scholarly journals Optimal Support of Wound Healing: New Insights

Dermatology ◽  
2020 ◽  
Vol 236 (6) ◽  
pp. 593-600 ◽  
Author(s):  
Jens Malte Baron ◽  
Martin Glatz ◽  
Ehrhardt Proksch
Keyword(s):  
Wound Healing ◽  
Best Practices ◽  
Wound Closure ◽  
Wound Care ◽  
Clinical Approach ◽  
Visual Appearance ◽  
Rapid Repair ◽  
Wound Recovery ◽  
Scar Management ◽  
Three Phases

<b><i>Background:</i></b> The ultimate goal of wound healing following minor injury is to form a tissue regenerate that has functionality and visual appearance as close to the original skin as possible. The body’s physiological response to any wound is traditionally characterised by three distinct steps: inflammation, proliferation and remodelling. <b><i>Summary:</i></b> New insights suggest that the three phases overlap (and even occur in parallel) in both time and space in the wound, necessitating a clinical approach that targets each stage simultaneously to ensure rapid repair and wound closure without further complications. Ingredients that exhibit activity across each of the three phases, such as dexpanthenol, are of value in the context of minor wound care and scar management. <b><i>Key Messages:</i></b> In addition to treatment and ingredient selection, it is also important to consider broader clinical best practices and self-care options that can be used to optimise the management of minor wounds. An individualised approach that can account for a patient’s unique requirements and preferences is critical in achieving effective wound recovery.

Management of Acute Wounds

2019 ◽  
Author(s):  
Lee D. Faucher ◽  
Angela L. Gibson
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Wound Closure ◽  
Wound Care ◽  
Connective Tissue Diseases ◽  
Skin Grafting ◽  
Adjunctive Treatment ◽  
Local Trauma ◽  
Life Threatening ◽  
Acute Wound

Acute wounds are the result of local trauma and may be associated with severe life-threatening injuries. All patients with acute wounds should be assessed for comorbidities such as malnutrition, diabetes, peripheral vascular disease, neuropathy, obesity, immune deficiency, autoimmune disorders, connective tissue diseases, coagulopathy, hepatic dysfunction, malignancy, smoking practices, medication use that could interfere with healing, and allergies. The authors address the key considerations in management of the acute wound, including anesthesia, location of wound repair (e.g. operating room or emergency department), hemostasis, irrigation, débridement, closure materials, timing and methods of closure, adjunctive treatment (e.g. tetanus and rabies prophylaxis, antibiotics, and nutritional supplementation), appropriate closure methods for specific wound types, dressings, postoperative wound care, and potential disturbances of wound healing.  This review contains 11 figures, 31 tables, and 92 references. Keywords: wound, wound infection, burns, suture, staple, wound closure, wound healing, dehiscence, skin grafting

scholarly journals Comparison of Topical Skin Adhesive and Simple Interrupted Nylon Sutures for Wound Closure in Forefoot Surgery: A Prospective Randomised Trial

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0039
Author(s):  
Robbie Ray ◽  
Thomas A. Goff ◽  
Paul M. Dearden ◽  
Peter W. Robinson ◽  
Peter Lam ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Wound Care ◽  
Randomised Trial ◽  
Data Set ◽  
Prospective Randomised Trial ◽  
Forefoot Surgery ◽  
High Satisfaction ◽  
Patient Reported

Category: Bunion Introduction/Purpose: There are many options for wound closure in forefoot surgery. The purpose of this study was to compare topical skin adhesive (2-Octyl-cyanoacrylate) to standard simple interrupted nylon sutures with attention to the quality of wound healing and the acceptability to the patient. Methods: Patients undergoing elective 1st ray forefoot surgery utilising a medial incision, either Hallux Valgus correction or 1st Metotarsophalangeal joint arthrodesis, were recruited to this study. Patients were randomly allocated during surgery to final layer wound closure with either the intervention topical skin adhesive (TSA) or the control interrupted nylon sutures (INS). Practicality was assessed by time taken for wound closure and subsequent time to perform wound care at 2 weeks postoperatively, wound care pain (VAS) and quality of wound healing was assessed at this point with a dedicated scoring tool, patient satisfaction and acceptability was assessed at 6 weeks postoperative. Results: 70 patients (18 bilateral) were recruited, resulting 42 feet in each study group (after 4 exclusions for incomplete data set). Mean age 61 (29-83). There were no statistical differences in the demographics or surgery performed between groups. Wound closure time was significantly slower for TSA (272 secs (SD 72.2) vs 229 secs (SD 58.8), p=0.0038). At 2 weeks postoperative wound care time was significantly faster for TSA (71 secs (SD 50.8) vs 120 Secs (SD 47.8), p<0.0001), and patient reported pain was significantly less with TSA (VAS 0 vs 2, p=0.025). Significantly more inflammation and wound edge separation was recorded with TSA (17 vs 5 cases, p=0.006) and (12 vs 3 cases, p=0.02) respectively. High satisfaction was reported in both groups with no signifcant difference. Conclusion: Topical skin adhesive and interrupted nylon sutures are both acceptable closure methods for forefoot surgery with high satisfaction rates, low pain scores and low complications. However, the observation of significantly more inflammation and areas of wound separation at the early post-operative period with topical skin adhesive is sufficient to recommend routine use of sutures.

The Use of Biologic Wound Healing Agents in Cheek Reconstruction

2021 ◽  
Author(s):  
Monal Depani ◽  
James Thornton
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Wound Care ◽  
Mobile Element ◽  
Excisional Biopsy ◽  
Advancement Flap ◽  
Mobile Elements ◽  
Skin Closure ◽  
Comorbid Conditions ◽  
The Face

AbstractThe unique requirements of reconstructing cheek defects, often with its proximity to the mobile elements of the face including the lip and the eyelid, have been met very handily with the directed and thoughtful use of biologic wound healing agents. One of the key advantages of these agents is their ability to provide coverage in patients with multiple comorbid conditions for the mobile elements of the cheek where the cervicofacial advancement flap is contraindicated due to its anesthetic requirement. The biologic agents are also highly successful coverage options for patients who have limited skin laxity to provide for proper skin closure using the standard cheek closure techniques with local flaps. In addition, these agents provide an ability to provide stable wound closure with minimal wound care while waiting for the excisional biopsy results to be finalized. This article describes the unique indications for biologic wound agents, including preservation of lip and eyelid mobile element anatomy without retraction from a local flap, which has not been previously described.

scholarly journals Forceful closure: cytoskeletal networks in embryonic wound repair

2019 ◽  
Vol 30 (12) ◽  
pp. 1353-1358 ◽  
Author(s):  
Katheryn E. Rothenberg ◽  
Rodrigo Fernandez-Gonzalez
Keyword(s):  
Wound Healing ◽  
Cell Biology ◽  
Wound Repair ◽  
Wound Closure ◽  
Cancer Metastasis ◽  
Cell Movement ◽  
Collective Cell Migration ◽  
Cell Movements ◽  
Rapid Repair ◽  
Cytoskeletal Networks

Embryonic tissues heal wounds rapidly and without scarring, in a process conserved across species and driven by collective cell movements. The mechanisms of coordinated cell movement during embryonic wound closure also drive tissue development and cancer metastasis; therefore, embryonic wound repair has received considerable attention as a model of collective cell migration. During wound closure, a supracellular actomyosin cable at the wound edge coordinates cells, while actin-based protrusions contribute to cell crawling and seamless wound healing. Other cytoskeletal networks are reorganized during wound repair: microtubules extend into protrusions and along cell–cell boundaries as cells stretch into damaged regions, septins accumulate at the wound margin, and intermediate filaments become polarized in the cells adjacent to the wound. Thus, diverse cytoskeletal networks work in concert to maintain tissue structure, while also driving and organizing cell movements to promote rapid repair. Understanding the signals that coordinate the dynamics of different cytoskeletal networks, and how adhesions between cells or with the extracellular matrix integrate forces across cells, will be important to elucidate the mechanisms of efficient embryonic wound healing and may have far-reaching implications for developmental and cancer cell biology.

Evidence-Based Best Practices: Wound Healing Tracking and Assessment

2013 ◽  
Author(s):  
Jessica Chin ◽  
Ibrahim Zeid ◽  
Sagar Kamarthi
Keyword(s):  
Wound Healing ◽  
Best Practices ◽  
Wound Care ◽  
Model Systems ◽  
Teaching Hospitals ◽  
Care Practice ◽  
Evidence Based ◽  
Institutional Settings ◽  
Care Assessment ◽  
Definition Of

Standard medical practice is known to have a history of varying definition of “standard”. As with any industry with multiple entities, each entity defines their standards and expectations according to what they believe is their customers’ (i.e. patients) needs and preferences. Recently, our research on developing a predictive wound care assessment methodology and system has extended our study into analyzing evidence-based best practices in wound care clinics. Our research on wound healing predictive model systems, revealed key differences in operational practice between the clinics that were visited in different institutional settings. The scope of this study evaluates our observed wound care practice and wound care treatment to determine if there is a common set of effective practice that can be developed to better standardize care. The purpose of this paper is to compare and contrast the operational practice and procedures at various community and teaching hospitals to determine if there is an ideal combination of tools and standard techniques that would be most beneficial to patient wound care. This paper will focus on methods of patient wound care. We will then present a model of “Evidence-Based Best Practices of Wound Care Assessment” that is based on the observation and interactions with various hospitals.

scholarly journals RESEARCH AND DEVELOPMENT IN WOUND MANAGEMENT PRODUCTS: A BRIEF REVIEW

2018 ◽  
Vol 11 (6) ◽  
pp. 17
Author(s):  
Surya Geetha V ◽  
Vishal Gupta N ◽  
Gowda Dv ◽  
Kulkarni Pk
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Wound Management ◽  
Skin Substitutes ◽  
Wound Recovery ◽  
Surgical Wounds ◽  
Wide Range ◽  
Healing Wounds ◽  
Dressing Materials ◽  
Normal Architecture

Wound can be defined as any process which leads to the disruption of the normal architecture of a tissue. They may be closed or open, for example, abrasions, lacerations, avulsions, ballistic and excised, or surgical wounds. Successful wound care includes advancing patient local and systemic conditions in conjunction with a perfect injury healing condition. Numerous wide assortments of dressing materials are accessible both for extreme and persistent non-healing wounds. A wide range of wound healing products have been produced to impact this injury condition to give a non-pathogen, ensured, and clammy region for healing to happen. A perfect injury dressing ought to limit loss of protein, electrolytes, and liquids from twisted and to diminish pain and contamination alongside wound healing. More current products are as of now being utilized to supplant or enlarge different substrates in the injury healing period. There is a sharp complexity to prior routine of wound administration, where the injury is permitted to dry, yet the present advancement was to move forward to the idea of wet injury recovering. This review of the present wounding periphery in wound recovery occurs at the most recent utilizations of silver and the employments of negative pressure wound gadgets, propelled dressings and skin substitutes, and biologic injury items including development of hydrogels and hyperbaric oxygen as an aid in wound mending. With the advancement of accessible dressings, the objective is to locate the most proper methodology or blend of modalities to optimize wound healing.

Preparation of Chitosan-Based Fiber Reticulated Medical Dressing and Its Application in Wound Care

2020 ◽  
Vol 12 (6) ◽  
pp. 921-931
Author(s):  
Peiying Han ◽  
Jie Ma ◽  
Min Lin ◽  
Xiaoyan Cai ◽  
Fang Fang
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Antibacterial Properties ◽  
Biological Properties ◽  
Wound Area ◽  
Cell Compatibility ◽  
Wound Recovery ◽  
Liquid Absorption ◽  
Healing Of Wounds ◽  
Chitosan Fiber

With the continuous development of medical dressings, patients start to focus on how to take care of wounds caused by different reasons. Therefore, there is a need for medical dressings that can stop the bleeding and promote the healing of wounds with excellent biological properties. This study produced seven different dressing samples by combining chitosan fiber and hydroentanglement technique. The different dressings were characterized and analyzed for biological properties. At the same time, 60 New Zealand rabbits were selected for wound care experiments. Respectively, the wounds were constructed and were treated with sample 1 and sample 3, which were selected as experimental materials from the prepared dressing samples. Besides, the polyacrylate (SAP) and common gauze were taken as the control materials. Then, different dressings were used to cover the wounds of rabbits. Three days later, the dressings were changed every few days to observe the wounds. At the same time, the wound area and wound healing scores of the sample 1 group, sample 3 group, and SAP group were counted at 7 days, 14 days and 21 days after the operations. During the experiment, the chitosan fiber-based fiber web dressing showed excellent hygroscopicity and rigidity. For the comparison of biological properties, different samples all had excellent cell compatibility and antibacterial properties. Meanwhile, the antibacterial properties of sample 1 and sample 3 were all above 90%. For the wound care experiment, the adsorbent rate of sample 1 dressing was the fastest in the first 8 min, reaching 70% of the maximum liquid absorption. For the comparison of the wound recovery area and wound healing scores, compared with SAP and common gauze, the medical dressings based on composite chitosan fiber-hydroentanglement technique had better wound recovery performance. This has proved that the medical dressings proposed in this study have better wound care performances.

scholarly journals Wound Healing with Electrical Stimulation Technologies: A Review

Polymers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 3790
Author(s):  
Yt Jun Cheah ◽  
Muhamad Ramdzan Buyong ◽  
Mohd Heikal Mohd Mohd Yunus
Keyword(s):  
Tissue Engineering ◽  
Wound Healing ◽  
Electrical Stimulation ◽  
Care Management ◽  
Wound Repair ◽  
Wound Closure ◽  
Wound Care ◽  
Smart Biomaterials

Electrical stimulation (ES) is an attractive field among clinicians in the topic of wound healing, which is common yet complicated and requires multidisciplinary approaches. The conventional dressing and skin graft showed no promise on complete wound closure. These urge the need for the exploration of electrical stimulation to supplement current wound care management. This review aims to provide an overview of electrical stimulation in wound healing. The mechanism of galvanotaxis related to wound repair will be reviewed at the cellular and molecular levels. Meanwhile, different modalities of externally applied electricity mimicking a physiologic electric field will be discussed and compared in vitro, in vivo, and clinically. With the emerging of tissue engineering and regenerative medicine, the integration of electroconductive biomaterials into modern miniaturised dressing is of interest and has become possible with the advancing understanding of smart biomaterials.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

Comparison of the ficus for the wound healing activity in various species

2020 ◽  
Vol 10 (4) ◽  
pp. 67-70
Author(s):  
Mothilal K ◽  
Akila CR ◽  
Mahender K ◽  
Chaitanya Kumar K ◽  
Ravi D
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Subcutaneous Tissue ◽  
Significant Activity ◽  
Herbal Extracts ◽  
Standard Drug ◽  
Excision Wound ◽  
Injuries And Wounds ◽  
Skin Conditions ◽  
Wound Healing Activity

Injuries and wounds are any sorts of damage to the skin or subcutaneous tissue. Usually, any wounds of such sorts are self-healed. Sometimes, there may be a delay in healing, and that delay is caused due to the functional delays in various processes of wound healing. All the Ficus plants show similar activities like the antioxidant, anti-inflammatory and wound healing properties 7including skin conditions like ulcers and rheumatism. The anthelmintic property and immunomodulatory are also seen. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. All the extracts showed a better healing ability, but the extract of FBO-100 showed the highest activity followed by FMO followed by FHO and finally the FRO. Overall, the activity of the extract ointment was comparable and was significant compared to the standard drug ointment. The wound closure of the extract ointment treated groups were better and were completed in 12 days, and the activity was more than 96%. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. The plants of microcarpa, benghalensis, religiosa and hispida are compared for the activity, and the order showed for the activity was FBO>FMO>FHO>FRO.

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