective, basic engineering standard testing requirements from wound dressings with respect to material types, microarchitecture and properties, to achieve the desirable performance in supporting healing and improving the quality of life of patients.
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- Karlsson, Matilda, et al.
(författare)
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Three Years Experience of a Novel Biosynthetic Cellulose Dressing in Burns
- 2019
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Ingår i: ADVANCES IN WOUND CARE. - : MARY ANN LIEBERT. - 2162-1918 .- 2162-1934. ; 8:2, s. 71-76
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The use of porcine xenograft (PX) is widely spread in burn care. However, it may cause immunologic responses and other ethical and cultural considerations in different cultures. Therefore, there is a need for alternatives. The aim of this work is to test a novel biosynthetic cellulose dressing (Epiprotect((R))) on burn patients. Approach: Charts from 38 patients with superficial burns (SBs) (n=18) or excised burns (n=20) that got biosynthetic cellulose dressing instead of PX at a national burn center during 3 years were reviewed. Time to healing, length of stay, and wound infection were extracted from the medical records. Results: SBs hospitalization time was 11 days comparable to PXs reported by others. In the excised group, median duration of hospital stay was 35 days. Time to healing was 28 days. Seven wound infections were confirmed in the superficial group (39%) and 11 infections in the excised group (61%). Patients with superficial wounds reported pain relief on application. Innovation: A dressing (17x21cm) consisting of biosynthetic cellulose replacing PX. Conclusion: Outcome of treatment of SBs or temporary coverage of excised deep burns with biosynthetic cellulose is comparable to treatment with PX. However, biosynthetic cellulose has benefits such as providing pain relief on application and ethical or cultural issues with the material is nonexistent.
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| 8. |
- Paydar, S., et al.
(författare)
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A Comparison of the Effects of Topical Prolavacid Solution (a Polyhexamethylene Biguanide-Based Wound Cleanser) and Medihoney Ointment in a Rat Model of Cutaneous Wound
- 2017
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Ingår i: Advances in Wound Care. - : Mary Ann Liebert Inc. - 2162-1918 .- 2162-1934. ; 6:12, s. 407-412
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This experimental work examined the healing effect and probable adverse impact of topical Prolavacid (R) solution (a polyhexamethylene biguanide-based wound cleanser) and topical Medihoney ointment in an animal model of cutaneous wound. Approach: We randomly divided 22 adult Sprague-Dawley rats (all were male) in two groups (n=11): (1) those for which Prolavacid solution was poured on the skin wound surface; and (2) those animals for which Medihoney (R) ointment was applied to the wounds. These two agents were applied daily throughout the study period (21 days). We photographically followed the wounds' contraction with imaging performed on days 0, 7, and 21 postwounding. The histopathologic features of the healing wounds were evaluated using skin biopsies taken on days 7 and 21 postwounding. Results: The difference in mean wound surface area between two groups was not statistically significant on the examined days. Histopathological assessment indicated no statistically significant difference between the Prolavacid- and Medihoney-treated groups on days 7 and 21. We did not detect tissue necrosis following the topical application of Prolavacid solution. Innovation: This was the first study to examine the efficacy and probable adverse consequences of topical Prolavacid on cutaneous wound healing process. Conclusion: Our work showed no statistically significant difference between the efficacy of daily topical application of Prolavacid and Medihoney products on the healing process of fresh cutaneous wounds in our rat model.
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| 9. |
- Succar, Julien, et al.
(författare)
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Mouse Mast Cell Protease-4 Recruits Leukocytes in the Inflammatory Phase of Surgically Wounded Skin
- 2019
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Ingår i: ADVANCES IN WOUND CARE. - : MARY ANN LIEBERT, INC. - 2162-1918 .- 2162-1934. ; 8:10, s. 469-475
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Mouse mast cell protease-4 (mMCP-4, also known as chymase) has both pro- and anti-inflammatory roles depending on the disease model. However, its effects have not been studied in surgically wounded skin. Given the significant clinical applications of modulating the inflammatory response in wound healing, we examined the role of mMCP-4 and the effect of its inhibitor chymostatin on leukocyte and polymorphonuclear cell (PMN) recruitment in our skin model. Approach: Recruitment was assessed on day-1 postwounding of three groups of mice (n = 10 each): mMCP-4 null mice, wild-type (WT) mice treated with the mMCP-4 inhibitor chymostatin, and WT with no other intervention. Leukocytes were stained with CD-45 cell marker, and PMN cells were stained with chloroacetate esterase. Results: The WT mice had 27 +/- 9 leukocytes per field compared with 11 +/- 6 for the mMCP-4 nulls, a decrease of 60% (p = 0.03), whereas the chymostatin-injected group had a count comparable with the uninjected WT controls at 24 +/- 9. The WT group had a PMN count of 96 +/- 12 cells, compared with just 24 +/- 8 in the mMCP-4 null group, a decrease of 75% (p = 0.001), whereas the chymostatin-treated group had 60 +/- 18 cells, a decrease of 38% compared with the WT group (p = 0.03). Innovation: We showed that the inflammatory process can be influenced by impeding the arrival of PMNs into the surgically injured site using the mMCP-4 inhibitor chymostatin. Conclusion: Chymase contributes to the recruitment of white blood cells in surgically wounded skin.
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