Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence

2021 ◽  
Vol 30 (12) ◽  
pp. 980-992
Author(s):  
Karen Ousey ◽  
Heather Hodgson ◽  
Mark G Rippon ◽  
Alan A Rogers
Keyword(s):  
Wound Healing ◽  
Clinical Evidence ◽  
Narrative Review ◽  
Wound Dressings ◽  
Fluid Loss ◽  
Subsequent Infection ◽  
First Line ◽  
Wound Healing Response ◽  
Skin Integrity ◽  
Wound Bed Preparation

A break in skin integrity must be repaired as quickly as possible to avoid excess blood and fluid loss, and to minimise the onset of infection. Hard-to-heal wounds, in which the progression of the wound healing response is compromised, present several challenges to healing (for example, the presence of devitalised tissue acting as a physical barrier to healing and as a focus for bacterial contamination with the potential for subsequent infection). The objective of this article is to present, as a narrative review, the clinical evidence supporting the use of a unique hydro-responsive wound dressing (HydroClean, HRWD1, PAUL HARTMANN AG, Germany). The dressing provides a simple treatment option to address a number of clinical challenges clinicians must overcome in order to facilitate wound healing progression. These studies demonstrated that this product supported successful debridement/cleansing of a wide variety of wounds, including hard-to-heal wounds, enabled wound bed preparation, and lead to positive healing outcomes, including in wounds that previously had failed to heal. The simplicity of using HRWD1 as a single dressing can help clinicians overcome a variety of challenges when treating both acute and hard-to-heal wounds, which, with the benefit of proven patient outcomes, could make it an ideal choice for a first-line treatment.

The clinical impact of hydroresponsive dressings in dynamic wound healing: Part I

2021 ◽  
Vol 30 (1) ◽  
pp. 15-24
Author(s):  
Francois Sterpione ◽  
Karine Mas ◽  
Mark Rippon ◽  
Alan Rogers ◽  
Georges Mayeux ◽  
...  
Keyword(s):  
Wound Healing ◽  
Comparative Study ◽  
Wound Dressing ◽  
Wound Closure ◽  
Clinical Effectiveness ◽  
Clinical Impact ◽  
Wound Dressings ◽  
Primary Measurement ◽  
Clinical Healing ◽  
Wound Bed Preparation

Objective: Management of any wound, either acute or hard-to-heal, might involve the use of multiple and different wound dressings in its treatment. This approach is necessary to overcome the myriad of clinical challenges the wound presents, as well as any underlying comorbidities that might affect the clinical outcomes. This article describes the clinical effectiveness of a coordinated wound dressing treatment regimen. Method: This was an open-labelled non-comparative study involving patients with a variety of hard-to-heal and acute wounds of differing levels of severity, but all of which required removal of devitalised tissue to enable wound healing to progress. The first phase used the hydroresponsive wound dressing HydroClean (PAUL HARTMANN AG, Germany). The PUSH score was used as the primary measurement parameter. Results: A total of 86 patients (38 male/48 female), with a mean age of 67.7±21.7 years, took part in the study. The results showed that the hydroresponsive dressing was effective in managing wound exudate production and promoting wound cleansing and debridement, supporting good wound bed preparation. Wound closure was observed in 16/86 (18.6%) wounds at the end of the study (20 weeks). This enabled clinicians to switch to alternative wound dressings to promote subsequent clinical healing outcomes. Conclusion: In this study, the hydroresponsive wound dressing was highly effective in preparing a clean wound bed such that the next stage of wound healing could be supported.

scholarly journals Antimicrobial resistance of the enteric protozoon Giardia duodenalis – A narrative review

2021 ◽  
Author(s):  
Ulrike Loderstädt ◽  
Hagen Frickmann
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Clinical Evidence ◽  
Giardia Duodenalis ◽  
Narrative Review ◽  
Resistance Testing ◽  
First Line ◽  
Therapeutic Success ◽  
Post Translational Modifications ◽  
Testing Algorithms

AbstractIntroductionAs therapy-refractory giardiasis is an emerging health issue, this review aimed at summarizing mechanisms of reduced antimicrobial susceptibility in Giardia duodenalis and strategies to overcome this problem.MethodsA narrative review on antimicrobial resistance in G. duodenalis was based upon a selective literature research.ResultsFailed therapeutic success has been observed for all standard therapies of giardiasis comprising nitroimidazoles like metronidazole or tinidazole as first line substances but also benznidazoles like albendazole and mebendazole, the nitrofuran furazolidone, the thiazolide nitazoxanide, and the aminoglycoside paromomycin. Multicausality of the resistance phenotypes has been described, with differentiated gene expression due to epigenetic and post-translational modifications playing a considerable bigger role than mutational base exchanges in the parasite DNA. Standardized resistance testing algorithms are not available and clinical evidence for salvage therapies is scarce in spite of research efforts targeting new giardicidal drugs.ConclusionIn case of therapeutic failure of first line nitroimidazoles, salvage strategies including various options for combination therapy exist in spite of limited evidence and lacking routine diagnostic-compatible assays for antimicrobial susceptibility testing in G. duodenalis. Sufficiently powered clinical and diagnostic studies are needed to overcome both the lacking evidence regarding salvage therapy and the diagnostic neglect of antimicrobial resistance.

Healing gone wrong: convergence of hemostatic pathways and liver fibrosis?

2020 ◽  
Vol 134 (16) ◽  
pp. 2189-2201
Author(s):  
Jessica P.E. Davis ◽  
Stephen H. Caldwell
Keyword(s):  
Wound Healing ◽  
Liver Disease ◽  
Hepatic Fibrosis ◽  
Cell Activation ◽  
Stellate Cell ◽  
Factor Xa ◽  
Clinical Trial Data ◽  
Chronic Liver ◽  
Healing Response ◽  
Wound Healing Response

Abstract Fibrosis results from a disordered wound healing response within the liver with activated hepatic stellate cells laying down dense, collagen-rich extracellular matrix that eventually restricts liver hepatic synthetic function and causes increased sinusoidal resistance. The end result of progressive fibrosis, cirrhosis, is associated with significant morbidity and mortality as well as tremendous economic burden. Fibrosis can be conceptualized as an aberrant wound healing response analogous to a chronic ankle sprain that is driven by chronic liver injury commonly over decades. Two unique aspects of hepatic fibrosis – the chronic nature of insult required and the liver’s unique ability to regenerate – give an opportunity for pharmacologic intervention to stop or slow the pace of fibrosis in patients early in the course of their liver disease. Two potential biologic mechanisms link together hemostasis and fibrosis: focal parenchymal extinction and direct stellate cell activation by thrombin and Factor Xa. Available translational research further supports the role of thrombosis in fibrosis. In this review, we will summarize what is known about the convergence of hemostatic changes and hepatic fibrosis in chronic liver disease and present current preclinical and clinical data exploring the relationship between the two. We will also present clinical trial data that underscores the potential use of anticoagulant therapy as an antifibrotic factor in liver disease.

Modulation Of Wound Healing Response In Chronic Irradiated Tissues

1993 ◽  
Vol 20 (3) ◽  
pp. 465-472 ◽  
Author(s):  
Thomas A. Mustoe ◽  
Beatriz H. Porras-Reyes
Keyword(s):  
Wound Healing ◽  
Healing Response ◽  
Wound Healing Response

Role of topical insulin therapy as an adjunct in the management of pressure ulcer

2020 ◽  
Vol 2 (3) ◽  
pp. 01-03
Author(s):  
Ravi Chittoria
Keyword(s):  
Wound Healing ◽  
Insulin Therapy ◽  
Pressure Ulcer ◽  
Healing Rate ◽  
Pressure Sore ◽  
Pressure Sores ◽  
Established Method ◽  
Wound Bed Preparation ◽  
Wound Healing Rate

Pressure ulcer or pressure sore is one of the complications seen in bedridden patients. Management of these ulcers is often challenging. But there is no well-established method that accelerates the wound healing rate. Various adjunctive methods are used for wound bed preparation before definitive reconstruction plan is made. Here we describe our experience in the role of insulin therapy as an adjunct in the management of pressure sores.

Corneal Femtosecond Laser Keratotomy Results in Isolated Stromal Injury and Favorable Wound-Healing Response

2007 ◽  
Vol 48 (5) ◽  
pp. 2068 ◽  
Author(s):  
Christian Meltendorf ◽  
Guido J. Burbach ◽  
Jens Bu¨hren ◽  
Reinhold Bug ◽  
Christian Ohrloff ◽  
...  
Keyword(s):  
Wound Healing ◽  
Femtosecond Laser ◽  
Healing Response ◽  
Wound Healing Response

scholarly journals Fabrication of Hybrid Nanofibers from Biopolymers and Poly (Vinyl Alcohol)/Poly (ε-Caprolactone) for Wound Dressing Applications

Polymers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 2104
Author(s):  
Sibusiso Alven ◽  
Blessing Atim Aderibigbe
Keyword(s):  
Mechanical Properties ◽  
Wound Healing ◽  
Vinyl Alcohol ◽  
Wound Dressing ◽  
Chronic Wounds ◽  
Cellular Adhesion ◽  
Wound Dressings ◽  
Poly Vinyl Alcohol ◽  
High Porosity ◽  
Hybrid Nanofibers

The management of chronic wounds is challenging. The factors that impede wound healing include malnutrition, diseases (such as diabetes, cancer), and bacterial infection. Most of the presently utilized wound dressing materials suffer from severe limitations, including poor antibacterial and mechanical properties. Wound dressings formulated from the combination of biopolymers and synthetic polymers (i.e., poly (vinyl alcohol) or poly (ε-caprolactone) display interesting properties, including good biocompatibility, improved biodegradation, good mechanical properties and antimicrobial effects, promote tissue regeneration, etc. Formulation of these wound dressings via electrospinning technique is cost-effective, useful for uniform and continuous nanofibers with controllable pore structure, high porosity, excellent swelling capacity, good gaseous exchange, excellent cellular adhesion, and show a good capability to provide moisture and warmth environment for the accelerated wound healing process. Based on the above-mentioned outstanding properties of nanofibers and the unique properties of hybrid wound dressings prepared from poly (vinyl alcohol) and poly (ε-caprolactone), this review reports the in vitro and in vivo outcomes of the reported hybrid nanofibers.

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