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.

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.

Ultrasound Devices to Treat Chronic Wounds: The Current Level of Evidence

2020 ◽  
Vol 19 (4) ◽  
pp. 341-349
Author(s):  
Georgios Kotronis ◽  
Prashanth R. J. Vas
Keyword(s):  
Health Care ◽  
Best Practice ◽  
Chronic Wounds ◽  
Wound Care ◽  
Low Frequency ◽  
Current Level ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Considerable Morbidity ◽  
Significant Health

Chronic wounds cause considerable morbidity and utilize significant health care resources. In addition to addressing wound etiology and treating infection, regular debridement is a key component of wound care with a proven ability to accelerate healing. In this regard, a significant innovation in wound care has been the development of ultrasound debridement technology. The purpose of this review is to evaluate the current evidence behind the technology with an emphasis on noncontact low-frequency (NCLF) ultrasound. A number of studies, especially those evaluating NCLF technology, have demonstrated the potential of ultrasound debridement to effectively remove devitalized tissue, control bioburden, alleviate pain, and expedite healing. However, most of the studies are underpowered, involve heterogeneous ulcer types, and demonstrate significant methodological limitations making comparison between studies difficult; there is a paucity of data on cost-effectiveness. Future clinical trials on ultrasound debridement technology must address the design issues prevalent in current studies, and report on clinically relevant endpoints before adoption into best-practice algorithms can be recommended.

Health professionals' perspectives on delivering patient-focused wound management: a qualitative study

2019 ◽  
Vol 28 (Sup7) ◽  
pp. S4-S13 ◽  
Author(s):  
Janet L. Kuhnke ◽  
David Keast ◽  
Sue Rosenthal ◽  
Robyn Jones Evans
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Best Practice ◽  
Care Delivery ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Evidence Based ◽  
Venous Leg Ulcer

Objective: This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes. Methods: A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes. Results: A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers. Conclusion: Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.

scholarly journals Evaluation of a Clinical Decision Support System in the Domain of Chronic Wound Management

2021 ◽  
Author(s):  
Stefan Vogel ◽  
Jendrik Richter ◽  
Stefanie Wache ◽  
Kerstin Pischek-Koch ◽  
Simone Auchter ◽  
...  
Keyword(s):  
Clinical Decision Support System ◽  
Chronic Wounds ◽  
Wound Care ◽  
Clinical Decision ◽  
Wound Management ◽  
Domain Experts ◽  
Nursing Science ◽  
It Systems ◽  
Chronic Wound Management ◽  
Software Prototype

The PosiThera project focuses on the management of chronic wounds, which is multi-professional and multi-disciplinary. For this context, a software prototype was developed in the project, which is intended to support medical and nursing staff with the assistance of artificial intelligence. In accordance with the user-centred design, national workshops were held at the beginning of the project with the involvement of domain experts in wound care in order to identify requirements and use cases of IT systems in wound care, with a focus on AI. In this study, the focus was on involving nursing and nursing science staff in testing the software prototype to gain insights into its functionality and usability. The overarching goal of the iterative testing and adaptation process is to further develop the prototype in a way that is close to care.

scholarly journals Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing

2021 ◽  
Vol 19 ◽  
pp. 228080002110549
Author(s):  
Michael Rodrigues ◽  
Thilagavati Govindharajan
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Care ◽  
Cost Effective ◽  
Wound Dressings ◽  
Wound Management ◽  
Histopathological Analysis ◽  
Diabetic Wound ◽  
Functional Material ◽  
Diabetic Wound Healing

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study. The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure. The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes. The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

Maggot Therapy in Wound Management in Modern Era and a Review of Published Literature

2010 ◽  
Vol 24 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Liya Davydov
Keyword(s):  
United States ◽  
American Medical Association ◽  
Wound Care ◽  
Cost Effective ◽  
Mechanisms Of Action ◽  
Wound Management ◽  
Maggot Therapy ◽  
Coding Guidelines ◽  
Near Future ◽  
Modern Era

Maggot therapy is an old remedy, which is being looked into with renewed interest. The use of medicinal maggots was approved by Food and Drug Administration (FDA) as a medical device in 2004. Maggot therapy appears to be efficacious, well tolerated, and cost-effective. Because American Medical Association (AMA) and Centers for Medicare and Medicaid (CMS) released reimbursement coding guidelines with regards to maggot therapy, there is a potential for a wider use of maggot therapy in United States in the near future. Several mechanisms of action suggested for maggots in debriding wounds are discussed. While maggot therapy demonstrated effectiveness in necrotic wounds, not all wound types respond well to maggot therapy. Future large, randomized, well-designed studies would help better delineate the place of maggot therapy among other options for wound care, and determine whether maggot therapy should be initiated earlier in the course of treatment, or continued to be used as a last resort.

scholarly journals Wound care with traditional, complementary and alternative medicine

2012 ◽  
Vol 45 (02) ◽  
pp. 418-424 ◽  
Author(s):  
Ananda A. Dorai
Keyword(s):  
Wound Healing ◽  
Alternative Medicine ◽  
Traditional Medicine ◽  
Care Management ◽  
Wound Care ◽  
Healing Process ◽  
Wound Management ◽  
Care Practice ◽  
Wound Therapy ◽  
The Ideal

ABSTRACTWound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People′s perception towards traditional medicine has also changed and is very encouraging. The concept of moist wound healing has been well accepted and traditional medicine has also incorporated this method to fasten the healing process. Several studies using herbal and traditional medicine from different continents have been documented in wound care management. Honey has been used extensively in wound care practice with excellent results. Recent scientific evidences and clinical trials conducted using traditional and alternative medicine in wound therapy holds good promise in the future.

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 Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review (Preprint)

2017 ◽  
Author(s):  
Clara Schaarup ◽  
Louise Bilenberg Pape-Haugaard ◽  
Ole Kristian Hejlesen
Keyword(s):  
Health Care ◽  
Decision Support ◽  
Literature Review ◽  
Clinical Decision Support ◽  
Systematic Literature Review ◽  
Health Care Professionals ◽  
Chronic Wounds ◽  
Wound Care ◽  
Clinical Decision ◽  
Decision Support Models

BACKGROUND Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers are a massive burden to health care facilities. Many randomized controlled trials on different wound care elements have been conducted and published in the Cochrane Library, all of which have only a low evidential basis. Thus, health care professionals are forced to rely on their own experience when making decisions regarding wound care. To progress from experience-based practice to evidence-based wound care practice, clinical decision support systems (CDSS) that help health care providers with decision-making in a clinical workflow have been developed. These systems have proven useful in many areas of the health care sector, partly because they have increased the quality of care, and partially because they have generated a solid basis for evidence-based practice. However, no systematic reviews focus on CDSS within the field of wound care to chronic wounds. OBJECTIVE The aims of this systematic literature review are (1) to identify models used in CDSS that support health care professionals treating chronic wounds, and (2) to classify each clinical decision support model according to selected variables and to create an overview. METHODS A systematic review was conducted using 6 databases. This systematic literature review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic reviews. The search strategy consisted of three facets, respectively: Facet 1 (Algorithm), Facet 2 (Wound care) and Facet 3 (Clinical decision support system). Studies based on acute wounds or trauma were excluded. Similarly, studies that presented guidelines, protocols and instructions were excluded, since they do not require progression along an active chain of reasoning from the clinicians, just their focus. Finally, studies were excluded if they had not undergone a peer review process. The following aspects were extracted from each article: authors, year, country, the sample size of data and variables describing the type of clinical decision support models. The decision support models were classified in 2 ways: quantitative decision support models, and qualitative decision support models. RESULTS The final number of studies included in the systematic literature review was 10. These clinical decision support models included 4/10 (40%) quantitative decision support models and 6/10 (60%) qualitative decision support models. The earliest article was published in 2007, and the most recent was from 2015. CONCLUSIONS The clinical decision support models were targeted at a variety of different types of chronic wounds. The degree of accessibility of the inference engines varied. Quantitative models served as the engine and were invisible to the health care professionals, while qualitative models required interaction with the user.

scholarly journals Efficacy of nano silver dressings over conventional dressings in chronic wounds

2018 ◽  
Vol 5 (12) ◽  
pp. 3995
Author(s):  
K. Suhas ◽  
P. Manvi Naga Manvi
Keyword(s):  
Chronic Wounds ◽  
Fungal Infections ◽  
Wide Spectrum ◽  
Cost Effective ◽  
Biological Properties ◽  
Nano Particles ◽  
Wound Management ◽  
Control Group ◽  
Study Group ◽  
Nano Silver

Background: Chronic wounds give rise to serious health problems, accompanied by a decrease in quality of life. Silver has been an effective agent with documented efficacy against wide spectrum of bacterial, viral, and fungal infections. Recently, many silver-based preparations are available for effective management of wounds. Among them silver nano particles, exhibit significantly novel and distinct physical, chemical, and biological properties. Due to their nano scale size, they have been elicited much interest in wound management. This study aims to compare the efficacy of nano silver dressing in chronic wounds with that of conventional dressings.Methods: This was a prospective study conducted in the Department of General Surgery, Alluri Sita Rama Raju Academy of Medical Sciences from August 2017 to August 2018. A total of 100 patients with chronic wounds were included in the study and were equally divided into-Study group and Control group randomly. Swab cultures were sent in all the patients. The study group received nano silver dressings while the controls received daily dressings with normal saline soaked gauges, betadine and hydrogen peroxide. Data regarding the time required for healing, number of days required for healing and percentage of healing are noted.Results: Nano silver dressings in the treatment of chronic wounds are found to be safe, effective, promoter of wound healing, promotes epithelization, accelerates healing, eliminates anaerobes and breaks microbial synergy more effectively than conventional dressing. Hence Nano silver spray prove to be more effective in the management of chronic wounds. In study group, 50% of patients stay for 3-4 weeks whereas in control group, 70% of patients stay for 5-6 weeks. 91-99% reduction in size of ulcer is seen in 43 out of 50 patients in study group whereas in control group only 8 out of 50 shows 91-99% reduction in size.Conclusions: Nano silver dressings is a cost effective option in ulcer management. It decreases the period of hospitalization and reduces the burden on the health care system.

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