Plastic chronic wound management with Cellutome

Phlebologie ◽  
2016 ◽  
Vol 45 (02) ◽  
pp. 100-105
Author(s):  
G. U. Seip
Keyword(s):  
Health Care Providers ◽  
Chronic Wounds ◽  
Donor Site ◽  
Skin Grafting ◽  
Minimal Invasive ◽  
Wound Management ◽  
Wound Treatment ◽  
Care Providers ◽  
Patients With Diabetes ◽  
Chronic Wound Management

SummaryChronic wounds continue to present a significant challenge to health-care providers around the globe. Unlike acute wounds, chronic wounds do not proceed through an orderly process of repair. In recent years many new modalities of modern wound treatment systems have been promoted. However, until recently there were few modalities designed to promote epithelialisation of a fully granulated wound. Mesh graft procedures have long been the gold standard for the management of acute wounds and chronic wounds but have also many disadvantages like discomfort associated with the donor site and the creation of a second painful wound (donor site).The increase of chronical wounds in Germany due to the average age of patients, the aggressiveness of medical treatment and increase of numbers of patients with diabetes and severe polymorbidity requires specialized wound treatment and plastic surgery. Since 2014 there was a new innovative system introduced in the market called Cellutome epidermal harvesting system. The Cellutome system is a epidermal harvesting system for skin grafting and can replace in many cases the traditional meshgraft procedure with a classic dermatoma. The skin donor section on the patient`s thigh heals within days without scarring. The system offers a precise, simplified and minimal invasive option for skin grafting in the treatment of especially chronic wounds.

scholarly journals A Narrative Review of the History of Skin Grafting in Burn Care

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 380
Author(s):  
Deepak K. Ozhathil ◽  
Michael W. Tay ◽  
Steven E. Wolf ◽  
Ludwik K. Branski
Keyword(s):  
Donor Site ◽  
Subsequent Development ◽  
Skin Grafting ◽  
Human Condition ◽  
Surgical Instruments ◽  
Wound Management ◽  
Burn Wound ◽  
Medical Progress ◽  
Burn Care ◽  
History Of

Thermal injuries have been a phenomenon intertwined with the human condition since the dawn of our species. Autologous skin translocation, also known as skin grafting, has played an important role in burn wound management and has a rich history of its own. In fact, some of the oldest known medical texts describe ancient methods of skin translocation. In this article, we examine how skin grafting has evolved from its origins of necessity in the ancient world to the well-calibrated tool utilized in modern medicine. The popularity of skin grafting has ebbed and flowed multiple times throughout history, often suppressed for cultural, religious, pseudo-scientific, or anecdotal reasons. It was not until the 1800s, that skin grafting was widely accepted as a safe and effective treatment for wound management, and shortly thereafter for burn injuries. In the nineteenth and twentieth centuries skin grafting advanced considerably, accelerated by exponential medical progress and the occurrence of man-made disasters and global warfare. The introduction of surgical instruments specifically designed for skin grafting gave surgeons more control over the depth and consistency of harvested tissues, vastly improving outcomes. The invention of powered surgical instruments, such as the electric dermatome, reduced technical barriers for many surgeons, allowing the practice of skin grafting to be extended ubiquitously from a small group of technically gifted reconstructive surgeons to nearly all interested sub-specialists. The subsequent development of biologic and synthetic skin substitutes have been spurred onward by the clinical challenges unique to burn care: recurrent graft failure, microbial wound colonization, and limited donor site availability. These improvements have laid the framework for more advanced forms of tissue engineering including micrografts, cultured skin grafts, aerosolized skin cell application, and stem-cell impregnated dermal matrices. In this article, we will explore the convoluted journey that modern skin grafting has taken and potential future directions the procedure may yet go.

Fluorescent Imaging and Precise Suppression of Bacterial Infection in Chronic Wounds by Porphyrin-Based Metal-Organic Framework Nanorod

2021 ◽  
Author(s):  
zhen zou ◽  
Lihua Zhang ◽  
Minzhi Ouyang ◽  
Yufei Zhang ◽  
Huanxiang Wang ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Antibacterial Agents ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Metal Organic Framework ◽  
Critical Role ◽  
Fluorescent Imaging ◽  
Wound Management ◽  
Metal Organic ◽  
Chronic Wound Management

Nano-antibacterial agents play a critical role in chronic wound management. However, an intelligent nanosystem that can provide both visual warning of infection and precise sterilization remains a hurdle. Herein, a...

scholarly journals A Patient-Held Medical Record Integrating Depression Care into Diabetes Care

2016 ◽  
Vol 7 ◽  
pp. JCM.S39766 ◽  
Author(s):  
Noriko Satoh-Asahara ◽  
Hiroto Ito ◽  
Tomoyuki Akashi ◽  
Hajime Yamakage ◽  
Kazuhiko Kotani ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Diabetes Care ◽  
Clinical Pathways ◽  
Coping Resources ◽  
Care Providers ◽  
Depression Care ◽  
Patients With Diabetes ◽  
And Coping ◽  
Levels Of Integration

Purpose Depression is frequently observed in people with diabetes. The purpose of this study is to develop a tool for individuals with diabetes and depression to communicate their comorbid conditions to health-care providers. Method We searched the Internet to review patient-held medical records (PHRs) of patients with diabetes and examine current levels of integration of diabetes and depression care in Japan. Results Eight sets of PHRs were found for people with diabetes. All PHRs included clinical follow-up of diabetes and multidisciplinary clinical pathways for diabetes care. No PHRs included depression monitoring and/or treatment. In terms of an integrated PHR for a patient comorbid with diabetes and depression, necessary components include hopes/preferences, educational information on diabetes complications and treatment, medical history, stress and coping, resources, and monitoring diabetes and depression. Conclusion A new PHR may be suitable for comorbid patients with diabetes and depression.

scholarly journals Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Diaa Othman
Keyword(s):  
Cost Effectiveness ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wound ◽  
National Standard ◽  
Wound Management ◽  
Care Providers ◽  
Wound Therapy ◽  
Patients Satisfaction ◽  
Chronic Wound Management

This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

Chronic wounds: the challenges of appropriate management

2019 ◽  
Vol 24 (Sup9) ◽  
pp. S26-S32 ◽  
Author(s):  
Leanne Atkin
Keyword(s):  
Wound Healing ◽  
Health Services ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Management ◽  
Product Selection ◽  
Wound Assessment ◽  
Moisture Balance ◽  
Selection For ◽  
Chronic Wound Management

The immense burden imposed by chronic wounds—those persisting over 6 weeks despite active intervention—on patients and health services is well recognised. There are various reasons for why a wound fails to progress towards closure, and clinicians must investigate the underlying cause of wound chronicity, as this information guides the management of such wounds. The TIME framework (T=tissue; I=infection/inflammation; M=moisture balance; E=wound edges) is a useful tool for practitioners to systematically undertake wound assessment and product selection. This article discusses chronic wound management based on the TIME framework, examining the aspects to be considered when managing chronic wounds. It also describes the process of dressing selection for overcoming the various barriers to wound healing, specifically discussing the AQUACEL family of dressings.

Understanding Financial Barriers to Care in Patients With Diabetes

2016 ◽  
Vol 43 (1) ◽  
pp. 78-86 ◽  
Author(s):  
David J. T. Campbell ◽  
Braden J. Manns ◽  
Brenda R. Hemmelgarn ◽  
Claudia Sanmartin ◽  
Alun Edwards ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Secondary Analysis ◽  
Care Providers ◽  
Financial Barriers ◽  
Face To Face ◽  
Semistructured Interviews ◽  
Patients With Diabetes ◽  
Data Saturation ◽  
The Impact

Purpose The purpose of this study was to better understand the impact that financial barriers have on patients with diabetes and the strategies that they use to cope with them. Methods A secondary analysis was conducted of 24 interviews with patients who had either type 1 or type 2 diabetes and perceived financial barriers, which were previously undertaken for a larger grounded theory study. Semistructured interviews were undertaken either face-to-face or by telephone. Data analysis was performed by 3 reviewers using inductive thematic analysis. Sampling for the original study continued until data saturation was achieved. Results The predominant aspects of care to which participants described financial barriers were medications, diabetes supplies, and healthy food. A variety of strategies are used by these patients. Participants described that their health care providers had the potential to either play an important supporting role; or alternatively, that they could also worsen the impacts of financial barriers. Conclusions Patients with diabetes experience financial barriers to various aspects of their care. While they use a variety of strategies to overcome their barriers, their health care providers can play a particularly important role in helping them manage these important barriers that impact their care and outcomes. Providers should ask patients about the existence of financial barriers, and employ strategies to mitigate against their impact.

scholarly journals Evaluation of a Clinical Decision Support System in the Domain of Chronic Wound Management

2021 ◽  
Author(s):  
Stefan Vogel ◽  
Jendrik Richter ◽  
Stefanie Wache ◽  
Kerstin Pischek-Koch ◽  
Simone Auchter ◽  
...  
Keyword(s):  
Clinical Decision Support System ◽  
Chronic Wounds ◽  
Wound Care ◽  
Clinical Decision ◽  
Wound Management ◽  
Domain Experts ◽  
Nursing Science ◽  
It Systems ◽  
Chronic Wound Management ◽  
Software Prototype

The PosiThera project focuses on the management of chronic wounds, which is multi-professional and multi-disciplinary. For this context, a software prototype was developed in the project, which is intended to support medical and nursing staff with the assistance of artificial intelligence. In accordance with the user-centred design, national workshops were held at the beginning of the project with the involvement of domain experts in wound care in order to identify requirements and use cases of IT systems in wound care, with a focus on AI. In this study, the focus was on involving nursing and nursing science staff in testing the software prototype to gain insights into its functionality and usability. The overarching goal of the iterative testing and adaptation process is to further develop the prototype in a way that is close to care.

scholarly journals Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis

10.2196/15574 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15574
Author(s):  
Lihong Chen ◽  
Lihui Cheng ◽  
Wei Gao ◽  
Dawei Chen ◽  
Chun Wang ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Studies ◽  
Mobile Phones ◽  
Standard Care ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Meta Analysis ◽  
Wound Management ◽  
Efficacy And Safety ◽  
Chronic Wound Management

Background Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management. Objective The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management. Methods We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints. Results A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P<.001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies. Conclusions Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.

Management of the Burn Wound

2019 ◽  
Author(s):  
Nicole S. Gibran ◽  
Jose P. Sterling ◽  
David M. Heimbach
Keyword(s):  
Wound Care ◽  
Donor Site ◽  
Skin Grafting ◽  
Wound Management ◽  
Skin Substitutes ◽  
Burn Wound ◽  
Burn Wounds ◽  
Initial Care ◽  
Wound Excision ◽  
Burn Depth

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds.  This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis,  sloughing, dressing

Management of the Burn Wound

2019 ◽  
Author(s):  
Nicole S. Gibran ◽  
Jose P. Sterling ◽  
David M. Heimbach
Keyword(s):  
Wound Care ◽  
Donor Site ◽  
Skin Grafting ◽  
Wound Management ◽  
Skin Substitutes ◽  
Burn Wound ◽  
Burn Wounds ◽  
Initial Care ◽  
Wound Excision ◽  
Burn Depth

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds.  This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis,  sloughing, dressing

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