scholarly journals Extracellular matrix and cellular senescence in venous leg ulcers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Debbie X. E. Lim ◽  
Toby Richards ◽  
Muholan Kanapathy ◽  
Thankiah Sudhaharan ◽  
Graham D. Wright ◽  
...  
Keyword(s):  
Cellular Senescence ◽  
Chronic Wounds ◽  
Second Harmonic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Venous Leg Ulcer ◽  
Non Invasive ◽  
Wound Assessment ◽  
High Prevalence ◽  
Invasive Method

AbstractHigh prevalence of non-healing chronic wounds contributes to a huge healthcare burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more of senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e. venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also report that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory of healing.

scholarly journals Extracellular matrix and cellular senescence in venous leg ulcers

2021 ◽  
Author(s):  
Debbie Xiu En Lim ◽  
Toby Richards ◽  
Muholan Kanapathy ◽  
Thankiah Sudhaharan ◽  
Graham Daniel Wright ◽  
...  
Keyword(s):  
Cellular Senescence ◽  
Chronic Wounds ◽  
Second Harmonic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Venous Leg Ulcer ◽  
Non Invasive ◽  
Wound Assessment ◽  
High Prevalence ◽  
Invasive Method

Abstract High prevalence of non-healing chronic wounds contributes to a huge health burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also reported that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory.

Convolutional neural networks for wound detection: the role of artificial intelligence in wound care

2019 ◽  
Vol 28 (Sup10) ◽  
pp. S13-S24
Author(s):  
Norihiko Ohura ◽  
Ryota Mitsuno ◽  
Masanobu Sakisaka ◽  
Yuta Terabe ◽  
Yuki Morishige ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Wound Care ◽  
Area Under The Curve ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
High Specificity ◽  
Assessment System ◽  
Data Sets ◽  
Venous Leg Ulcer ◽  
Wound Assessment

Objective: Telemedicine is an essential support system for clinical settings outside the hospital. Recently, the importance of the model for assessment of telemedicine (MAST) has been emphasised. The development of an eHealth-supported wound assessment system using artificial intelligence is awaited. This study explored whether or not wound segmentation of a diabetic foot ulcer (DFU) and a venous leg ulcer (VLU) by a convolutional neural network (CNN) was possible after being educated using sacral pressure ulcer (PU) data sets, and which CNN architecture was superior at segmentation. Methods: CNNs with different algorithms and architectures were prepared. The four architectures were SegNet, LinkNet, U-Net and U-Net with the VGG16 Encoder Pre-Trained on ImageNet (Unet_VGG16). Each CNN learned the supervised data of sacral pressure ulcers (PUs). Results: Among the four architectures, the best results were obtained with U-Net. U-Net demonstrated the second-highest accuracy in terms of the area under the curve (0.997) and a high specificity (0.943) and sensitivity (0.993), with the highest values obtained with Unet_VGG16. U-Net was also considered to be the most practical architecture and superior to the others in that the segmentation speed was faster than that of Unet_VGG16. Conclusion: The U-Net CNN constructed using appropriately supervised data was capable of segmentation with high accuracy. These findings suggest that eHealth wound assessment using CNNs will be of practical use in the future.

Health professionals' perspectives on delivering patient-focused wound management: a qualitative study

2019 ◽  
Vol 28 (Sup7) ◽  
pp. S4-S13 ◽  
Author(s):  
Janet L. Kuhnke ◽  
David Keast ◽  
Sue Rosenthal ◽  
Robyn Jones Evans
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Best Practice ◽  
Care Delivery ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Evidence Based ◽  
Venous Leg Ulcer

Objective: This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes. Methods: A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes. Results: A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers. Conclusion: Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.

scholarly journals Case Study: Diabetic Foot Ulcer Nursing Management Using Ozone Regional Non-Invasive (ORNI)Therapy as A Combination Of Care

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Irma Puspita Arisanty ◽  
Debie - Dahlia
Keyword(s):  
Assessment Tool ◽  
Wound Care ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Nursing Management ◽  
Ozone Therapy ◽  
Average Growth ◽  
Non Invasive

<p><strong><em>Background: </em></strong><em>DFU patients must be treated properly less than 30 days to prevent infection spread to the bone, causes smaller opportunity to recovery and higher risk for amputation. Ozone therpay has a clearer clinical effect, affects the wound healing process, it can be seen by decreasing the length of stay.</em><strong><em> Method:</em></strong><em> Case studies of 3 DFU patients who were given ORNi therapy. Wound evaluation using </em><em>Bettes-Jenssen Assessment tool skoring system. </em><strong><em>Results: </em></strong><em>There were significant improvement in these cases after given a noninvasive regional ozone therapy (ORNi) as a combination in standard treatment for 5 – 7 times. There are no sign of infection, granulation and epithelization processes were running optimal and exudate production was controlled. </em><strong><em>Conclusions and recommendation: </em></strong><em>Using ORNi therapy as an adjunct to standard care has shown a significant improvement. The rate of granulation and epithelization during 15 days of treatment has an average growth rate of granulation and epithelization up to 22%. Researchers recommend to do more research with suficcient sample size related to the use of ozone therapy as an adjunct in wound care. </em></p>

scholarly journals Maggot debridement therapy for the treatment of diabetic foot ulcers: robbing the rich past to give to the sore

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Joseph Cutteridge ◽  
Katarzyna Bera
Keyword(s):  
Diabetic Foot ◽  
Chronic Wounds ◽  
Multiorgan Failure ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Necrotic Tissue ◽  
Foot Care ◽  
Surgical Interventions ◽  
Wound Debridement ◽  
Maggot Debridement Therapy

A diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus that results in significant morbidity and mortality. The lifetime risk of a patient with diabetes developing a DFU is 15-25%1. Furthermore, the incidence of DFUs is increasing in line with the growing burden of diabetes worldwide. The number of lower limb amputations secondary to diabetes has reached an all-time high in England, with 26,378 recorded from 2014-2017, an increase of 19.4% from 2010-20132. Maggot debridement therapy (MDT) involves the application of sterile larvae, usually of the species Lucilla sericata (common green bottle fly), which remove devitalised tissue to promote wound healing. This historical therapy re-emerged in the 1990s to combat the increasing incidence of recalcitrant wounds, such as DFUs. Since its reintroduction, there has been ongoing debate in the medical literature regarding the efficacy of MDT in the treatment of DFUs and other chronic wounds. We present the case of a 57-year-old male admitted with diabetic foot sepsis and multiorgan failure and discuss how MDT was used to complement initial surgical and antibiotic management. A 14-day course of MDT improved wound debridement and decreased necrotic tissue burden, after which no further surgical interventions were needed. This case provides further evidence that MDT is effective in the selective debridement of necrotic tissue and can aid the preservation of limb length in DFU patients, thereby highlighting the importance of MDT in multispecialist diabetic foot care.

scholarly journals Three-Dimensional Human Tissue Models That Incorporate Diabetic Foot Ulcer-Derived Fibroblasts Mimic In Vivo Features of Chronic Wounds

2015 ◽  
Vol 21 (5) ◽  
pp. 499-508 ◽  
Author(s):  
Anna G. Maione ◽  
Yevgeny Brudno ◽  
Olivera Stojadinovic ◽  
Lara K. Park ◽  
Avi Smith ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Human Tissue ◽  
Chronic Wounds ◽  
Three Dimensional ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Tissue Models

Influence of bioengineered skin substitutes on diabetic foot ulcer and venous leg ulcer outcomes

2008 ◽  
Vol 17 (12) ◽  
pp. 517-527 ◽  
Author(s):  
C. Barber ◽  
A. Watt ◽  
C. Pham ◽  
K. Humphreys ◽  
A. Penington ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Leg Ulcer ◽  
Skin Substitutes ◽  
Venous Leg Ulcer ◽  
Bioengineered Skin

Bioactive and superabsorbent cellulosic dressing grafted alginate and Carthamus tinctorius polysaccharide extract for the treatment of chronic wounds

2020 ◽  
pp. 004051752093521
Author(s):  
Yassine El-Ghoul ◽  
Fahad M Alminderej
Keyword(s):  
Diabetic Foot ◽  
Chronic Wounds ◽  
Negative Impact ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Carthamus Tinctorius ◽  
Biological Properties ◽  
Attenuated Total Reflection ◽  
Curing Conditions ◽  
Textile Functionalization

Diabetic foot ulcers have a negative impact on the lives of patients and are highly vulnerable to infection, leading to amputation too often. It is essential that the patient with a diabetic foot ulcer receives the best possible care. Herein, we developed a new functionalized cellulosic wound dressing with high-improved healing properties, able to be a serious alternative for diabetic acute wounds. First, a bioactive polysaccharide was extracted from the Carthamus tinctorius plant. Then a new crosslinked polymer-based alginate/ C. tinctorius polymer extract was prepared and checked for combined antimicrobial and tissue regeneration properties. Afterward, the efficiency of the textile functionalization process was optimized through studying the influence of different grafting parameters: curing conditions and the concentration of the impregnating solution. The drop method wettability technique exhibited significant improvement in the hydrophilicity behavior of treated textile samples, which increased with the grafting rate. Attenuated total reflection Fourier-transform infrared spectroscopy and thermogravimetric analysis or differential thermal analysis were investigated to test whether the chemical permanent grafting resisted the severe standard washing conditions. The tensile strength characteristics showed that the grafting does not affect the original mechanical properties of treated textile dressings. A morphological study via scanning electron microscopy images confirmed the permanent textile finishing performance and permitted us to assess its chemical grafting approach onto the treated surfaces. The biological and the bacteriological investigations of functionalized dressings proved that the functional biomaterial could be used as a medical bioactive device with improved biological properties.

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