Chitooligosaccharide-europium (III) functional micron complex with visualized inflammation monitoring, immunomodulation and pro-vascularization activities for effective wound healing of pressure ulcers injury

Abstract Aim Pressure ulcers (PUs) affect over 700,000 patients per annum and are associated with an up to fourfold increase in mortality rate in older populations with complex pathologies. NICE guidelines for PU management involve a combination of low-grade technological interventions, including dressings and foam mattresses, while technology-centric therapies are not offered. The aim of this systematic review is to evaluate the effectiveness of any novel and high-grade technological PU interventions. Method The PubMed, Embase (via Ovid), Web of Science and CINAHL databases were electronically searched using free-text and MeSH search strings. Results evaluating the type of technological intervention, outcome measures and wound healing rates, duration of hospital stay, requirement for surgical debridement, infection and mortality rates were methodically assessed. Results An initial search identified 900 articles. Using the PRISMA guidance, 25 studies were included, encompassing 845 patients. 28 novel modalities of high-grade innovations were identified, with distinguished technologies including smart wireless bandages and 3D-printed wound repair scaffolds. Overall, 92.8% of devices demonstrated an improvement in wound healing (P < 0.05). A novel framework was created from the different innovations identified to approach adopting innovation in PU management. Conclusions The majority of high-technology innovations identified in this systematic review significantly improve PU healing, thus offering an additional pathway to standard care. Given the annual cost of PUs (£531 million), it is vital innovative technologies are considered as the NHS transitions into a digital age. Therefore, further studies are essential and recommended to evaluate the potential benefit of the promising, innovative technologies identified.

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THE EFFICACY OF HONEY AS AN ALTERNATIVE TO STANDARD ANTISEPTIC CARE IN THE TREATMENT OF CHRONIC PRESSURE ULCERS AND DIABETIC FOOT ULCERS IN ADULTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i11.42560 ◽

2021 ◽

pp. 37-47

Author(s):

GF PEREIRA ◽

M BALMITH ◽

M NELL

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Bacterial Infections ◽

Chronic Wounds ◽

Pressure Ulcers ◽

Keyword Search ◽

Selection Process ◽

Foot Ulcers ◽

Published Data ◽

Diabetic Foot Ulcers

Objective: A chronic wound fails to progress through the phases of wound healing in an orderly and appropriate process, and poses a major challenge to wound care professionals. Pressure ulcers (PUs) and diabetic foot ulcers (DFUs) are classified as chronic wounds. Antiseptics, such as povidone-iodine (PVP-I), are often used to treat bacterial infections in chronic wounds; however, their efficacy and ability to accelerate wound healing has come into question. As a result, current medical research is now focusing on alternative and natural antiseptic agents, such as honey, for the treatment of chronic wounds. The aim of this study was to analyze the wound healing effects of honey in PU and DFU treatment in comparison to standard antiseptic care. Methods: A systematic literature search of PubMed, ScienceDirect, and ClinicalKey was conducted to identify all published data of clinical trials and narrative reviews that investigated or reported the use of honey and standard antiseptics in the treatment of PUs and DFUs in adults. A keyword search was then performed using the following keywords: “PUs”, “DFUs”, “antiseptics”, “PVP-I”, “honey”, “Manuka honey (MH)”, and “wound healing”. Database restrictions were implemented based on the inclusion and exclusion criteria, notably the report’s availability, completion status and language, the sample populations’ age, as well as, the date of publication. A preferred reporting item for systematic review and meta-analysis (preferred reporting items for systematic reviews and meta-analyzes) diagram was constructed illustrating the study selection process. The eligibility of articles was assessed by the screening of titles, abstracts and full texts. A total of 12 articles were included in this study comprising of 775 patients with PUs, DFUs or a combination of PUs and DFUs. Results: Results indicated that honey reduced bacterial infection, reduced pain and edema experienced by patients, reduced the odor of the wound and promoted wound healing in the treatment of chronic ulcers. Honey was also found to be effective in the process of debridement and exudate removal. Conclusion: Honey was found to be highly effective in the treatment of PUs and DFUs and should be considered as an alternative to standard antiseptic care in the treatment of chronic wounds. However, the literature in this study is limited and so further research into honey and its antiseptic-promoting activity in wound healing is recommended.

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Rapid detection of biofilm by wound blotting following sharp debridement of chronic pressure ulcers predicts wound healing: A preliminary study

International Wound Journal ◽

10.1111/iwj.13256 ◽

2019 ◽

Vol 17 (1) ◽

pp. 191-196 ◽

Cited By ~ 7

Author(s):

Gojiro Nakagami ◽

Gregory Schultz ◽

Aya Kitamura ◽

Takeo Minematsu ◽

Kaname Akamata ◽

...

Keyword(s):

Wound Healing ◽

Rapid Detection ◽

Pressure Ulcers ◽

Preliminary Study

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Enteral Nutrition in the Prevention and Treatment of Pressure Ulcers in Adult Critical Care Patients

Critical Care Nurse ◽

10.4037/ccn2014950 ◽

2014 ◽

Vol 34 (6) ◽

pp. 15-27 ◽

Cited By ~ 7

Author(s):

Jill Cox ◽

Louisa Rasmussen

Keyword(s):

Wound Healing ◽

Critical Care ◽

Nutritional Status ◽

Pressure Ulcers ◽

Burden Of Illness ◽

Evidence Based ◽

Adequate Nutrition ◽

Nutritional Guidelines ◽

Registered Dietician ◽

Critical Care Patients

Prevention and healing of pressure ulcers in critically ill patients can be especially challenging because of the patients’ burden of illness and degree of physiological compromise. Providing adequate nutrition may help halt the development or worsening of pressure ulcers. Optimization of nutrition can be considered an essential ingredient in prevention and healing of pressure ulcers. Understanding malnutrition in critical care patients, the effect of nutrition on wound healing, and the application of evidence-based nutritional guidelines are important aspects for patients at high risk for pressure ulcers. Appropriate screenings for nutritional status and risk for pressure ulcers, early collaboration with a registered dietician, and administration of appropriate feeding formulations and micronutrient and macronutrient supplementation to promote wound healing are practical solutions to improve the nutritional status of critical care patients. Use of nutritional management and enteral feeding protocols may provide vital elements to augment nutrition and ultimately result in improved clinical outcomes.

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The Japanese registry for surgery of ischial pressure ulcers: STANDARDS-I

Journal of Wound Care ◽

10.12968/jowc.2020.29.sup9a.s39 ◽

2020 ◽

Vol 29 (Sup9a) ◽

pp. S39-S47

Author(s):

Hideyuki Yanagi ◽

Hiroto Terashi ◽

Yoshimitsu Takahashi ◽

Katsuyuki Okabe ◽

Katsumi Tanaka ◽

...

Keyword(s):

Wound Healing ◽

Pressure Ulcers ◽

Functional Independence ◽

Surgical Indications ◽

Spastic Paralysis ◽

Medical Institutions ◽

Surgical Application ◽

Secondary Endpoints ◽

Complete Wound Healing ◽

Discharge From Hospital

Objective: To clarify the surgical indications and the appropriate perioperative management of ischial pressure ulcers (PUs). Method: A two-year prospective, nationwide registry study was carried out across 26 medical institutions in Japan. All participating institutions managed ischial PUs according to the standardisation of total management and surgical application for the refractory decubitus (STANDARDS-I) perioperative protocol. Analysis was conducted on a range of clinically or statistically important variables for the achievement of primary or secondary endpoints: complete wound healing and hospital discharge at three months, and complete wound healing at one month after surgery, respectively. Results: A total of 59 patients took part in the study. All patients underwent surgery for ischial PUs during the study period. Patients who had achieved the primary endpoint had a higer preoperative functional independence measurement (FIM score), a higher ‘G’ score in the DESIGN-R scale and were more likely to have healed by primary intention. Patients who had achieved the secondary endpoint were more likely to have spastic paralysis, preoperative physiotherapy and localised infection of the wound, among other variables. Conclusion: This survey suggests that preoperative physiotherapy increases the speed of wound healing, and good granulation of the wound bed preoperatively increases the likelihood of woundless discharge from hospital, whereas the existence of comorbidities negatively influences the likelihood of woundless discharge from hospital. The study also suggests that the existence of spastic paralysis, preoperative infection of the wound, or surgical reduction of the ischial tubercle speeds up the healing of the wound. However, the wound failed to heal significantly more often in patients with increasing white blood cell count after surgery.

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Micronutrients, wound healing, and prevention of pressure ulcers

Nutrition ◽

10.1016/j.nut.2010.05.015 ◽

2010 ◽

Vol 26 (9) ◽

pp. 858 ◽

Cited By ~ 6

Author(s):

Hans Biesalski

Keyword(s):

Wound Healing ◽

Pressure Ulcers

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Effectiveness of Platelet-Rich Plasma and Hyaluronic Acid for the Treatment and Care of Pressure Ulcers

Biological Research For Nursing ◽

10.1177/1099800414535840 ◽

2014 ◽

Vol 17 (2) ◽

pp. 152-158 ◽

Cited By ~ 26

Author(s):

Javier Ramos-Torrecillas ◽

Olga García-Martínez ◽

Elvira De Luna-Bertos ◽

Francisco Manuel Ocaña-Peinado ◽

Concepción Ruiz

Keyword(s):

Wound Healing ◽

Hyaluronic Acid ◽

Peripheral Blood ◽

Pressure Ulcers ◽

Platelet Rich Plasma ◽

Blood Platelet ◽

Control Group ◽

Treatment Groups ◽

Ulcer Area ◽

Complete Wound Healing

Platelet-rich growth factor (PRGF) is a natural source of growth factors (GF), while hyaluronic acid (HA) is a biopolymer present in the extracellular matrix of skin, cartilage, bone, and brain, among other tissues. Both are involved in the pathophysiological mechanisms underlying wound healing. The objective of this study was to evaluate the clinical efficacy (as measured by ulcer area) and safety (as measured by signs of infection) of PRGF and PRGF plus HA in the treatment of pressure ulcers (PUs). Patients ( N = 100) with 124 Stage II–III PUs were randomized to a control group ( n = 25 PUs) for standard care or to case groups for treatment with one ( n = 34 PUs) or two ( n = 25 PUs) doses of PRGF from their own peripheral blood, or two doses of PRGF plus HA ( n = 40 PUs). All ulcers were followed up every 3 days for a 36-day period. At 36 days, a significant reduction in ulcer area ( p ≤ .001) was observed in all treatment groups, with a mean reduction of more than 48.0% versus baseline. The greatest mean reduction (80.4% vs. baseline) was obtained with the PRGF plus HA regimen. Complete wound healing was observed in 32.0% of PUs treated with two doses of PRGF ( p ≤ .002) and in 37.5% of those treated with two doses of PRGF plus HA ( p ≤ .004). There were no signs of infection in any PUs during the 36-day follow-up period. The degree of wound healing was inversely correlated with the consumption of drugs such as statins and with the peripheral blood platelet levels of patients at baseline.

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Recent Advances in the Development of Nitric Oxide-Releasing Biomaterials and Their Application Potentials in Chronic Wound Healing

Journal of Materials Chemistry B ◽

10.1039/d1tb00847a ◽

2021 ◽

Author(s):

Min Wu ◽

Zhihui Lu ◽

Keke Wu ◽

Changwoo Nam ◽

Lin Zhang ◽

...

Keyword(s):

Nitric Oxide ◽

Wound Healing ◽

Persistent Infection ◽

Diabetic Foot ◽

Chronic Wounds ◽

Pressure Ulcers ◽

Chronic Wound ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Nitric Oxide Releasing

Chronic wounds, such as pressure ulcers, vascular ulcers and diabetic foot ulcers (DFUs), often stays in a state of pathological inflammation and suffers from persistent infection, excess inflammation, and hypoxia,...

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