A review of interventions to reduce pain in chronic wounds

2019 ◽  
Vol 24 (Sup12) ◽  
pp. S12-S17
Author(s):  
Helen Snelgrove ◽  
Anne Baileff
Keyword(s):  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Collagen Matrix ◽  
Community Services ◽  
Nitroglycerin Ointment ◽  
Native Collagen ◽  
Assessment And Treatment ◽  
Wound Pain

Reduction of chronic wound pain has the potential to improve patients' quality of life, expedite the healing process and, ultimately, relieve pressure on community services. Despite this, education on pain assessment in the management of chronic wounds is lacking. This literature review seeks to provide evidence-based recommendations to reduce chronic wound pain and inform the practice of community nurses. The results of a thematic analysis indicate that a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective. The review also highlights the need for an individualised approach to the assessment and treatment of pain in patients with chronic wounds.

scholarly journals Wound dressings: curbing inflammation in chronic wound healing

2021 ◽  
Author(s):  
Davide Vincenzo Verdolino ◽  
Helen A. Thomason ◽  
Andrea Fotticchia ◽  
Sarah Cartmell
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Healing Process ◽  
Standard Of Care ◽  
The Elderly ◽  
Wound Dressings ◽  
Wound Healing Process

Chronic wounds represent an economic burden to healthcare systems worldwide and a societal burden to patients, deeply impacting their quality of life. The incidence of recalcitrant wounds has been steadily increasing since the population more susceptible, the elderly and diabetic, are rapidly growing. Chronic wounds are characterised by a delayed wound healing process that takes longer to heal under standard of care than acute (i.e. healthy) wounds. Two of the most common problems associated with chronic wounds are inflammation and infection, with the latter usually exacerbating the former. With this in mind, researchers and wound care companies have developed and marketed a wide variety of wound dressings presenting different compositions but all aimed at promoting healing. This makes it harder for physicians to choose the correct therapy, especially given a lack of public quantitative data to support the manufacturers’ claims. This review aims at giving a brief introduction to the clinical need for chronic wound dressings, focusing on inflammation and evaluating how bio-derived and synthetic dressings may control excess inflammation and promote healing.

scholarly journals Functional Mining of the Crotalus Spp. Venom Protease Repertoire Reveals Potential for Chronic Wound Therapeutics

Molecules ◽  
2020 ◽  
Vol 25 (15) ◽  
pp. 3401
Author(s):  
David Meléndez-Martínez ◽  
Luis Fernando Plenge-Tellechea ◽  
Ana Gatica-Colima ◽  
Martha Sandra Cruz-Pérez ◽  
José Manuel Aguilar-Yáñez ◽  
...  
Keyword(s):  
Wound Healing ◽  
Serine Proteases ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Wound Healing Process ◽  
Major Health Problem ◽  
Normal Wound Healing ◽  
Alternative Sources ◽  
Fibrin Clots

Chronic wounds are a major health problem that cause millions of dollars in expenses every year. Among all the treatments used, active wound treatments such as enzymatic treatments represent a cheaper and specific option with a fast growth category in the market. In particular, bacterial and plant proteases have been employed due to their homology to human proteases, which drive the normal wound healing process. However, the use of these proteases has demonstrated results with low reproducibility. Therefore, alternative sources of proteases such as snake venom have been proposed. Here, we performed a functional mining of proteases from rattlesnakes (Crotalus ornatus, C. molossus nigrescens, C. scutulatus, and C. atrox) due to their high protease predominance and similarity to native proteases. To characterize Crotalus spp. Proteases, we performed different protease assays to measure and confirm the presence of metalloproteases and serine proteases, such as the universal protease assay and zymography, using several substrates such as gelatin, casein, hemoglobin, L-TAME, fibrinogen, and fibrin. We found that all our venom extracts degraded casein, gelatin, L-TAME, fibrinogen, and fibrin, but not hemoglobin. Crotalus ornatus and C. m. nigrescens extracts were the most proteolytic venoms among the samples. Particularly, C. ornatus predominantly possessed low molecular weight proteases (P-I metalloproteases). Our results demonstrated the presence of metalloproteases capable of degrading gelatin (a collagen derivative) and fibrin clots, whereas serine proteases were capable of degrading fibrinogen-generating fibrin clots, mimicking thrombin activity. Moreover, we demonstrated that Crotalus spp. are a valuable source of proteases that can aid chronic wound-healing treatments.

scholarly journals Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

2018 ◽  
Vol 19 (4) ◽  
pp. 373-382 ◽  
Author(s):  
Victor Alexandrovich Stupin ◽  
Ruslan Borisovich Gabitov ◽  
Tatiana Georgievna Sinelnikova ◽  
Ekaterina Vladimirovna Silina
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
World Literature ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Treatment Algorithm ◽  
Diabetic Foot Syndrome ◽  
Results Of Treatment ◽  
Native Collagen ◽  
Chronic Ulcers

Abstract The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

scholarly journals The influence of chronic wound leg on the quality of life of patients // Uticaj hronične rane noge na kvalitet života bolesnika

2017 ◽  
Vol 4 (1) ◽  
pp. 13
Author(s):  
Tatjana Ivanković Zrnić ◽  
Dragana Bojinović Rodić ◽  
Jelena Nikolić Pucar ◽  
Mirjana Vučurević Ozren
Keyword(s):  
Quality Of Life ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Financial Burden ◽  
Psychological Impact ◽  
Complete Healing ◽  
Psychological State ◽  
Validated Questionnaire ◽  
The Impact

A chronic wound can greatly impair the quality of life of patients. Early we can consider chronic if there is no complete healing after six weeks of treatment. Over time, several different instruments have been developed to monitor the impact of a chronic wound on the quality of life of patients. The original required a lot of time to complete, remained incomplete, and there was a need to develop a standardized, short, multi-dimensional questionnaire. This led to the formation of a “Wound-QoL” questionnaire used in assessing the quality of life of patients with a chronic wound.In our institution, a pilot study was conducted on the impact of chronic wounds on the quality of life of patients, using a validated questionnaire. The study included 32 patients whose wounds were transplanted to the Institute. The questionnaires were completed at the beginning of the wound treatment at the institution.In physical terms, a chronic wound has a central impact on our respondents, but its psychological impact is most pronounced. On everyday activities, the influence of the wound is assessed in men as small, and an equal number of women consider it to have a small and big effect. Respondents believe that treating chronic wounds does not carry a large financial burden. It is necessary to assess the quality of life of patients with chronic wound before and after treatment and possible healing of the wound in order to see the impact of chronic wounds on the positive psychological state of the wound and the motivation to heal.

scholarly journals The role of the social community networks in the care of chronic wounds

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Isabella Lo Castro
Keyword(s):  
Quality Of Life ◽  
Social Network ◽  
Clinical Practice ◽  
Chronic Wounds ◽  
Healing Process ◽  
Community Networks ◽  
Social Community ◽  
Positive Effects ◽  
Operational Concept

The aim of this article is to suggest a multidisciplinary approach to the clinical practice of treating patients with chronic wounds (CW). It will take into consideration and further investigate the relational and community dimensions of patients and his/her caregivers, as these affect the very quality of life and healing process. Scientific literature and clinical experience underline that taking family, friend, professional and community networks of patients into consideration may represent either a strengthening or weakening factor that improves/undermines the improvement of the patients’ psychological and physical conditions. Based on some of well-known reference, a systemic-relational interpretation has been applied to the Chronic Care Model used on patients with CW; in particular, Carlos Sluzki’s theoretical and operational concept based on the idea of social network was used. Approaching clinical practice by considering the patients’ psychosocial and community aspects and their social network has positive effects on the quality of life and leverages the healing process, also through therapeutic and intervention choices of the caring team that encourage compliance.

scholarly journals An EGF- and Curcumin-Co-Encapsulated Nanostructured Lipid Carrier Accelerates Chronic-Wound Healing in Diabetic Rats

Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4610
Author(s):  
Hye-Jin Lee ◽  
Moses Jeong ◽  
Young-Guk Na ◽  
Sung-Jin Kim ◽  
Hong-Ki Lee ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Double Emulsion ◽  
Average Diameter ◽  
Diabetic Rats ◽  
Wound Healing Process ◽  
Nanostructured Lipid Carrier

Nanostructured lipid carriers (NLC) are capable of encapsulating hydrophilic and lipophilic drugs. The present study developed an NLC containing epidermal growth factor (EGF) and curcumin (EGF–Cur-NLC). EGF–Cur-NLC was prepared by a modified water-in-oil-in-water (w/o/w) double-emulsion method. The EGF–Cur-NLC particles showed an average diameter of 331.8 nm and a high encapsulation efficiency (81.1% and 99.4% for EGF and curcumin, respectively). In vitro cell studies were performed using two cell types, NIH 3T3 fibroblasts and HaCaT keratinocytes. The results showed no loss of bioactivity of EGF in the NLC formulation. In addition, EGF–Cur-NLC improved in vitro cell migration, which mimics the wound healing process. Finally, EGF–Cur-NLC was evaluated in a chronic wound model in diabetic rats. We found that EGF–Cur-NLC accelerated wound closure and increased the activity of antioxidant enzymes. Overall, these results reveal the potential of the NLC formulation containing EGF and curcumin to promote healing of chronic wounds.

scholarly journals Immunology of Acute and Chronic Wound Healing

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 700
Author(s):  
Kamila Raziyeva ◽  
Yevgeniy Kim ◽  
Zharylkasyn Zharkinbekov ◽  
Kuat Kassymbek ◽  
Shiro Jimi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Inflammatory Factors ◽  
Wound Healing Process ◽  
Macrophage Phenotype ◽  
Microbial Biofilms ◽  
Inflammatory Phase ◽  
Persistent Inflammation

Skin wounds greatly affect the global healthcare system, creating a substantial burden on the economy and society. Moreover, the situation is exacerbated by low healing rates, which in fact are overestimated in reports. Cutaneous wounds are generally classified into acute and chronic. The immune response plays an important role during acute wound healing. The activation of immune cells and factors initiate the inflammatory process, facilitate wound cleansing and promote subsequent tissue healing. However, dysregulation of the immune system during the wound healing process leads to persistent inflammation and delayed healing, which ultimately result in chronic wounds. The microenvironment of a chronic wound is characterized by high quantities of pro-inflammatory macrophages, overexpression of inflammatory mediators such as TNF-α and IL-1β, increased activity of matrix metalloproteinases and abundance of reactive oxygen species. Moreover, chronic wounds are frequently complicated by bacterial biofilms, which perpetuate the inflammatory phase. Continuous inflammation and microbial biofilms make it very difficult for the chronic wounds to heal. In this review, we discuss the role of innate and adaptive immunity in the pathogenesis of acute and chronic wounds. Furthermore, we review the latest immunomodulatory therapeutic strategies, including modifying macrophage phenotype, regulating miRNA expression and targeting pro- and anti-inflammatory factors to improve wound healing.

scholarly journals Molecular systems for targeted delivery and controlled release of growth factors for chronic wound treatment

2020 ◽  
Vol 5 (3) ◽  
pp. 6-15
Author(s):  
A. R. Lipunov ◽  
I. M. Afanasov ◽  
E. S. Vorobeva ◽  
A. B. Chuhnina ◽  
M. G. Gladkova ◽  
...  
Keyword(s):  
Growth Factors ◽  
Controlled Release ◽  
Targeted Delivery ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Healing Process ◽  
Free Form ◽  
Signaling Proteins ◽  
Molecular Systems ◽  
Proliferation And Differentiation

Growth factors (GFs) are endogenous signaling proteins, that regulate cell migration, proliferation and differentiation in tissue regeneration. GFs’ concentrations in chronic wounds are pathologically reduced. This leads to a disruption of the healing process and makes chronic wounds treatment more complicated. There are drugs currently used in clinical practice, that contain GFs in a free form. However, their efficiency for chronic wounds treatment is limited, as GFs are quickly degraded in a proteolytic environment of chronic wounds. In order to overcome this limitation biocompatible molecular systems for targeted delivery and controlled release are proposed, such as: micro- and nanoparticles, hydrogels, scaffolds. GFs roles in the healing process, chronic wounds pathophysiology and molecular systems for GFs targeted delivery and controlled release are reviewed.

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