Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

2020 ◽  
Vol 29 (Sup9b) ◽  
pp. S1-S22 ◽  
Author(s):  
Georgina Gethin ◽  
Sebastian Probst ◽  
Jan Stryja ◽  
Natalia Christiansen ◽  
Patricia Price
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Patient Knowledge ◽  
Person Centered Care ◽  
Centered Care ◽  
Recommendations For Practice ◽  
The Impact

Background Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided. Aim We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research. Method Using a systematic review methodology, we searched six databases for full-text papers from 2009–2019 published in peer-reviewed journals with no limits on language. Results Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care. Conclusions The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

An audit to assess the impact of prescribing a monofilament fibre debridement pad for patients with unhealed wounds after six months

2021 ◽  
Vol 30 (5) ◽  
pp. 381-388
Author(s):  
Joanna Burnett ◽  
Andrew Kerr ◽  
Margaret Morrison ◽  
Abbe Ruston
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Wound Care ◽  
Mechanical Method ◽  
Dry Skin ◽  
Business Services ◽  
Clinical Role ◽  
Show Evidence ◽  
The Impact

A monofilament fibre debridement pad has been found to be a rapid and effective mechanical method of removing dry skin, biofilm and debris from acute and chronic wounds with minimal patient discomfort. Evidence of its impact on prescribing and wound healing, however, has been more limited. The aim of this audit was to show evidence of the monofilament fibre debridement pad's impact on wound treatment costs through an analysis of NHS wound-care prescribing data in England. A dataset for 486 uniquely identified patients who had been newly prescribed the monofilament fibre debridement pad was obtained from the NHS Business Services Authority. All data were anonymised. Costs were identified for the six months before and six months after the month of first prescription of the monofilament fibre debridement pad. The total cost of wound-care prescribing fell by 14% or £101,723 in the six months after the intervention compared with the six months before. The average monthly expenditure per patient fell from £244 before the intervention to £209 (n=486) after. These results indicate that use of the monofilament fibre debridement pad could reduce prescribing costs and the use of antimicrobial and negative pressure therapies. Further research is warranted to investigate the clinical role of the monofilament fibre debridement pad in wound healing

scholarly journals Antlerogenic stem cells extract accelerate chronic wound healing: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Janusz Kmiecik ◽  
Michał Jerzy Kulus ◽  
Jarosław Popiel ◽  
Agnieszka Cekiera ◽  
Marek Cegielski
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Small Population ◽  
Area Ratio ◽  
Wound Treatment ◽  
Ki 67 ◽  
Pressure Therapy

Abstract Background Chronic wounds constitute a significant medical and social problem. Chronic wound treatment may be supported by various techniques, such as negative pressure therapy, phototherapy or stem cells therapy, yet most of those supporting therapies need more evidence to be used for standard wound care. Current study covers the use of sonicated Antlerogenic Stem Cells (ASC) extract on chronic wounds. Methods Study was performed on 20 dermatological patients with venous leg ulcers, divided into two groups – treated with and without ASC extract respectively. The area and circumference of the wounds during the follow-up visits were measured on the wound imprint. Dynamics of wound healing was determined and compared between control and study group; statistics includes changes in absolute values (wound area, circumference), as well as relative (percentage of wound decrease, circumference/area ratio) and their change in time. For the purpose of Ki-67 immunohistochemical staining, sections were sampled from the wound edge at distinct check-points during therapy. Results of both groups were compared with Student test or Mann-Whitney test, depending on results distribution. Results Besides Ki-67 expression, all tested wound healing parameters (including relative and absolute wound decrease and changes in circumference/area ratio) were statistically significant more favorable in experimental group. Conclusion ASC extract significantly supported standard chronic wound treatment. Due to small population of study the results should be considered preliminary, yet promising for further research.

Chronic Wounds: Innovations in Diagnostics and Therapeutics

2019 ◽  
Vol 25 (41) ◽  
pp. 5772-5781 ◽  
Author(s):  
Marieke Haalboom
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Current Knowledge ◽  
Wound Care ◽  
Healing Process ◽  
Diagnostic Tools ◽  
Bacterial Invasion ◽  
Wound Healing Process ◽  
Limited Effectiveness

Background: A major global health issue is the existence of chronic wounds. Appropriate diagnosis and treatment is essential to promote wound healing and prevent further complications. Traditional methods for treatment and diagnosis of chronic wounds have shown to be of limited effectiveness. Therefore, there is a need for the development of diagnostic and therapeutic innovations in chronic wound care. Objective: This mini-review aims to provide insight in the current knowledge of the wound healing process and the deficiencies encountered in chronic wounds, which provides a basis for the development of innovations in chronic wound care. Furthermore, promising diagnostic and therapeutic innovations will be highlighted. Methods: Literature was searched for recent articles (=<10 years) describing the current knowledge about the wound healing process and chronic wounds. The most promising diagnostic and therapeutic innovations were gathered from articles published in the past 5 years. Results/Conclusion: Wound healing is a well-organized process consisting of four phases: coagulation, inflammation, proliferation and wound remodelling. Chronic wounds often stagnate in the inflammatory phase and/or experience an impaired proliferative phase. This mini-review has demonstrated that increased knowledge about the processes involved in wound healing has paved the way for the development of new diagnostic tools and treatments for chronic wounds. Increased knowledge about bacterial invasion and infection in has encouraged researchers to develop diagnostic tools to help clinicians detect these phenomena appropriately and in time. Other researchers have shown that they are able to design/extract biochemical compounds that intervene in the disrupted healing processes in chronic wounds.

Using 3D Modeling and Neural Networks to Predict Time-to-Heal for Chronic, Nonhealing Wounds

2013 ◽  
Vol 7 (4) ◽  
Author(s):  
Jessica S. Chin ◽  
Ibrahim Zeid ◽  
Sagar Kamarthi
Keyword(s):  
Neural Networks ◽  
Wound Healing ◽  
Chronic Diseases ◽  
3D Modeling ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Engineering System ◽  
Care Research ◽  
National Healthcare

Chronic wound is an important national healthcare problem, compounded by the fact that patients with chronic diseases such as diabetes are always vulnerable to develop chronic wounds. Wound care research has two strands: clinical and computational. On the clinical side, research has been focusing on how to effectively treat wounds. This includes measuring wounds, tracking their progression with time, and assessing their health. On the computational side, little has been done to treat a wound as an engineering system that needs to be modeled and analyzed with the ultimate goal of predicting the progress of wound healing and determining the factors that influence wound healing.

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 Application Research of the Moist Wound Theory in Chronic Wound Nursing

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shuying Ling
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Wound Complications ◽  
Control Group ◽  
Application Research ◽  
Significant Difference ◽  
Wound Pain ◽  
Experimental Group

Objective — To explore the application value of observation of moist wound theory in chronic wound care. Methods — From February 2019 to May 2020, a total of 96 patients with chronic wounds were treated in this hospital. The patients were divided into two groups based on the two-color ball method, with 48 cases in each group. Routine wound nursing (48 patients, the control group) and moist wound theory (48 patients, the experimental group) were used to compare the wound healing between the two groups. Results — The wound healing rate of 48 patients in the experimental group was significantly higher than that in the control group, and there was a significant difference (P<0.05). The incidence of chronic wound complications (wound pain, wound infection, tissue adhesion) of 48 patients in the experimental group was significantly lower than that in the control group, and there was a significant difference (P<0.05). Conclusion — The application of moist wound theory in chronic wound nursing can promote the rehabilitation of patients with chronic wounds, improve the rate of wound healing, reduce the incidence of complications, and improve the patients' nursing efficacy.

scholarly journals Modern Dressing Wound Care Mempercepat Proses Penyembuhan Ulkus Kaki pada Pasien Diabetes: A Systematic Review

2021 ◽  
Vol 7 (1) ◽  
pp. 146-155
Author(s):  
Bangu Bangu ◽  
Heriviyatno Julika Siagian ◽  
Rosani Naim ◽  
Evodius Nasus
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Green Tea ◽  
Chronic Wound ◽  
Wound Care ◽  
Healing Process ◽  
Wound Dressings ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Cost Effective Treatment

Foot ulcers in diabetic patients should receive treatment to reduce the risk of infection and amputation and improve function and quality of life. Wound care techniques are developing very quickly, which can help nurses and patients to improve the healing of foot ulcers in diabetic patients. Several wound care methods that can accelerate the healing process of foot ulcers in DM patients include modern wound dressings, the process of healing diabetic ulcers. With modern dressing methods, chronic wound care with modern dressings, the potential of green tea in wound healing, honey as a debridement agent. Objective: This study reviews several dressing methods that accelerate the healing process of foot ulcers in diabetic patients. This study uses a Systematic Review based on Preferred Reporting Items for Systematic Reviews & Meta-Analyses (PRISMA) to identify all published literature using relevant databases and keywords. In the 5 articles that we analyzed, the use of modern wound dressings proved to be more effective in accelerating wound healing, especially foot ulcers in diabetic patients. Modern wound care (Modern wound dressing), chronic wound care with modern dressings, the potential of green tea in wound healing, Honey as a debridement agent: a systematic review. And the role of the family in helping patients take medication regularly is the right choice to accelerate the healing process of foot ulcers in diabetic patients with more cost-effective treatment.

scholarly journals Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim
Keyword(s):  
Systematic Review ◽  
Cognitive Function ◽  
Effect Size ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Clinical Excellence ◽  
Dementia Care ◽  
Person Centered Care ◽  
Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

scholarly journals Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

2021 ◽  
Vol 22 (4) ◽  
pp. 1538 ◽  
Author(s):  
Pietro Gentile ◽  
Simone Garcovich
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Wound Healing ◽  
Soft Tissue ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Skin Wounds ◽  
Soft Tissue Defects ◽  
Chronic Skin ◽  
Tissue Defects

The number of clinical trials evaluating adipose-derived mesenchymal stem cells (AD-MSCs), platelet-rich plasma (PRP), and biomaterials efficacy in regenerative plastic surgery has exponentially increased during the last ten years. AD-MSCs are easily accessible from various fat depots and show intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. AD-MSCs have been used in the treatment of soft tissue defects and chronic wounds, employed in conjunction with a fat grafting technique or with dermal substitute scaffolds and platelet-rich plasma. In this systematic review, an overview of the current knowledge on this topic has been provided, based on existing studies and the authors’ experience. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on AD-MSCs, PRP, and biomaterials used in soft tissue defects and chronic wounds. Of the 2136 articles initially identified, 422 articles focusing on regenerative strategies in wound healing were selected and, consequently, only 278 articles apparently related to AD-MSC, PRP, and biomaterials were initially assessed for eligibility. Of these, 85 articles were excluded as pre-clinical, experimental, and in vitro studies. For the above-mentioned reasons, 193 articles were selected; of this amount, 121 letters, expert opinions, commentary, and editorials were removed. The remaining 72 articles, strictly regarding the use of AD-MSCs, PRP, and biomaterials in chronic skin wounds and soft tissue defects, were analyzed. The studies included had to match predetermined criteria according to the patients, intervention, comparator, outcomes, and study design (PICOS) approach. The information analyzed highlights the safety and efficacy of AD-MSCs, PRP, and biomaterials on soft tissue defects and chronic wounds, without major side effects.

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