scholarly journals Infection Probability Index: Implementation of an Automated Chronic Wound Infection Marker

2021 ◽  
Vol 11 (1) ◽  
pp. 169
Author(s):  
Franziska Schollemann ◽  
Janosch Kunczik ◽  
Henriette Dohmeier ◽  
Carina Barbosa Pereira ◽  
Andreas Follmann ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Imaging Techniques ◽  
User Input ◽  
Reactive Protein ◽  
Obesity And Diabetes ◽  
Image Pairs ◽  
Probability Index ◽  
Infection Marker

The number of people suffering from chronic wounds is increasing due to demographic changes and the global epidemics of obesity and diabetes. Innovative imaging techniques within the field of chronic wound diagnostics are required to improve wound care by predicting and detecting wound infections to accelerate the application of treatments. For this reason, the infection probability index (IPI) is introduced as a novel infection marker based on thermal wound imaging. To improve usability, the IPI was implemented to automate scoring. Visual and thermal image pairs of 60 wounds were acquired to test the implemented algorithms on clinical data. The proposed process consists of (1) determining various parameters of the IPI based on medical hypotheses, (2) acquiring data, (3) extracting camera distortions using camera calibration, and (4) preprocessing and (5) automating segmentation of the wound to calculate (6) the IPI. Wound segmentation is reviewed by user input, whereas the segmented area can be refined manually. Furthermore, in addition to proof of concept, IPIs’ correlation with C-reactive protein (CRP) levels as a clinical infection marker was evaluated. Based on average CRP levels, the patients were clustered into two groups, on the basis of the separation value of an averaged CRP level of 100. We calculated the IPIs of the 60 wound images based on automated wound segmentation. Average runtime was less than a minute. In the group with lower average CRP, a correlation between IPI and CRP was evident.

Challenges and New Therapeutic Approaches in the Management of Chronic Wounds

2020 ◽  
Vol 21 (12) ◽  
pp. 1264-1275
Author(s):  
Hongmin Sun ◽  
Lakshmi Pulakat ◽  
David W. Anderson
Keyword(s):  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Drug Resistant ◽  
Therapeutic Approaches ◽  
New Therapeutic Approaches ◽  
Venous Ulcers ◽  
Obesity And Diabetes ◽  
The Us ◽  
Healing Wounds

Chronic non-healing wounds are estimated to cost the US healthcare $28-$31 billion per year. Diabetic ulcers, arterial and venous ulcers, and pressure ulcers are some of the most common types of chronic wounds. The burden of chronic wounds continues to rise due to the current epidemic of obesity and diabetes and the increase in elderly adults in the population who are more vulnerable to chronic wounds than younger individuals. This patient population is also highly vulnerable to debilitating infections caused by opportunistic and multi-drug resistant pathogens. Reduced microcirculation, decreased availability of cytokines and growth factors that promote wound closure and healing, and infections by multi-drug resistant and biofilm forming microbes are some of the critical factors that contribute to the development of chronic non-healing wounds. This review discusses novel approaches to understand chronic wound pathology and methods to improve chronic wound care, particularly when chronic wounds are infected by multi-drug resistant, biofilm forming microbes.

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.

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.

scholarly journals Prevalence of chronic wounds and structural quality indicators of chronic wound care in Dutch nursing homes

2013 ◽  
Vol 12 (6) ◽  
pp. 630-635 ◽  
Author(s):  
Armand ALM Rondas ◽  
Jos MGA Schols ◽  
Ellen E Stobberingh ◽  
Ruud JG Halfens
Keyword(s):  
Nursing Homes ◽  
Quality Indicators ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Structural Quality

scholarly journals The chronic wound virome: phage diversity and associations with wounds and healing outcomes

2022 ◽  
Author(s):  
Samuel Verbanic ◽  
John Deacon ◽  
Irene A. Chen
Keyword(s):  
Bacterial Community ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Bacterial Community Composition ◽  
Taxonomic Composition ◽  
Metagenomic Sequencing ◽  
Care Clinic ◽  
Before And After ◽  
And Function

Two leading impediments to chronic wound healing are polymicrobial infection and biofilm formation. Recent studies have characterized the bacterial fraction of these microbiomes and have begun to elucidate compositional correlations to healing outcomes. However, the factors that drive compositional shifts are still being uncovered. The virome may play an important role in shaping bacterial community structure and function. Previous work on the skin virome determined that it was dominated by bacteriophages, viruses that infect bacteria. To characterize the virome, we enrolled 20 chronic wound patients presenting at an outpatient wound care clinic in a microbiome survey, collecting swab samples from healthy skin and chronic wounds before and after a single, sharp debridement procedure. We investigated the virome using a virus-like particle enrichment procedure, shotgun metagenomic sequencing, and a k-mer-based, reference-dependent taxonomic classification method. Taxonomic composition, diversity, and associations to covariates are presented. We find that the wound virome is highly diverse, with many phages targeting known pathogens, and may influence bacterial community composition and functionality in ways that impact healing outcomes.

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.

scholarly journals Principles of Best Diagnostic Practice in Tissue Repair and Wound Healing: An Expert Consensus

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 50
Author(s):  
David G. Armstrong ◽  
Karen Bauer ◽  
Greg Bohn ◽  
Marissa Carter ◽  
Robert Snyder ◽  
...  
Keyword(s):  
Protease Activity ◽  
Pathogenic Bacteria ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Signs ◽  
Care Practice ◽  
Invasive Infection ◽  
Consensus Panel ◽  
Advanced Therapies

Chronic wound treatment currently relies heavily on visual assessment by clinicians; however, the clinical signs and symptoms of infection and inflammation are unreliable in chronic wounds. The specialty of wound care has witnessed the advent of advanced interventions, such as cellular and/or tissue based products (CTP). The success of advanced therapies relies on preparing the wound bed by reducing bacterial burden and inflammation. The lack of diagnostics in chronic wound care leads to uncertainty in the adequacy of wound bed preparation. Recent research suggests that two novel point-of-care diagnostic tests can assist in the detection of chronic inflammation known as elevated neutrophil derived protease activity (EPA) and bacterial pathogenesis known as bacterial protease activity(BPA) in chronic wounds. Despite the evidence, however, clinicians report that incorporating diagnostics into every day practice is challenging and across the globe, they have requested guidance on their use. Methods and Recommendations: A panel of wound care experts, experienced with these tests, met to develop guidelines on their use in wound care practice. The consensus panel concluded that the clinician should test for BPA first. The panel maintained that the risk of invasive infection resulting from the presence of pathogenic bacteria was the greatest threat to the patient’s health. If the BPA test is negative, the panel recommended testing for EPA. In addition, it was suggested that if the wound failed to progress after the elevated BPA was treated and subsequent testing was negative for BPA, the clinician should consider testing for EPA. Conclusions: In this manuscript, the consensus panel suggests pathways for testing, treating, and retesting for EPA and BPA. The panel expects that following the algorithm has the potential to improve healing outcomes, result in more cost-effective use of advanced therapies, and improve antimicrobial stewardship by guiding antimicrobial use.

scholarly journals Sap Extract Papaya for Autolitic Debridement Chronic Wound

Jurnal NERS ◽  
2015 ◽  
Vol 10 (2) ◽  
pp. 296
Author(s):  
Tri Johan Agus Yuswanto ◽  
Tanto Hariyanto
Keyword(s):  
Molecular Weight ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Enzyme Level ◽  
Wound Dressings ◽  
Control Group ◽  
Protein Markers ◽  
Protease Enzyme ◽  
Sugar Levels

Introduction: The high cost of drugs or specific wound dressings for chronic wounds can be healed at least in two weeks depending on the stage of the wound and blood sugar levels. Hence the need for an innovative processing of natural resources (NR) to produce a chronic wound care products that are accessible to all people.  One of the current trends is to use protease enzymes (sap extract papaya) that serves as autolitic debridement in the treatment of chronic wounds. The aims of this research was to indentify characteristics of protease enzyme present in sap of papaya. Method: This study was a descriptive exploratory that doing pure protease enzyme extract of papaya sap. Results: Molecular weight measurement using a kit Pre-stained Protein Markers (Broad Range) for SDS PAGE, Nacalai tesque No. 02525 showed a homogeneous molecular weight that slightly above 28 kD. Measurements of the enzyme levels using NanoDrop Spectrophotometer ND kit-1000 (with a distilled water marker) showed a relatively homogeneous enzyme level with a range between 43% - 61% and 53, 88% in average. The addition of papaya sap extract into each tube containing 7 ml gelatin obtained results: the control group there were clots perfectly on gelatin; groups with the addition of 2 drops (± 0.5 ml) obtained 50% hydrolyzed gelatin; and groups with the addition of 4 drops (± 0.5 ml) obtained 75% hydrolyzed gelatin. Discussion: The results showed that papaya sap extraction synonymous with protease enzyme. Papaya sap extraction activity (protease enzymes) on hydrolyzing gelatin shows a qualitative picture. Therefore, it can be used as autholitic debridement. Further, the following study is essential to identify structure and activity of the enzyme with a more determinant (temperature, time, and dose).Keywords: sap papaya extraction, protease enzymes

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