scholarly journals Wounds: an overlooked burden (Part 1) – effective wound management starts with proper wound assessment

2020 ◽  
pp. 196-198
Author(s):  
H Parkar ◽  
AD Cromarty
Keyword(s):  
Wound Healing ◽  
General Practice ◽  
Healthcare Professionals ◽  
Chronic Wound ◽  
Treatment Strategies ◽  
Daily Basis ◽  
Wound Management ◽  
Wound Treatment ◽  
Wound Assessment ◽  
Wound Type

Healthcare professionals in general practice are tasked with treatment and management of wounds on a daily basis. The prognoses of these wounds are directly affected by the ability of the clinician to assess these wounds according to several parameters, including the wound type and the features which determine whether a wound is acute or transforming to a chronic wound. This can be achieved by proper and continuous wound assessment, which should guide wound treatment strategies to ensure optimal wound healing and prevent progression to complicated wounds.

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.

Tools and Components of Wound Healing Assessment

2013 ◽  
Author(s):  
Jessica Chin ◽  
Ibrahim Zeid ◽  
Sagar Kamarthi
Keyword(s):  
Wound Healing ◽  
Healing Rate ◽  
Chronic Wound ◽  
Historical Data ◽  
Wound Management ◽  
Wound Assessment ◽  
Healing Wounds ◽  
Chronic Wound Management ◽  
Healing Assessment ◽  
Wound Healing Rate

Chronic wound assessment and analysis has long been a major healthcare issue. Chronic wound management and treatment cost billions of dollars each year. The research to alleviate the burden of non-healing wounds and predicting when they will heal is progressing at incremental pace. Characteristics of a chronic wound are unique to both the patient and wound itself. Like a fingerprint, each wound has a unique set of properties that tell a story about its health and viability. Although each person’s wound is individual, there are a few underlying pathologies that are common amongst all wounds. For example, all wounds have a definite surface area, depth, and temperature at any given time. By knowing these common characteristics across all wounds, we can use both historical data and collected data to determine wound healing patterns and wound healing rates. The purpose of this study is to develop an algorithm that uses photography and statistical modeling to predict an approximate wound healing rate for lower appendage wounds. We focus on lower appendage wounds with a depth of 1–2 mm because lower appendage wounds account for approximately 70% of wounds seen at wound clinics.

scholarly journals Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis

10.2196/15574 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e15574
Author(s):  
Lihong Chen ◽  
Lihui Cheng ◽  
Wei Gao ◽  
Dawei Chen ◽  
Chun Wang ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Studies ◽  
Mobile Phones ◽  
Standard Care ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Meta Analysis ◽  
Wound Management ◽  
Efficacy And Safety ◽  
Chronic Wound Management

Background Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management. Objective The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management. Methods We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints. Results A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P<.001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies. Conclusions Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.

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 Ekek anti mikroba terapi larva

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Sunny Wangko
Keyword(s):  
Wound Healing ◽  
Chronic Wound ◽  
Healing Process ◽  
Wound Management ◽  
Wound Healing Process ◽  
Healing Wounds ◽  
Chronic Wound Management ◽  
Very High ◽  
Anti Inflammation ◽  
Larval Therapy

Abstract: Chronic wound is still a world-wide problem that spends a very high cost related to its management and treatment. Although there are a lot of promising studies about wound healing process, the prevalence and incidence of chronic wound and its complications are still high. Conventionally, the management of chronic wound consists of surgical debridement, manual irrigation, dressing, and antimicrobial therapy (topical and/or systemic). It is accepted that microbial biofilm and its complexity play important roles in non-healing wounds. This biofilm consists of polymicrobial colonies embedded in exopolymeric matrix produced by the biofilm itself and has a high tolerance to host defence mechanisme, antibiotics, and antiseptics. Larval therapy has been approved by FDA to be used in chronic wound management. It has antimicrobial effects besides its other effects on wound healing inter alia mechanical debridement, anti-inflammation, angiogenesis, and destabilization of biofilm enzymes. Further studies are needed to explore the effects of larval therapy, especially its excretion/secretion components, so that it can be applicated more aesthetically.Keywords: chronic wound, wound healing process, biofilm, larval therapyAbstrak: Luka kronis merupakan masalah kesehatan di seluruh dunia yang telah memboroskan biaya cukup tinggi. Walaupun telah terjadi kemajuan dan pemahaman mengenai penyembuhan luka, prevalensi dan insidensi luka kronis dan komplikasinya tetap meningkat pesat. Secara konvensional, perawatan luka kronis terdiri dari debrideman, irigasi manual, dressing untuk mempertahankan kelembaban, dan terapi antimikroba (topikal dan atau sistemik). Adanya biofilm mikroba serta kompleksitasnya pada luka kronis telah disepakati sebagai salah satu kunci gagalnya penyembuhan luka. Biofilm mikroba terdiri dari koloni-koloni mikroorganisme polimikrobial terkemas dalam matriks eksopolimerik yang diproduksi olehnya sendiri dan memiliki toleransi tinggi terhadap pertahanan pejamu (host), antibiotik, dan antiseptik. Terapi larva telah diterima oleh FDA dan telah terbukti berefek antimikroba disamping efek lainnya terhadap penyembuhan luka, antara lain: debrideman mekanis, anti-inflamasi, angiogenesis, dan destabilisasi enzim biofilm pada luka. Studi lanjut diperlukan untuk mengeksplorasi efek terapi larva terutama komponen ekskresi/skresi larva terhadap penyembuhan luka agar dapat diaplikasikan secara lebih estetik.Kata kunci: luka kronis, penyembuhan luka, biofilm, terapi larva

scholarly journals TERAPI LARVA PADA LUKA KRONIS TERBUKA

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Sunny Wangko
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Chronic Wound ◽  
Healing Process ◽  
Bioactive Molecules ◽  
Wound Management ◽  
Wound Healing Process ◽  
Beneficial Effects ◽  
Infected Wounds ◽  
Larval Therapy

Abstract: The usage of larvae in wound treatment has been known across the centuries in different countries. However, larval therapy is offered when the conventional therapy has failed in the management of chronic, infected wounds. Concerning the larval therapy, it was presumed that the wound healing was due to the mechanical debridement effect of the larval movement and of their hooks. To date, a variety of study reports reveals that there are several beneficial effects of the larval therapy, inter alia: secretion/excretion of larvae contains enzymes, growth factors, and cytokines that collaborate in the wound healing process. The bioactive molecules in the secretion/excretion of the larvae has to be further studied and to be developed, therefore, they can be applied in the wound management efficiently and economically. Keywords: larval therapy, chronic wound, healing process.     Abstrak: Walaupun pemanfaatan larva pada luka kronis telah sangat lama dikenal di berbagai negara, terapi larva umumnya digunakan bila terapi konvensional telah gagal. Awalnya diduga bahwa efek debridemen mekanis oleh gerakan larva dan kaitnya yang paling berperan. Dewasa ini, laporan berbagi studi telah mengungkapkan bahwa larva menyekresi dan menyintesis berbagai bahan baik berupa enzim, sitokin, dan growth factors yang turut berperan dalam proses penyembuhan luka. Adanya molekul bioaktif dalam ekskresi dan sekresi larva perlu diteliti dan dikembangkan agar dapat diaplikasikan dengan lebih efisien dan ekonomis. Kata kunci: terapi larva, luka kronis, penyembuhan luka.

scholarly journals Instillation-TIME (iTIME) as a rationale amendment for TIME conception. Is there enough evidence for the efficiency of negative pressure wound therapy with instillation (iNPWT) to announce a breakthrough idea for wound treatment?

2019 ◽  
Vol 6 (2) ◽  
pp. 7-8
Author(s):  
Adam Bobkiewicz ◽  
Adam Studniarek ◽  
Łukasz Krokowicz ◽  
Michał Drews ◽  
Tomasz Banasiewicz
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Care Management ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wound ◽  
Wound Care ◽  
Wound Treatment ◽  
Wound Therapy ◽  
Number Of Patients ◽  
Moisture Balance

An increased number of patients developing difficult-to-heal wounds results in billions spending for chronic wound care management. Introduction of TIME conception has been a breakthrough idea for wound healing based on phase-adapted wound therapy that interacts and influence each other and included: T – tissue management, I - infection control, M - moisture balance, E - edge of the wound. Negative pressure wound therapy (NPWT) revolutionized the management of wound healing. Moreover, recently NPWT with instillation (iNPWT) has gained the popularity of optimizing wound healing. In the context of acceleration of wound healing, iNPWT meets the criteria of the TIME conception. All individual components of TIME strategy are found in iNPWT providing “all in one” conception. Such management is easy to apply, monitor and it is well- tolerated by patients. Based on the current studies, iNPWT is found to be an important alternative for other methods of wound healing. It is believed that iNPWT will evolve and gain popularity as an innovative treatment for TIME conception.

scholarly journals Wound Microbiology and Associated Approaches to Wound Management

2001 ◽  
Vol 14 (2) ◽  
pp. 244-269 ◽  
Author(s):  
P. G. Bowler ◽  
B. I. Duerden ◽  
D. G. Armstrong
Keyword(s):  
Wound Healing ◽  
Clinical Signs ◽  
Sampling Technique ◽  
Wound Management ◽  
Anaerobic Microorganisms ◽  
Microbial Density ◽  
Mucosal Surfaces ◽  
Wound Assessment ◽  
Assessment And Treatment ◽  
Systemic Antibiotics

SUMMARY The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds.

Dressing Selection in Chronic Wound Management

2002 ◽  
Vol 92 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Susie Seaman
Keyword(s):  
Wound Healing ◽  
Chronic Wound ◽  
Wound Care ◽  
Wound Management ◽  
Transparent Films ◽  
Chronic Wound Management

The concept of moist wound healing has been examined and gradually accepted by wound care clinicians during the last 40 years, and has led to the development of hundreds of dressings that support a moist wound environment. This article discusses the characteristics of an ideal dressing in an effort to assist clinicians in making appropriate dressing choices from common categories, including transparent films, hydrocolloids, foams, absorptive wound fillers, hydrogels, collagens, and gauzes. Reimbursement issues are also discussed. (J Am Podiatr Med Assoc 92(1): 24-33, 2002)

scholarly journals Povidone Iodine Ointment vs Cadexomer Iodine Ointment in Management of the Chronic Wound: A Study Protocol

2021 ◽  
pp. 33-37
Author(s):  
Shubham Gupta ◽  
Raju Kamalrao Shinde ◽  
Sangita Shinde
Keyword(s):  
Health Care ◽  
Wound Healing ◽  
Granulation Tissue ◽  
Health Care Professionals ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Povidone Iodine ◽  
Wound Management ◽  
Tissue Formation ◽  
Granulation Tissue Formation

Introduction: Chronic wound and its care has always been a health burden for patient, health care professionals and the entire health care system. There have been certain topical preparations available in market today for application in chronic wound management. In our study, we are comparing effects of cadexomer and povidone iodine ointment in context of reduction in bacterial overload, slough reduction, facilitations of granulation tissue formation, reduction in size of the wound and ultimately in percentage of wound healing and its cost of management. Aim: Comparison of outcome of Povidone Iodine Ointment and Cadexomer iodine Ointment in management of the wound. Methodology: This cross section observational study has been conducted among 40 patients diagnosed as chronic wound with 20 patients in each group. Student’s paired t-test and Pearson’s Correlation Coefficient is being used as statistical analysis. Results: The percentage of patient treated with cadexomer iodine ointment shows significantly (p<0.05) higher rate of wound healing along with significant reduction in bacterial overload and promotion of granulation tissue formation. Conclusion: Cadexomer as a vector with iodine ointment shows higher rate of reduction of biofilm, slough and debris with better rate of promotion of granulation tissue formation, thus leading to increased and effective rate of healing of wound as well as cost effective management of chronic wounds.

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