scholarly journals Case Report: Freeze-Dried Human Amniotic Membrane Allograft for the Treatment of Chronic Wounds: Results of a Multicentre Observational Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Iveta Schmiedova ◽  
Zuzana Ozanova ◽  
Elen Stastna ◽  
Ludmila Kiselakova ◽  
Bretislav Lipovy ◽  
...  
Keyword(s):  
Observational Study ◽  
Amniotic Membrane ◽  
Human Body ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Standard Of Care ◽  
Wound Management ◽  
Human Amniotic Membrane ◽  
Freeze Dried

An inability of the human body to heal acute wounds under certain conditions results in the formation of chronic ulcers. Chronic wounds not only cause significant pain and discomfort for patients but also serve as an entry for microorganisms into the human body, which can result in serious life-threatening problems and become a significant burden for the patients and society. The current work present results of a multicentre prospective observational study demonstrating the use of a lyophilized amniotic membrane (AM) in the treatment of chronic wounds (various etiologies). Lyophilized AM produced under the commercial brand Amnioderm® was used as an allograft material for therapy of chronic wounds, in addition to chronic ulcer standard-of-care (SoC) protocols. The duration of wounds considered for the application of AM ranged between 2 months and 11 years. In total, 16 patients were enrolled to the study, of which eight were completely healed, six demonstrated a significantly reduced ulcer size, and two did not respond to the AM therapy. The current study unambiguously demonstrates an effective alternative to the standard of chronic wound care and confirms a significant effect of the AM application for chronic wound management as a new SoC.

scholarly journals Freeze-dried bovine amniotic membrane as a cell delivery scaffold in a porcine model of radiation-induced chronic wounds

2021 ◽  
Vol 48 (4) ◽  
pp. 448-456
Author(s):  
Daemyung Oh ◽  
Daegu Son ◽  
Jinhee Kim ◽  
Sun-Young Kwon
Keyword(s):  
Amniotic Membrane ◽  
Chronic Wounds ◽  
Porcine Model ◽  
Chronic Wound ◽  
Stromal Vascular Fraction ◽  
Cell Delivery ◽  
Analysis Group ◽  
Stem Cell Delivery ◽  
Freeze Dried ◽  
Radiation Induced

Background Locoregional stem cell delivery is very important for increasing the efficiency of cell therapy. Amnisite BA (Amnisite) is a freeze-dried amniotic membrane harvested from bovine placenta. The objective of this study was to investigate the retention of cells of the stromal vascular fraction (SVF) on Amnisite and to determine the effects of cell-loaded Amnisite in a porcine radiation-induced chronic wound model.Methods Initially, experiments were conducted to find the most suitable hydration and incubation conditions for the attachment of SVF cells extracted from pig fat to Amnisite. Before seeding, SVFs were labeled with PKH67. The SVF cell-loaded Amnisite (group S), Amnisite only (group A), and polyurethane foam (group C) were applied to treat radiation-induced chronic wounds in a porcine model. Biopsy was performed at 10, 14, and 21 days post-operation for histological analysis.Results Retaining the SVF on Amnisite required 30 minutes for hydration and 1 hour for incubation. A PKH67 fluorescence study showed that Amnisite successfully delivered the SVF to the wounds. In histological analysis, group S showed increased re-epithelialization and revascularization with decreased inflammation at 10 days post-operation.Conclusions SVFs had acceptable adherence on hydrated Amnisite, with successful cell delivery to a radiation-induced chronic wound model.

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.

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 Prevention and therapy of acute and chronic wounds using NPWT devices during the COVID-19 pandemic, recommendation from The NPWT Working Group

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Tomasz Banasiewicz ◽  
Rolf Becker ◽  
Adam Bobkiewicz ◽  
Marco Fraccalvieri ◽  
Wojciech Francuzik ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chronic Wounds ◽  
Hospital Admissions ◽  
Wound Care ◽  
Care Center ◽  
Management Strategies ◽  
Hospital Staff ◽  
Wound Management ◽  
Health Care Center ◽  
Single Use

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedical support with visual wound healing monitoring and video conversations have the potential to minimize the number of unnecessary in-person visits in patients with wounds and therefore substantially increase the level of care.

A Retrospective Analysis of Clinical Use and Outcomes Using Viable Placental Membrane Allografts in Chronic Wounds

2021 ◽  
Vol 33 (12) ◽  
pp. 329-333
Author(s):  
Laura Swoboda
Keyword(s):  
Retrospective Analysis ◽  
Real World ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Arterial Disease ◽  
Wound Management ◽  
Foot Ulcers ◽  
Controlled Trials ◽  
Clinical Use ◽  
Exposed Bone

Introduction. Viable placental membrane (vPM) has been shown to decrease time to healing, adverse wound events, and wound-related infections. Wound research exclusion criteria commonly exclude wound types other than diabetic foot ulcers and venous leg ulcers (VLUs), comorbidities including peripheral arterial disease (PAD) and uncontrolled diabetes mellitus (DM), and wounds with exposed bone or tendon. Objective. This retrospective research study evaluated the clinical use and outcomes of the vPM with living mesenchymal stem cells used in chronic wound management in the community hospital outpatient department setting with the goal of comparing real-world use and outcomes of the product with use and outcomes described in the chronic wound literature. Materials and Methods. A retrospective analysis on vPM treatments at a Wisconsin academic health system’s community hospitals. Participants included all patients who received vPM therapy between July 1, 2016, and August 21, 2019. Results. A total of 89 patients received vPM treatment during the study period (mean age, 70 years; 69% male [n = 61], 31% female [n = 28]). Wound types were 54% diabetic or neuropathic foot ulcers (n = 48), 17% VLUs (n = 15), 7% pressure injuries (n = 6), and 22% atypical wounds (n = 20). The average wound duration prior to vPM initiation was 104 days. Average wound size at presentation was 6.9 cm2. Of study participants 54% had PAD (n = 48), 63% had DM (n = 56), 33.7% had DM and PAD (n = 30), and 17% had exposed bone or tendon (n = 15). Average adjusted time to healing after initiation of vPM was 81.2 days. The percentage of wounds healed 12 weeks after initiation of vPM treatment was 57%. Conclusions. Effectiveness of vPM observed in controlled trials also was observed in this real-world study on vPM for multiple wound types, patients with comorbidities including PAD and uncontrolled DM, and wounds with exposed bone or tendon. Results of this study were not statistically different from those reported in the literature. More randomized controlled trials are needed to explore the efficacy of vPM on patient presentations common to wound healing centers.

Wound infections: an overview

2021 ◽  
Vol 26 (Sup6) ◽  
pp. S22-S25
Author(s):  
Martha Williams
Keyword(s):  
Wound Infection ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Economic Factors ◽  
Ageing Population ◽  
Wound Infections ◽  
The Many ◽  
Systemic Therapies ◽  
Socio Economic Factors

In the ever-changing world of wound care and nursing, it remains apparent that chronic wounds are a growing challenge. Evidence shows that age increases the likelihood of developing a chronic wound, which supports the notion that the burden of these wounds on the NHS is likely to further intensify with the ageing population. There are many reasons why a wound may fail to progress, including wound aetiology, comorbidities and environmental and socio-economic factors. One of the most significant reasons why wounds may fail to progress and become chronic is untreated wound infection. In order for clinicians to be able to treat and manage wound infections, it is vital that they understand how infection develops, the many ways in which infections may present themselves and how and when to initiate appropriate topical and systemic therapies to treat wound bed infections. The present article provides an overview of wound bed infections and their management.

Effect of Topical Oxygen Therapy on Chronic Wounds

2021 ◽  
Vol 39 ◽  
Author(s):  
Crystal James ◽  
◽  
So Park ◽  
Denise Alabi ◽  
John Lantis ◽  
...  
Keyword(s):  
Personal Experience ◽  
Oxygen Therapy ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Treatment Modalities ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence ◽  
The Past ◽  
Ischemic Ulcers

Over the past three decades, there has been a growing interest in the use of oxygen therapy to promote wound healing. Although the most commonly recognized oxygen therapy for the treatment of chronic wounds is hyperbaric oxygen therapy, topical oxygen therapy has a greater level of evidence supporting its use in chronic wound care. Still, it is imperative that these two treatment modalities be recognized not merely as competitors, but as distinct therapeutic entities. Through personal experience and a thorough literature review, we investigated the use of topical oxygen therapy in the management of chronic wounds. The benefits of using topical oxygen therapy have been demonstrated in patients with diabetic foot ulcers, ischemic ulcers, post-revascularization ulcers, and pressure ulcers. There are several topical oxygen devices currently on the market that are versatile, relatively low-risk, and generally well-tolerated by patients. While these devices have been used in the treatment of chronic wounds at different locations and of different etiologies, other uses of these devices are still being investigated. Topical oxygen therapy is yet another tool in our arsenal to be used in treating difficult to heal chronic wounds and could potentially be used more readily.

Survey of Surgeons’ Perspectives of Wound Care Centers and Chronic Wound Care

2019 ◽  
Vol 85 (12) ◽  
pp. 1369-1375
Author(s):  
Victoria R. Rendell ◽  
Thomas J. Esposito ◽  
Angela Gibson
Keyword(s):  
Online Survey ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Nationwide Survey ◽  
Relationship Status ◽  
Care Pathways ◽  
Multidisciplinary Management ◽  
Career Focus

Multidisciplinary management of chronic wounds using comprehensive wound centers improves outcomes. With an increasing need for wound providers, little is known about surgeons’ roles in wound centers. An online survey of two national surgical organization members covered demographics, wound center characterization, and surgeons’ perspectives of wound centers and wound care. Surgeon perspectives were compared by age, gender, and relationship status. Three hundred sixty-four surgeons responded. Respondents were mostly older than 50 years, male, in practice older than 10 years, and used wound centers. Most respondents reported favorable experiences with wound centers but uncertainty about financial details. Most respondents were interested in formal wound care certification and participation in a wound practice, particularly as a transition to the retirement option for older surgeons. Surgeons are interested in pursuing a career focus in wound care. Further efforts are needed to educate surgeons and create a pathway for surgeons to become wound center directors. In a nationwide survey, surgeon perspectives on wound centers and wound specialization were positive, although financial understanding was limited. The importance of this finding is the support of wound care pathways for surgeons.

scholarly journals Telemedicine for wound management

2012 ◽  
Vol 45 (02) ◽  
pp. 412-417 ◽  
Author(s):  
Ravi K. Chittoria
Keyword(s):  
Health Care ◽  
Chronic Wounds ◽  
Wound Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Wound Management ◽  
Care Practice ◽  
Telemedicine Technology ◽  
Store And Forward ◽  
Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

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.

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