WorldWideScience

Sample records for advanced wound management

  1. Management of gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Ordog, G.; Drew, R.

    1987-01-01

    Management of Gunshot Wounds provides a review of wound ballistics and a systemic review of gunshot wound management of all major body areas and systems. This volume includes information on pre-hospital care, nursing care, and care of infants, children, and the elderly patient with gunshot wounds. This volume also features information on: lead toxicity; complications of gunshot wounds; socioeconomic aspects of gunshot wounds; the forensic and pathological aspects of gunshot wounds; future directions in the care of gunshot wounds.

  2. Effectively managing wound exudate.

    Science.gov (United States)

    Chamanga, Edwin

    2015-09-01

    The management of wound exudate remains a clinical challenge despite technological advances in products with better exudate-handling capacities. This clinical challenge is occasionally encountered when thick exudate (viscous exudate) is present, and when most modern dressings do not possess the capabilities to manage the viscosity while enabling exudate absorption. Maceration to the peri-wound area poses another challenge, irrespective of the number of topical barrier application products on the market and the innovation of dressing products that lock exudate away or those that encourage vertical wicking. In addition to all the above, in clinical practice, the assessment and documentation of wound exudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings. PMID:26322408

  3. Wound healing and treating wounds: Chronic wound care and management.

    Science.gov (United States)

    Powers, Jennifer G; Higham, Catherine; Broussard, Karen; Phillips, Tania J

    2016-04-01

    In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers. PMID:26979353

  4. Wound healing and treating wounds: Chronic wound care and management.

    Science.gov (United States)

    Powers, Jennifer G; Higham, Catherine; Broussard, Karen; Phillips, Tania J

    2016-04-01

    In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers.

  5. Novel advancements in wound healing

    Directory of Open Access Journals (Sweden)

    reza Ghaderi

    2014-05-01

    Full Text Available Maintaining skin integrity is vital in humans and animals to protect the organisms against dehydration, bleeding, and ingress of microorganisms. In order to do this, in Man and other evolved animals a sophisticated mechanism of wound healing occurs. At first the gap is quickly filled with a thin layer of fibrinous exudate, re-epithelialized, and rapidly replaced by new matrix. It is obvious that the speed of wound healing depends upon many factors such as the size of the wound, blood supply to the area, presence or absence of foreign bodies and microorganisms, age, health and nutritional status of the patient of the patient. Acute and chronic wounds care has extremely changed in recent years. Recenly, some traditional medications honey and other herbal medications( and new procedures are available that can be used to accelerate the healing of skin wounds.In the present article the most novel advances made in wound care and management in recent years were reviewed.

  6. Telemedicine for wound management

    OpenAIRE

    Chittoria, Ravi K.

    2012-01-01

    The 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 ...

  7. Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective

    OpenAIRE

    Jeffery, Lt Col S. L. A.

    2009-01-01

    Objective: The purpose of this article is to describe the treatment of injuries resulting from land mine explosions using a holistic approach that includes gauze-based negative pressure wound therapy (NPWT) and encompasses wound bed preparation, exudate management, and infection control. Method: In the treatment of 3 traumatic injuries, each requiring limb amputation, we describe the application of NPWT using the Chariker-Jeter system, which uses a single layer of saline-moistened antimicrobi...

  8. Telemedicine for wound management

    Directory of Open Access Journals (Sweden)

    Ravi K Chittoria

    2012-01-01

    Full Text Available The 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.

  9. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B;

    2014-01-01

    of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found......Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of wound management in Denmark and suggests how improvements might be achieved....

  10. Managing painful chronic wounds: the Wound Pain Management Model

    DEFF Research Database (Denmark)

    Price, Patricia; Fogh, Karsten; Glynn, Chris;

    2007-01-01

    document persistent wound pain and not to develop a treatment and monitoring strategy to improve the lives of persons with chronic wounds. Unless wound pain is optimally managed, patient suffering and costs to health care systems will increase. Udgivelsesdato: 2007-Apr......Chronic wound pain is not well understood and the literature is limited. Six of 10 patients venous leg ulcer experience pain with their ulcer, and similar trends are observed for other chronic wounds. Chronic wound pain can lead to depression and the feeling of constant tiredness. Pain related...... to the wound should be handled as one of the main priorities in chronic wound management together with addressing the cause. Management of pain in chronic wounds depends on proper assessment, reporting and documenting patient experiences of pain. Assessment should be based on six critical dimensions...

  11. Recent advances in topical wound care

    OpenAIRE

    Sarabahi, Sujata

    2012-01-01

    There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound,...

  12. Chronic wound management and research

    OpenAIRE

    Romanelli M

    2014-01-01

    Marco Romanelli Wound Healing Research Unit, Division of Dermatology, University of Pisa, Pisa, ItalyI would like to share with you a new open access peer-reviewed journal – Chronic Wound Care Management and Research, published by Dove Medical Press. Chronic Wound Care Management and Research is an international, peer-reviewed, open-access online journal publishing original research, case reports, reviews, editorials, and commentaries on the management of chronic wounds and...

  13. The management of perineal wounds

    Directory of Open Access Journals (Sweden)

    Ramesh k Sharma

    2012-01-01

    Full Text Available Management of perineal wounds can be very frustrating as these invariably get contaminated from the ano-genital tracts. Moreover, the apparent skin defect may be associated with a significant three dimensional dead space in the pelvic region. Such wounds are likely to become chronic and recalcitrant if appropriate wound management is not instituted in a timely manner. These wounds usually result after tumor excision, following trauma or as a result of infective pathologies like hideradenitis suppurativa or following thermal burns. Many options are available for management of perineal wounds and these have been discussed with illustrative case examples. A review of literature has been done for listing commonly instituted options for management of the wounds in perineum.

  14. Advanced Therapeutic Dressings for Effective Wound Healing--A Review.

    Science.gov (United States)

    Boateng, Joshua; Catanzano, Ovidio

    2015-11-01

    Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care.

  15. Management of Traumatic Wounds and a Novel Approach to Delivering Wound Care in Children.

    Science.gov (United States)

    Bernabe, Kathryn Q; Desmarais, Thomas J; Keller, Martin S

    2014-04-01

    Significance: The costs and morbidity of pediatric traumatic wounds are not well known. The literature lacks a comprehensive review of the volume, management, and outcomes of children sustaining soft tissue injury. We briefly review the existing literature for traumatic wounds such as open fractures and burns. Such injuries require dedicated wound care and we propose a novel approach for more efficient and more effective delivery of dedicated pediatric wound care. Recent Advances: New pediatric literature is emerging regarding the long-term effects of wound care pain in traumatic injuries-especially burns. A variety of wound dressings and alternative management techniques exist and are geared toward reducing wound care pain. Our institution utilizes a unique model to provide adequate sedation and pain control through a dedicated pediatric wound care unit. We believe that this model reduces the cost of wound care by decreasing emergency department and operating room visits as well as hospital length of stay. Critical Issues: First, medical costs related to pediatric traumatic wound care are not insignificant. The need for adequate pain control and sedation in children with complex wounds is traditionally managed with operating room intervention. Afterward, added costs can be from a hospital stay for ongoing acute wound management. Second, morbidities of complex traumatic wounds are shown to be related to the acute wound care received. Future Directions: Further guidelines are needed to determine the most effective and efficient care of complex traumatic soft tissue injuries in the pediatric population.

  16. Wound pruritus: pathophysiology and management

    Directory of Open Access Journals (Sweden)

    Paul JC

    2015-08-01

    Full Text Available Julia C PaulSchool of Nursing, Oakland University, Rochester, MI, USAPurpose: The objective of this article is to review literature on wound pruritus, with a focus on summarizing pathophysiology and management.Method: Literature related to the physiology of itch was reviewed. PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL, and Embase were searched for all research studies written in English which include “wound” (injury/burn and “pruritus” (itch in the title or abstract. Articles were accepted if they involved wounds or acute burns. Literature related to options for management of wound pruritus was reviewed.Results: While all types of wounds can be the source of associated pruritus, most studies have been done concerning pruritus associated with burns. There are treatment options for pruritus which can be considered for management of wound pruritus. Conclusion: Further research is indicated to gain insights into the problem of wound pruritus. As more is learned about the physiology of wound pruritus, more effective management strategies can be developed and employed.Keywords: wound, chronic itch, C-fibers, spinothalamic tract, positron emission tomography, pruritogens

  17. Recent advances in topical wound care

    Directory of Open Access Journals (Sweden)

    Sujata Sarabahi

    2012-01-01

    Full Text Available There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ′magical dressings′. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention.

  18. Principles of Wound Management and Wound Healing in Exotic Pets.

    Science.gov (United States)

    Mickelson, Megan A; Mans, Christoph; Colopy, Sara A

    2016-01-01

    The care of wounds in exotic animal species can be a challenging endeavor. Special considerations must be made in regard to the animal's temperament and behavior, unique anatomy and small size, and tendency toward secondary stress-related health problems. It is important to assess the entire patient with adequate systemic evaluation and consideration of proper nutrition and husbandry, which could ultimately affect wound healing. This article summarizes the general phases of wound healing, factors that affect healing, and principles of wound management. Emphasis is placed on novel methods of treating wounds and species differences in wound management and healing. PMID:26611923

  19. Principles of Wound Management and Wound Healing in Exotic Pets.

    Science.gov (United States)

    Mickelson, Megan A; Mans, Christoph; Colopy, Sara A

    2016-01-01

    The care of wounds in exotic animal species can be a challenging endeavor. Special considerations must be made in regard to the animal's temperament and behavior, unique anatomy and small size, and tendency toward secondary stress-related health problems. It is important to assess the entire patient with adequate systemic evaluation and consideration of proper nutrition and husbandry, which could ultimately affect wound healing. This article summarizes the general phases of wound healing, factors that affect healing, and principles of wound management. Emphasis is placed on novel methods of treating wounds and species differences in wound management and healing.

  20. Management of radiation wounds

    OpenAIRE

    Subramania Iyer; Deepak Balasubramanian

    2012-01-01

    Radiotherapy forms an integral part in cancer treatment today. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to effect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. This impairment results in fibrosis, nonhealing ulcers, lymphoedema and radionecrosis amongst others. ...

  1. Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kaitani T

    2015-02-01

    Full Text Available Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan; 5Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 6Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; 7Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Aims and objectives: We investigated the effectiveness and safety of an advanced pressure ulcer (PU management protocol comprising 1 ultrasonography to assess the deep tissue, 2 use of a non-contact thermometer to detect critical colonization, 3 conservative sharp debridement, 4 dressing selection, 5 negative pressure wound therapy, and 6 vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs. Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician’s orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow

  2. Management of radiation wounds

    Directory of Open Access Journals (Sweden)

    Subramania Iyer

    2012-01-01

    Full Text Available Radiotherapy forms an integral part in cancer treatment today. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to effect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. This impairment results in fibrosis, nonhealing ulcers, lymphoedema and radionecrosis amongst others. This article will discuss the pathophysiology in brief, along with the manifestations of radiation-induced injury and the treatment available currently

  3. News in wound healing and management

    DEFF Research Database (Denmark)

    Gottrup, Finn; Jørgensen, Bo; Karlsmark, Tonny

    2009-01-01

    PURPOSE OF REVIEW: Nonhealing wounds are a significant problem in the healthcare system all over the world. The present review focuses on some recent developments and promising clinical progresses in wound management. RECENT FINDINGS: New findings have increased our knowledge in several wound areas......-TNFalpha) and Lactobacillus plantarum cultures have also been successfully used in hard to heal, atypical wounds. Knowledge on influencing factors as smoking and biofilm on the healing process has also been improved. Smoking results in delayed healing and increased risk of postoperative infection, whereas the role of biofilm...... is still at an exploratory level. Organizing models for optimal wound management are constantly being developed and refined. SUMMARY: Recent knowledge on the importance of new dressing materials containing active substances, new treatments for atypical wounds, influencing factors on the healing process...

  4. Local wound care and topical management of hidradenitis suppurativa.

    Science.gov (United States)

    Alavi, Afsaneh; Kirsner, Robert S

    2015-11-01

    Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating disease predominantly involving apocrine gland-bearing skin. The folliculoinfundibular dysfunction and an aberrant cutaneous immune response to commensal bacteria are recognized as potential contributors. Topical antibiotics, such as clindamycin, and keratolytic agents have been used in the management of early stages of HS. Proper wound care is a key part of management, particularly in patients with advanced HS. The evidence for the optimal topical therapy or optimal local wound care is limited. As such, a multidisciplinary approach is necessary to address all aspects of HS, including topical therapy, systemic therapy, and proper wound care. The focus of this paper is to review the evidence for the topical management and local wound care strategies in patients with HS. PMID:26470618

  5. Cutaneous wound healing: Current concepts and advances in wound care

    OpenAIRE

    Kenneth C Klein; Somes Chandra Guha

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2...

  6. Use of advanced technologies across the wound care spectrum: prologue.

    Science.gov (United States)

    Kirsner, Robert S; Romanelli, Marco

    2016-09-01

    The growing trends of ageing populations and increasing prevalence of diabetes have given rise to an expanding number of problematic acute and chronic wounds. Over the past two decades, the use of negative pressure wound therapy (NPWT) with and without instillation of topical wound solutions has expanded to include treatment of a large variety of wounds. Additionally, the use of NPWT specifically designed for use over closed surgical incisions has been associated with favourable results. The recent introduction of an automated epidermal harvesting system, which neither creates a donor site wound nor requires the use of a surgeon, operating room or anaesthesia, has facilitated the use of epidermal grafting. This supplement highlights some of the advanced wound approaches that have been developed to address challenging wounds and the growing burden of wound care affecting both the patient and the health care system. PMID:27547957

  7. Cutaneous wound healing: Current concepts and advances in wound care

    Directory of Open Access Journals (Sweden)

    Kenneth C Klein

    2014-01-01

    Full Text Available A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT, as used at our institution (CAMC, and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society may vary widely from country to country and payment system. [3] In the USA, CMS (Centers for Medicare and Medicaid Services approved indications for HBOT vary from that of the UHMS for logistical reasons. [1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise.

  8. DIABETIC WOUND HEALING MANAGEMENT- A PEER REVIEW

    OpenAIRE

    Harshavardhan Pathapati; T.E. Gopala Krishna Murthy; B. Ramanaiah; Davu Srinivas

    2014-01-01

    Objectives: Diabetes is a metabolic disorder mainly impairs the body glucose utilization capacity due to this perforcely repressing the immuno-dysfunction (decreases chemotaxis, phagocytosis and intracellular killing actions) and collagen synthesis which are essential in wound debridement management of diabetic patients. Delayed wound healing is considered as one of the most repulsive disabling and costly complication of diabetes. People with diabetes have extenuated circulation, poor resista...

  9. Current management of wound healing

    DEFF Research Database (Denmark)

    Gottrup, F; Karlsmark, T

    2009-01-01

    While the understanding of wound pathophysiology has progressed considerably over the past decades the improvements in clinical treatment has occurred to a minor degree. During the last years, however, new trends and initiatives have been launched, and we will continue to attain new information...

  10. A comprehensive review of advanced biopolymeric wound healing systems.

    Science.gov (United States)

    Mayet, Naeema; Choonara, Yahya E; Kumar, Pradeep; Tomar, Lomas K; Tyagi, Charu; Du Toit, Lisa C; Pillay, Viness

    2014-08-01

    Wound healing is a complex and dynamic process that involves the mediation of many initiators effective during the healing process such as cytokines, macrophages and fibroblasts. In addition, the defence mechanism of the body undergoes a step-by-step but continuous process known as the wound healing cascade to ensure optimal healing. Thus, when designing a wound healing system or dressing, it is pivotal that key factors such as optimal gaseous exchange, a moist wound environment, prevention of microbial activity and absorption of exudates are considered. A variety of wound dressings are available, however, not all meet the specific requirements of an ideal wound healing system to consider every aspect within the wound healing cascade. Recent research has focussed on the development of smart polymeric materials. Combining biopolymers that are crucial for wound healing may provide opportunities to synthesise matrices that are inductive to cells and that stimulate and trigger target cell responses crucial to the wound healing process. This review therefore outlines the processes involved in skin regeneration, optimal management and care required for wound treatment. It also assimilates, explores and discusses wound healing drug-delivery systems and nanotechnologies utilised for enhanced wound healing applications. PMID:24985412

  11. 75 FR 11919 - Smith and Nephew, Inc., Wound Management-Largo Division, Including On-Site Leased Workers From...

    Science.gov (United States)

    2010-03-12

    ... to the production of advanced wound care products such as adhesive dressings, non-adhesive dressings... Employment and Training Administration Smith and Nephew, Inc., Wound Management-Largo Division, Including On... workers of Smith and Nephew, Inc., Wound Management-Largo Division, Largo, Florida, including...

  12. [Wound management in patients with chronic wounds in ambulatory nursing--a pilot study].

    Science.gov (United States)

    Panfil, Eva-Maria; Mayer, Herbert; Junge, Wolfram; Laible, Jochen; Lindenberg, Eveline; Trümner, Andrea; Wordel, Anja; Evers, Georges C M

    2002-08-01

    Currently relevant data about prevalence of chronic wounds and wound management in home care nursing services are not available for Germany. In this study 38 home care nursing services were surveyed by means of a questionnaire. Response rate was 61%. Results showed that almost 9% of the home care nursing services treated patients suffering from chronic wounds. The most common wound was the pressure ulcer with a prevalence of 4.1%, followed by leg ulcer (2.7%) and the diabetic foot (1%). The questionnaire about wound management was completed for 47 patients of 24 home care services. 29 of the patients were females and 18 males. The average age of the patients was 78 years. Important diagnostic information about the nature and the recurrence rate of the wounds was not available to the nursing staff. The average time that a wound existed was 6.7 years with a range of 3 weeks to 45 years. 87% of the patients had their wound dressings on a daily basis. The average time needed for wound dressing was 17 minutes. Wound management often occurred in a idiosyncratic way and did not always follow evidence based practice. Wound management can be significantly improved by the use of modern wound dressing, reduction of the frequency of wound dressings, standardized wound documentation and better co-operation with doctors, nursing experts and health insurance organisations. Basis on the convenience nature of the sample results of this survey should be generalized and interpreted with caution. This study gives clear indications of the significance of the problem. More studies with representative samples are needed. PMID:12244826

  13. Wound management for the 21st century: combining effectiveness and efficiency.

    Science.gov (United States)

    Lindholm, Christina; Searle, Richard

    2016-07-01

    Treatment of wounds of different aetiologies constitutes a major part of the total health care budget. It is estimated that 1·5-2 million people in Europe suffer from acute or chronic wounds. These wounds are managed both in hospitals and in community care. The patients suffering from these wounds report physical, mental and social consequences of their wounds and the care of them. It is often believed that the use of wound dressings per se is the major cost driver in wound management, whereas in fact, nursing time and hospital costs are together responsible for around 80-85% of the total cost. Healing time, frequency of dressing change and complications are three important cost drivers. However, with the use of modern, advanced technology for more rapid wound healing, all these cost drivers can be substantially reduced. A basic understanding of the terminology and principles of Health Economics in relation to wound management might therefore be of interest. PMID:27460943

  14. Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples.

    Science.gov (United States)

    Benskin, Linda L

    2016-06-01

    Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens. Ultimately, polymeric membrane dressings (PMDs) were observed to meet patient care needs while also reducing clinic staff time and resources, and a PMD protocol of care was developed. Three (3) representative patients who presented with acute wounds and infection are described: a 20-year-old man with a hand abscess, a 16-year-old boy with a malleolus wound, and an approximately 20-year-old woman with an injection abscess, all otherwise relatively healthy, albeit undernourished. All 3 patients re- ceived oral antibiotics, their wounds were initially cleansed and debrided, and an appropriate configuration of either regular or silver-containing PMDs was applied to all exposed wound surfaces. Dressing changes were scheduled based upon the personalized plan of care. In all 3 patients, the pain-relieving properties of PMDs allowed resumption of activi- ties within 1 day of initiating treatment, the dressings' continuous wound cleansing system kept the wounds clean and free of infection despite the challenging environment, and the wounds healed steadily. Managing infected acute wounds with PMDs through complete wound closure was time efficient for clinic staff and met all 4 major patient goals of care. Randomized, controlled studies to compare wound and quality of life outcomes in patients whose infected wounds are managed with PMDs compared with those whose wounds are managed with other advanced dressings are warranted. PMID

  15. Management of postoperative instrumented spinal wound infection

    Institute of Scientific and Technical Information of China (English)

    FANG Xiu-tong; Kirkham B.Wood

    2013-01-01

    Background Wound infection following spinal instrumented surgery is a frequent complication.The optimal treatment of acute deep wound infection following spinal instrumentation fusion remains controversial because of variability in cohort identification,definition of an infection,and the instrument used to measure outcomes.This retrospective study evaluated the clinical curative effect for postoperative spinal infection after instrumented spine fusion with extensive debridement,or implant removal.Methods From January 2004 to October 2009,851 patients were identified who underwent surgical treatment of spinal diseases.The medical records of patients who developed infections were reviewed in detail.Results Of 851 patients,41 (4.9%) developed an infection.Thirty-three were acute,and eight were delayed.Acute infected cases were managed with antibiotic therapy,and aggressive debridement of the wound and soft tissues leaving all instrumentation in situ in all but one patient.The most common symptoms of acute infection included:posterior incisional drainage (26 of 33 patients),back pain (22 of 33 patients) and fever (13 of 33 patients).Among patients with delayed onset infection,five of eight patients had local pain,four of eight patients had incision drainage,and one patient had a prolonged period of intermittent fever.The most frequent causative organism for postoperative spinal infection following spine surgery is Staphylococcus aureus.Pseudarthrosis was noted in long-term follow-up in four of 41 patients.Conclusions We recommend irrigation and debridement,no instrumentation removal,and,if necessary,repeat debridement followed by delayed primary closure for the treatment of acute deep infection with instrumentation.

  16. French national wound management survey: choice criteria of dressings.

    Science.gov (United States)

    Meaume, Sylvie; Barrois, Brigitte; Faucher, Nathalie

    Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary.

  17. Understanding effective management of postoperative wounds

    OpenAIRE

    Ousey, Karen; Roberts, Peter

    2013-01-01

    Acute surgical wounds generally heal with no problems. However, some wounds blister around the periwound area and surgical site infection postoperatively, partly due to inappropriate choice of wound dressing. These complications can cause pain, discomfort, persistent wound leakage, and possible risk of surgical site infection (Jester et al, 2000; Bhattacharyya et al, 2005; Cosker et al, 2005). Postoperative blistering and infection have been identified as the main problems in hip and knee rep...

  18. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-11-01

    Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.

  19. SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

    2015-07-01

    Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

  20. Advances in Wound Healing: A Review of Current Wound Healing Products

    OpenAIRE

    Murphy, Patrick S.; Gregory R.D. Evans

    2012-01-01

    Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest appl...

  1. Advances in research on mechanisms of the effect of negative pressure wound treatment in wound healing

    OpenAIRE

    Li, Lei(Beijing Institute of Petrochemical Technology, Beijing, 102617, People's Republic of China); Kai-yang LV; Wu, Guo-Sheng; Zhu, Shi-hui

    2014-01-01

    Negative pressure wound treatment (NPWT) refers to apply a highly porous material between the wound and a semipermeable membrane, and it is then connected to a suction apparatus, leading to a minimal deformation of wound, resulting in promoting cell proliferation and wound repair. These devices may significantly expedite wound healing, facilitate the formation of granulation tissue, and reduce the complexity of subsequent reconstructive operations. In recent years, along with wide clinical us...

  2. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Study Design: Randomized control trial. Place and Duration of Study: Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. Methodology: The study consisted of 278 patients, with 139 patients each in Group A and B, who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Results: Mean age of presentation in group Awas 55.88 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2and in group B 15.09 ± 2.81 cm2(p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p < 0.001). Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A(p < 0.001). Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers. (author)

  3. Managing Advanced Parkinson Disease

    Science.gov (United States)

    ... well.” 11 Managing Advanced Parkinson Disease DENTAL CARE Oral hygiene should remain an important part of the daily routine in order to prevent serious dental problems and the development of other illnesses. The ...

  4. EDUCATIONAL PERSPECTIVES ON SIMULATED LEARNING IN WOUND MANAGEMENT

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2014-01-01

    them the opportunity to practice skills and gives a realistic insight in the com-plexity of managing the chronic wound. Conclusions: Simulated learning is a useful pedagogical strategy in wound management. It is effective in relation to practical skills training and ability to reflect. It is yet...... with artificial chronic wounds. The course consists of 6 lessons - a mixture of ordinary theoretical classroom teaching and facilitated learning in our simulation laboratory. Students encounter 5 patients (mannequins) and are given the medical history of the patients. The ability of the students to reflect...... is challenged in relation to identification of risk factors and in the process of choosing suitable bandages. The emphasis in practical skills training are: cleansing, debridement and wound dressing. Results: In evaluation of the course students express that simulated learning creates motiva-tion and offers...

  5. The prevalence, management and outcome for acute wounds identified in a wound care survey within one English health care district.

    Science.gov (United States)

    Vowden, Kathryn R; Vowden, Peter

    2009-02-01

    This paper reports the characteristics and local management of 826 acute wounds identified during an audit across all health care providers serving the population of Bradford, UK. Of the wounds encountered 303 were traumatic wounds and 237 primary closures with smaller numbers of other acute wound types. Of the 303 traumatic wounds 174 occurred in women (57.4%). Men predominated in the under 45s (65M:26F), this being largely accounted for by hand and finger trauma (n = 62) particularly in patients of working age (M32:F12). Women predominated in the over 65s (50M:130F), this being largely accounted for by lower limb traumatic wounds (M24:F91), the majority of these being in patients 65 and over (M14:F82). In this sub-group of 96 patients 25 had wounds of 6 weeks or longer duration, only 3 had undergone Doppler assessment and only 2 received compression bandaging. Typically these wounds were of recent origin and small in size (under 1 week and less than 5 cm2 in surface area) however exceptions occurred where 10 people had wounds over 25 cm2 in area while 3 wounds had been present for over 5 years. 101 (12.2%) of the encountered wounds were considered to be infected although the practice of wound swabbing in the presence of presumed infection seemed inadequate with 37.6% of all infected acute wounds not being swabbed while 97 non-infected wounds were swabbed. Where wounds were swabbed 4.5% were found to be MRSA positive. Across all acute wound types (with the sole exception of primary closures) antimicrobial wound dressings were the most prevalent form of dressing and covered 56 (55.4%) of all infected wounds.

  6. Advances in research on mechanisms of the effect of negative pressure wound treatment in wound healing

    Directory of Open Access Journals (Sweden)

    Lei LI

    2014-10-01

    Full Text Available Negative pressure wound treatment (NPWT refers to apply a highly porous material between the wound and a semipermeable membrane, and it is then connected to a suction apparatus, leading to a minimal deformation of wound, resulting in promoting cell proliferation and wound repair. These devices may significantly expedite wound healing, facilitate the formation of granulation tissue, and reduce the complexity of subsequent reconstructive operations. In recent years, along with wide clinical use, the therapeutic effect of NPWT has been recognized, but the mechanism of its clinical effect still needs further research. DOI: 10.11855/j.issn.0577-7402.2014.08.15

  7. Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations

    OpenAIRE

    Nicks, Bret A.; Ayello, Elizabeth A.; Woo, Kevin; Nitzki-George, Diane; Sibbald, R. Gary

    2010-01-01

    Background As millions of emergency department (ED) visits each year include wound care, emergency care providers must remain experts in acute wound management. The variety of acute wounds presenting to the ED challenge the physician to select the most appropriate management to facilitate healing. A complete wound history along with anatomic and specific medical considerations for each patient provides the basis of decision making for wound management. It is essential to apply an evidence‐bas...

  8. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  9. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve.

  10. Advanced Distribution Management System

    Science.gov (United States)

    Avazov, Artur R.; Sobinova, Liubov A.

    2016-02-01

    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  11. Aide memoire for the management of gunshot wounds.

    Science.gov (United States)

    MacFarlane, C

    2002-07-01

    The hospitals in Johannesburg deal with about 4,000 gunshot wounds a year. Although most are from hand guns, a number are from high velocity, military-type weapons. Extensive experience has been built up and many lessons learned. Attention is directed to the actual damage inflicted rather than on theoretical predictions based on presumed velocity of the bullets involved, as this can often be misleading. Some patients are delayed in their presentation to emergency departments, in other cases several gunshot wound patients arrive at the same time, requiring appropriate triage and urgent management.

  12. Negative pressure wound therapy: clinical utility

    OpenAIRE

    Sandoz H

    2015-01-01

    Heidi Sandoz Accelerate CIC, Mile End Hospital, London, UK Abstract: Negative pressure wound therapy (NPWT), also known as topical negative pressure therapy, has been increasingly used in health care for the management of a wide variety of wounds over the last 2–3 decades. It is an advanced therapy that can be helpful to accelerate wound healing in both acute and chronic wounds by delivering negative pressure (suction) to the wound bed. More recent advancements in the application o...

  13. Advanced thermal management materials

    CERN Document Server

    Jiang, Guosheng; Kuang, Ken

    2012-01-01

    ""Advanced Thermal Management Materials"" provides a comprehensive and hands-on treatise on the importance of thermal packaging in high performance systems. These systems, ranging from active electronically-scanned radar arrays to web servers, require components that can dissipate heat efficiently. This requires materials capable of dissipating heat and maintaining compatibility with the packaging and dye. Its coverage includes all aspects of thermal management materials, both traditional and non-traditional, with an emphasis on metal based materials. An in-depth discussion of properties and m

  14. Maggot Debridement Therapy: Advancing to the Past in Wound Care.

    Science.gov (United States)

    Klaus, Kelsey; Steinwedel, Cynthia

    2015-01-01

    Maggot debridement therapy (MDT) is experiencing resurgence as an effective alternative to conventional mechanical debridement in nonhealing wounds, especially those with antibiotic-resistant organisms. MDT has antibiotic, antifungal, and anti-inflammatory properties. Military use is on the rise.

  15. Difficult wounds: radiation wounds

    International Nuclear Information System (INIS)

    In an era of modern radiotherapy, problems associated with the indiscriminate treatment of benign disease have largely disappeared. Skin sparing effects of super voltage radiation equipment make the problems previously seen with orthovoltage equipment less frequent. Vigilance on the part of the workers in the field, in general, protects from the disasters that befell Thomas Edison's laboratory assistant. Despite these modern advances, the reconstructive surgeon often faces problems of managing acute local radiation injury from accident following planned therapeutic radiation or the ulcerations and breakdowns seen months or years after radiation therapy. The single most serious hazard to surgery in radiated tissue is the lodgment of bacteria in this tissue rendered avascular by the radiation and secondary necrosis from the infection itself. The principles of management are no different from those used for other chronic granulating wounds: local wound care, appropriate topical antibacterial therapy, systemic antibiotics during the perioperative period and, most importantly, adequate soft tissue coverage

  16. [Gunshot wound to the kidney: case report and therapeutic management].

    Science.gov (United States)

    Maruschke, M; Hakenberg, O W

    2008-04-01

    Gunshot wounds to the kidney occur with different regional incidence. They are commonly combined with thoracic and abdominal injuries. Gunshot wounds may be caused by low-velocity or high-velocity bullets. The latter are usually used with military weapons and cause a higher degree of tissue damage. The therapeutic management of renal gunshot wounds has changed in recent decades resulting in more organ-preserving strategies. An imperative indication for surgical exploration of the kidney is critical renal bleeding with symptoms of hypovolaemic shock. We report the case of a 23-year-old male admitted to the hospital with combined gunshot wounds from a small-bore weapon with damage of the liver, stomach and the left kidney. There were no signs of thoracic injuries. The patient underwent transabdominal exploration with treatment of the liver and stomach lesions, removal of the bullet and preservation of the left kidney. A percutaneous nephrostomy and drainage of the retroperitoneal region were inserted; antibiotic prophylaxis was given. A 4-week postoperative intravenous pyelogram showed complete integrity of the upper left tract and good renal function.

  17. Recent advances on the development of wound dressings for diabetic foot ulcer treatment--a review.

    Science.gov (United States)

    Moura, Liane I F; Dias, Ana M A; Carvalho, Eugénia; de Sousa, Hermínio C

    2013-07-01

    Diabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches. PMID:23542233

  18. Field surgery on a future conventional battlefield: strategy and wound management.

    OpenAIRE

    Ryan, J M; Cooper, G. J.; Haywood, I. R.; Milner, S. M.

    1991-01-01

    Most papers appearing in the surgical literature dealing with wound ballistics concern themselves with wound management in the civilian setting. The pathophysiology of modern war wounds is contrasted with ballistic wounds commonly encountered in peacetime, but it should be noted that even in peacetime the modern terrorist may have access to sophisticated military weaponry, and that patients injured by them may fall within the catchment area of any civilian hospital. Management problems associ...

  19. Use of negative pressure wound therapy in the management of infected abdominal wounds containing mesh: an analysis of outcomes.

    Science.gov (United States)

    Baharestani, Mona Mylene; Gabriel, Allen

    2011-04-01

    The purpose of this study was to examine the clinical outcomes of negative pressure wound therapy (NPWT) using reticulated open-cell foam (ROCF) in the adjunctive management of abdominal wounds with exposed and known infected synthetic mesh. A non randomised, retrospective review of medical records for 21 consecutive patients with infected abdominal wounds treated with NPWT was conducted. All abdominal wounds contained exposed synthetic mesh [composite, polypropylene (PP), or knitted polyglactin 910 (PG) mesh]. Demographic and bacteriological data, wound history, pre-NPWT and comparative post-NPWT, operative procedures and complications, hospital length of stay (LOS) and wound healing outcomes were all analysed. Primary endpoints measured were (1) hospital LOS prior to initiation of NPWT, (2) total time on NPWT, (3) hospital LOS from NPWT initiation to discharge and (4) wound closure status at discharge. A total of 21 patients with abdominal wounds with exposed, infected mesh were treated with NPWT. Aetiology of the wounds was ventral hernia repair (n = 11) and acute abdominal wall defect (n = 10). Prior to NPWT initiation, the mean hospital LOS for the composite, PP and PG meshes were 76 days (range: 21-171 days), 51 days (range: 32-62 days) and 19 days (range: 12-39 days), respectively. The mean hospital LOS following initiation of NPWT for wounds with exposed composite, PP and PG mesh were 28, 31 and 32 days, respectively. Eighteen of the 21 wounds (86%) reached full closure after a mean time of 26 days of NPWT and a mean hospital LOS of 30 days postinitiation of NPWT. Three wounds, all with composite mesh left in situ, did not reach full closure, although all exhibited decreased wound dimensions, granulating beds and decreased surface area exposure of mesh. During NPWT/ROCF, one hypoalbuminemic patient with exposed PP mesh developed an enterocutaneous fistula over a prior enterotomy site. This patient subsequently underwent total mesh extraction, takedown of

  20. Wound healing and hyper-hydration - a counter intuitive model

    OpenAIRE

    Ousey, Karen; Cutting, Keith

    2016-01-01

    Winters seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle confusion may arise betwe...

  1. Managing Acute Wounds with Negative Pressure System in a Developing Country

    OpenAIRE

    Akpaloo, J.; Yorke, J.; Agbenorku, P.; Yenli, E. M. T.

    2013-01-01

    Introduction. The negative pressure system has been found to be a valuable addition to the various procedures of wound management and has been widely accepted to be safe and effective in promoting wound healing. Aim. The study seeks to find out the outcome of the use of the VAC device in the treatment of patients with acute wounds. Materials and Methods. Between January 2009 and December 2011, a consecutive nonrandomized study was conducted among 48 patients who presented with acute wounds at...

  2. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    LENUS (Irish Health Repository)

    Skerritt, Louise

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  3. Advanced glaucoma: Management pearls

    Directory of Open Access Journals (Sweden)

    Girum W Gessesse

    2013-01-01

    Full Text Available A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient′s perspective. The physician may also feel that they are in a difficult position managing the patient′s disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ′biopsychosociospiritual′ (BPSS profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health, psychological considerations (e.g., fear, depression, socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite, and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life.

  4. Nutrition in Wound Care Management: A Comprehensive Overview.

    Science.gov (United States)

    Quain, Angela M; Khardori, Nancy M

    2015-12-01

    Wound care is a multidisciplinary specialty requiring many physiologic and immunologic processes as well as physical, social, and societal factors to achieve successful wound closure. Most wounds are treated with combinations of antimicrobials, protective barriers, and topical growth agents, including skin and biologic grafts.The role of nutrition in wound healing may be overlooked in the wound care patient. Like the specialty, it is often multifaceted, with many nutritional components playing a variety of roles in the wound healing process. Suboptimal nutrition can alter immune function, collagen synthesis, and wound tensile strength, all of which are essential in the wound healing process. It is also important to remember that not all wounds are equal: a burn is different from a diabetic foot ulcer, which is different from a pressure ulcer. Nonetheless, nutrition is a common denominator for all wound patients, and what is studied in 1 wound population is often relevant in another. Due to the complexities of monitoring and measuring both wound healing and dietary intake, randomized, controlled trials of wound care patients are difficult to conduct, and much of the data concerning nutrition in wound care relies on combined supplements. In summary, it appears that some nutrients are necessary only if deficient, whereas others may become conditionally essential and serve a therapeutic role. All of the nutrients discussed should be viewed as a component of a broader, complete diet. This article is a summary of wound healing and the roles of a variety of macronutrients and micronutrients in the process. PMID:27447105

  5. Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

    Science.gov (United States)

    Meloni, Marco; Izzo, Valentina; Vainieri, Erika; Giurato, Laura; Ruotolo, Valeria; Uccioli, Luigi

    2015-01-01

    Diabetic foot (DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers (DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy (NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs. PMID:25992316

  6. Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

    Directory of Open Access Journals (Sweden)

    Fahmida Alam

    2014-01-01

    Full Text Available Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey’s antibacterial activity on diabetic wound-related microorganisms and honey’s clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.

  7. Wound management and the use of mouth rinse in mandibular third molar surgery.

    Science.gov (United States)

    Vlcek, Daniel; Razavi, Amir; Kuttenberger, Johannes J

    2015-01-01

    The aim of this survey was to assess the knowledge and practice of Swiss dentists regarding wound management and the use of mouth rinse in surgical removal of mandibular third molars (MTM). A postal survey was conducted among all 3,288 dentists who are members of the Swiss Dental Society (SSO) representing the majority of dentists in Switzerland. The questionnaire consisted of 13 questions with mostly multiple-choice answers. Demographic profile, surgical experience, the use of antibiotics, and wound management, i.e. wound closure and the use of mouth rinse were assessed. The response rate was 55%. Semi-closed (59.1%), closed (19%) and open wound management (11.7%) were applied most often. Semi-closed wound management was preferred in the German-speaking region (67%) and closed wound management was preferred in the French-speaking region (55%). For semi-closed wound healing, drains impregnated with terra-cortril (42%) and iodoform-Vaseline (40%) were used. For closed wound management, most dentists reported leaving the wound to heal with the blood clot only (60.5%). Most dentists (74.5%) prescribed chlorhexidine 0.2% (CHX) mouth rinse when performing MTM surgery and a combination of immediate preoperative and postoperative use was preferred. Semi-closed wound management with drain and CHX mouth rinse is frequently used in Switzerland in the perioperative management in MTM surgery. It is a well-documented procedure leading to favourable outcomes without using any systemic antibiotics. However, wound management techniques differ between the three linguistic regions. PMID:26472719

  8. Preparing Student Nurses for the Future of Wound Management: Telemedicine in a Simulated Learning Enviroment

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2015-01-01

    was to integrate the concept of telemedicine for wound care into a simulation-based class for undergraduate student nurses and to evaluate their experiences with this integrated learning method. Methods: Five medium-fidelity mannequins were used in a simulated learning environment consisting of a simulated...... laboratory and a simulated wound clinic. A primitive electronic platform was used to allow the students to experience the benefits and challenges of telemedicine in wound care. At the end of the course, the students were asked to evaluate the course based on their experiences with telemedicine and simulation......Background: The Danish Society for Wound Healing advocates for the use of telemedicine in chronic wound management. It is crucial that student nurses are prepared for the technological demands of the future so that they will be competent to manage chronic wounds. Aim: The aim of this project...

  9. Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery

    OpenAIRE

    Karlakki, S.; Brem, M.; Giannini, S.; Khanduja, V.; Stannard, J; R. Martin

    2013-01-01

    Objectives The period of post-operative treatment before surgical wounds are completely closed remains a key window, during which one can apply new technologies that can minimise complications. One such technology is the use of negative pressure wound therapy to manage and accelerate healing of the closed incisional wound (incisional NPWT). Methods We undertook a literature review of this emerging indication to identify evidence within orthopaedic surgery and other surgical disciplines. Liter...

  10. Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management

    DEFF Research Database (Denmark)

    Gottrup, F; Apelqvist, J; Price, P

    2010-01-01

    While there is a consensus that clinical practice should be evidence based, this can be difficult to achieve due to confusion about the value of the various approaches to wound management. To address this, the European Wound Management Association (EWMA) set up a Patient Outcome Group whose remit...

  11. NEGATIVE PRESSURE WOUND THERAPY (NPWT FOR THE MANAGEMENT OF DIABETIC FOOT WOUND

    Directory of Open Access Journals (Sweden)

    Wesiana Heris Santy

    2015-11-01

    Full Text Available Complications often experienced by people with diabetes are complications in the feet ( 15 % called diabetic foot ( Akhtyo , 2009 . Where the injury to the leg if not treated properly will lead to infections and ultimately need to be amputated .The purpose of writing articles is to review and discuss the evidence-based literature bersadarkanpraktice of Negative Pressure Wound Therapy Effectiveness ( NPWT on the healing of diabetic foot ulcers.One technology that is used to prevent and avoid lower limb amputation is the technique of negative pressure or Negative Pressure Wound Therapy ( NPWT . This negative pressure technique has grown rapidly and now has been widely used in many countries , especially in Western European countries ( Germany and the United States . Negative pressure technique has the advantage that it is relatively cheaper cost than the use of hyperbaric oxygen . Results obtained by several studies that the use of NPWT may improve wound healing process through efforts to create a moist wound environment and decrease edema that becomes optimal wound healing , throw that out of the wound exudate so that the protease enzyme in the exudate also go wasted , this enzyme is known to interfere wound healing process . The other benefit is that it can stimulate cell growth by increasing angiogenesis physically , so that the growth of new cells will be maximal Abstrak : Komplikasi sering dialami pengidap diabetes adalah komplikasi pada kaki (15% disebut kaki diabetes (Akhtyo, 2009.Dimana luka pada kaki jika tidak ditangani dengan baik akan menyebabkan terjadinya infeksi dan akhirnya perlu di amputasi. Tujuan penulisan artikel adalah mengkaji dan membahas literature bersadarkan evidence based praktice  tentang Efektifitas Negative Pressure Wound Therapy (NPWT pada penyembuhan ulkus kaki Diabetik. Salah satu teknologi yang digunakan untuk mencegah dan menghindari amputasi ekstremitas bawah adalah  teknik tekanan negatif atau Negative

  12. [Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism].

    Science.gov (United States)

    Liu, Yi

    2016-06-01

    With the development of social economy, people's lifestyle has changed accompanied with the problem of population aging. The spectrum of disease also varied accordingly, thus led to complicated and varied wound aetiology, along with the formation of innumerably changed acute and chronic wounds. Therefore, it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline. The extraordinary agent wound is caused by some uncommon or rare etiological factors, the specialty of which lays on the unique mechanism of wound formation, and a lot of disciplines were involved in the diagnosis and management of the wound. A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology. The primary diseases which induced the uncommon agent wound should be targeted and treated effectively; meanwhile, a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment.

  13. [Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism].

    Science.gov (United States)

    Liu, Yi

    2016-06-01

    With the development of social economy, people's lifestyle has changed accompanied with the problem of population aging. The spectrum of disease also varied accordingly, thus led to complicated and varied wound aetiology, along with the formation of innumerably changed acute and chronic wounds. Therefore, it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline. The extraordinary agent wound is caused by some uncommon or rare etiological factors, the specialty of which lays on the unique mechanism of wound formation, and a lot of disciplines were involved in the diagnosis and management of the wound. A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology. The primary diseases which induced the uncommon agent wound should be targeted and treated effectively; meanwhile, a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment. PMID:27321484

  14. Burn wound: Pathophysiology and its management by herbal plants

    Directory of Open Access Journals (Sweden)

    Dhirender Kaushik

    2013-01-01

    Full Text Available In human body, wound healing is a normal biological phenomenon. Burns may be acute or chronic depending upon the source and its time of exposure. Burn wounds may be superficial, partial or full thickness wounds. When skin comes in contact with higher temperature, protein denaturation takes place due to which the plasma membrane integrity is lost. When skin is burned, a number of inflammatory mediators and releasing agents such as histamine, nitric oxide, oxygen free radicals, eicosanoid products, tumor necrosis factors, and interleukins etc., are released at the site. For wound healing mechanism, the keratinocytes has to move from uninjured site to the burned area. For deeper burns this process takes a long time. By some unknown mechanisms, burn wounds may convert from one form to another form. So burn wound depth must be accurately measured before starting the treatment to prevent the complications. Burns can be induced in experimental animals by using different models. Many treatments such as herbal drugs, topical agents, gene therapy, volume therapy, and rehabilitation can be employed. This review article mainly deals with the theoretical and practical aspects of burn wound healing. Some burn wound healing plants with their chemical constituents, plant part used, uses and animal models are described here.

  15. [Advances in the mechanism of mesenchymal stem cells in promoting wound healing].

    Science.gov (United States)

    Zhu, Wenjing; Sun, Haobo; Lyu, Guozhong

    2015-12-01

    Mesenchymal stem cells possess the ability of self-renewal and multiple differentiation potential, thus exert immunomodulatory effect during tissue repair. Mesenchymal stem cells can stimulate angiogenesis and promote tissue repair through transdifferentiation and secreting a variety of growth factors and cytokines. This review outlines the advances in the mechanism of mesenchymal stem cells in promoting wound healing, including alleviation of inflammatory response, induction of angiogenesis, and promotion of migration of mesenchymal stem cells to the site of tissue injury.

  16. Management of advanced corneal ectasias.

    Science.gov (United States)

    Maharana, Prafulla K; Dubey, Aditi; Jhanji, Vishal; Sharma, Namrata; Das, Sujata; Vajpayee, Rasik B

    2016-01-01

    Corneal ectasias include a group of disorders characterised by progressive thinning, bulging and distortion of the cornea. Keratoconus is the most common disease in this group. Other manifestations include pellucid marginal degeneration, Terrien's marginal degeneration, keratoglobus and ectasias following surgery. Advanced ectasias usually present with loss of vision due to high irregular astigmatism. Management of these disorders is difficult due to the peripheral location of ectasia and associated severe corneal thinning. Newer contact lenses such as scleral lenses are helpful in a selected group of patients. A majority of these cases requires surgical intervention. This review provides an update on the current treatment modalities available for management of advanced corneal ectasias. PMID:26294106

  17. Evaluation of an off-the-shelf mobile telemedicine model in emergency department wound assessment and management.

    Science.gov (United States)

    Van Dillen, Christine; Silvestri, Salvatore; Haney, Marisa; Ralls, George; Zuver, Christian; Freeman, Dave; Diaz, Lissa; Papa, Linda

    2013-02-01

    We examined the agreement between a videoconference-based evaluation and a bedside evaluation in the management of acute traumatic wounds in an emergency department. Adult and paediatric patients with acute wounds of various severities to the face, trunk and/or extremities presenting to the emergency department within 24 hours of injury were enrolled. Research assistants transmitted video images of the wound to an emergency physician using a laptop computer. The physician completed a standard wound assessment form before conducting a bedside evaluation and then completing a second assessment form. The primary outcome measure was wound length and depth. We also assessed management decision-making. A total of 173 wounds were evaluated. The correlation coefficient between video and bedside assessments was 0.96 for wound length. The mean difference between the lengths was 0.02 cm (SD 0.91). Management of the wound would have been the same in 94% of cases. The agreement on wound characteristics and wound management ranged from 84-100%. The highest correlation was 0.92 in suture material used and the lowest correlation was 0.64 in wound type. The ability of video images to distinguish between a minor and non-minor wound, and predicting the need for hospital management, had high degrees of sensitivity and specificity. The study showed that wound characteristics and management decisions appear to correlate well between video and bedside evaluations.

  18. Terapija s kontroliranim negativnim tlakom: Negative wound pressure therapy:

    OpenAIRE

    Ciringer, Miha; Smrke, Dragica; TRILLER, CIRIL

    2011-01-01

    Wound management represents a great burden for the patients' quality of life and also for the healthcare expenditures. The understanding of the complex cellular and molecular mechanisms involved in the healing process enabled the recent development in the field of wound dressing. One of the recent advances in the field is the negative wound pressure therapy. This modern wound dressing consists of a special foam or gauze that fills the entire wound volume and a microprocessor guided pump that ...

  19. Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

    OpenAIRE

    Stanirowski, Paweł Jan; Wnuk, Anna; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2015-01-01

    Purpose The last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention an...

  20. Organization and management of the treatment for the wounded in 8.12 Tinjin Port Explosion, China

    Institute of Scientific and Technical Information of China (English)

    Xiao-Xia Guo; Zhi-Jun Li; Hui Li; Zhi-Xiang Zhang; Cong-Zhe Xu; Bin Zhu

    2015-01-01

    Tianjin Medical University General Hospital treated 233 wounded in 8.12 Tinjin Port explosion.Here we would like to analyze the treatment process for the wounded, and share the experiences of organization and management for emergency rescue operation.

  1. Effects and mechanisms of a microcurrent dressing on skin wound healing:a review

    Institute of Scientific and Technical Information of China (English)

    Chao Yu; Zong-Qian Hu; Rui-Yun Peng

    2014-01-01

    The variety of wound types has resulted in a wide range of wound dressings, with new products frequently being introduced to target different aspects of the wound healing process. The ideal wound dressing should achieve rapid healing at a reasonable cost, with minimal inconvenience to the patient. Microcurrent dressing, a novel wound dressing with inherent electric activity, can generate low-level microcurrents at the device-wound contact surface in the presence of moisture and can provide an advanced wound healing solution for managing wounds. This article offers a review of the effects and mechanisms of the microcurrent dressing on the healing of skin wounds.

  2. NEGATIVE PRESSURE WOUND THERAPY (NPWT) FOR THE MANAGEMENT OF DIABETIC FOOT WOUND

    OpenAIRE

    Wesiana Heris Santy

    2015-01-01

    Complications often experienced by people with diabetes are complications in the feet ( 15 % ) called diabetic foot ( Akhtyo , 2009) . Where the injury to the leg if not treated properly will lead to infections and ultimately need to be amputated .The purpose of writing articles is to review and discuss the evidence-based literature bersadarkanpraktice of Negative Pressure Wound Therapy Effectiveness ( NPWT ) ) on the healing of diabetic foot ulcers.One technology that is used to prevent and ...

  3. Advances in Management of Retinoblastoma

    Institute of Scientific and Technical Information of China (English)

    Kensei; Minoda

    1992-01-01

    Retinobiastoma is a highly malignant intraocular tumor of children that requires accurate diagnosis to prompt treatment. This article reviewed clinical, pathological and follow-up data on 1 147 cases of retinobiastoma registered in Japan from 1975 to 1982. It is obvious that the prognosis of children with retinobiastoma has improved remarkably in recent years. The current advances in the management of the retinobiastoma were discussed.

  4. Medical management of radio-contaminated wounded by the French military health service

    International Nuclear Information System (INIS)

    The French armed forces health service has set up in France specialized installation only designed and used to take care of radio contaminated patients. These installations can be used for the military and for the civilians, e.g. in case of an accident in a civilian nuclear installation or in case of terrorist attack with a few injured. The main principles of the medical management of a radio contaminated wounded are: - Trauma care is the first priority, - External decontamination has to be treated as fast and reasonably as possible, - Medical treatment for internal contamination is more efficiency that is given earlier (stable iodine, DTPA). Three type of installations have been developed to take charge of contaminated patient or with a suspicion of contamination: - The hasty decontamination post, to take into account the involved victims physically fit, - The advance post for radio-contaminated wounded (P.A.B.R.C.), for the relative emergency whom evacuation can be delayed after medical examination, - The center for the treatment of radio-contaminated wounded(C.T.B.R.C.), in an hospital area, for the absolute emergencies (needing some resuscitation and emergency surgery for saving life, like stopping an hemorrhage). Each military hospital in France has is own C.T.B.R.C. These structures are dedicated to the decontamination, that means that all type of decontamination would be conducted here: skin decontamination, internal decontamination by specific de-contaminant if needed, and decontamination of a contaminated wound by surgical means. This type of surgery might be associated with a precise detection. At his arrival, in a first time, the victim is examined by an emergency physician who is in charge of the structure. Secondly, he makes a triage concerning the medical emergency to identify the type of emergency, life threatening emergency or not. - If the patient is a critical case then the medical treatment takes precedence over contamination - If the patient is

  5. Gauze-based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum.

    Science.gov (United States)

    Fraccalvieri, Marco; Fierro, Maria Teresa; Salomone, Marco; Fava, Paolo; Zingarelli, Enrico M; Cavaliere, Giovanni; Bernengo, Maria G; Bruschi, Stefano

    2014-04-01

    Pyoderma gangrenosum (PG) is an uncommon ulcerative, non-infective chronic inflammatory skin disorder of unknown aetiology. Systemic therapies are necessary to control the associated medical diseases, and, due to the inflammatory nature of PG, topical or systemic immunosuppressant agents are effective, but wound healing is usually slow. Negative wound pressure therapy (NPWT) has become an important tool for the management of complex skin ulcers, and usage in PG has been recently described in the literature: we present four cases of classic PG in which NPWT in association with systemic therapy achieved wound healing and a drastic pain reduction. PMID:22891652

  6. Recent advances in lightweight, filament-wound composite pressure vessel technology

    Science.gov (United States)

    Lark, R. F.

    1977-01-01

    A review of recent advances is presented for lightweight, high performance composite pressure vessel technology that covers the areas of design concepts, fabrication procedures, applications, and performance of vessels subjected to single cycle burst and cyclic fatigue loading. Filament wound fiber/epoxy composite vessels were made from S glass, graphite, and Kevlar 49 fibers and were equipped with both structural and nonstructural liners. Pressure vessels structural efficiencies were attained which represented weight savings, using different liners, of 40 to 60 percent over all titanium pressure vessels. Significant findings in each area are summarized.

  7. Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management

    DEFF Research Database (Denmark)

    Gottrup, F; Apelqvist, J; Price, P

    2010-01-01

    was to produce recommendations on clinical data collection in wound care. This document, produced by the group and disseminated by JWC, identifies criteria for producing rigorous outcomes in both randomised controlled trials and clinical studies, and describes how to ensure studies are consistent......While there is a consensus that clinical practice should be evidence based, this can be difficult to achieve due to confusion about the value of the various approaches to wound management. To address this, the European Wound Management Association (EWMA) set up a Patient Outcome Group whose remit...

  8. Recent advances on the association of apoptosis in chronic non healing diabetic wound

    OpenAIRE

    Arya, Awadhesh K; Tripathi, Richik; Kumar, Santosh; Tripathi, Kamlakar

    2014-01-01

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement...

  9. Surgical wound management with adhesive polyurethane membrane: a preferred method for routine usage

    OpenAIRE

    Tinckler, L.

    1984-01-01

    The author gives an account of his experience of the use in some 1600 patients of adhesive polyurethane membrane, marketed as Op-site, both for skin closure and wound dressing, in combination, as a routine method of surgical wound management in a wide variety of surgical operations. The technique of utilising this method is described in detail, as also are the advantages for patients, nursing and medical staff.

  10. Compression, collagen and bacteria-binding: different approaches for wound management.

    Science.gov (United States)

    Fronzo, C

    2016-06-01

    In May 2016, BSN medical hosted three clinical symposia at the EWMA conference in Bremen, Germany. These introduced the challenges of managing wounds in patients with CVD, the potential of collagen-based products to stimulate wound healing, and the combination of bacteria-binding dressings with NPWT. Camila Fronzo, JWC chief sub editor, was there to summarise the main points of each session. PMID:27286669

  11. Advances in water resources management

    CERN Document Server

    Yang, Chih; Wang, Mu-Hao

    2016-01-01

    This volume provides in-depth coverage of such topics as multi-reservoir system operation theory and practice, management of aquifer systems connected to streams using semi-analytical models, one-dimensional model of water quality and aquatic ecosystem-ecotoxicology in river systems, environmental and health impacts of hydraulic fracturing and shale gas, bioaugmentation for water resources protection, wastewater renovation by flotation for water pollution control, determination of receiving water’s reaeration coefficient in the presence of salinity for water quality management, sensitivity analysis for stream water quality management, river ice process, and computer-aided mathematical modeling of water properties. This critical volume will serve as a valuable reference work for advanced undergraduate and graduate students, designers of water resources systems, and scientists and researchers. The goals of the Handbook of Environmental Engineering series are: (1) to cover entire environmental fields, includin...

  12. Management of stab wounds to the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    João Baptista Rezende-Neto

    2014-01-01

    Full Text Available The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE, through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.

  13. Wearable light management system for light stimulated healing of large area chronic wounds (Conference Presentation)

    Science.gov (United States)

    Kallweit, David; Mayer, Jan; Fricke, Sören; Schnieper, Marc; Ferrini, Rolando

    2016-03-01

    Chronic wounds represent a significant burden to patients, health care professionals, and health care systems, affecting over 40 million patients and creating costs of approximately 40 billion € annually. We will present a medical device for photo-stimulated wound care based on a wearable large area flexible and disposable light management system consisting of a waveguide with incorporated micro- and nanometer scale optical structures for efficient light in-coupling, waveguiding and homogeneous illumination of large area wounds. The working principle of this innovative device is based on the therapeutic effects of visible light to facilitate the self-healing process of chronic wounds. On the one hand, light exposure in the red (656nm) induces growth of keratinocytes and fibroblasts in deeper layers of the skin. On the other hand, blue light (453nm) is known to have antibacterial effects predominately at the surface layers of the skin. In order to be compliant with medical requirements the system will consist of two elements: a disposable wound dressing with embedded flexible optical waveguides for the light management and illumination of the wound area, and a non-disposable compact module containing the light sources, a controller, a rechargeable battery, and a data transmission unit. In particular, we will report on the developed light management system. Finally, as a proof-of-concept, a demonstrator will be presented and its performances will be reported to demonstrate the potential of this innovative device.

  14. Management of wound infection after lumbar arthrodesis maintaining the instrumentation

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2015-06-01

    Full Text Available OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.RESULTS: Mean age was 59.31 (±13.17 years old and most patients were female (94.7%; 18/19. The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.CONCLUSION: Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.

  15. [Advances in the effects of pH value of micro-environment on wound healing].

    Science.gov (United States)

    Tian, Ruirui; Li, Na; Wei, Li

    2016-04-01

    Wound healing is a complex regeneration process, which is affected by lots of endogenous and exogenous factors. Researches have confirmed that acid environment could prevent wound infection and accelerate wound healing by inhibiting bacteria proliferation, promoting oxygen release, affecting keratinocyte proliferation and migration, etc. In this article, we review the literature to identify the potential relationship between the pH value of wound micro-environment and the progress of wound healing, and summarize the clinical application of variation of pH value of micro-environment in wound healing, thereby to provide new treatment strategy for wound healing.

  16. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    OpenAIRE

    Hasan, Muhammed Y.; Teo, Rachel; Nather, Aziz

    2015-01-01

    Negative-pressure wound therapy (NPWT) plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, ...

  17. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  18. Wound care with traditional, complementary and alternative medicine

    OpenAIRE

    Ananda A Dorai

    2012-01-01

    Wound 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. T...

  19. Management of penetrating abdominal and thoraco-abdominal wounds: A retrospective study of 186 patients.

    Science.gov (United States)

    Barbois, S; Abba, J; Guigard, S; Quesada, J L; Pirvu, A; Waroquet, P A; Reche, F; Risse, O; Bouzat, P; Thony, F; Arvieux, C

    2016-08-01

    This is a single center retrospective review of abdominal or abdomino-thoracic penetrating wounds treated between 2004 and 2013 in the gastrointestinal and emergency unit of the university hospital of Grenoble, France. This study did not include patients who sustained blunt trauma or non-traumatic wounds, as well as patients with penetrating head and neck injury, limb injury, ano-perineal injury, or isolated thoracic injury above the fifth costal interspace. In addition, we also included cases that were reviewed in emergency department morbidity and mortality conferences during the same period. Mortality was 5.9% (11/186 patients). Mean age was 36 years (range: 13-87). Seventy-eight percent (145 patients) suffered stab wounds. Most patients were hemodynamically stable or stabilized upon arrival at the hospital (163 patients: 87.6%). Six resuscitative thoracotomies were performed, five for gunshot wounds, one for a stab wound. When abdominal exploration was necessary, laparotomy was chosen most often (78/186: 41.9%), while laparoscopy was performed in 46 cases (24.7%), with conversion to laparotomy in nine cases. Abdominal penetration was found in 103 cases (55.4%) and thoracic penetration in 44 patients (23.7%). Twenty-nine patients (15.6%) had both thoracic and abdominal penetration (with 16 diaphragmatic wounds). Suicide attempts were recorded in 43 patients (23.1%), 31 (72.1%) with peritoneal penetration. Two patients (1.1%) required operation for delayed peritonitis, one who had had a laparotomy qualified as "negative", and another who had undergone surgical exploration of his wound under general anesthesia. In conclusion, management of clear-cut or suspected penetrating injury represents a medico-surgical challenge and requires effective management protocols. PMID:27318585

  20. In Vitro Models in BiocompatibilityAssessment for Biomedical-Grade Chitosan Derivatives in Wound Management

    Directory of Open Access Journals (Sweden)

    Lim Chin Keong

    2009-03-01

    Full Text Available One of the ultimate goals of wound healing research is to find effective healing techniques that utilize the regeneration of similar tissues. This involves the modification of various wound dressing biomaterials for proper wound management. The biopolymer chitosan (b-1,4-D-glucosamine has natural biocompatibility and biodegradability that render it suitable for wound management. By definition, a biocompatible biomaterial does not have toxic or injurious effects on biological systems. Chemical and physical modifications of chitosan influence its biocompatibility and biodegradability to an uncertain degree. Hence, the modified biomedical-grade of chitosan derivatives should be pre-examined in vitro in order to produce high-quality, biocompatible dressings. In vitro toxicity examinations are more favorable than those performed in vivo, as the results are more reproducible and predictive. In this paper, basic in vitro tools were used to evaluate cellular and molecular responses with regard to the biocompatibility of biomedical-grade chitosan. Three paramount experimental parameters of biocompatibility in vitro namely cytocompatibility, genotoxicity and skin pro-inflammatory cytokine expression, were generally reviewed for biomedical-grade chitosan as wound dressing.

  1. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment.

    Science.gov (United States)

    Topaz, Moris

    2012-05-01

    Regulated negative pressure-assisted wound therapy (RNPT) should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound's environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT) is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review. PMID:23162229

  2. Recent advances on the association of apoptosis in chronic non healing diabetic wound

    Institute of Scientific and Technical Information of China (English)

    Awadhesh; K; Arya; Richik; Tripathi; Santosh; Kumar; Kamlakar; Tripathi

    2014-01-01

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophagesand myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.

  3. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

    Directory of Open Access Journals (Sweden)

    Moris Topaz

    2012-01-01

    Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  4. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    Science.gov (United States)

    Hasan, Muhammed Y.; Teo, Rachel; Nather, Aziz

    2015-01-01

    Negative-pressure wound therapy (NPWT) plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. This review article summarizes current knowledge about the role of NPWT in the management of the diabetic foot and its mode of action, clinical applications, and recent developments. PMID:26140663

  5. Growth modulation of fibroblasts by chitosan-polyvinyl pyrrolidone hydrogel: Implications for wound management?

    Indian Academy of Sciences (India)

    Makarand Risbud; Anandwardhan Hardikar; Ramesh Bhonde

    2000-03-01

    Wounds in adults and fetuses differ in their healing ability with respect to scar formation. In adults, wounds lacking the epidermis exhibit excess collagen production and scar formation. Fibroblasts synthesize and deposit a collagen rich extracellular matrix. The early migration and proliferation of fibroblasts in the wound area is implicated in wound scarring. We have synthesized a hydrogel from chitosan-polyvinyl pyrrolidone (PVP) and examined its effect on fibroblast growth modulation in vitro. The hydrogel was found to be hydrophilic as seen from its octane contact angle (141·2 ± 0·37°). The hydrogel was non-toxic and biocompatible with fibroblasts and epithelial cells as confirmed by the 3(4,5-dimethylthiazolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) assay. It showed dual properties by supporting growth of epithelial cells (SiHa) and selectively inhibiting fibroblast (NIH3T3) growth. Growth inhibition of fibroblasts resulted from their inability to attach on to the hydrogel. These findings are supported by image analysis, which revealed a significant difference ( < 0·05) between the number of fibroblasts attached to the hydrogel in tissue culture as compared to tissue culture treated polystyrene (TCPS) controls. However, no significant difference was observed ( > 0·05) in the number of epithelial (SiHa) cells attached on to the hydrogel as compared to the TCPS control. Although in vivo experiments are awaited, these findings point to the possible use of chitosan-PVP hydrogels in wound-management.

  6. [Advances in the research of treating refractory diabetic wounds with stem cells].

    Science.gov (United States)

    Gong, Jiahong; Lu, Shuliang

    2014-12-01

    With the growth of aging society, China has become the country of population with the highest incidence of diabetes in the world. Diabetes leads to pathological changes in vascular and nervous system, rendering the diabetic skin fragile and hard to heal if wounded; in the end most diabetic wounds tend to become chronic skin ulcers. The refractory diabetic wound is the result of various endogenous and exogenous factors. It is a quite complicated pathophysiologic event which lacks an effective and specific therapeutic method in clinic. The use of stem cells could be a new approach of treating diabetic chronic wounds since they have a potential ability of self-renovation and multi-directional differentiation which will promote angiogenesis and wound healing process, thus be beneficial in the care of ischemia diseases of the lower limb. This article reviews basic theory of treating diabetic wound and the changes in microenvironment, and prompts many successful cases in curing refractory diabetic wounds.

  7. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Diaa Othman

    2012-01-01

    Full Text Available This is a paper reviewing the National Health Service (NHS agenda in relation to the use of Negative Pressure Wound Therapy (NPWT in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  8. Microsoft System Center Configuration Manager advanced deployment

    CERN Document Server

    Coupland, Martyn

    2014-01-01

    If you are an experienced Configuration Manager administrator looking to advance your career or get more from your current environment, then this book is ideal for you. Prior experience of deploying and managing a Configuration Manager site would be helpful in following the examples throughout this book.

  9. Comparisons in the Medical Management of Three Cases of Plutonium-Contaminated Wounds

    International Nuclear Information System (INIS)

    Three cases are described having small wounds on the fingers contaminated by plutonium. In each patient routine decontamination procedures were carried out which were sufficiently rigorous to ensure that all contamination was removed from the intact skin leaving only that remaining in the depths of the wound. The medical management of these patients followed much the same sort of pattern in each case, i.e. excision of the wound was undertaken and this was either preceded or followed by the intravenous administration of DTPA. However, the times at which these various procedures were carried out varied in relation to each other and to the time of injury, and, therefore, one of the purposes of this paper is to discuss the effect of this time variation on the ultimate wound and total body content of plutonium. In one of the patients an attempt has been made to define the relative effectiveness of small and large quantities of DTPA on urinary plutonium excretion, this being achieved by the alternative administration of the DTPA in doses of 1 g and 0.1 g. (author)

  10. [Advances in the research of an animal model of wound due to Mycobacterium tuberculosis infection].

    Science.gov (United States)

    Chen, Ling; Jia, Chiyu

    2015-12-01

    Tuberculosis ranks as the second deadly infectious disease worldwide. The incidence of tuberculosis is high in China. Refractory wound caused by Mycobacterium tuberculosis infection ranks high in misdiagnosis, and it is accompanied by a protracted course, and its pathogenic mechanism is still not so clear. In order to study its pathogenic mechanism, it is necessary to reproduce an appropriate animal model. Up to now the study of the refractory wound caused by Mycobacterium tuberculosis infection is just beginning, and there is still no unimpeachable model for study. This review describes two models which may reproduce a wound similar to the wound caused by Mycobacterium tuberculosis infection, so that they could be used to study the pathogenesis and characteristics of a tuberculosis wound in an animal.

  11. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    LENUS (Irish Health Repository)

    2012-02-01

    Aim. To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. Design. The study used a survey method. Methods. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Results. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. Conclusion. Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. Relevance to clinical practice. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The

  12. Increasing the options for management of large and complex chronic wounds with a scalable, closed-system dressing for maggot therapy.

    Science.gov (United States)

    Felder, John M; Hechenbleikner, Elizabeth; Jordan, Marion; Jeng, James

    2012-01-01

    As reconstructive specialists, burn surgeons are often involved in managing large wounds of various etiologies. Such wounds can pose a management challenge, especially if they are chronic or occur in the setting of critical illness or multiple medical comorbidities. Medical maggots are an effective, selective, and low-risk method for wound debridement. However, their use in large and geometrically complex wounds is limited by the lack of scalability in currently available dressings, which are appropriate for smaller wounds but become cumbersome and ineffective in larger ones. This report describes a novel dressing designed for application of maggot debridement therapy in large and complex wounds. The authors then discuss how use of this dressing may create new management strategies for such wounds by allowing maggots to mechanically debride big, infected wounds. They describe the construction of a maggot containment dressing based on modified components from a negative pressure wound therapy system and provide a case report highlighting its successful clinical use in a large contaminated chronic wound resulting from Fournier's gangrene. In the case described, the novel dressing provided scalability, containment of maggots, control of secretions, and ease of use. The dressing created an environment suitable for maggot survival and allowed effective debridement of a heavily contaminated groin wound. The novel dressing described is shown to function appropriately, allowing controlled use of maggots for effective debridement of large, irregular wounds. Facilitating the use of maggots in such wounds may broaden the algorithm for their management.

  13. Electrospun nanofibers as dressings for chronic wound care: advances, challenges, and future prospects.

    Science.gov (United States)

    Abrigo, Martina; McArthur, Sally L; Kingshott, Peter

    2014-06-01

    Chronic non-healing wounds show delayed and incomplete healing processes and in turn expose patients to a high risk of infection. Treatment currently focuses on dressings that prevent microbial infiltration and keep a balanced moisture and gas exchange environment. Antibacterial delivery from dressings has existed for some time, with responsive systems now aiming to trigger release only if infection occurs. Simultaneously, approaches that stimulate cell proliferation in the wound and encourage healing have been developed. Interestingly, few dressings appear capable of simultaneously impairing or treating infection and encouraging cell proliferation/wound healing. Electrospinning is a simple, cost-effective, and reproducible process that can utilize both synthetic and natural polymers to address these specific wound challenges. Electrospun meshes provide high-surface area, micro-porosity, and the ability to load drugs or other biomolecules into the fibers. Electrospun materials have been used as scaffolds for tissue engineering for a number of years, but there is surprisingly little literature on the interactions of fibers with bacteria and co-cultures of cells and bacteria. This Review examines the literature and data available on electrospun wound dressings and the research that is required to develop smart multifunctional wound dressings capable of treating infection and healing chronic wounds.

  14. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated. PMID:1603689

  15. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  16. Advanced Interval Management: A Benefit Analysis

    Science.gov (United States)

    Timer, Sebastian; Peters, Mark

    2016-01-01

    This document is the final report for the NASA Langley Research Center (LaRC)- sponsored task order 'Possible Benefits for Advanced Interval Management Operations.' Under this research project, Architecture Technology Corporation performed an analysis to determine the maximum potential benefit to be gained if specific Advanced Interval Management (AIM) operations were implemented in the National Airspace System (NAS). The motivation for this research is to guide NASA decision-making on which Interval Management (IM) applications offer the most potential benefit and warrant further research.

  17. Training Australian military health care personnel in the primary care of maxillofacial wounds from improvised explosive devices.

    Science.gov (United States)

    Reed, B E; Hale, R G

    2010-06-01

    Severe facial wounds frequently result from improvised explosive devices (IEDs) as the face is still vulnerable despite advances in personal protection of soldiers. In contrast to the poor outcomes with civilian maxillofacial trauma management methods initially employed by the US Army for maxillofacial wounds from IEDs, advances in wound management methods for such injuries by the US Army have resulted in significant improvements in appearance and function. This article describes the features of a short course in the primary management of combat related maxillofacial wounds for deployed health care personnel who may not be facial specialists, including contemporary treatment techniques for those confronting wounds from IEDs which are explained in this course.

  18. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    Directory of Open Access Journals (Sweden)

    Muhammed Y. Hasan

    2015-07-01

    Full Text Available Negative-pressure wound therapy (NPWT plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. This review article summarizes current knowledge about the role of NPWT in the management of the diabetic foot and its mode of action, clinical applications, and recent developments.

  19. Debridement Techniques in Pediatric Trauma and Burn-Related Wounds

    Science.gov (United States)

    Block, Lisa; King, Timothy W.; Gosain, Ankush

    2015-01-01

    Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5–7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds. Data concerning methods, volume, solution and timing for irrigation of acute traumatic wounds, timing and methods of wound debridement, including hydrosurgery and plasma knife coblation, and wound dressings are presented. Additionally, data concerning the long-term psychosocial outcomes following acute injury are presented. Critical Issues: The care of pediatric trauma and burn-related wounds requires prompt assessment, pain control, cleansing, debridement, application of appropriate dressings, and close follow-up. Ideally, a knowledgeable multidisciplinary team cares for these patients. A limitation in the care of these patients is the relative paucity of data specific to the care of acute traumatic wounds in the pediatric population. Future Directions: Research is ongoing in the arenas of new debridement techniques and instruments, and in wound dressing technology. Dedicated research on these topics in the pediatric population will serve to strengthen and advance the care of pediatric patients with acute traumatic and burn wounds. PMID:26487978

  20. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    Directory of Open Access Journals (Sweden)

    Karaaslan F

    2014-12-01

    Full Text Available Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation was studied retrospectively. From February 2011 to January 2012, six patients (females out of 317 (209 females; 108 males were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9–19 and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections.Results: The incidence of deep postoperative surgical site infection was six (1.89% patients (females out of 317 patients (209 females; 108 males at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3–8 irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12–16 months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks.Conclusion: The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections.Keywords: surgical infection, NPWT, VAC, TLIF

  1. How Symmetrical Assumptions Advance Strategic Management Research

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Hallberg, Hallberg

    2014-01-01

    We develop the case for symmetrical assumptions in strategic management theory. Assumptional symmetry obtains when assumptions made about certain actors and their interactions in one of the application domains of a theory are also made about this set of actors and their interactions in other...... application domains of the theory. We argue that assumptional symmetry leads to theoretical advancement by promoting the development of theory with greater falsifiability and stronger ontological grounding. Thus, strategic management theory may be advanced by systematically searching for asymmetrical...

  2. Guideline for the management of wounds in patients with lower-extremity neuropathic disease: an executive summary.

    Science.gov (United States)

    Crawford, Penny Ellen; Fields-Varnado, Myra

    2013-01-01

    This article summarizes the WOCN Evidence-Based Clinical Practice Guideline for Management of Wounds in Patients with Lower Extremity Neuropathic Disease. It is intended for use by physicians, nurses, therapists, and other health care professionals who work with adults who have or are at risk for, lower-extremity neuropathic disease (LEND), and includes updated scientific literature available from January 2003 through February 2012. The full guideline contains definitions of lower extremity neuropathic disorders and disease, prevalence of the problem, relevance and significance of the disorders, as well as comprehensive information about etiology, the nervous system, pathogenesis, and the overall management goals for patients at risk for developing neuropathic foot ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. The guideline also provides two approaches to interventions. The first focuses on prevention strategies to reduce the risk of developing LEND wounds or recurrence, including life-long foot offloading, routine dermal temperature surveillance, use of adjunctive therapies, medication management, and implementing lower extremity amputation prevention measures and patient self-care education. The second approach summarized LEND wound management strategies including wound cleansing, debridement, infection management, maintenance of intact peri-wound skin, nutrition considerations, pain and paresthesia management, edema management, offloading and management of gait and foot deformity, medication management, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and several appendices regarding an algorithm to determine wound etiology, pharmacology, Lower Extremity Amputation (LEAP) Program, diabetes foot screening and other information is available at the end of the guideline.

  3. Use of antibiotics in the management of postirradiation wound infection and sepsis

    International Nuclear Information System (INIS)

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references

  4. Use of antibiotics in the management of postirradiation wound infection and sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Brook, I.

    1988-07-01

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references.

  5. Thermoelectric Devices Advance Thermal Management

    Science.gov (United States)

    2007-01-01

    Thermoelectric (TE) devices heat, cool, and generate electricity when a temperature differential is provided between the two module faces. In cooperation with NASA, Chico, California-based United States Thermoelectric Consortium Inc. (USTC) built a gas emissions analyzer (GEA) for combustion research. The GEA precipitated hydrocarbon particles, preventing contamination that would hinder precise rocket fuel analysis. The USTC research and design team uses patent-pending dimple, pin-fin, microchannel and microjet structures to develop and design heat dissipation devices on the mini-scale level, which not only guarantee high performance of products, but also scale device size from 1 centimeter to 10 centimeters. USTC continues to integrate the benefits of TE devices in its current line of thermal management solutions and has found the accessibility of NASA technical research to be a valuable, sustainable resource that has continued to positively influence its product design and manufacturing

  6. Managing Security in Advanced Computational Infrastructure

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Proposed by Education Ministry of China, Advanced Computational Infrastructure (ACI) aims at sharing geographically distributed high-performance computing and huge-capacity data resource among the universities of China. With the fast development of large-scale applications in ACI, the security requirements become more and more urgent. The special security needs in ACI is first analyzed in this paper, and security management system based on ACI is presented. Finally, the realization of security management system is discussed.

  7. Advances in Business and Management Forecasting

    CERN Document Server

    Lawrence, Kenneth D

    2011-01-01

    The topics within Advances in Business and Management Forecasting will normally include sales and marketing, forecasting, new product forecasting, judgmentally-based forecasting, the application of surveys to forecasting, forecasting for strategic business decisions, improvements in forecasting accuracy, and sales response models.

  8. Surgical management of advanced ocular adnexal amyloidosis.

    Science.gov (United States)

    Patrinely, J R; Koch, D D

    1992-06-01

    Ocular adnexal amyloidosis is characterized by amyloid deposition within the deep connective tissue layers of the eyelids, conjunctiva, and anterior orbit. Management of advanced cases has traditionally been unsatisfactory, with either no surgery offered because of fear of hemorrhage or an en bloc resection performed of the entire involved area. We present two cases of advanced periorbital amyloidosis successfully managed by preserving the anatomic planes of the eyelids and meticulously debulking the deposits with a spooned curette. Lax eyelid tendons and aponeuroses were simultaneously repaired, and no sacrifice of eyelid tissues was necessary. One patient remained asymptomatic for 2 years after surgery before developing early reaccumulation in the lower eyelids. The other patient required additional eyelid debulking and ptosis revision 8 months after surgery, but was in stable condition at follow-up 2 years after surgery. This technique offers safe, easily repeatable, nondestructive treatment for advanced periocular amyloidosis.

  9. Advances in Management of Acute Pancreatitis.

    Science.gov (United States)

    Janisch, Nigeen H; Gardner, Timothy B

    2016-03-01

    This article reviews advances in the management of acute pancreatitis. Medical treatment has been primarily supportive for this diagnosis, and despite extensive research efforts, there are no pharmacologic therapies that improve prognosis. The current mainstay of management, notwithstanding the ongoing debate regarding the volume, fluid type, and rate of administration, is aggressive intravenous fluid resuscitation. Although antibiotics were used consistently for prophylaxis in severe acute pancreatitis to prevent infection, they are no longer used unless infection is documented. Enteral nutrition, especially in patients with severe acute pancreatitis, is considered a cornerstone in management of this disease. PMID:26895677

  10. Advances in Management of Acute Pancreatitis.

    Science.gov (United States)

    Janisch, Nigeen H; Gardner, Timothy B

    2016-03-01

    This article reviews advances in the management of acute pancreatitis. Medical treatment has been primarily supportive for this diagnosis, and despite extensive research efforts, there are no pharmacologic therapies that improve prognosis. The current mainstay of management, notwithstanding the ongoing debate regarding the volume, fluid type, and rate of administration, is aggressive intravenous fluid resuscitation. Although antibiotics were used consistently for prophylaxis in severe acute pancreatitis to prevent infection, they are no longer used unless infection is documented. Enteral nutrition, especially in patients with severe acute pancreatitis, is considered a cornerstone in management of this disease.

  11. Clinical judgment and decision making in wound assessment and management: is experience enough?

    Science.gov (United States)

    Logan, Gemma

    2015-03-01

    The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.

  12. Negative pressure wound therapy: clinical utility

    Directory of Open Access Journals (Sweden)

    Sandoz H

    2015-04-01

    Full Text Available Heidi Sandoz Accelerate CIC, Mile End Hospital, London, UK Abstract: Negative pressure wound therapy (NPWT, also known as topical negative pressure therapy, has been increasingly used in health care for the management of a wide variety of wounds over the last 2–3 decades. It is an advanced therapy that can be helpful to accelerate wound healing in both acute and chronic wounds by delivering negative pressure (suction to the wound bed. More recent advancements in the application of NPWT have provided clinicians with wider choices of utilization. There are now devices available that can deliver irrigation to the wound bed, be used for closed surgical incisions, or are disposable and highly portable. Systematic reviews considering NPWT have been published previously. These usually focus on one wound group or device and fail to offer practical clinical guidance due to the scrutiny offered to the evidence via a systematic review process. Here, an overview of the history of NPWT, the varieties of device available, their wide clinical application, and the evidence to support its use are explored in a pragmatic way. Keywords: negative pressure, wound, incision, healing, pain 

  13. Cultural Understanding of Wounds, Buruli Ulcers and Their Management at the Obom Sub-district of the Ga South Municipality of the Greater Accra Region of Ghana.

    Directory of Open Access Journals (Sweden)

    Eric Koka

    2016-07-01

    Full Text Available This study was conducted with the aim to understand some of the cultural belief systems in the management of wounds and patients practices that could contaminate wounds at the Obom sub-district of the Ga South Municipality of Ghana.This was an ethnographic study using in-depth interviews, Focus Group Discussions and participant observation techniques for data collection. Observations were done on Buruli ulcer patients to document how they integrate local and modern wound management practices in the day-to-day handling of their wounds. Content analysis was done after the data were subjected to thematic coding and representative narratives selected for presentation.It was usually believed that wounds were caused by charms or spirits and, therefore, required the attention of a native healer. In instances where some patients' wounds were dressed in the hospital by clinicians whose condition/age/sex contradict the belief of the patient, the affected often redress the wounds later at home. Some of the materials often used for such wound dressing include urine and concoctions made of charcoal and gunpowder with the belief of driving out evil spirits from the wounds.Clinicians must therefore be aware of these cultural beliefs and take them into consideration when managing Buruli ulcer wounds to prevent redressing at home after clinical treatment. This may go a long way to reduce secondary infections that have been observed in Buruli ulcer wounds.

  14. Survey on Knowledge and Management about Wound Pain of 85 Wound Treatment Nurses%某院85名伤口治疗护士伤口疼痛认知及管理情况分析

    Institute of Scientific and Technical Information of China (English)

    吕娟; 宁宁; 叶霞; 廖灯彬; 陈佳丽

    2012-01-01

    目的 了解伤口治疗护士对伤口疼痛相关知识的掌握程度及目前临床实践中伤口疼痛管理现状,为开展伤口疼痛教学及提高临床伤口疼痛管理水平提供参考依据.方法 自行设计调查问卷,采用便利抽样的方法选取四川省某大型三级甲等医院85名参与伤口治疗工作的护士作为研究对象,从其对伤口疼痛的基本认知情况、伤口疼痛评估情况、伤口疼痛的管理措施及接受伤口疼痛相关培训4个方面进行问卷调查,调查数据采用SPSS 17.0软件进行数据处理.结果 伤口治疗护士对伤口疼痛相关知识缺乏,41%不了解伤口疼痛的分类,37%认为伤口疼痛不会影响伤口愈合,25%认为伤口疼痛不可避免;伤口管理的现状并不理想,28%未对伤口疼痛进行评估,48%根据临床经验来评估伤口疼痛,选择新型敷料控制伤口疼痛的只有14%;100%认为有必要设置伤口疼痛培训课程.结论 伤口治疗护士对伤口疼痛认知情况并不理想,临床实践中伤口疼痛的管理亟待改善,需要不断地增强伤口疼痛管理的培训教育,更新观念,以提高临床伤口治疗水平.%Objective To understand wound treatment nurses' knowledge about wound pain, to know the status of wound pain management and to provide basic information for future teaching and management of wound pain. Methods A self-designed questionnaire was used to survey 85 wound treatment nurses in a large hospital in Sichuan province. The questionnaire included four parts: wound treatment nurses' knowledge about wound pain; assessment for wound pain; the frequently-used measures in wound pain management and the wound pain training for wound treatment nurses. Results Nurses lacked knowledge about wound pain. Of the total, nurses had no idea of types of wound pain accounted for 41%. Besides, 37% of the nurses believed that wound pain would not affect wound healing. Meanwhile, 25% of them regarded that wound pain is

  15. Water Management Applications of Advanced Precipitation Products

    Science.gov (United States)

    Johnson, L. E.; Braswell, G.; Delaney, C.

    2012-12-01

    Advanced precipitation sensors and numerical models track storms as they occur and forecast the likelihood of heavy rain for time frames ranging from 1 to 8 hours, 1 day, and extended outlooks out to 3 to 7 days. Forecast skill decreases at the extended time frames but the outlooks have been shown to provide "situational awareness" which aids in preparation for flood mitigation and water supply operations. In California the California-Nevada River Forecast Centers and local Weather Forecast Offices provide precipitation products that are widely used to support water management and flood response activities of various kinds. The Hydrometeorology Testbed (HMT) program is being conducted to help advance the science of precipitation tracking and forecasting in support of the NWS. HMT high-resolution products have found applications for other non-federal water management activities as well. This presentation will describe water management applications of HMT advanced precipitation products, and characterization of benefits expected to accrue. Two case examples will be highlighted, 1) reservoir operations for flood control and water supply, and 2) urban stormwater management. Application of advanced precipitation products in support of reservoir operations is a focus of the Sonoma County Water Agency. Examples include: a) interfacing the high-resolution QPE products with a distributed hydrologic model for the Russian-Napa watersheds, b) providing early warning of in-coming storms for flood preparedness and water supply storage operations. For the stormwater case, San Francisco wastewater engineers are developing a plan to deploy high resolution gap-filling radars looking off shore to obtain longer lead times on approaching storms. A 4 to 8 hour lead time would provide opportunity to optimize stormwater capture and treatment operations, and minimize combined sewer overflows into the Bay.ussian River distributed hydrologic model.

  16. Managing the gap: balancing advances in technology with advances in management practice.

    Science.gov (United States)

    Ritchie, D

    1997-01-01

    Expenditure on information systems is widely anticipated to lead to improved management of health care resources. Despite large investments in hardware and software, these expectations are difficult to realise. Part of the difficulty lies in the manner in which information systems are applied to, rather than integrated within, organisations. This paper considers some of the the personal and organisational issues that need to be addressed to 'manage the gap' in balancing advances in information technology with advances in management practice. The issues identified are consistent with the concept of a learning organisation dealing with environmental change.

  17. Understanding methods of wound debridement.

    Science.gov (United States)

    Atkin, Leanne

    Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequently because of inadequate debridement. The autolytic process becomes overwhelmed by high levels of endotoxins released from damaged tissue (Broadus, 2013). Therefore wound debridement becomes an integral part of chronic-wound management and practitioners involved in wound care must be fully competent at wound-bed assessment and have an awareness of the options available for debridement. This article will review wound-bed assessment, highlighting variations in devitalised tissue, and explore options available for wound debridement, taking into consideration patients’ pain and quality of life.

  18. [Advancement of maggot including living body to treat chronic infected wounds].

    Science.gov (United States)

    Zhang, Zhen; Wang, Shouyu; Diao, Yunpeng; Zhang, Houli; Huang, Shanshan; Lv, Decheng

    2009-12-01

    Human has used maggot to treat diseases for thousands of years. In recent years, with abuse of antibiotic and the rising incidence of antibiotic resistance, maggot therapy, as a surgical alternative, is mainly applied to treat chronic infected wounds on account of its low cost, efficacy and safety. Its mechanisms are disinfection, bio-debridement and enhancement of tissue regeneration. Maggot therapy which serves as a kind of biological therapy is promising. However, living maggot therapy could result in inevitable complications, so that we should apply traditional Chinese medicine theory to investigate and develop new delivery method of maggot. The review summarizes the past and present of maggot therapy.

  19. Information management systems improve advanced plant design

    Energy Technology Data Exchange (ETDEWEB)

    Turk, R.S.; Serafin, S.A.; Leckey, J.B. [ABB-Combustion Engineering, Inc., Windsor, CT (United States); Morgan, J.S. [Duke Engineering & Services, Charlotte, NC (United States)

    1994-12-31

    Computer-aided engineering tools are proving invaluable in both the design and operation of nuclear power plants. ABB Combustion Engineering`s Advanced Light Water Reactor (ALWR) features a computerized Information Management System (IMS) as an integral part of the design. The System 80+ IMS represents the most powerful information management tool for Nuclear Power Plants commercially available today. Developed by Duke Power Company specifically for use by nuclear power plant owner operators, the IMS consists of appropriate hardware and software to manage and control information flow for all plant related work or tasks in a systematic, consistent, coordinated and informative manner. A significant feature of this IMS is that it is primarily based on plant data. The principal design tool, PASCE (Plant Application and Systems from Combustion Engineering), is comprised of intelligent databases that describe the design and from which accurate plant drawings are created. Additionally the IMS includes, at its hub, a relational database management system and an associated document management system. During the design phase, the IMS captures all design information in a database as it is generated. Interrelated data are automatically checked for consistency. Engineers and managers from various disciplines are automatically and simultaneously notified of pending changes. The 3-D model automatically checks for interferences and can be used to simulate the removal and replacement of equipment. Thus any potential difficulties can be corrected in the design phase. Document and data search times are greatly reduced by the querying capabilities of the system.

  20. Management of locally advanced prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Heather Payne

    2009-01-01

    The management of all stages of prostate cancer is an increasingly complex process and involves a variety of available treatments and many disciplines.Despite prostate-specific antigen (PSA) testing,the presentation of prostate cancer at a locally advanced stage is common in the UK,accounting for one-third of all new cases.There is no universally accepted definition of locally advanced prostate cancer;the term is loosely used to encompass a spectrum of disease profiles that show high-risk features.Men with high-risk prostate cancer generally have a significant risk of disease progression and cancer-related death if left untreated.High-risk patients,including those with locally advanced disease,present two specific challenges.There is a need for local control as well as a need to treat any microscopic metastases likely to be present but undetectable until disease progression.The optimal treatment approach will therefore often necessitate multiple modalities.The exact combinations,timing and intensity of treatment continue to be strongly debated.Management decisions should be made after all treatments have been discussed by a multidisciplinary team (including urologists,oncologists,radiologists,pathologists and nurse specialists) and after the balance of benefits and side effects of each therapy modality has been considered by the patient with regard to his own individual circumstances.This article reviews the current therapy options.

  1. Best practice in wound assessment.

    Science.gov (United States)

    Benbow, Maureen

    2016-03-01

    Accurate and considered wound assessment is essential to fulfil professional nursing requirements and ensure appropriate patient and wound management. This article describes the main aspects of holistic assessment of the patient and the wound, including identifying patient risk factors and comorbidities, and factors affecting wound healing to ensure optimal outcomes.

  2. Ionically Crosslinked Chitosan Hydrogels for the Controlled Release of Antimicrobial Essential Oils and Metal Ions for Wound Management Applications

    Directory of Open Access Journals (Sweden)

    Wan Li Low

    2016-03-01

    Full Text Available The emerging problems posed by antibiotic resistance complicate the treatment regime required for wound infections and are driving the need to develop more effective methods of wound management. There is growing interest in the use of alternative, broad spectrum, pre-antibiotic antimicrobial agents such as essential oils (e.g., tea tree oil, TTO and metal ions (e.g., silver, Ag+. Both TTO and Ag+ have broad spectrum antimicrobial activity and act on multiple target sites, hence reducing the likelihood of developing resistance. Combining such agents with responsive, controlled release delivery systems such as hydrogels may enhance microbiocidal activity and promote wound healing. The advantages of using chitosan to formulate the hydrogels include its biocompatible, mucoadhesive and controlled release properties. In this study, hydrogels loaded with TTO and Ag+ exhibited antimicrobial activity against P. aeruginosa, S. aureus and C. albicans. Combining TTO and Ag+ into the hydrogel further improved antimicrobial activity by lowering the effective concentrations required, respectively. This has obvious advantages for reducing the potential toxic effects on the healthy tissues surrounding the wound. These studies highlight the feasibility of delivering lower effective concentrations of antimicrobial agents such as TTO and Ag+ in ionically crosslinked chitosan hydrogels to treat common wound-infecting pathogens.

  3. Advances in mechanisms of negative pressure wound therapy%负压创面疗法作用机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘道宏; 唐佩福; 张立海

    2014-01-01

    负压创面疗法处理临床上各种创面均具有显著效果。对其作用机制的研究有助于指导正确应用及进一步改进。本文综述了近些年负压创面疗法作用机制研究的最新进展。被广泛接受的机制包括收缩创面、稳定局部环境、减轻水肿和清除渗出物、增加血流灌注和促进肉芽组织形成等,而细菌清除和抗菌作用方面的机制尚存争议。%Negative-pressure wound therapy (NPWT) exerts a significant effect on different wounds. Studies on its mechanisms contribute to its correct application and further improvement. Following is a review of the update advances in its mechanisms. NPWT can reduce the wound surface area, stabilize the wound environment, alleviate wound edema, remove wound exudates, increase blood flow, and promote granulation tissue formation, which are the widely accepted mechanisms of NPWT. However, it is still controversial on its antimicrobial efficacy and bacterial clearance.

  4. Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene.

    Science.gov (United States)

    Hu, Ning; Wu, Xing-Huo; Liu, Rong; Yang, Shu-Hua; Huang, Wei; Jiang, Dian-Ming; Wu, Qiang; Xia, Tian; Shao, Zeng-Wu; Ye, Zhe-Wei

    2015-08-01

    Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection. PMID:26223928

  5. Katupila (Securinega leucopyrus) as a potential option for diabetic wound management

    OpenAIRE

    Ahamed Shahan Ajmeer; Tukaram Sambhaji Dudhamal; Sanjay Kumar Gupta; Vyasdeva Mahanta

    2014-01-01

    In acute and chronic wounds, Katupila (Securinega leucopyrus) (Willd.) Muell is a commonly used folklore remedy in Sri Lanka and Saurashtra region of India. We report a case of Madhumehajanya Dushta Vrana (chronic diabetic wound) that was treated with local application of S. leucopyrus in paste form once daily. Wound healed within a month with normal pigmentation and minimal scar. This case also demonstrated possible antimicrobial potential in the treatment of Dushta Vrana.

  6. Katupila Securinega leucopyrus as a potential option for diabetic wound management

    Directory of Open Access Journals (Sweden)

    Ahamed Shahan Ajmeer

    2014-01-01

    Full Text Available In acute and chronic wounds, Katupila (Securinega leucopyrus (Willd. Muell is a commonly used folklore remedy in Sri Lanka and Saurashtra region of India. We report a case of Madhumehajanya Dushta Vrana (chronic diabetic wound that was treated with local application of S. leucopyrus in paste form once daily. Wound healed within a month with normal pigmentation and minimal scar. This case also demonstrated possible antimicrobial potential in the treatment of Dushta Vrana.

  7. Management of advanced medullary thyroid cancer.

    Science.gov (United States)

    Hadoux, Julien; Pacini, Furio; Tuttle, R Michael; Schlumberger, Martin

    2016-01-01

    Medullary thyroid cancer arises from calcitonin-producing C-cells and accounts for 3-5% of all thyroid cancers. The discovery of a locally advanced medullary thyroid cancer that is not amenable to surgery or of distant metastases needs careful work-up, including measurement of serum calcitonin and carcinoembryonic antigen (and their doubling times), in addition to comprehensive imaging to determine the extent of the disease, its aggressiveness, and the need for any treatment. In the past, cytotoxic chemotherapy was used for treatment but produced little benefit. For the past 10 years, tyrosine kinase inhibitors targeting vascular endothelial growth factor receptors and RET (rearranged during transfection) have been used when a systemic therapy is indicated for large tumour burden and documented disease progression. Vandetanib and cabozantinib have shown benefits on progression-free survival compared with placebo in this setting, but their toxic effect profiles need thorough clinical management in specialised centres. This Review describes the management and treatment of patients with advanced medullary thyroid cancer with emphasis on current targeted therapies and perspectives to improve patient care. Most treatment responses are transient, emphasising that mechanisms of resistance need to be better understood and that the efficacy of treatment approaches should be improved with combination therapies or other drugs that might be more potent or target other pathways, including immunotherapy. PMID:26608066

  8. Teaching Wound Care Management: A Model for the Budget Conscious Educator

    Science.gov (United States)

    Berry, David C.

    2012-01-01

    For the author, the concept of wound care has always been a challenging topic to demonstrate. How to teach the concept without having a student in need of wound care or without having to spend money to buy another simulation manikin/model? The author has recently created a simulation to demonstrate and practice the cleaning, closing, and dressing…

  9. Advances in biomedical imaging using THz technology with applications to burn-wound assessment

    Science.gov (United States)

    Tewari, Priyamvada; Kealey, Colin; Sung, Jun; Maccabi, Ashkan; Bajwa, Neha; Singh, Rahul; Culjat, Martin; Stojadinovic, Alexander; Grundfest, Warren; Taylor, Zachary D.

    2012-02-01

    Terahertz (THz) hydration sensing and image has been a topic of increased interest recently due largely to improvements in source and detector technology and the identification of applications where current hydration sensing techniques are insufficient. THz medical imaging is an expanding field of research and tissue hydration plays a key role in the contrast observed in THz tissue reflectance and absorbance maps. This paper outlines the most recent results in burn and corneal imaging where hydration maps were used to assess tissue status. A 3 day study was carried out in rat models where a THz imaging system was used to assess the severity and extent of burn throughout the first day of injury and at the 24, 48, and 72 hour time points. Marked difference in tissue reflectance were observed between the partial and full thickness burns and image features were identified that may be used as diagnostic markers for burn severity. Companion histological analysis performed on tissue excised on Day 3 confirms hypothesized burn severity. The results of these preliminary animal trials suggest that THz imaging may be useful in burn wound assessment where current clinical modalities have resolution and/or sensitivity insufficient for accurate diagnostics.

  10. Advances in Management of Hepatocellular Carcinoma.

    Science.gov (United States)

    Intaraprasong, Pongphob; Siramolpiwat, Sith; Vilaichone, Ratha-Korn

    2016-01-01

    Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor and a high impact health problem worldwide. The prevalence of HCC is particularly high in many Asian and African countries. Some HCC patients have no symptoms prior to diagnosis and many of them therefore present at late stage and have a grave prognosis. The well-established causes of HCC are chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection or alcoholic cirrhosis and nonalcoholic steatohepatitis. The Barcelona Clinic Liver Cancer (BCLC) Staging System remains the most widely used for HCC management guidelines. To date, the treatments for HCC are still very challenging for physicians due to limited resources in many parts of the world, but many options of management have been proposed, including hepatic resection, liver transplantation, ablative therapy, chemoembolization, sora nib and best supportive care. This review article describes the current evidence-based management of HCC with focus on early to advance stages that impact on patient overall survival. PMID:27644603

  11. Biofilm in wound care.

    Science.gov (United States)

    Rajpaul, Kumal

    2015-03-01

    A biofilm can be described as a microbial colony encased in a polysaccharide matrix which can become attached to a wound surface. This can affect the healing potential of chronic wounds due to the production of destructive enzymes and toxins which can promote a chronic inflammatory state within the wound. Biofilms can be polymicrobial and can result in delayed wound healing and chronic wound infection resistant to antibiotics, leading to prolonged hospitalisation for some patients. There appears to be a correlation between biofilms and non-healing in chronic wounds. It is suggested that biofilms are a major player in the chronicity of wounds. They are a complex concept to diagnose and management needs to be multifactorial.

  12. Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

    OpenAIRE

    Meloni, Marco; Izzo, Valentina; Vainieri, Erika; Giurato, Laura; Ruotolo, Valeria; Uccioli, Luigi

    2015-01-01

    Diabetic foot (DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers (DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these,...

  13. Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

    Directory of Open Access Journals (Sweden)

    Azoury SC

    2015-09-01

    Full Text Available Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention

  14. Management of intestinal obstruction in advanced malignancy

    Directory of Open Access Journals (Sweden)

    Henry John Murray Ferguson

    2015-09-01

    Full Text Available Patients with incurable, advanced abdominal or pelvic malignancy often present to acute surgical departments with symptoms and signs of intestinal obstruction. It is rare for bowel strangulation to occur in these presentations, and spontaneous resolution often occurs, so the luxury of time should be afforded while decisions are made regarding surgery. Cross-sectional imaging is valuable in determining the underlying mechanism and pathology. The majority of these patients will not be suitable for an operation, and will be best managed in conjunction with a palliative medicine team. Surgeons require a good working knowledge of the mechanisms of action of anti-emetics, anti-secretories and analgesics to tailor early management to individual patients, while decisions regarding potential surgery are made. Deciding if and when to perform operative intervention in this group is complex, and fraught with both technical and emotional challenges. Surgery in this group is highly morbid, with no current evidence available concerning quality of life following surgery. The limited evidence concerning operative strategy suggests that resection and primary anastomosis results in improved survival, over bypass or stoma formation. Realistic prognostication and involvement of the patient, care-givers and the multidisciplinary team in treatment decisions is mandatory if optimum outcomes are to be achieved.

  15. Advanced Security Management in Metro Ethernet Networks

    Directory of Open Access Journals (Sweden)

    Ammar Rayes

    2010-01-01

    Full Text Available With the rapid increase in bandwidth and the introduction of advanced IP services including voice, high-speed internet access, and video/IPTV, consumers are more vulnerable to malicious users than ever. In recent years, providing safe and sound networks and services have been the zenith priority for service providers and network carriers alike. Users are hesitant to subscribe to new services unless service providers guarantee secure connections. More importantly, government agencies of many countries have introduced legislations requiring service providers to keep track andrecords of owners of IP and MAC addresses at all time.In this paper, we first present an overview of Metro Ethernet (or Ethernet-To-The-Home/Business (ETTx and compare with various IP broadband access technologies including DSL, wireless and cable. We then outline major security concerns for Metro Ethernet networks including network and subscriber/end user security.Next we introduce state-of-the-art algorithms to prevent attackers from stealing any IP or MAC addresses. Our proposal is to use network management in conjunction with hardware features for security management to provide a secure and spoofing-free ETTx network. The key idea behind our proposal is to utilize network management to enforce strict (port, MAC, IP binding in the access network to provide subscriber security.The paper then proposes an adaptive policy-based security controller to quickly identify suspected malicious users, temporarily isolate them without disconnecting them from the network or validating their contracts, and then carry the required analysis. The proposed controller identifies malicious users without compromising between accurate but lengthy traffic analysis and premature decision. It also provides the ability to make granular corrective actions that are adaptive to any defined network condition.

  16. Measurement of localized tissue water – clinical application of bioimpedance spectroscopy in wound management

    International Nuclear Information System (INIS)

    Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was highly sensitive with the potential to detect changes of as little as 20 μl in extracellular fluid. Thirdly the relative changes in R0, R∞ and Ri following sub-cutaneous injections of saline were consistent with redistribution of water from the extracellular to intracellular space and /or removal from the local area as may occur during wound healing.

  17. Measurement of localized tissue water - clinical application of bioimpedance spectroscopy in wound management

    Science.gov (United States)

    Ward, L. C.; Sharpe, K.; Edgar, D.; Finlay, V.; Wood, F.

    2013-04-01

    Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was highly sensitive with the potential to detect changes of as little as 20 μl in extracellular fluid. Thirdly the relative changes in R0, R∞ and Ri following sub-cutaneous injections of saline were consistent with redistribution of water from the extracellular to intracellular space and /or removal from the local area as may occur during wound healing.

  18. Maggot therapy in wound management in modern era and a review of published literature.

    Science.gov (United States)

    Davydov, Liya

    2011-02-01

    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.

  19. Recent Advances in Postoperative Pain Management

    OpenAIRE

    Vadivelu, Nalini; Mitra, Sukanya; Narayan, Deepak

    2010-01-01

    Good pain control after surgery is important to prevent negative outcomes such as tachycardia, hypertension, myocardial ischemia, decrease in alveolar ventilation, and poor wound healing. Exacerbations of acute pain can lead to neural sensitization and release of mediators both peripherally and centrally. Clinical wind up occurs from the processes of N-Methyl D-Aspartate (NMDA) activation, wind up central sensitization, long-term potentiation of pain (LTP), and transcription-dependent sensiti...

  20. Biomedical-Grade Chitosan in Wound Management and Its Biocompatibility In Vitro

    OpenAIRE

    Halim, Ahmad Sukari; Lim, Chin Keong

    2010-01-01

    Chitosan and chitosan-based derivatives have various medical applications. It is wellknown that chitosan possesses medicinal properties that accelerate wound healing and tissue regeneration. Chitosan is a natural product. It is biocompatible and biodegradable, enabling it to be used for wound dressing material. However, the practical use of chitosan is restricted to the unmodified forms, as these are water-insoluble and have high viscosity and the tendency to coagulate with proteins at high p...

  1. Microvascular free flaps in the management of war wounds with tissue defects

    OpenAIRE

    Kozarski Jefta; Panajotović Ljubomir; Novaković Marijan

    2003-01-01

    Background. War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects. With the aim of closing war wounds, covering deep structures, or making the prec...

  2. Advanced Management Communication: An Elective Course in Corporate Communication.

    Science.gov (United States)

    Argenti, Paul A.

    1986-01-01

    Proposes a college-level elective course in advanced management communication that would teach future managers how to communicate with shareholders, the media, financial analysts, and the labor force. (SRT)

  3. Clinical recommendations and practical guide for negative pressure wound therapy with instillation.

    Science.gov (United States)

    Gupta, Subhas; Gabriel, Allen; Lantis, John; Téot, Luc

    2016-04-01

    Effective wound management involves a comprehensive assessment of the patient and the wound to determine an optimal wound treatment plan. It is critical to identify and address factors that may impair wound healing, prior to selecting the most appropriate therapy for each patient. Negative pressure wound therapy (NPWT) is a well-established advanced therapy that has been successful in adjunctive management of acute and chronic wounds. In recent years, the introduction of topical wound solution delivery in combination with NPWT has provided further benefits to wound healing. A commercially available system now offers automated, volumetric control of instilled topical wound solutions with a dwell time in combination with NPWT (NPWTi-d; V.A.C. VeraFlo Therapy, KCI, an Acelity company, San Antonio, TX). This NPWTi-d system differs from other instillation systems in that a timed, predetermined volume of topical wound solution is intermittently delivered (versus continuously fed) and allowed to dwell in the wound bed (without NPWT), for a user-selected period of time before NPWT is resumed. This added accuracy and process simplification of solution delivery in tandem with NPWT have prompted use of NPWTi-d as first-line therapy in a wider subset of complex wounds. However, considerably more research is required to validate efficacy of NPWTi-d in various wound types. The purpose of this review is to provide a relevant overview of wound healing, describe current literature supporting the adjunctive use of NPWTi-d, propose a clinical approach for appropriate application of NPWTi-d and conclude with case studies demonstrating successful use of NPWTi-d. Based on this review, we conclude that either a large case series examining effects of NPWTi-d on different wound types or possibly a large prospective registry evaluating NPWTi-d with real-world topical wound solutions versus immediate debridement and closure would be valuable to the medical community in evaluating the

  4. Advances in Understanding and Managing Chronic Urticaria.

    Science.gov (United States)

    Moolani, Yasmin; Lynde, Charles; Sussman, Gordon

    2016-01-01

    There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA (2)LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H 1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H 1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options.

  5. Cell Therapy for Wound Healing

    OpenAIRE

    You, Hi-Jin; Han, Seung-Kyu

    2014-01-01

    In covering wounds, efforts should include utilization of the safest and least invasive methods with goals of achieving optimal functional and cosmetic outcome. The recent development of advanced wound healing technology has triggered the use of cells to improve wound healing conditions. The purpose of this review is to provide information on clinically available cell-based treatment options for healing of acute and chronic wounds. Compared with a variety of conventional methods, such as skin...

  6. Microvascular free flaps in the management of war wounds with tissue defects

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2003-01-01

    Full Text Available Background. War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects. With the aim of closing war wounds, covering deep structures, or making the preconditions for reconstruction of deep structures, free flaps were applied in primary, delayed, or secondary term. The main criteria for using free flaps were general condition of the wounded, extent, location, and structure of tissue defects. The aim was also to point out the advantages and disadvantages of the application of free flaps in the treatment of war wounds. Methods. One hundred and eleven microvascular free flaps were applied, both simple and complex, for closing the war wounds with extensive tissue defects. The main criteria for the application of free flaps were: general condition of the wounded, size, localization, and structure of tissue defects. For the extensive defects of the tissue, as well as for severely contaminated wounds latissimus dorsi free flaps were used. For tissue defects of distal parts of the lower extremities, scapular free flaps were preferred. While using free tissue transfer for recompensation of bone defects, free vascularized fibular grafts were applied, and in skin and bone defects complex free osteoseptocutaneous fibular, free osteoseptocutaneous radial forearm, and free skin-bone scapular flaps were used. Results. After free flap transfer 16 (14,4% revisions were performed, and after 8 unsuccessful revisions another free flaps were utilized in 3 (37,5% patients, and cross leg flaps in 5 (62,5% patients. Conclusion. The treatment of war wounds with large tissue defects by the application of free microvascular flaps

  7. Successful Management of a Cesarean Scar Defect with Dehiscence of the Uterine Incision by Using Wound Lavage

    Directory of Open Access Journals (Sweden)

    Akinori Ida

    2014-01-01

    Full Text Available Cesarean scar defects (CSDs that can be visualized using transvaginal ultrasonography (TVUS may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4 had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.

  8. Recent advances in multidisciplinary management ofhepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Asmaa I Gomaa; Imam Waked

    2015-01-01

    The incidence of hepatocellular carcinoma (HCC)is increasing, and it is currently the second leadingcause of cancer-related death worldwide. Potentiallycurative treatment options for HCC include resection,transplantation, and percutaneous ablation, whereaspalliative treatments include trans-arterial chemoembolization(TACE), radioembolization, and systemictreatments. Due to the diversity of available treatmentoptions and patients' presentations, a multidisciplinary team should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved moleculartargeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC.

  9. Natural language processing and advanced information management

    Science.gov (United States)

    Hoard, James E.

    1989-01-01

    Integrating diverse information sources and application software in a principled and general manner will require a very capable advanced information management (AIM) system. In particular, such a system will need a comprehensive addressing scheme to locate the material in its docuverse. It will also need a natural language processing (NLP) system of great sophistication. It seems that the NLP system must serve three functions. First, it provides an natural language interface (NLI) for the users. Second, it serves as the core component that understands and makes use of the real-world interpretations (RWIs) contained in the docuverse. Third, it enables the reasoning specialists (RSs) to arrive at conclusions that can be transformed into procedures that will satisfy the users' requests. The best candidate for an intelligent agent that can satisfactorily make use of RSs and transform documents (TDs) appears to be an object oriented data base (OODB). OODBs have, apparently, an inherent capacity to use the large numbers of RSs and TDs that will be required by an AIM system and an inherent capacity to use them in an effective way.

  10. Development of Advanced Spent Fuel Management Process

    International Nuclear Information System (INIS)

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm2 and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields

  11. Development of Advanced Spent Fuel Management Process

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Chung Seok; Choi, I. K.; Kwon, S. G. (and others)

    2007-06-15

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm{sup 2} and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields.

  12. Wound care in horses.

    Science.gov (United States)

    Caston, Stephanie S

    2012-04-01

    Care of equine wounds in the field can be a challenging endeavor. Many times, wound care is complicated by chronicity or by prior inappropriate care in addition to the great degree of tissue trauma that occurred when the horse was wounded. Recognizing involvement of synovial structures, loss of skin, and damage to bone are critical in the initial examination of wounds and will guide future care. Education of clients is also important in that preparing them for possible outcomes during healing may help improve compliance and proper treatment of wound. Owners and trainers often perform much of the daily care and monitoring of equine wounds and thus can greatly assist or impede the progress. Bandaging is important to management of equine wounds-especially on the limbs-and is sometimes overlooked because of its labor-intensive nature and the desire for a spray, ointment, or salve that will heal the wound. The practitioner that improves and utilizes his or her understanding of the wound-healing process in concert with his or her knowledge of local anatomy will be the one who is best equipped to care for wounds in ambulatory practice.

  13. Biofilms in wounds

    DEFF Research Database (Denmark)

    Cooper, R A; Bjarnsholt, Thomas; Alhede, M

    2014-01-01

    Following confirmation of the presence of biofilms in chronic wounds, the term biofilm became a buzzword within the wound healing community. For more than a century pathogens have been successfully isolated and identified from wound specimens using techniques that were devised in the nineteenth...... extracellular polymeric substances (EPS). Cells within such aggregations (or biofilms) display varying physiological and metabolic properties that are distinct from those of planktonic cells, and which contribute to their persistence. There are many factors that influence healing in wounds and the discovery...... of biofilms in chronic wounds has provided new insight into the reasons why. Increased tolerance of biofilms to antimicrobial agents explains the limited efficacy of antimicrobial agents in chronic wounds and illustrates the need to develop new management strategies. This review aims to explain the nature...

  14. Wound healing and hyper-hydration: a counterintuitive model.

    Science.gov (United States)

    Rippon, M G; Ousey, K; Cutting, K F

    2016-02-01

    Winter's seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle, confusion may arise between what is deemed to be an adequate level of tissue hydration and the risk of developing maceration. In addition, the counter-intuitive model 'hyper-hydration' of tissue appears to frustrate the moist wound healing approach and advocate a course of intervention whereby tissue is hydrated beyond what is a normally acceptable therapeutic level. This paper discusses tissue hydration, the cause and effect of maceration and distinguishes these from hyper-hydration of tissue. The rationale is to provide the clinician with a knowledge base that allows optimisation of treatment and outcomes and explains the reasoning behind wound healing using hyper-hydration. Declaration of interest: K. Cutting is a Clinical Research Consultant to the medical device and biotechnology industry. M. Rippon is Visiting Clinical Research Fellow, University of Huddersfield and K. Ousey provides consultancy for a range of companies through the University of Huddersfield including consultancy services for Paul Hartmann Ltd on HydroTherapy products.

  15. Does topical wound oxygen (TWO2) offer an improved outcome over conventional compression dressings (CCD) in the management of refractory venous ulcers (RVU)? A parallel observational comparative study.

    LENUS (Irish Health Repository)

    Tawfick, W

    2009-07-01

    Topical wound oxygen (TWO(2)) may help wound healing in the management of refractory venous ulcers (RVU). The aim of this study was to measure the effect of TWO(2) on wound healing using the primary end-point of the proportion of ulcers healed at 12 weeks. Secondary end-points were time to full healing, percentage of reduction in ulcer size, pain reduction, recurrence rates and Quality-Adjusted Time Spent Without Symptoms of disease and Toxicity of Treatment (Q-TWiST).

  16. The intelligent user interface for NASA's advanced information management systems

    Science.gov (United States)

    Campbell, William J.; Short, Nicholas, Jr.; Rolofs, Larry H.; Wattawa, Scott L.

    1987-01-01

    NASA has initiated the Intelligent Data Management Project to design and develop advanced information management systems. The project's primary goal is to formulate, design and develop advanced information systems that are capable of supporting the agency's future space research and operational information management needs. The first effort of the project was the development of a prototype Intelligent User Interface to an operational scientific database, using expert systems and natural language processing technologies. An overview of Intelligent User Interface formulation and development is given.

  17. Advanced Hybrid Particulate Collector Project Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.J.

    1995-11-01

    As the consumption of energy increases, its impact on ambient air quality has become a significant concern. Recent studies indicate that fine particles from coal combustion cause health problems as well as atmospheric visibility impairment. These problems are further compounded by the concentration of hazardous trace elements such as mercury, cadmium, selenium, and arsenic in fine particles. Therefore, a current need exists to develop superior, but economical, methods to control emissions of fine particles. Since most of the toxic metals present in coal will be in particulate form, a high level of fine- particle collection appears to be the best method of overall air toxics control. However, over 50% of mercury and a portion of selenium emissions are in vapor form and cannot be collected in particulate control devices. Therefore, this project will focus on developing technology not only to provide ultrahigh collection efficiency of particulate air toxic emissions, but also to capture vapor- phase trace metals such as mercury and selenium. Currently, the primary state-of-the-art technologies for particulate control are fabric filters (baghouses) and electrostatic precipitators (ESPs). However, they both have limitations that prevent them from achieving ultrahigh collection of fine particulate matter and vapor-phase trace metals. The objective of this project is to develop a highly reliable advanced hybrid particulate collector (AHPC) that can provide > 99.99 % particulate collection efficiency for all particle sizes between 0.01 and 50 14m, is applicable for use with all U.S. coals, and is cost-0443competitive with existing technologies. Phase I of the project is organized into three tasks: Task I - Project Management, Reporting, and Subcontract Consulting Task 2 - Modeling, Design, and Construction of 200-acfm AHPC Model Task 3 - Experimental Testing and Subcontract Consulting

  18. [Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

    Science.gov (United States)

    Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

    2004-01-01

    In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness. PMID:14999922

  19. [Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

    Science.gov (United States)

    Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

    2004-01-01

    In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness.

  20. An audit to assess the perspectives of U.S. wound care specialists regarding the importance of proteases in wound healing and wound assessment.

    Science.gov (United States)

    Snyder, Robert J; Cullen, Breda; Nisbet, Lorraine T

    2013-12-01

    Chronic wounds represent an aberrant biochemistry that creates a toxic proteolytic milieu which can be detrimental to the healing process. Rebalancing the wound microenvironment and addressing elevated protease activity (EPA) could therefore help facilitate healing. To understand how clinicians currently diagnose and manage excessive proteolytic activity, 183 survey responses from US wound specialists were collated and analysed to find out their perceptions on the role of proteases. The majority of respondents (>98%) believed proteases were important in wound healing and that a point-of-care (POC) protease test could be useful. This study yielded a low response rate (7.1%, n = 183); however, there were adequate data to draw significant conclusions. Specialists perceived that fibrin, slough, granulation tissue and rolled wound edges could indicate EPA. About 43% of respondents, however, failed to give a correct response when asked to review photographs to determine if excessive protease activity was present, and the perceived visual signs for EPA did not correlate with the wounds that had EPA; no statistical differences between professions were observed. Respondents chose debridement, wound cleansing and advanced therapies as important in reducing excessive protease activity. It was concluded that specialists have a need for POC diagnostic tests. On the basis of the responses to wound photos, it was determined that there were no visual cues clinicians could use in determining excessive protease activity. Additional research is recommended to evaluate the efficacy of a POC diagnostic test for protease activity and the treatments and therapies applied when EPA is found.

  1. Burn wound: How it differs from other wounds?

    Directory of Open Access Journals (Sweden)

    V K Tiwari

    2012-01-01

    Full Text Available Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

  2. Developing an outpatient wound care clinic in an acute rehabilitation setting.

    Science.gov (United States)

    Sheehan, Diane Dudas; Zeigler, Mary H

    2010-01-01

    People with disability are at high risk for skin breakdown,which requires ongoing prevention and management. An outpatient rehabilitation wound clinic was developed to handle a variety of acute and chronic wounds for this unique population. This article describes how two advanced practice nurses proposed the idea for the wound care clinic and formulated a business plan, which was critical to successfully administering an outpatient wound care service. Essential components of the business plan included the goals, scope of service, professional practice model, benefits, rationale, marketing analysis, predicted volumes, regulatory imperatives, and financial needs.

  3. Recent advances in wound dressings for diabetic foot%糖尿病足创面敷料研究进展

    Institute of Scientific and Technical Information of China (English)

    朱平; 严励

    2009-01-01

    糖尿病足创而治疗是一个需要多学科参与的复杂临床课题,敷料在其中的作用不容忽视.理想的敷料应既能够保护伤口、减轻局部症状,又能够维持伤口湿润、促进创面愈合.任何一类敷料都不可能具有伞部功能,但是每一种敷料都具有各自的特点.水凝胶敷料能促进组织自溶,在治疗坏死组织较多的创面时可与外科清创结合使用.藻酸盐和泡沫敷料具有良好的吸收性,适合于渗液量大的伤口.含生长因子敷料和牛物工:程皮肤组织替代物在系统治疗3周以上仍难愈合的创面中疗效显著.感染性伤口应避免使用密闭性敷料,含抗生索的敷料可能有效.对于渗液较多的创面更换次数需要增加,避免周围组织浸渍.总之,敷料的选择应从创面的临床特点、患者自身的需求和成本效益等多方面考虑.%The managment of diabetic foot is a complicated clinical issue which involves many as-pects ,wound dressings play an important adjunctive role in the treatment of diabetic foot ulceration. Ideally, dressings should protect wound, alleviate symptoms, and maintain a moist wound environment, etc. No single dressing fulfills all the function ,however,each category of dressings has particular characteristics that aid se-lection. Hydrogels facilitate autolysis and may be beneficial in managing ulcers with necrotic tissue. Foam and alginate dressings arc highly absorbent and effective for heavily exuding wounds. The dressing containing growth factor or bioengineered tissue has been effectively and safely used to increase the incidence of com-plete wound closure. Occlusive dressings should be avoided for infected wounds, dressing impregnated with antibiotics or silver may be eligible for these wounds. In a word, decisions regarding which dressing to apply should be based on the characteristics of the ulcer, patient's preferences and cost effectiveness.

  4. 部队住院伤病员管理的难点与对策%The dififculties and Countermeasures of management of hospitalized wounded troops

    Institute of Scientific and Technical Information of China (English)

    刘昱甬; 秦梅红

    2015-01-01

    the management of the wounded troops is the key and difficult point in military hospital management. The author analyzes the wounded characteristics and management difficulties, introduced by measures to strengthen medical staff awareness of service and the sick and wounded of ideological education, perfect management mechanism, carrying out high-quality care etc., high quality completed the task of the sick and wounded were, to realize the safety management of the sick and wounded.%部队伤病员管理是部队医院管理的重点和难点。笔者剖析了伤病员特点和管理难点,介绍了通过强化医务人员服务意识和伤病员思想教育、完善管理机制、开展优质护理等措施,高质量地完成了伤病员收治任务,实现了伤病员的安全管理。

  5. Manuka honey in wound management: greater than the sum of its parts?

    Science.gov (United States)

    White, R

    2016-09-01

    Few involved in wound care will have escaped the considerable interest which has been generated by the resurgence in honey. Equally, there will be many clinicians around the globe who are wondering why all the fuss, as they will have been using honey all along. However, even with the advent of 'medical-grade' honey, combined with considerable research into the numerous potential modes of action, there remains a lingering scepticism regarding the value of honey as a justified, modern intervention in wound care. The purpose of this brief review is to summarise the ongoing chemical, biochemical and microbiological research and to correlate it with clinical outcomes. The purpose being to present the enquiring clinician with an evidence summary with which clinical choices may be made. While much of the early research was into generic honeys, one particular source, manuka, appears especially effective, and as such this has been the focus of recent studies. PMID:27608515

  6. Advanced and controlled drug delivery systems in clinical disease management

    NARCIS (Netherlands)

    Brouwers, JRBJ

    1996-01-01

    Advanced and controlled drug delivery systems are important for clinical disease management. In this review the most important new systems which have reached clinical application are highlighted. Microbiologically controlled drug delivery is important for gastrointestinal diseases like ulcerative co

  7. Complementary and alternative therapies for management of odor in malignant fungating wounds: a critical review

    OpenAIRE

    Gethin G; McIntosh C; Probst S

    2016-01-01

    Georgina Gethin,1 Caroline McIntosh,2 Sebastian Probst3 1School of Nursing and Midwifery, National University of Ireland, Galway, 2Discipline of Podiatric Medicine, National University of Ireland, Galway, Ireland; 3School of Health, University of Applied Sciences Western Switzerland, Geneva, Switzerland Abstract: Malignant fungating wounds (MFWs) affect an estimated 5%–10% of all people with cancer. They have a profound effect on the individual, and their associated symptoms such as bl...

  8. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    Jeschke, Marc

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased lite...

  9. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    AD Rogers; MG, Jeschke

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literatu...

  10. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    OpenAIRE

    Karaaslan F; Erdem Ş; Mermerkaya MU

    2014-01-01

    Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar in...

  11. Effective use of negative pressure wound therapy provides quick wound-bed preparation and complete graft take in the management of chronic venous ulcers.

    Science.gov (United States)

    Egemen, Onur; Ozkaya, Ozay; Ozturk, Muhammed Besir; Aksan, Tolga; Orman, Çağdaş; Akan, Mithat

    2012-04-01

    Venous ulcers are characterised by longstanding and recurrent loss of skin integrity. Once occurred, healing is slow and recurrence is high because of inappropriate conditions of the wound bed. This study involves 20 patients with chronic venous ulcers at least 6 weeks of duration treated with negative pressure wound therapy (NPWT). Patients underwent a radical debridement of all devitalised tissues in the first operation. After adequate haemostasis, silver-impregnated polyurethane foam was applied. Once the wounds were determined to be clean and adequate granulation tissue formation was achieved, split-thickness skin grafts were applied. Black polyurethane foam was applied over them. All wounds completely healed without the need for further debridement or regrafting. The mean number of silver-impregnated foam dressing changes prior to grafting was 2·9 (one to eight changes). The mean number of NPWT foam changes was 2·6 after skin grafting (two to five changes). Two patients who did not use conservative treatments for chronic venous insufficiency (CVI) after discharge from the hospital had recurrence of venous ulcers in the follow-up period. Application of NPWT provides quick wound-bed preparation and complete graft take in venous ulcer treatment. PMID:21992173

  12. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    LENUS (Irish Health Repository)

    Gethin, Georgina

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.

  13. Recent advances in the management of choreas

    OpenAIRE

    Burgunder, Jean-Marc

    2013-01-01

    The management of patients with chorea, in particular Huntington’s disease, is a complex task requiring skills in a number of areas. This paper reviews new knowledge on this topic and places it in the context of established procedures. It is focused on Huntington’s disease, since this is the disorder, for which most publications on management have been published in the past few years. Management starts with appropriate diagnosis and differential diagnosis, with the aim of finding disorders wi...

  14. Advances in wound care theory and technology%伤口护理理论与技术进展

    Institute of Scientific and Technical Information of China (English)

    王庆梅; 唐艳光

    2012-01-01

    This paper reviews the progress in wound care research at home and abroad in recent years in regard to the aspects of wound healing theory,development of occlusive dressings,and wound care technology,etc.Wound care methods are constantly updated along with the development of medical science and technology,as well as theory and practice of nursing.Clinical nursing staff should acquire the latest knowledge of wound care,treat patients with appropriate methods of dressing and cover materials according to their conditions,and make effort to promote nutritional state,alleviate pain,and promote psychological care of patients,thus to provide patients with integral and dynamic wound care.%伤口指皮肤组织的完整性受到破坏,常伴有机体物质的缺失.伤口护理是护理工作的一项重要内容,随着研究的不断深入,其处置理念和处置手段都发生了变化;从简单的伤口消毒到选择治疗性创面敷料,从传统的保持伤口干燥逐渐转变为维持局部微湿环境.本文以伤口愈合理论、伤口敷料以及伤口护理技术为例,综述当前研究进展.

  15. Burn wound: How it differs from other wounds?

    OpenAIRE

    Tiwari, V K

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock wh...

  16. Advanced Interval Management (IM) Concepts of Operations

    Science.gov (United States)

    Barmore, Bryan E.; Ahmad, Nash'at N.; Underwood, Matthew C.

    2014-01-01

    This document provides a high-level description of several advanced IM operations that NASA is considering for future research and development. It covers two versions of IM-CSPO and IM with Wake Mitigation. These are preliminary descriptions to support an initial benefits analysis

  17. Management of low velocity gunshot wounds to the anterior urethra: the role of primary repair versus urinary diversion alone.

    Science.gov (United States)

    Husmann, D A; Boone, T B; Wilson, W T

    1993-07-01

    The management of partial transection of the anterior urethra following penetrating penile injuries is controversial. Optional therapeutic techniques range from a primary sutured reapproximation to urinary diversion alone. We recently managed 17 low velocity gunshot wounds to the external genitalia in which the missile traversed the penile corpus cavernosum, and was associated with less than 40% transection of the corpus spongiosum and anterior urethra. Nine patients were managed with suprapubic diversion, skin débridement and corporeal closure along with placement of a urethral catheter. Eight patients were managed by suprapubic diversion, débridement, closure of the corporeal bodies and a primary sutured reapproximation of the anterior urethra. Urethral strictures developed in 7 patients (78%) managed by a suprapubic tube and urethral stenting during an average followup of 20 months (range 18 to 24). In contrast, 1 patient (12%) managed by a sutured urethral approximation had a urethral stricture during an average followup of 20 months (range 18 to 30, p placement of a suprapubic catheter and primary repair of the urethra. PMID:8510278

  18. Advanced Data Collection for Inventory Management

    Science.gov (United States)

    Opresko, G. A.; Leet, J. H.; Mcgrath, D. F.; Eidson, J.

    1987-01-01

    Bar-coding, radio-frequency, and voice-operated systems selected. Report discusses study of state-of-the-art in automated collection of data for management of large inventories. Study included comprehensive search of literature on data collection and inventory management, visits to existing automated inventory systems, and tours of selected supply and transportation facilities at Kennedy Space Center. Information collected analyzed in view of needs of conceptual inventory-management systems for Kennedy Space Center and for manned space station and other future space projects.

  19. Manejo quirúrgico urgente de heridas faciales por mordedura humana Urgent surgical management of facial human bite wounds

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2011-09-01

    Full Text Available Las heridas por mordedura pueden generar algunas dificultades quirúrgicas en su manejo inicial debido a su especial predisposición a las complicaciones sépticas y la importante destrucción tisular frecuentemente asociada. Sin embargo, es importante su reparación inmediata, especialmente en el caso de amputaciones y colgajos por avulsión. Las mordeduras humanas se hallan envueltas además en consideraciones psicológicas que incrementan la dificultad del tratamiento debido a las espectativas estéticas de los pacientes que las sufren. Este trabajo analiza 7 casos de mordedura facial humana desde los puntos de vista epidemiológico y clínico. Presentamos y discutimos el uso de los tejidos amputados como fuente de injertos de piel, injertos condrales y el papel de los colgajos locales en dos tiempos en la cirugía de urgencia de estas lesiones.Bite wounds can create several surgical difficulties in their initial management due to the special facility for infectious complications and the frequent association with extensive tissue damage. However, the immediate repair its desirable, mainly in amputations and flap avulsions. The human bite wounds are also involved by psychological considerations that increase the difficulty of the treatment due to patient´s aesthetic expectations. This article analyzes 7 cases of facial human bites under the epidemiological and clinical points of view. The use of the amputated tissues to obtain skin grafts, condral grafts, and the role of local two stage flaps in the emergency surgery of these wounds are exposed and discussed.

  20. Advanced Interference Management Technique: Potentials and Limitations

    OpenAIRE

    Lee, Namyoon; Heath Jr, Robert W.

    2014-01-01

    Interference management has the potential to improve spectrum efficiency in current and next generation wireless systems (e.g. 3GPP LTE and IEEE 802.11). Recently, new paradigms for interference management have emerged to tackle interference in a general class of wireless networks: interference shaping and interference exploitation. Both approaches offer better performance in interference-limited communication regimes than traditionally thought possible. This article provides a high-level ove...

  1. Surgical management of advanced gastric cancer: An evolving issue.

    Science.gov (United States)

    Marano, L; Polom, K; Patriti, A; Roviello, G; Falco, G; Stracqualursi, A; De Luca, R; Petrioli, R; Martinotti, M; Generali, D; Marrelli, D; Di Martino, N; Roviello, F

    2016-01-01

    Worldwide, gastric cancer represents the fifth most common cancer and the third leading cause of cancer deaths. Although the overall 5-year survival for resectable disease was more than 70% in Japan due to the implementation of screening programs resulting in detection of disease at earlier stages, in Western countries more than two thirds of gastric cancers are usually diagnosed in advanced stages reporting a 5-year survival rate of only 25.7%. Anyway surgical resection with extended lymph node dissection remains the only curative therapy for non-metastatic advanced gastric cancer, while neoadjuvant and adjuvant chemotherapies can improve the outcomes aimed at the reduction of recurrence and extension of survival. High-quality research and advances in technologies have contributed to well define the oncological outcomes and have stimulated many clinical studies testing multimodality managements in the advanced disease setting. This review article aims to outline and discuss open issues in current surgical management of advanced gastric cancer. PMID:26632080

  2. Cetylpyridinium chloride and miramistin as antiseptic substances in chronic wound management - prospects and limitations.

    Science.gov (United States)

    Fromm-Dornieden, Carolin; Rembe, Julian-Dario; Schäfer, Nadine; Böhm, Julia; Stuermer, Ewa K

    2015-04-01

    The antimicrobial activity of cetylpyridinium chloride (CPC) and miramistin (MST) solutions at different concentrations (5×10(-5) to 0.4%) and a dressing, containing 0.15% CPC, were tested against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli after 30 (solutions) and 60 min (fleece) incubation, respectively. Furthermore, the cytotoxic effects of CPC and MST were examined in human keratinocyte (HaCaT) and murine fibroblast (L929) cell lines. A dose of 3×10(-3)% CPC or MST was sufficient to entirely eradicate S. aureus after 30 min incubation. To achieve the same effect, higher concentrations were required against E. coli (0.025% CPC; 0.0125% MST) and P. aeruginosa (0.5% CPC; 0.05% MST). The CPC-fleece showed a high antiseptic effect against all three bacterial strains, although it did not completely eliminate P. aeruginosa. Both substances showed a high cytotoxic impact at higher tested concentrations (CPC >3×10(-3)%; MST >8×10(-4)%). CPC showed high antimicrobial potency at low concentrations against S. aureus, accompanied by low cytotoxic (side) effects at these concentrations, whilst the required minimal concentration to eradicate E. coli and P. aeruginosa was shown to be cytotoxic for keratinocytes and fibroblasts. The necessary antibacterial amounts of MST were lower, but also cytotoxic in direct contact with typical human wound cells. With regard to demographic changes and increasing bacterial resistance, new effective antiseptics, such as CPC and MST, incorporated in wound dressings without releasing an active substance could help to improve the treatment and healing rates of chronic wounds.

  3. Advanced Radio Resource Management for IMT

    DEFF Research Database (Denmark)

    Monserrat, Jose M.; Sroka, Pawel; Auer, Gunther;

    The race towards IMT-Advanced was recently started by ITU-R who distributed a Circular Letter asking for the submission of new technology proposals. The European Celtic project WINNER+ is bridging together experts from industry, academia and government all around Europe to devise this next fourth...... in current OFDMAbased cellular systems to enhance system performance. A brief description of each technique together with the relevant state of the art is provided....

  4. Advanced Fuel Cell System Thermal Management for NASA Exploration Missions

    Science.gov (United States)

    Burke, Kenneth A.

    2009-01-01

    The NASA Glenn Research Center is developing advanced passive thermal management technology to reduce the mass and improve the reliability of space fuel cell systems for the NASA exploration program. An analysis of a state-of-the-art fuel cell cooling systems was done to benchmark the portion of a fuel cell system s mass that is dedicated to thermal management. Additional analysis was done to determine the key performance targets of the advanced passive thermal management technology that would substantially reduce fuel cell system mass.

  5. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    OpenAIRE

    Cowman, Seamus; GETHIN, GEORGINA; Clarke, Eric; Moore, Zena; Craig, Gerardine; Jordan-O'Brien, Julie; McLain, Niamh; Strapp, Helen

    2011-01-01

    Aim.  To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background.  A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. De...

  6. A preliminary study of the effect of closed incision management with negative pressure wound therapy over high-risk incisions

    OpenAIRE

    Perry, Karen L.; Rutherford, Lynda; Sajik, David M. R.; Bruce, Mieghan

    2015-01-01

    Background Certain postoperative wounds are recognised to be associated with more complications than others and may be termed high-risk. Wound healing can be particularly challenging following high-energy trauma where wound necrosis and infection rates are high. Surgical incision for joint arthrodesis can also be considered high-risk as it requires extensive and invasive surgery and postoperative distal limb swelling and wound dehiscence are common. Recent human literature has investigated th...

  7. The role of arthroscopy in the management of low-velocity gunshot wounds of the knee joint.

    Science.gov (United States)

    Parisien, J S; Esformes, I

    1984-05-01

    Eight patients with low-velocity civilian gunshot wounds of the knee were examined and evaluated by arthroscopy. Three of these patients were also treated by surgical arthroscopy and underwent limited arthrotomy for bullet removal. In two patients small arthrotomy incisions were made following arthroscopic exploration for removal of bullets. Two patients underwent diagnostic arthroscopy. One underwent internal fixation for a chondral fracture of the femoral condyle. The majority of patients sustained intra-articular damage and retained foreign materials (denim flecks and metallic shards) and osteochondral fragments. There were no postoperative infections after a minimum follow-up period of one year. Arthroscopy is highly effective in the diagnosis and surgical management of low-velocity gunshot wounds of the knee both alone and in combination with limited arthrotomy depending on the severity of the condylar damage. The length of the hospital stay is reduced (length of stay exceeded 3-4 days only as a result of intravenous antibiotic coverage). Physical therapy requirements are minimal. Active mobility and a full range of motion are regained more rapidly with arthroscopy than with surgical exposure of multiple exploratory incisions or conventional standard arthrotomy. PMID:6705381

  8. Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management

    NARCIS (Netherlands)

    Aldaz, G.; Shluzas, L.A.; Pickham, D.; Eris, O.; Sadler, J.; Joshi, S.; Leifer, L.

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing p

  9. Synthesis of multifunctional bioresponsive polymers for the management of chronic wounds.

    Science.gov (United States)

    Nyanhongo, Gibson S; Sygmund, Christoph; Ludwig, Roland; Prasetyo, Endry Nugroho; Guebitz, Georg M

    2013-07-01

    Novel multifunctional bioresponsive gelatin and alginate based hydrogels with in-built antioxidant regenerating system and antimicrobial properties were successfully synthesized. These hydrogels are based on the versatile reactions catalyzed by cellobiose dehydrogenase (CDH). CDH uses cellobiose and cello-oligosacharides as electron donors to reduce oxidized phenolic antioxidants, quinones, or molecular oxygen to H₂O₂ (a well-known antimicrobial agent). The antioxidant regenerating system consisting of CDH and cellobiose increased the ability of catechol to quench nitric oxide (NO), superoxide (O₂⁻) and hydroxyl radicals (OH•) in solution and when incorporated into hydrogels. The CDH loaded into the hydrogels free of oxidized phenolic antioxidants and quinones reduced molecular to H₂O₂ resulting in the complete inhibition of the growth of Stapylococcus aeureus, Bacillus subtilis, Pseudomonas putida, Escherichia coli and Cellulomonasmicrobium cellulans. This study therefore presents a new concept for synthesizing multifunctional bioresponsive chronic wound dressing polymers with in-built continuous antioxidant system able to continuously quench [reactive oxygen species (ROS) and reactive nitrogen species (RNOS)], and antimicrobial properties able to prevent microbial colonization of wound.

  10. Phases management for advanced life support processes

    NARCIS (Netherlands)

    Eckhard, F.; Brunink, J.A.J.; Tuinstra, B.; Assink, J.W.; Ten Asbroek, N.; Backx, V.; Klaassen, A.; Waters, G.; Stasiak, M.A.; Dixon, M.; Ordoñez-Inda, L.

    2005-01-01

    For a planetary base, a reliable life support system including food and water supply, gas generation and waste management is a condition sine qua non. While for a short-term period the life support system may be an open loop, i.e. water, gases and food provided from the Earth, for long-term missions

  11. Wound care dressings and choices for care of wounds in the home.

    Science.gov (United States)

    Adkins, Carrie L

    2013-05-01

    Statistics from various resources report that many patients in home healthcare settings have wounds. These vary from surgical, pressure, neuropathic, trauma, stasis, and venous wounds. These require the assessment, knowledge, and expertise of a clinician to assist them with wound care management. The purpose of this article is to identify and categorize types of wound care products appropriate for the various types of wounds that clinicians care for and manage in the home.

  12. 伤口护理风险预案的制订及应用效果评价%The development and application of wound care risk protocol in risk management of wound care

    Institute of Scientific and Technical Information of China (English)

    蒋琪霞; 彭青; 周昕; 李晓华

    2012-01-01

    Objective To explore the effect of wound care risk protocol for risk management of wound care. Methods The risk factors of wound care were identified based on literature review and retrospective cases analysis. Then,the eight step wound care risk protocol was developed and applied in nursing management of wound care after nurse training. The patient satisfaction, the incidence and severity of adverse events were recorded before and after the implementation of wound care risk protocol. Results After the implementation of wound care risk protocol,the incidence of adverse events decreased from 7.805% to 2.037%(P<0.05). The patient satisfaction increased from(98.62±0.63)% to (95.61+0.81 )%(P<0.05). The severity of adverse events was lower than before (P<0.05). Conclusion The implementation of wound care risk protocol can reduce the incidence and severity of adverse events, and increase patient satisfaction. It is an effective method for risk management of wound care.%目的 探讨伤口护理风险预案在伤口护理风险管理中的作用.方法 通过文献检索和回顾性分析,找出伤口护理中常见的风险问题,制订相应的伤口护理风险预案,设定风险管理八步骤方法,培训护士掌握并应用.评价风险预案管理实施前后的患者满意率、不良事件发生率和等级.结果 风险预案实施后的不良事件发生率为2.037%,低于实施前的7.805%,差异有统计学意义(P<0.05);患者满意率为(98.62±0.63)%,高于实施前的(95.61±0.81)%,差异有统计学意义(P<0.05).不良事件等级的严重度低于实施前(P<0.05).结论 伤口护理风险预案有助于降低患者不良事件发生率及其严重度,可提高患者满意率,是伤口护理风险管理的有效方法.

  13. System and method for advanced power management

    Science.gov (United States)

    Atcitty, Stanley; Symons, Philip C.; Butler, Paul C.; Corey, Garth P.

    2009-07-28

    A power management system is provided that includes a power supply means comprising a plurality of power supply strings, a testing means operably connected to said plurality of power supply strings for evaluating performance characteristics of said plurality of power supply strings, and a control means for monitoring power requirements and comprising a switching means for controlling switching of said plurality of power supply strings to said testing means.

  14. Management of advanced hair loss patterns.

    Science.gov (United States)

    Beehner, Michael L

    2013-08-01

    This article covers how to manage patients with extensive hair loss in whom complete, dense coverage is not possible. In addition to discussing planning a transplant pattern for already bald men, I discuss a conservative approach for recognizing and transplanting younger patients who have telltale warning signs that may evolve to extensive hair loss. For both groups, a variant of a frontal forelock-type pattern is usually the best course to follow. PMID:24017980

  15. Advanced User Interfaces for Product Management Systems

    OpenAIRE

    Gundelsweiler, Fredrik; Reiterer, Harald

    2008-01-01

    Few of today s EPDM (electronic product data management) systems make use of valuable approaches in user interface design and information visualization as suggested by researchers. In this paper, we describe a design approach addressing the problems of searching, browsing, visualizing and filtering information in hierarchically structured graphs. The main problem areas we identified are the amount of data, the possibly complex hierarchical structure in combination with a chronological version...

  16. Neonatal Seizures. Advances in Mechanisms and Management.

    OpenAIRE

    Glass, HC

    2013-01-01

    Seizures occur in approximately 1–5 per 1,000 live births, and are among the most common neurologic conditions managed by a neonatal neurocritical care service. There are several, age-specific factors that are particular to the developing brain, which influence excitability and seizure generation, response to medications, and impact of seizures on brain structure and function. Neonatal seizures are often associated with serious underlying brain injury such as hypoxia-ischemia, stroke or hemor...

  17. Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

    Science.gov (United States)

    Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D

    2016-08-01

    Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies.

  18. Advances in the management of chronic insomnia.

    Science.gov (United States)

    Kay-Stacey, Margaret; Attarian, Hrayr

    2016-01-01

    Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients' health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these treatments. However, in recent years, alternative ways of providing these behavioral therapies that make them more widely available have been investigated. Drugs also play an important role in the treatment of insomnia and new drugs have been introduced as options for treating patients with sleep initiation and sleep maintenance insomnia. In this review, we will discuss advances in the past six years in both non-pharmacologic and pharmacologic treatments for patients with chronic insomnia. We will also review the controversies surrounding some of the current drug treatments, as well as the role that technology and personal activity monitoring devices may play in treating insomnia. PMID:27383400

  19. Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post-operative wound infections:University of Calabar Teaching Hospital experience

    Institute of Scientific and Technical Information of China (English)

    Jombo GT; Akpan S; Epoke J; Denen Akaa P; Odey F

    2010-01-01

    Objective:To ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs). Methods:The study was retrospective in nature and was compiled for a period of five years (1st February, 2004-31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients’ records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software. Results:Of the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1%of the culture positive specimens with its rate of recovery decreasing with age progression (P0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and co-trimoxazole were the least active antibiotics, with no antibiotic having a 100%activity against the organism. Conclusions:In view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.

  20. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

    Directory of Open Access Journals (Sweden)

    Nasir Nur-Azida

    2010-06-01

    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  1. Management of patients with advanced prostate cancer

    DEFF Research Database (Denmark)

    Gillessen, S; Omlin, A; Attard, G;

    2015-01-01

    -resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion......, and not based on a critical review of the available evidence, are presented. The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online. Detailed...

  2. Knowledge Management Platform in Advanced Product Quality Planning

    Science.gov (United States)

    Chiliban, Bogdan; Baral, Lal Mohan; Kifor, Claudiu

    2014-12-01

    Knowledge is an essential part of organizational competitiveness. This vital resource must be managed correctly within organizations in order to achieve desired performance levels within all undertakings. The process of managing knowledge is a very difficult one due to the illusive nature of the resource itself. Knowledge is stored within every aspect of an organization starting from people and ending with documents and processes. The Knowledge Management Platform is designed as a facilitator for managers and employees in all endeavours knowledge related within the Advanced Product Quality Planning Procedure

  3. A review on recent advances on knowledge management implementations

    Directory of Open Access Journals (Sweden)

    Maghsoud Amiri

    2013-03-01

    Full Text Available Knowledge management plays an essential role on developing efficient systems in educational systems. However, there are different factors influencing the success of knowledge management. In this paper, we review recent advances on implementation of knowledge management (KM in different areas and discuss why some of KM implementations fail and how they could turn to a successful one. The review focus more on recently published papers in different perspective from the implementation of KM in educational units to KM implementation on project management field.

  4. Identifying wound prevalence using the Mobile Wound Care program.

    Science.gov (United States)

    Walker, Judi; Cullen, Marianne; Chambers, Helen; Mitchell, Eleanor; Steers, Nicole; Khalil, Hanan

    2014-06-01

    Measuring the prevalence of wounds within health care systems is a challenging and complex undertaking. This is often compounded by the clinicians' training, the availability of the required data to collect, incomplete documentation and lack of reporting of this type of data across the various health care settings. To date, there is little published data on wound prevalence across regions or states. This study aims to identify the number and types of wounds treated in the Gippsland area using the Mobile Wound Care (MWC™) program. The MWC program has enabled clinicians in Gippsland to collect data on wounds managed by district nurses from four health services. The main outcomes measured were patient characteristics, wound characteristics and treatment characteristics of wounds in Gippsland. These data create several clinical and research opportunities. The identification of predominant wound aetiologies in Gippsland provides a basis on which to determine a regional wound prospective and the impact of the regional epidemiology. Training that incorporates best practice guidelines can be tailored to the most prevalent wound types. Clinical pathways that encompass the Australian and New Zealand clinical practice guidelines for the management of venous leg ulcers can be introduced and the clinical and economical outcomes can be quantitatively measured. The MWC allows healing times (days) to be benchmarked both regionally and against established literature, for example, venous leg ulcers.

  5. ENHANCEMENT OF PROJECT MANAGEMENT THROUGH ADVANCED PROJECT MANAGEMENT SOFTWARE

    OpenAIRE

    Manuel, Jaison

    2010-01-01

    Engineering Procurement and Construction firms utilize project management information systems mainly to schedule the project activities, monitor progress of the activities, analyzing the earned value and controlling the budget. This enables project professionals to access greater information quality to enhance productivity and thereby reducing the project complexity. The selection of appropriate project management system for construction firm, implementation and use of these tools are tasks n...

  6. Autosomal dominant polycystic kidney disease: recent advances in clinical management.

    Science.gov (United States)

    Mao, Zhiguo; Chong, Jiehan; Ong, Albert C M

    2016-01-01

    The first clinical descriptions of autosomal dominant polycystic kidney disease (ADPKD) go back at least 500 years to the late 16 (th) century. Advances in understanding disease presentation and pathophysiology have mirrored the progress of clinical medicine in anatomy, pathology, physiology, cell biology, and genetics. The identification of PKD1 and PKD2, the major genes mutated in ADPKD, has stimulated major advances, which in turn have led to the first approved drug for this disorder and a fresh reassessment of patient management in the 21 (st) century. In this commentary, we consider how clinical management is likely to change in the coming decade. PMID:27594986

  7. Development of advanced JGIS considering qualify management and project management

    International Nuclear Information System (INIS)

    A system for managing and integrating the technical information of R and D was developed (JGIS: JAEA Geological Disposal Information Integration System). The subjects are to improve the usability as the system and the usability to record the information and the data in order to display the function of the system sufficiently and in order to enable the practical use of the system. In this study the aims are to display the function of JGIS and to enable the researchers as the users to recognize the significance of using JGIS. We built the conceptual design in order to implement the function of quality management and project management to JGIS. We considered that researchers could access the portal site of the research projects which were set as the WBS (Work Breakdown Structure) items and could confirm which WBS item the research project belonged to in the whole plan. We also considered that the research projects could be managed by using the conformity assessment sheets which were adopted for the quality management. The appendix contains the example of application of real projects to JGIS and the user's manual of JGIS (Example of a study of potential impact of natural phenomena). We demonstrated that researchers could confirm which WBS item the research project related to in JGIS and could manage the quality of the research projects by using the conformity assessment sheets in JGIS. (author)

  8. Advancing the science of forensic data management

    Science.gov (United States)

    Naughton, Timothy S.

    2002-07-01

    Many individual elements comprise a typical forensics process. Collecting evidence, analyzing it, and using results to draw conclusions are all mutually distinct endeavors. Different physical locations and personnel are involved, juxtaposed against an acute need for security and data integrity. Using digital technologies and the Internet's ubiquity, these diverse elements can be conjoined using digital data as the common element. This result is a new data management process that can be applied to serve all elements of the community. The first step is recognition of a forensics lifecycle. Evidence gathering, analysis, storage, and use in legal proceedings are actually just distinct parts of a single end-to-end process, and thus, it is hypothesized that a single data system that can also accommodate each constituent phase using common network and security protocols. This paper introduces the idea of web-based Central Data Repository. Its cornerstone is anywhere, anytime Internet upload, viewing, and report distribution. Archives exist indefinitely after being created, and high-strength security and encryption protect data and ensure subsequent case file additions do not violate chain-of-custody or other handling provisions. Several legal precedents have been established for using digital information in courts of law, and in fact, effective prosecution of cyber crimes absolutely relies on its use. An example is a US Department of Agriculture division's use of digital images to back up its inspection process, with pictures and information retained on secure servers to enforce the Perishable Agricultural Commodities Act. Forensics is a cumulative process. Secure, web-based data management solutions, such as the Central Data Repository postulated here, can support each process step. Logically marrying digital technologies with Internet accessibility should help nurture a thought process to explore alternatives that make forensics data accessible to authorized individuals

  9. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Birke-Sorensen, Hanne; Kruse, Marie;

    formation (52%) compared to standard care. The reduction in wound dehiscence was not statistically significant. The numbers needed to treat were 3 (seroma), 17 (dehiscence), and 25 (infection). Methodical heterogeneity across studies led to downgrading quality of evidence to moderate for infection......Aim: Postoperative wound complications make many surgical procedures unnecessarily complex, particularly in high-risk patients. Negative Pressure Wound Therapy is well recognized in the management of open wounds. In recent years, it has been introduced as well in the management of closed surgical...... incisions to reduce postoperative wound complications, though the evidence base to support this intervention is limited. The aim of this study was to assess if Negative Pressure Wound Therapy (NPWT) reduces postoperative complications when applied on closed surgical incisions. Method: A systematic review...

  10. Advance on wound non-healing of diabetes mellitus%糖尿病创面难愈机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    孙晓磊; 施森; 何延政

    2008-01-01

    Wound healing is a complicated biological process, which consists of inflammatory cells, re-pairing cells, extracellular matrix, cell factors, et al. These factors participate in the process of wound heal-ing in great harmony and coordination. The sufferers of diabetes mellitus are vulnerable to skin injury ,which often results in non-healing or healing delay, which became an urgent difficulty and warm spot unsolved in clinic. So far, especially for the last few years, great progress has been made in the mechanism of wound non-healing of Diabetes Mellitus, mainly including signal pathways, angiopoiesis, neuropeptides, advanced glycation end products, cell apoptosis and matrix metaltoproteinases.%创面愈合是一个复杂的生物学过程,是炎性细胞、修复细胞、细胞外基质及细胞因子等多因素共同参与并高度协调、相互调控的复杂过程.糖尿病患者皮肤易受损伤,损伤后创面愈合延迟或不愈合,成为临床上亟待解决的难点和热点.近几年来,糖尿病创面难愈机制的研究进展迅速,主要围绕在信号通路、血管生成、神经肽、糖基化终末产物、细胞凋亡及基质金属蛋白酶等方面.本文就此作一综述.

  11. Management of locally advanced breast cancer: Evolution and current practice

    OpenAIRE

    Rustogi Ashish; Budrukkar Ashwini; Dinshaw Ketayun; Jalali Rakesh

    2005-01-01

    Locally advanced breast cancer (LABC) accounts for a sizeable number (30-60%) of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the management of ...

  12. Advanced information processing system: Input/output network management software

    Science.gov (United States)

    Nagle, Gail; Alger, Linda; Kemp, Alexander

    1988-01-01

    The purpose of this document is to provide the software requirements and specifications for the Input/Output Network Management Services for the Advanced Information Processing System. This introduction and overview section is provided to briefly outline the overall architecture and software requirements of the AIPS system before discussing the details of the design requirements and specifications of the AIPS I/O Network Management software. A brief overview of the AIPS architecture followed by a more detailed description of the network architecture.

  13. Decision support tools for advanced energy management

    Energy Technology Data Exchange (ETDEWEB)

    Marik, Karel; Schindler, Zdenek; Stluka, Petr [Honeywell Prague Laboratory, Pod vodarenskou vezi 4, 182 08 Prague 8 (Czech Republic)

    2008-06-15

    Rising fuel costs boost energy prices, which is a driving force for improving efficiency of operation of any energy generation facility. This paper focuses on enhancing the operation of distributed integrated energy systems (IES), system that bring together all forms of cooling, heating and power (CCHP) technologies. Described methodology can be applied in power generation and district heating companies, as well as in small-scale systems that supply multiple types of utilities to consumers in industrial, commercial, residential and governmental spheres. Dispatching of such system in an optimal way needs to assess large number of production and purchasing schemes in conditions of continually changing market and variable utility demands influenced by many external factors, very often by weather conditions. The paper describes a combination of forecasting and optimization methods that supports effective decisions in IES system management. The forecaster generates the future most probable utility demand several hours or days ahead, derived from the past energy consumer behaviour. The optimizer generates economically most efficient operating schedule for the IES system that matches these forecasted energy demands and respects expected purchased energy prices. (author)

  14. Recommendations for managing cutaneous disorders associated with advancing age.

    Science.gov (United States)

    Humbert, Philippe; Dréno, Brigitte; Krutmann, Jean; Luger, Thomas Anton; Triller, Raoul; Meaume, Sylvie; Seité, Sophie

    2016-01-01

    The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the literature from 2004 to 2014 using PubMed was performed by a working group of six European dermatologists with clinical and research experience in dermatology. Basic topical therapy can restore and protect skin barrier function, which relieves problems associated with xerosis, prevents aggravating moisture-associated skin damage, and enhances quality of life. In conclusion, the authors provide physicians with practical recommendations to assist them in implementing basic skin care for the elderly in an integrated care approach. PMID:26929610

  15. Recommendations for managing cutaneous disorders associated with advancing age

    Directory of Open Access Journals (Sweden)

    Humbert P

    2016-02-01

    Full Text Available Philippe Humbert,1 Brigitte Dréno,2 Jean Krutmann,3 Thomas Anton Luger,4 Raoul Triller,5 Sylvie Meaume,6 Sophie Seité71Research and Studies Centre on the Integument (CERT, Clinical Investigation Centre (CIC BT506, Department of Dermatology, Besançon University Hospital, University of Franche-Comté, Besançon, France; 2Department of Dermato-Cancerology, Nantes University Hospital, Nantes, France; 3IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine-University, Düsseldorf, Germany; 4Department of Dermatology, University of Münster, Münster, Germany; 5International Centre of Dermatology, Hertford British Hospital, Levallois, France; 6Geriatric Service, Wounds and Healing, Rothschild Hôspital, Paris, France; 7La Roche-Posay Dermatological Laboratories, Asnières, FranceAbstract: The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the

  16. Advances in migraine management: implications for managed care organizations.

    Science.gov (United States)

    Dodick, David W; Lipsy, Robert J

    2004-05-01

    Migraine headache is a disabling disease that poses a significant societal burden. Stratified care and early intervention are current strategies for migraine management. It has been shown that early treatment with triptans in select patients can improve treatment outcomes. Triptans are selective 5-HT receptor agonists that are specific and effective treatments in the management of migraine, and they meet the acute treatment goal of rapid relief with minimal side effects. Triptans are associated with improved quality of life. Factors such as speed of onset, need for a second triptan dose, and patient satisfaction should be considered in the selection of a specific triptan treatment. Appropriate treatment can decrease costs. The patient's migraine history and response to prior therapy should be considered when selecting acute treatment. Cost-effectiveness models can be used to understand the effect of treatment choices on health care budgets. The direct cost per migraine episode, driven primarily by the need for rescue medications, is important to include in economic models. All aspects of effectiveness (efficacy, tolerability, and cost) should be considered to reduce overall managed care expenditures for migraine treatment. The improved clinical profiles of the triptans provide substantial value to managed care organizations.

  17. p38 MAPK inhibition reduces diabetes-induced impairment of wound healing

    OpenAIRE

    Satyanarayana Medicherla; Scott Wadsworth; Breda Cullen; Derek Silcock; et al.

    2009-01-01

    Satyanarayana Medicherla1, Scott Wadsworth2, Breda Cullen3, Derek Silcock3, Jing Y Ma1, Ruban Mangadu1, Irene Kerr1, Sarvajit Chakravarty1, Gregory L Luedtke1, Sundeep Dugar1, Andrew A Protter1, Linda S Higgins11Scios Inc., Fremont, CA, USA; 2Center for Biomaterials and Advanced Technologies, Somerville, NJ, USA; 3Johnson & Johnson Wound Management, Gargrave, UKAbstract: In healthy tissue, a wound initiates an inflammatory response characterized by the presence of a hematoma,...

  18. The interrelationships between wound management, thermal stress, energy metabolism, and temperature profiles of patients with burns.

    Science.gov (United States)

    Wallace, B H; Caldwell, F T; Cone, J B

    1994-01-01

    This prospective randomized study was performed to evaluate the metabolic and thermal responsiveness of patients with burns to thermal stress with three protocols of wound care: group I (n = 7) treated with dressings and variable ambient temperature selected for patients subjective comfort; group II (n = 7) treated without dressings and variable ambient temperature for patient comfort; group III (n = 6) treated without dressings and ambient temperature of 25 degrees C, electromagnetic heaters were set to achieve patient subjective comfort; and group IV (n = 6) healthy volunteers. After baseline partitional calorimetry was performed, individual patients were cold-challenged while subjectively comfortable by sequentially lowering either the ambient temperature or the output from the electromagnetic heaters. Heat balance and temperatures were obtained after each perturbation in external energy support. For patients in groups I and II, subjective perception of thermal comfort (warm, neutral, neutral and fed, cool, or cold) was more strongly correlated (p temperature. For patients treated with electromagnetic heaters, changes in heat production were most strongly correlated with the energy output from the electromagnetic heaters. Even though the environmental conditions required to achieve a particular level of comfort are quite different between treatment groups, the difference in temperature between the patient's surface and ambient is approximately the same for groups I, II, and IV for each subjective state.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. [Recent advances in dry eye: etiology, pathogenesis and management].

    Science.gov (United States)

    Qin, Yi; Pan, Zhi-qiang

    2013-09-01

    Dry eye is one of the most common and multifactorial disease of the ocular surface that results in ocular discomfort, blurred vision, reduced quality of life, and decreased productivity. Recent advances in our knowledge of the causation of dry eye open opportunities for improving diagnosis , and disease management and for developing new, more effective therapies to manage this widely prevalent and debilitating disease state. In light of the above knowledge, the present article reviews the newer theories and reports on etiology , pathogenesis and management of dry eye.

  20. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

    Directory of Open Access Journals (Sweden)

    Ahmadi Koorosh

    2013-06-01

    Full Text Available 【Abstract】Objective: Since appropriate and time-table methods in trauma care have an important impact on patients’ outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS program on medical interns' performance in simulated trauma patient management. Methods: A descriptive and analytical study before and after the training was conducted on 24 randomly se-lected undergraduate medical interns from Imam Reza Hos-pital in Mashhad, Iran. On the first day, we assessed in-terns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre-and post- ATLS periods, were compared through SPSS ver-sion 15.0 software. P values less than 0.05 were considered statistically significant. Results: Our findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P<0.001, P=0.016 and P=0.01 respectively. Conclusion: ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns. Key words: Advanced Trauma Life Support Care; Knowledge; Inservice training; Wounds and injuries

  1. A Global Perspective on Wound Care

    OpenAIRE

    Serena, Thomas E

    2014-01-01

    The development of an interprofessional team approach to the care of acute and chronic wounds is a worldwide challenge. This global unmet need has recently been recognized by the World Health Organization (WHO) and addressed by the Association for the Advancement of Wound Care (AAWC) Global Volunteers program. This article provides an overview of the escalating international wound problem. Current programs established to deal with wounds in resource-poor countries are presented as well as inf...

  2. State-of-the-art wound healing: skin substitutes for chronic wounds.

    Science.gov (United States)

    Han, George

    2014-01-01

    The care of chronic wounds represents an important and evolving area of dermatology. With a rising prevalence of chronic wounds bearing notable effects on patient morbidity including amputations, appropriate and effective intervention to treat these debilitating wounds can make a significant clinical impact. In recent years, several advanced bioactive wound dressings have been developed to specifically treat chronic nonhealing wounds. These wound dressings encompass a wide range of products containing synthetic matrix scaffolds, animal-derived matrices, and human tissue. With several of these wound dressings, randomized controlled trials (RCTs) have demonstrated improvement in wound healing; furthermore, cost-effectiveness studies have suggested that these products may reduce the overall cost of treating a chronic wound. Familiarity with these products and their appropriate use may be helpful to dermatologists treating chronic wounds.

  3. Low-level laser therapy: An experimental design for wound management: A case-controlled study in rabbit model

    Directory of Open Access Journals (Sweden)

    Hossein Hodjati

    2014-01-01

    Full Text Available Background: There is a wide array of articles in medical literature for and against the laser effect on wound healing but without discrete effect determination or conclusion. This experimental study aims to evaluate the efficacy of low-level laser therapy on wound healing. Materials and Methods: Thirty-four rabbits were randomly enrolled in two groups after creating a full thickness of 3 × 3 cm wound. The intervention group received low density laser exposure (4 J/cm 2 on days 0, 3 and 6 with diode helium-neon low-intensity laser device (wl = 808 nm and in control group moist wound dressing applied. Finally, wound-healing process was evaluated by both gross and pathological assessment. Results: Fibrin formation was the same in the two groups (P = 0.4 but epithelialisation was much more in laser group (P = 0.02. Wound inflammation of the laser group was smaller than that of the control groups but statistical significance was not shown (P = 0.09. Although more smooth muscle actin was found in the wounds of the laser group but it was not statistically significant (P = 0.3. Wound diameter showed significant decrease in wound area in laser group (P = 0.003. Conclusion: According to our study, it seems that low-level laser therapy accelerates wound healing at least in some phases of healing process. So, we can conclude that our study also shows some hopes for low level laser therapy effect on wound healing at least in animal model.

  4. 建立多学科合作机制精准治疗特殊原因创面%Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2016-01-01

    With the development of social economy,people's lifestyle has changed accompanied with the problem of population aging.The spectrum of disease also varied accordingly,thus led to complicated and varied wound aetiology,along with the formation of innumerably changed acute and chronic wounds.Therefore,it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline.The extraordinary agent wound is caused by some uncommon or rare etiological factors,the specialty of which lays on the unique mechanism of wound formation,and a lot of disciplines were involved in the diagnosis and management of the wound.A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology.The primary diseases which induced the uncommon agent wound should be targeted and treated effectively;meanwhile,a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment.

  5. Advanced thermal management materials for concentrator photovoltaic arrays

    Science.gov (United States)

    Zweben, Carl

    2010-08-01

    Thermal management is a critical issue for photovoltaics (PVs), especially concentrator photovoltaic systems. Thermal management problems are similar for all semiconductors, including those used in microelectronics and other optoelectronic applications, such as lasers, light-emitting diodes (LEDs), detectors and displays. We divide the thermal management problem into two parts: heat dissipation and thermal stresses. Heat dissipation affects efficiency and lifetime. Thermal stresses affect manufacturing yield and lifetime. Traditional thermal management materials all have serious deficiencies. Copper and aluminum have high coefficients of thermal expansion (CTEs), which can cause severe thermal stresses during manufacturing and in service. Compliant attach materials, used to minimize thermal stresses, all have major drawbacks. Traditional low-CTE thermal management materials have relatively low thermal conductivities and are hard to machine. In response to these deficiencies, new thermal management materials have been, and are continuing to be developed, which have low CTEs and thermal conductivities up to four times that of copper. Some are reportedly are cheaper than copper. In this paper, we survey the six categories of advanced thermal materials, including properties, state of maturity and cost. We also review a CPV application in which an advanced metal matrix composite with a tailored CTE eliminated solder joint failure and provided other benefits.

  6. Overutilization of bracing in the management of penetrating spinal cord injury from gunshot wounds.

    Science.gov (United States)

    Eftekhary, Nima; Nwosu, Kenneth; McCoy, Eric; Fukunaga, Dudley; Rolfe, Kevin

    2016-07-01

    OBJECTIVE Penetrating gunshot wounds (GSWs) to the spinal column are stable injuries and do not require spinal orthoses or bracing postinjury. Nonetheless, a high number of GSW-related spinal cord injury (SCI) patients are referred with a brace to national rehabilitation centers. Unnecessary bracing may encumber rehabilitation, create skin breakdown or pressure ulcers, and add excessive costs. The aim of this study was to confirm the stability of spinal column injuries from GSWs and quantify the overutilization rate of bracing based on long-term follow-up. METHODS This retrospective cohort study was performed at a nationally renowned rehabilitation center. In total, 487 GSW-related SCI patients were transferred for rehabilitation and identified over the last 14 years. Retrospective chart review and telephone interviews were conducted to identify patients who were braced at the initial treating institution and determine if late instability, deformity, or neurological deterioration resulted in secondary surgery or intervention. In addition, 396 unoperated patients were available for analysis after 91 patients were excluded for undergoing an initial destabilizing surgical dissection or laminectomy, thereby altering the natural history of the injury. All of these 396 patients who presented with a brace had bracing discontinued upon reaching the facility. RESULTS In total, 203 of 396 patients were transferred with a spinal brace, demonstrating an overutilization rate of 51%. No patients deteriorated neurologically or needed later surgery for spinal column deformity or instability attributable to the injury. All patients had stable injuries. The patterns of injury and severity of neurological injury did not vary between patients who were initially braced or unbraced. The average follow-up was 7.8 years (range 1-14 years) and the average age was 25 years (range 10-62 years). CONCLUSIONS The incidence of brace overutilization for penetrating GSW-related SCI was 51%. Long

  7. Advance simulation capability for environmental management (ASCEM) - 59065

    International Nuclear Information System (INIS)

    The United States Department Energy (DOE) Office of Environmental Management (EM) determined that uniform application of advanced modeling in the subsurface could help reduce the cost and risks associated with its environmental cleanup mission. In response to this determination, the EM Office of Technology Innovation and Development (OTID), Groundwater and Soil Remediation (GW and S) began the program Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for integrating data and scientific understanding to enable prediction of contaminant fate and transport in natural and engineered systems. This initiative supports the reduction of uncertainties and risks associated with EM?s environmental cleanup and closure programs through better understanding and quantifying the subsurface flow and contaminant transport behavior in complex geological systems. This involves the long-term performance of engineered components, including cementitious materials in nuclear waste disposal facilities that may be sources for future contamination of the subsurface. This paper describes the ASCEM tools and approach and the ASCEM programmatic accomplishments completed in 2010 including recent advances and technology transfer. The US Department of Energy Office of Environmental Management has begun development of an Advanced Simulation Capability for Environmental Management, (ASCEM). This program will provide predictions of the end states of contaminated areas allowing for cost and risk reduction of EM remedial activities. ASCEM will provide the tools and approaches necessary to standardize risk and performance assessments across the DOE complex. Through its Phase One demonstration, the ASCEM team has shown value to the EM community in the areas of High Performance Computing, Data Management, Visualization, and Uncertainty Quantification. In 2012, ASCEM will provide an initial limited release of a community code for

  8. Radiotherapy and wound healing.

    Science.gov (United States)

    Devalia, Haresh L; Mansfield, Lucy

    2008-03-01

    This review article discusses basic radiation physics and effects of radiation on wounds. It examines various postulated hypothesis on the role of circulatory decrease and radiation-induced direct cellular damage. The new concept related to the radiation pathogenesis proposes that there is a cascade of cytokines initiated immediately after the radiation. Sustained activation of myofibroblasts in the wound accounts for its chronicity. Recent advances highlight that transforming growth factor beta1 is the master switch in pathogenesis of radiation fibrosis. This articles overviews its role and summarises the available evidences related to radiation damage. The goal of this article was to provide its modern understanding, as future research will concentrate on antagonising the effects of cytokines to promote wound healing. PMID:18081782

  9. The principles of holistic wound assessment.

    Science.gov (United States)

    Brown, Annemarie

    This article is the second in a series designed to enhance nurses' knowledge of wound management. It highlights the importance of assessing patients holistically, and provides an overview of the key factors that should be considered when assessing a wound. A well-designed template enables nurses to carry out a comprehensive assessment that ensures accurate documentation to monitor wound healing.

  10. Combination of adrenomedullin with its binding protein accelerates cutaneous wound healing.

    Directory of Open Access Journals (Sweden)

    Juan-Pablo Idrovo

    Full Text Available Cutaneous wound continues to cause significant morbidity and mortality in the setting of diseases such as diabetes and cardiovascular diseases. Despite advances in wound care management, there is still an unmet medical need exists for efficient therapy for cutaneous wound. Combined treatment of adrenomedullin (AM and its binding protein-1 (AMBP-1 is protective in various disease conditions. To examine the effect of the combination treatment of AM and AMBP-1 on cutaneous wound healing, full-thickness 2.0-cm diameter circular excision wounds were surgically created on the dorsum of rats, saline (vehicle or AM/AMBP-1 (96/320 μg kg BW was topically applied to the wound daily and wound size measured. At days 3, 7, and 14, skin samples were collected from the wound sites. AM/AMBP-1 treated group had significantly smaller wound surface area than the vehicle group over the 14-day time course. At day 3, AM/AMBP-1 promoted neutrophil infiltration (MPO, increased cytokine levels (IL-6 and TNF-α, angiogenesis (CD31, VEGF and TGFβ-1 and cell proliferation (Ki67. By day 7 and 14, AM/AMBP-1 treatment decreased MPO, followed by a rapid resolution of inflammation characterized by a decrease in cytokines. At the matured stage, AM/AMBP-1 treatment increased the alpha smooth muscle actin expression (mature blood vessels and Masson-Trichrome staining (collagen deposition along the granulation area, and increased MMP-9 and decreased MMP-2 mRNA expressions. TGFβ-1 mRNA levels in AM/AMBP-1 group were 5.3 times lower than those in the vehicle group. AM/AMBP-1 accelerated wound healing by promoting angiogenesis, collagen deposition and remodeling. Treatment also shortened the days to reach plateau for wound closure. Thus, AM/AMBP-1 may be further developed as a therapeutic for cutaneous wound healing.

  11. Advanced information technology for training and emergency management

    International Nuclear Information System (INIS)

    Modern information technology provides many possibilities for improving both the safety and the availability of nuclear installations. A Nordic research programme was started in 1977, in which several organizations in Denmark, Finland, Norway and Sweden has been participating. The work has on a general level been addressing control rooms, human reliability and information technology for nuclear power plants. The research has had impact on the development of the control room solutions and the training simulators in Finland and also in the other Nordic countries. The present phase of the Nordic cooperation is investigating the use of advanced information technology in emergency management. The paper gives a brief introduction to the use of advance information technology for training and emergency management, which is based on the experience from the Nordic projects and other similar application projects in Finland. The paper includes also references to results from several of the projects. (author)

  12. Nutritional management of the patient with advanced cancer.

    Science.gov (United States)

    Theologides, A

    1977-02-01

    Protein-calorie malnutrition, vitamin and other deficiencies, and weight loss frequently develop in cancer patients. Although there is no evidence that aggressive nutritional management prolongs survival, it may improve the quality of life. Efforts should be made to maintain adequate daily caloric intake with appropriate food selection and with control of complications interfering with nutrition. In selected patients, intravenous hyperalimentation can provide adequate nutrition during potentially effective chemotherapy or radiotherapy. Elemental diets also may be a source of complete or supplemental nutrition. Further experience with both approaches will help to clarify their role in the nutritional management of the patient with advanced cancer.

  13. Advanced Inverter Functions and Communication Protocols for Distribution Management

    Energy Technology Data Exchange (ETDEWEB)

    Nagarajan, Adarsh; Palmintier, Bryan; Baggu, Murali

    2016-05-05

    This paper aims at identifying the advanced features required by distribution management systems (DMS) service providers to bring inverter-connected distributed energy resources into use as an intelligent grid resource. This work explores the standard functions needed in the future DMS for enterprise integration of distributed energy resources (DER). The important DMS functionalities such as DER management in aggregate groups, including the discovery of capabilities, status monitoring, and dispatch of real and reactive power are addressed in this paper. It is intended to provide the industry with a point of reference for DER integration with other utility applications and to provide guidance to research and standards development organizations.

  14. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Science.gov (United States)

    Aldaz, Gabriel; Shluzas, Lauren Aquino; Pickham, David; Eris, Ozgur; Sadler, Joel; Joshi, Shantanu; Leifer, Larry

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs) requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16), we (i) examined feature preferences for hands-free digital image capture and documentation, and (ii) compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15) = -3.873, p care. PMID:25902061

  15. Advanced materials for thermal management of electronic packaging

    CERN Document Server

    Tong, Xingcun Colin

    2011-01-01

    The need for advanced thermal management materials in electronic packaging has been widely recognized as thermal challenges become barriers to the electronic industry's ability to provide continued improvements in device and system performance. With increased performance requirements for smaller, more capable, and more efficient electronic power devices, systems ranging from active electronically scanned radar arrays to web servers all require components that can dissipate heat efficiently. This requires that the materials have high capability of dissipating heat and maintaining compatibility

  16. Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes

    Directory of Open Access Journals (Sweden)

    Grützner V

    2015-06-01

    that responsive antimicrobial nanocomposites could be used as an advanced drug delivery system and a promising addition to current best practice wound infection prophylaxis with few side effects.Keywords: enzyme-responsive nanosystems, burn wound infection, endothelial cells, wound healing

  17. Advances in the research of laser Doppler perfusion imaging in burn wounds%激光多普勒血流灌注成像在烧伤创面中的应用研究进展

    Institute of Scientific and Technical Information of China (English)

    刘晶; 许龙顺; 胡大海; 屈怡; 王国栋; 王洪涛

    2014-01-01

    Laser Doppler perfusion imaging (LDPI)works through the Doppler effect of light wave,and it could depict the blood flow value of the entire wound in two-dimensional image without contacting the detection site directly.In resent years,LDPI has been proved to be effective to evaluate healing potential of a wound,and to predict burn depth and scar formation.The accuracy of LDPI is higher than other traditional methods and technique.However,there are still many influencing factors for the clinical application of LDPI scanning.This paper presents a comprehensive overview of advances in the research of LDPI for clinical application in the care of burn wounds and influencing factors for accurate scanning.

  18. 创面信息管理系统:一种标准化的创面信息采集、存储和处理方案%Wound information management system: a standardized scheme for acquisition, storage and management of wound information

    Institute of Scientific and Technical Information of China (English)

    刘虎; 苏荣家; 吴敏洁; 张毅; 裘向军; 冯建刚; 谢挺; 陆树良

    2012-01-01

    Objective To form a wound information management scheme with objectivity,standardization,and convenience by means of wound information management system. Methods A wound information management system was set up with the acquisition terminal,the defined wound description,the data bank,and related softwares.The efficacy of this system was evaluated in clinical practice. Results The acquisition terminal was composed of the third generation mobile phone and the software.It was feasible to get access to the wound information,including description,image,and therapeutic plan from the data bank by mobile phone.During 4 months,a collection of a total of 232 wound treatment information was entered,and accordingly standardized data of 38 patients were formed automatically. Conclusions This system can provide standardized wound information management by standardized techniques of acquisition,transmission,and storage of wound information.It can be used widely in hospitals,especially primary medical institutions.Data resource of the system makes it possible for epidemiological study with large sample size in future.%目的 利用新型创面信息管理系统,探讨客观、标准化和便利的创面信息管理方案.方法 选择创面信息采集终端,确定创面信息采集内容,制作相关软件,建立创面信息数据库和创面信息管理系统.在临床应用中评价其效能. 结果 由第3代手机和操作软件共同构成标准化创面信息采集系统,借助终端手机可以从数据库中获取相关信息,包括创面的文字描述、图像及治疗方案等.使用4个月,共录入就诊信息232例次,已自动生成38例患者的完整资料. 结论 该系统能够将创面信息采集标准化并传输储存,适用于医院特别是基层卫生机构,为未来大样本的流行病学调查提供了良好的数据平台.

  19. Development and Application of Wound Assessment Management System%伤口病案信息管理系统的开发与应用

    Institute of Scientific and Technical Information of China (English)

    任皓; 毛中亮; 邱明辉

    2015-01-01

    针对医院换药中心采用传统纸质方式录入伤口病案工作量大、效率低,病案保存的完整性、连续性差,伤口评估和处理缺乏统一规范的问题,研发了一套操作方便、实用性强的伤口病案信息管理系统。该系统规范了伤口的评估标准和处理内容,并建立了连贯、完整的电子伤口病案数据库,从而提高了对病例数据进行统计分析的效率,为伤口评估和跟踪治疗提供确切依据。该系统作为子系统与医院HIS系统相结合,有效提高换药中心伤口病案的管理水平和工作效率。%To solve the problem of large workload,low efficiency,the poor continuity and integrity of the medical record and being lack of standardized research in traditional wound information management sys-tem,this paper proposed a simple and practical wound assessment management system. The system stand-ardized the wound standards,the content of the assessment and treatment,and established a coherent, fully electronic wound medical record database,thus it improves the efficiency of the statistical analysis of the case data and provides the basis for wound evaluation and follow-up treatment. The system,being used as a subsystem,can be combined with HIS system effectively to improve the management level and work efficiency of the wound medical treatment center.

  20. [Guideline 'Wound Care': recommendations for 5 challenging areas].

    Science.gov (United States)

    Brölmann, Fleur E; Vermeulen, Hester; Go, Peter M N Y H; Ubbink, Dirk T

    2013-01-01

    The interdisciplinary evidence-based guideline 'Wound Care' covers the treatment and management of acute wounds in adults and children and by all wound care disciplines. This guideline answers 5 basic questions with 38 recommendations covering wound cleansing, pain relief, instructing the patient, various dressings and the organisational aspects of wound care. The guideline recommendations include not to cleanse wounds that are primarily closed, to cleanse acute open wounds with clean tap water, to use the WHO pain ladder as the basis for the choice of analgesics for continuous wound pain, to administer lidocaine or prilocaine for localized pain relief during manipulation, not to cover primarily closed wounds with dressings, to use simple dressings for open wounds and to give the patient clear instructions. The guideline also advises about wound registration, documentation and hand-over of wound care, and recommends making clear agreements about referrals and responsibilities.

  1. Bone marrow derived cell-seeded extracellular matrix: A novel biomaterial in the field of wound management

    OpenAIRE

    V. Remya; Naveen Kumar; Sharma, A. K.; Mathew, Dayamon D.; Mamta Negi; S.K. Maiti; Sameer Shrivastava; S. Sonal; KURADE, N.P.

    2014-01-01

    Aim: Extensive or irreversible damage to the skin often requires additional skin substitutes for reconstruction. Biomaterials have become critical components in the development of effective new medical therapies for wound care. Materials and Methods: In the present study, a cell matrix construct (bone marrow-derived cells (BMdc) seeded extracellular matrix [ECM]) was used as a biological substitute for the repair of full-thickness skin wound. ECM was developed by decellularizing fish swim ...

  2. Negative pressure wound therapy management of the “open abdomen” following trauma: a prospective study and systematic review

    OpenAIRE

    Navsaria Pradeep; Nicol Andrew; Hudson Donald; Cockwill John; Smith Jennifer

    2013-01-01

    Abstract Introduction The use of Negative Pressure Wound Therapy (NPWT) for temporary abdominal closure of open abdomen (OA) wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. Methods A prospective study on trauma patients requiring temporary abdominal closure (TAC) with grade 1or 2 OA was ...

  3. Water quality management of aquifer recharge using advanced tools.

    Science.gov (United States)

    Lazarova, Valentina; Emsellem, Yves; Paille, Julie; Glucina, Karl; Gislette, Philippe

    2011-01-01

    Managed aquifer recharge (MAR) with recycled water or other alternative resources is one of the most rapidly growing techniques that is viewed as a necessity in water-short areas. In order to better control health and environmental effects of MAR, this paper presents two case studies demonstrating how to improve water quality, enable reliable tracing of injected water and better control and manage MAR operation in the case of indirect and direct aquifer recharge. Two water quality management strategies are illustrated on two full-scale case studies, including the results of the combination of non conventional and advanced technologies for water quality improvement, comprehensive sampling and monitoring programs including emerging pollutants, tracer studies using boron isotopes and integrative aquifer 3D GIS hydraulic and hydrodispersive modelling.

  4. Advanced methods of microscope control using μManager software

    Directory of Open Access Journals (Sweden)

    Arthur D Edelstein

    2014-07-01

    Full Text Available µManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, µManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we present a guide to using some of the recently added advanced µManager features, including hardware synchronization, simultaneous use of multiple cameras, projection of patterned light onto a specimen, live slide mapping, imaging with multi-well plates, particle localization and tracking, and high-speed imaging.

  5. The development of an advanced information management system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2005-07-01

    Performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. KAERI is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective of AIMS development is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. We designed the PSA information database system for the following purposes: integrated PSA information management software, sensitivity analysis, quality assurance, anchor to another reliability database. The AIMS consists of a PSA Information database, Information browsing (searching) modules, and PSA automatic quantification manager modules.

  6. Recent Advances in Management of Pediatric Food Allergy

    Directory of Open Access Journals (Sweden)

    Katherine Anagnostou

    2015-12-01

    Full Text Available Many children now suffer with a food allergy, immunoglobulin E (IgE and/or non-IgE mediated. Food allergies have a significant impact on the child’s quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review.

  7. Recent Advances in Management of Pediatric Food Allergy.

    Science.gov (United States)

    Anagnostou, Katherine; Swan, Kate; Fox, Adam T

    2015-01-01

    Many children now suffer with a food allergy, immunoglobulin E (IgE) and/or non-IgE mediated. Food allergies have a significant impact on the child's quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review. PMID:27417375

  8. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  9. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    DEFF Research Database (Denmark)

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost......, the sensitivity analysis showed that 77% of patients achieved a cost reduction when changing to the FWMS. CONCLUSION: The FWMS was less costly than traditional methods for managing abdominal fistula, probably due to longer wear time and less time spent on each pouching session....

  10. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  11. 噬菌体治疗创面细菌感染研究进展%Advances in the treatment of wound bacterial infection with phage

    Institute of Scientific and Technical Information of China (English)

    崔泽龙

    2015-01-01

    The treatment of wound bacterial infection is an extremely difficult problem in clinic, especially in patients with large wounds which are infected by multidrug resistant, pan-resistant or omni-resistant bacteria.In recent years, with a grim prospect of antibiotic resistance, phage therapy is re-valued by researchers after being ignored for nearly half a century.Phage therapy has made great achievements in prevention and control of bacterial infection of open wounds.This review is mainly focused on the latest research progress of phage therapy in wound bacterial infection.

  12. Evaluation of the efficacy of hyperbaric oxygen therapy in the management of chronic nonhealing ulcer and role of periwound transcutaneous oximetry as a predictor of wound healing response: A randomized prospective controlled trial

    Directory of Open Access Journals (Sweden)

    Sarbjot Kaur

    2012-01-01

    Full Text Available Background: Hyperbaric oxygen therapy (HBOT is a treatment option for chronic nonhealing wounds. Transcutaneous oximetry (TCOM is used for wound assessment. We undertook a randomized prospective controlled trial to evaluate the role of HBOT in healing of chronic nonhealing wounds and to determine whether TCOM predicts healing. Materials and Methods: This study was conducted in 30 consenting patients with nonhealing ulcer. The patients were randomized into group HT (receiving HBOT in addition to conventional treatment and group CT (receiving only conventional treatment. Duration of treatment in both the groups was 30 days. Wound ulcer was analyzed based on size of the wound, exudates, presence of granulation tissue, and wound tissue scoring. Tissue oxygenation (TcPO 2 was measured on 0, 10 th , 20 th , and 30 th day. Results: There was 59% reduction in wound area in group HT and 26% increase in wound area in group CT. Ten patients in group HT showed improvement in wound score as compared to five patients in group CT. Complete healing was seen in three patients in group HT as compared to none in group CT. Surgical debridement was required in 6 patients in group HT and 10 patients in group CT. One patient in group HT required amputation as compared to five patients in group CT. A positive correlation was found between TcPO 2 value and various markers of wound healing. Conclusion: HBOT has a definitive adjunctive role in the management of chronic nonhealing ulcers. It decreases the amputation rate and improves patient outcome. Periwound TcPO 2 may be used as a predictor of response to HBOT and has a positive correlation with wound healing.

  13. Holistic wound assessment in primary care.

    Science.gov (United States)

    Cornforth, Amber

    2013-12-01

    Wound care is expensive and can cause immeasurable stress and inconvenience to patients and their significant others. It is therefore in the best interest of the patient, their significant others and the NHS as a whole that wounds are expertly assessed, managed and healed in the quickest timeframe possible. Nurses play a pivotal role in the process of accurate holistic wound assessment, evaluation and treatment. This article aims to help further develop and enhance both professional and clinical wound care assessment and evaluation skills. Pertinent wound care literature is critically reviewed and the crucial nature and important components of comprehensive wound assessment for facilitating the highest possible quality wound care to patients are presented alongside recommendations regarding how the enhanced knowledge and skills could be applied into everyday wound care practice.

  14. Development of the Advanced Nuclear Safety Information Management (ANSIM) System

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Jae Min; Ko, Young Cheol; Song, Tai Gil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    Korea has become a technically independent nuclear country and has grown into an exporter of nuclear technologies. Thus, nuclear facilities are increasing in significance at KAERI (Korea Atomic Energy Research Institute), and it is time to address the nuclear safety. The importance of nuclear safety cannot be overemphasized. Therefore, a management system is needed urgently to manage the safety of nuclear facilities and to enhance the efficiency of nuclear information. We have established ISP (Information Strategy Planning) for the Integrated Information System of nuclear facility and safety management. The purpose of this paper is to develop a management system for nuclear safety. Therefore, we developed the Advanced Nuclear Safety Information Management system (hereinafter referred to as the 'ANSIM system'). The ANSIM system has been designed and implemented to computerize nuclear safety information for standardization, integration, and sharing in real-time. Figure 1 shows the main home page of the ANSIM system. In this paper, we describe the design requirements, contents, configurations, and utilizations of the ANSIM system

  15. Bacterial Wound Culture

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Bacterial Wound Culture Share this page: Was this page helpful? Also known as: Aerobic Wound Culture; Anaerobic Wound Culture Formal name: Culture, wound Related ...

  16. Advanced construction management for lunar base construction - Surface operations planner

    Science.gov (United States)

    Kehoe, Robert P.

    1992-01-01

    The study proposes a conceptual solution and lays the framework for developing a new, sophisticated and intelligent tool for a lunar base construction crew to use. This concept integrates expert systems for critical decision making, virtual reality for training, logistics and laydown optimization, automated productivity measurements, and an advanced scheduling tool to form a unique new planning tool. The concept features extensive use of computers and expert systems software to support the actual work, while allowing the crew to control the project from the lunar surface. Consideration is given to a logistics data base, laydown area management, flexible critical progress scheduler, video simulation of assembly tasks, and assembly information and tracking documentation.

  17. Advanced fuels for plutonium management in pressurized water reactors

    International Nuclear Information System (INIS)

    Several fuel concepts are under investigation at CEA with the aim of manage plutonium inventories in pressurized water reactors. This options range from the use of mature technologies like MOX adapted in the case of MOX-EUS (enriched uranium support) and COmbustible Recyclage A ILot (CORAIL) assemblies to more innovative technologies using IMF like DUPLEX and advanced plutonium assembly (APA). The plutonium burning performances reported to the electrical production go from 7 to 60 kg (TW h)-1. More detailed analysis covering economic, sustainability, reliability and safety aspects and their integration in the whole fuel cycle would allow identifying the best candidate

  18. Cryogenic Fluid Management Technologies for Advanced Green Propulsion Systems

    Science.gov (United States)

    Motil, Susan M.; Meyer, Michael L.; Tucker, Stephen P.

    2007-01-01

    In support of the Exploration Vision for returning to the Moon and beyond, NASA and its partners are developing and testing critical cryogenic fluid propellant technologies that will meet the need for high performance propellants on long-term missions. Reliable knowledge of low-gravity cryogenic fluid management behavior is lacking and yet is critical in the areas of tank thermal and pressure control, fluid acquisition, mass gauging, and fluid transfer. Such knowledge can significantly reduce or even eliminate tank fluid boil-off losses for long term missions, reduce propellant launch mass and required on-orbit margins, and simplify vehicle operations. The Propulsion and Cryogenic Advanced Development (PCAD) Project is performing experimental and analytical evaluation of several areas within Cryogenic Fluid Management (CFM) to enable NASA's Exploration Vision. This paper discusses the status of the PCAD CFM technology focus areas relative to the anticipated CFM requirements to enable execution of the Vision for Space Exploration.

  19. Development of advanced mixed oxide fuels for plutonium management

    International Nuclear Information System (INIS)

    A number of advanced Mixed Oxide (MOX) fuel forms are currently being investigated at Los Alamos National Laboratory that have the potential to be effective plutonium management tools. Evolutionary Mixed Oxide (EMOX) fuel is a slight perturbation on standard MOX fuel, but achieves greater plutonium destruction rates by employing a fractional nonfertile component. A pure nonfertile fuel is also being studied. Initial calculations show that the fuel can be utilized in existing light water reactors and tailored to address different plutonium management goals (i.e., stabilization or reduction of plutonium inventories residing in spent nuclear fuel). In parallel, experiments are being performed to determine the feasibility of fabrication of such fuels. Initial EMOX pellets have successfully been fabricated using weapons-grade plutonium

  20. [A telemedicine consultation in the framework of a wound and wound healing network].

    Science.gov (United States)

    Perrier-Bonnet, Sabine

    2016-01-01

    I: n Languedoc-Roussillon, the Domoplaies telemedicine project provides support to nurses experiencing difficulties with the treatment of a wound at home or in a health institute. Thanks to new communication and information technologies, doctors and nurses with expertise in wounds and wound healing can offer individualised care management. PMID:27633698

  1. Wound care in venous ulcers.

    Science.gov (United States)

    Mosti, G

    2013-03-01

    Wound dressings: ulcer dressings should create and maintain a moist environment on the ulcer surface. It has been shown that in an ulcer with a hard crust and desiccated bed, the healing process is significantly slowed and sometimes completely blocked so favouring infection, inflammation and pain. In contrast a moist environment promotes autolytic debridement, angiogenesis and the more rapid formation of granulation tissue, favours keratinocytes migration and accelerates healing of wounds. Apart from these common characteristics, wound dressings are completely different in other aspects and must be used according to the ulcer stage. In necrotic ulcers, autolytic debridement by means of hydrogel and hydrocolloids or with enzymatic paste is preferred. In case of largely exuding wounds alginate or hydrofibre are indicated. When bleeding occurs alginate is indicated due to its haemostatic power. Where ulcers are covered by granulation tissue, polyurethane foams are preferred. When infection coexists antiseptics are necessary: dressing containing silver or iodine with large antibacterial spectrum have proved to be very effective. In the epithelization stage polyurethane films or membranes, thin hydrocolloids or collagen based dressings are very useful to favour advancement of the healing wound edge. Despite these considerations, a Cochrane review failed to find advantages for any dressing type compared with low-adherent dressings applied beneath compression. Surgical debridement and grafting of wounds, negative wound pressure treatment: surgical and hydrosurgical debridement are indicated in large, necrotic and infected wounds as these treatments are able to get rid of necrotic, infected tissue very quickly in a single surgical session, thereby significantly accelerating wound bed preparation and healing time. Negative wound pressure treatment creating a negative pressure on ulcer bed is able to favour granulation tissue and shorten healing time. In case of hard

  2. Advances in Medical Management of Early Stage and Advanced Breast Cancer: 2015.

    Science.gov (United States)

    Witherby, Sabrina; Rizack, Tina; Sakr, Bachir J; Legare, Robert D; Sikov, William M

    2016-01-01

    Standard management of early stage and advanced breast cancer has been improved over the past few years by knowledge gained about the biology of the disease, results from a number of eagerly anticipated clinical trials and the development of novel agents that offer our patients options for improved outcomes or reduced toxicity or both. This review highlights recent major developments affecting the systemic therapy of breast cancer, broken down by clinically relevant patient subgroups and disease stage, and briefly discusses some of the ongoing controversies in the treatment of breast cancer and promising therapies on the horizon.

  3. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Directory of Open Access Journals (Sweden)

    Ju Geon Pak

    2012-01-01

    Full Text Available Pulse oximetry data such as saturation of peripheral oxygen (SpO2 and pulse rate are vital signals for early diagnosis of heart disease. Therefore, various pulse oximeters have been developed continuously. However, some of the existing pulse oximeters are not equipped with communication capabilities, and consequently, the continuous monitoring of patient health is restricted. Moreover, even though certain oximeters have been built as network models, they focus on exchanging only pulse oximetry data, and they do not provide sufficient device management functions. In this paper, we propose an advanced pulse oximetry system for remote monitoring and management. The system consists of a networked pulse oximeter and a personal monitoring server. The proposed pulse oximeter measures a patient’s pulse oximetry data and transmits the data to the personal monitoring server. The personal monitoring server then analyzes the received data and displays the results to the patient. Furthermore, for device management purposes, operational errors that occur in the pulse oximeter are reported to the personal monitoring server, and the system configurations of the pulse oximeter, such as thresholds and measurement targets, are modified by the server. We verify that the proposed pulse oximetry system operates efficiently and that it is appropriate for monitoring and managing a pulse oximeter in real time.

  4. 间充质干细胞促进创面愈合机制的研究进展%Advances in the mechanism of mesenchymal stem cells in promoting wound healing

    Institute of Scientific and Technical Information of China (English)

    朱文静; 孙浩博; 吕国忠

    2015-01-01

    Mesenchymal stem cells possess the ability of self-renewal and multiple differentiation potential, thus exert immunomodulatory effect during tissue repair.Mesenchymal stem cells can stimulate angiogenesis and promote tissue repair through transdifferentiation and secreting a variety of growth factors and cytokines.This review outlines the advances in the mechanism of mesenchymal stem cells in promoting wound healing, including alleviation of inflammatory response, induction of angiogenesis, and promotion of migration of mesenchymal stem cells to the site of tissue injury.

  5. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES).

    Science.gov (United States)

    Prevaldi, Carolina; Paolillo, Ciro; Locatelli, Carlo; Ricci, Giorgio; Catena, Fausto; Ansaloni, Luca; Cervellin, Gianfranco

    2016-01-01

    Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). PMID:27330546

  6. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Directory of Open Access Journals (Sweden)

    Gabriel Aldaz

    Full Text Available Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16, we (i examined feature preferences for hands-free digital image capture and documentation, and (ii compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15 = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13 = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16 = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital

  7. Advanced Mission Management System for Unmanned Aerial Vehicles

    Directory of Open Access Journals (Sweden)

    R. Anand Raji

    2014-09-01

    Full Text Available The paper presents advanced mission management system (MMS for unmanned aerial vehicles, based on integrated modular avionics (IMA architecture. IMA architecture enables the MMS to host high end functions for autonomous navigation and attack. MMS is a collection of systems to execute the mission objectives. The system constitutes mission computer (MC, sensors and other sub-systems. The MMS-MC needs to execute advanced algorithms like terrain referenced navigation, vision-aided navigation, automatic target recognition, sensor fusion, online path planning, and tactical planning for autonomy and safety. This demands high-end architecture in terms of hardware, software, and communication. The MMS-MC is designed to exploit the benefits of IMA concepts such as open system architecture, hardware and software architecture catering for portability, technology transparency, scalability, system reconfigurability and fault tolerance. This paper investigates on advanced navigation methods for augmenting INS with terrain-referenced navigation and vision-aided navigation during GPS non-availability. This paper also includes approach to implement these methods and simulation results are provided accordingly, and also discusses in a limited way, the approach for implementing online path planning.Defence Science Journal, Vol. 64, No. 5, September 2014, pp.438-444, DOI:http://dx.doi.org/10.14429/dsj.64.5992

  8. The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing

    Directory of Open Access Journals (Sweden)

    Mui Koon Tan

    2012-01-01

    Full Text Available Honey is one of the oldest substances used in wound management. Efficacy of Gelam honey in wound healing was evaluated in this paper. Sprague-Dawley rats were randomly divided into four groups of 24 rats each (untreated group, saline group, Intrasite Gel group, and Gelam honey group with 2 cm by 2 cm full thickness, excisional wound created on neck area. Wounds were dressed topically according to groups. Rats were sacrificed on days 1, 5, 10, and 15 of treatments. Wounds were then processed for macroscopic and histological observations. Gelam-honey-dressed wounds healed earlier (day 13 than untreated and saline treated groups, as did wounds treated with Intrasite Gel. Honey-treated wounds exhibited less scab and only thin scar formations. Histological features demonstrated positive effects of Gelam honey on the wounds. This paper showed that Gelam honey dressing on excisional wound accelerated the process of wound healing.

  9. Prognostics Health Management for Advanced Small Modular Reactor Passive Components

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Ryan M.; Ramuhalli, Pradeep; Coble, Jamie B.; Mitchell, Mark R.; Wootan, David W.; Hirt, Evelyn H.; Berglin, Eric J.; Bond, Leonard J.; Henager, Charles H.

    2013-10-18

    In the United States, sustainable nuclear power to promote energy security is a key national energy priority. Advanced small modular reactors (AdvSMR), which are based on modularization of advanced reactor concepts using non-light-water reactor (LWR) coolants such as liquid metal, helium, or liquid salt may provide a longer-term alternative to more conventional LWR-based concepts. The economics of AdvSMRs will be impacted by the reduced economy-of-scale savings when compared to traditional LWRs and the controllable day-to-day costs of AdvSMRs are expected to be dominated by operations and maintenance costs. Therefore, achieving the full benefits of AdvSMR deployment requires a new paradigm for plant design and management. In this context, prognostic health management of passive components in AdvSMRs can play a key role in enabling the economic deployment of AdvSMRs. In this paper, the background of AdvSMRs is discussed from which requirements for PHM systems are derived. The particle filter technique is proposed as a prognostics framework for AdvSMR passive components and the suitability of the particle filter technique is illustrated by using it to forecast thermal creep degradation using a physics-of-failure model and based on a combination of types of measurements conceived for passive AdvSMR components.

  10. Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review

    OpenAIRE

    Ousey, Karen; Atkinson, Ross A.; Williamson, J. Bradley; Lui, Steve

    2013-01-01

    Background context The management of postoperative spinal wound complication remains a challenge, with surgical site infection (SSI) incidence rates ranging from 0.4% to 20% after spinal surgery. Negative pressure wound therapy (NPWT) has been highlighted as an intervention that may stimulate healing and prevent SSI. However, the wound healing mechanism by NPWT and its effectiveness in spinal wounds still remain unclear. Purpose To systematically search, critically appraise, and su...

  11. BALANCED SCORECARD AS AN ADVANCED MANAGEMENT CONCEPT WITHIN THE INTEGRATED QUALITY MANAGEMENT MODEL

    Directory of Open Access Journals (Sweden)

    Stevan Zivojinovic

    2008-03-01

    Full Text Available The significance of >Integratedquality management< (IQM model, originating form St.Gallen-model, is reflected in the need for synergic application of new and advanced concepts of management theory and practise. Balanced score card (BSC within IQM model becomes a catalyst of business success for a modern organization by focusing on organizational variables-business strategy, organization structure and corporate culture. BSC is the leading system of performance tracking and strategy implementation, consistent with other management concepts and methods for managing process improvement. Through BSC, IQM processes' activities correlate with organization business results. BSC management processes enable integration of all decision-making levels, from institutional via strategic to operative, in the process starting from planing, i.e. formulating and implementation of strategy, to feed back by performance measurement and control.

  12. Management of burn wounds.

    Science.gov (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  13. Hyaluronate nanoparticles included in polymer films for the prolonged release of vitamin E for the management of skin wounds.

    Science.gov (United States)

    Pereira, Gabriela Garrastazu; Detoni, Cassia Britto; Balducci, Anna Giulia; Rondelli, Valeria; Colombo, Paolo; Guterres, Silvia Stanisçuaski; Sonvico, Fabio

    2016-02-15

    Lecithin and hyaluronic acid were used for the preparation of polysaccharide decorated nanoparticles loaded with vitamin E using the cationic lipid dioctadecyldimethylammonium bromide (DODMA). Nanoparticles showed mean particle size in the range 130-350 nm and narrow size distribution. Vitamin E encapsulation efficiency was higher than 99%. These nanoparticles were incorporated in polymeric films containing Aloe vera extract, hyaluronic acid, sodium alginate, polyethyleneoxide (PEO) and polyvinylalcohol (PVA) as an innovative treatment in skin wounds. Films were thin, flexible, resistant and suitable for application on burn wounds. Additionally, in vitro occlusion study highlighted the dependence of the occlusive effect on the presence of nanoparticles. The results obtained show that the bioadhesive films containing vitamin E acetate and Aloe vera could be an innovative therapeutic system for the treatment of skin wounds, such as burns. The controlled release of the vitamin along with a reduction in water loss through damaged skin provided by the nanoparticle-loaded polymer film are considered important features for an improvement in wound healing and skin regeneration. PMID:26769495

  14. [Translation medicine in wound healing: successful cases and personal deliberation].

    Science.gov (United States)

    Fu, Xiaobing

    2014-02-01

    Local wound care is the key step in wound management, and it is affected by many factors. The innovation and translation application of some new theories and skills may help accelerate local wound healing velocity and improve wound healing quality. In this paper, the translation medicine in wound healing, such as debridement, dressings, and tissue engineering products, are reviewed. In the meantime, personal consideration concerning their successful and future development is given. PMID:24684981

  15. Management of locally advanced breast cancer: Evolution and current practice

    Directory of Open Access Journals (Sweden)

    Rustogi Ashish

    2005-01-01

    Full Text Available Locally advanced breast cancer (LABC accounts for a sizeable number (30-60% of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT has made a tremendous impact on the management of LABC. NACT was initiated to institute systemic therapy upfront at the earliest in this group of patients with a high risk of micrometastasis burden. While NACT did not yield a survival advantage, it has however made breast conservation possible in selected group of cases. Large number of studies and many randomised trials have been done in women with LABC in order to improve the therapeutic decisions and also the local control and survival. With this background we have reviewed various treatment options in patients with LABC which should possibly help in guiding the clinicians for optimal management of LABC.

  16. The management of localized and locally advanced prostate cancer - 1995

    International Nuclear Information System (INIS)

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. - The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. - Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. - The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachy therapy. The current status of radical prostatectomy and cryotherapy will be summarized. - Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. - Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. - The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  17. Advanced Hemodynamic Management in Patients with Septic Shock

    Science.gov (United States)

    Huber, Wolfgang; Nierhaus, Axel; Kluge, Stefan; Reuter, Daniel A.; Wagner, Julia Y.

    2016-01-01

    In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these “organ dysfunction syndromes” is a key therapeutic component. It needs, however, to be differentiated between “early goal-directed therapy” (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and “hemodynamic management” using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to “usual care” in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation. “Hemodynamic management” comprises (a) making the diagnosis of septic shock as one differential diagnosis of circulatory shock, (b) assessing the hemodynamic status including the identification of therapeutic conflicts, and (c) guiding therapeutic interventions. We propose two algorithms for hemodynamic management using transpulmonary thermodilution-derived variables aiming to optimize the cardiocirculatory and pulmonary status in adult ICU patients with septic shock. The complexity and heterogeneity of patients with septic shock implies that individualized approaches for hemodynamic management are mandatory. Defining individual hemodynamic target values for patients with septic shock in different phases of the disease must be the focus of future studies. PMID:27703980

  18. Research progress on the assessment and management of odour in malignant fungating wounds%恶性肿瘤伤口气味评估与管理的研究进展

    Institute of Scientific and Technical Information of China (English)

    瞿小龙; 蒋琪霞

    2014-01-01

    恶性肿瘤伤口是一种复杂的伤口,随着恶性肿瘤的高发生率越来越受到医护人员的关注。在护理恶性肿瘤伤口的患者时,控制症状是其主要目的。本文就恶性肿瘤伤口最常见的气味症状的评估与管理进行综述,为临床恶性肿瘤伤口气味的控制提供参考。%Malignant fungating wounds were complex wounds and were concerned by healthcare workers, with the high incidence of malignant tumors. Malignant fungating wounds were often associated with multiple symptoms, including commonly malodour, wound related pain, exudates, bleeding and local infection. The purpose of caring patients with malignant fungating wounds was to control the symptom. This article reviewed the assessment and management of odour which was the most common symptom in patients with malignant fungating wounds. It can provide some evidences for controlling odour in clinical malignant fungating wounds.

  19. Current wound healing procedures and potential care.

    Science.gov (United States)

    Dreifke, Michael B; Jayasuriya, Amil A; Jayasuriya, Ambalangodage C

    2015-03-01

    In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting microRNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage microenvironment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection - all in the hopes of early detection of complications.

  20. Recent advances in the management of radiation colitis

    Institute of Scientific and Technical Information of China (English)

    Jannis Kountouras; Christos Zavos

    2008-01-01

    Radiation colitis,an insidious,progressive disease of increasing frequency,develops 6 mo to 5 years after regional radiotherapy for malignancy,owing to the deleterious effects of the latter on the colon and the small intestine.When dealing with radiation colitis and its complications,the most conservative modality should be employed because the areas of intestinal injury do not tend to heal.Acute radiation colitis is mostly selflimited,and usually,only supportive management is required.Chronic radiation colitis,a poorly predictable progressive disease,is considered as a precancerous lesion;radiation-associated malignancy has a tendency to be diagnosed at an advanced stage and to bear a dismal prognosis.Therefore,management of chronic radiation colitis remains a major challenge owing to the progressive evolution of the disease,including development of fibrosis,endarteritis,edema,fragility,perforation,partial obstruction,and cancer.Patients are commonly managed conservatively.Surgical intervention is difficult to perform because of the extension of fibrosis and alterations in the gut and mesentery,and should be reserved for intestinal obstruction,perforation,fistulas,and severe bleeding.Owing to the difficulty in managing the complications of acute and chronic radiation colitis,particular attention should be focused onto the prevention strategies.Uncovering the fibrosis mechanisms and the molecular events underlying radiation bowel disease could lead to the introduction of new therapeutic and/or preventive approaches.A variety of novel,mostly experimental,agents have been used mainly as a prophylaxis,and improvements have been made in radiotherapy delivery,including techniques to reduce the amount of exposed intestine in the radiation field,as a critical strategy for prevention.

  1. Management of a patient with advanced BRAF-mutant melanoma.

    Science.gov (United States)

    Ashworth, Michelle T; Daud, Adil

    2014-03-01

    A 49-year-old man initially diagnosed in 1995 with cutaneous melanoma presented to the authors' institution in 2009 with metastatic, BRAF V600E-mutant melanoma. His treatment course to date has included surgery, adjuvant radiotherapy, and interferon, metastasectomies, granulocyte-macrophage colony-stimulating factors, a clinical trial with the BRAF inhibitor vemurafenib (PLX-4032), clinical trial with combination BRAF plus MEK inhibition with vemurafenib plus GDC-0973, and combination targeted and immune therapy with vemurafenib plus the anti-CTLA4 antibody ipilimumab. This case report illustrates the long-term management of a patient with metastatic melanoma using targeted and immune therapy, evolution in treatment guidelines, next directions in research, and the critical role of clinical trials in advancement of patient care.

  2. Advanced techniques using the plant as indicator of irrigation management

    Directory of Open Access Journals (Sweden)

    Barbara dos Santos Esteves

    2015-05-01

    Full Text Available The methodologies which are considered the most promising for irrigation management are those based on the analysis of the water status of the plants themselves. This justifies the study and improvement of indicators based on automatic and continuous measures to enable real-time monitoring data, as indices from sap flow, dendrometry and leaf turgor pressure techniques. The aim of this paper is to analyze such methodologies in order to demonstrate their principles, advantages and challenges. In conclusion, the methodologies analyzed still have many technological advances and challenges before being presented to the final user. The future research should work these tools for elaboration of technical indexes that allow their simplification, on the instrumental point of view, and the interpretation of their results.

  3. Advances in the Management of Cerebral Vascular Disease

    Directory of Open Access Journals (Sweden)

    Muhammad Imran Qadir

    2015-06-01

    Full Text Available A cerebral vascular disease occurred with the arteries of brain due to the less supply of blood.  Stroke is mostly caused by cerebral vascular disease and it is also a common cause of vascular dementia due to reduced oxygen supply and blood flow to the brain. In industrialized countries, neurologic disability is most frequently caused by cerebeovascular disease. Individuals with cardiovascular disease, diabetes and high blood pressure etc are at higher possibility for cerebral vascular disease. After malignancy and heart disease, cerebral vascular disease is the third leading of death and estimated that an average 500,000 new stroke occurred in each year. Advance techniques such as Carotid Endarterectomy, Magnetic resonance imaging, Angiography and Single photon emission computed tomography etc are used for management of cerebral vascular disease.

  4. Methods and Systems for Advanced Spaceport Information Management

    Science.gov (United States)

    Fussell, Ronald M. (Inventor); Ely, Donald W. (Inventor); Meier, Gary M. (Inventor); Halpin, Paul C. (Inventor); Meade, Phillip T. (Inventor); Jacobson, Craig A. (Inventor); Blackwell-Thompson, Charlie (Inventor)

    2007-01-01

    Advanced spaceport information management methods and systems are disclosed. In one embodiment, a method includes coupling a test system to the payload and transmitting one or more test signals that emulate an anticipated condition from the test system to the payload. One or more responsive signals are received from the payload into the test system and are analyzed to determine whether one or more of the responsive signals comprises an anomalous signal. At least one of the steps of transmitting, receiving, analyzing and determining includes transmitting at least one of the test signals and the responsive signals via a communications link from a payload processing facility to a remotely located facility. In one particular embodiment, the communications link is an Internet link from a payload processing facility to a remotely located facility (e.g. a launch facility, university, etc.).

  5. Advances in the Management of Transient Ischaemic Attack and Stroke

    Directory of Open Access Journals (Sweden)

    Mayra J Montalvo

    2016-07-01

    Full Text Available Among many important advances in the management of transient ischaemic attack (TIA and stroke are: the updated definition of TIA; risk stratification scores for TIA; the urgent diagnostic and treatment process for TIA; thrombectomy treatment for large vessel occlusive ischaemic stroke; cryptogenic stroke evaluation and treatment, including long-term monitoring for paroxysmal atrial fibrillation; and strategies to improve outcomes for patients including mirror therapy for neglect and timing of mobilisation after stroke. Future research will focus on: antiplatelet strategies after TIA; selecting patients for treatment with recanalisation therapies in an extended time window; uncovering the cause of strokes previously defined as cryptogenic; and better defining the optimal timing and dose of mobilisation after stroke.

  6. Hepatocellular carcinoma:current management and recent advances

    Institute of Scientific and Technical Information of China (English)

    Wan-Yee Lau; Eric C. H. Lai

    2008-01-01

    BACKGROUND:Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the iffth most common cancer in the world, and the third most common cause of cancer-related death. Without speciifc treatment, the prognosis is very poor. The goal of management is"cancer control"-a reduction in its incidence and mortality as well as an improvement in the quality of life of patients with HCC and their families. This article aims to review the current management of HCC and its recent advances. DATA SOURCES:A MEDLINE database search was performed to identify relevant article using the keywords"hepatocellular carcinoma", "hepatectomy", "liver transplantation", and"local ablative therapy". Additional papers and book chapters were identiifed by a manual search of the references from the key articles. RESULTS:Liver resection and liver transplantation remain the options that give the best chance of a cure. Recent evidence suggests that local ablative therapy may offer comparable survival results in patients with small HCC, and preserved liver function. Transarterial chemoembolization (TACE) is the most promising palliative modality for unresectable HCC, but other techniques, such as transarterial radioembolization (TARE), and local ablative therapy, have also shown comparable results. CONCLUSIONS:Early diagnosis of HCC remains a key goal in improving the prognosis of patients. During the last two decades, operative mortality and surgical outcome of liver resection and liver transplantation for HCC have improved. Progress also has been made in multi-modality therapy which can increase the chance of survival and improve the quality of life for patients with advanced HCC.

  7. Advances in the management of pediatric pulmonary hypertension.

    Science.gov (United States)

    Oishi, Peter; Datar, Sanjeev A; Fineman, Jeffrey R

    2011-09-01

    Pulmonary hypertension is a rare disease in neonates, infants, and children, and is associated with substantial morbidity and mortality. An adequate understanding of the controlling pathophysiologic mechanisms is lacking. Moreover, a minority of research is focused specifically on neonatal and pediatric populations. Although therapeutic options have increased over the past several decades, they remain limited. In advanced pulmonary hypertension, progressive pulmonary vascular functional and structural changes ultimately cause increased pulmonary vascular impedance, right-ventricular failure, and death. Management includes the prevention and/or treatment of active pulmonary vasoconstriction, the support of right-ventricle function, treatment of the underlying disease (if possible), and the promotion of regressive remodeling of structural pulmonary vascular changes. Most currently available therapies augment or inhibit factors, or mediators of their downstream signaling cascades, that originate in the pulmonary vascular endothelium. These pathways include nitric-oxide/cyclic guanosine monophosphate (cGMP), prostacyclin, and endothelin-1. The ability to reverse advanced structural changes remains an as yet unattained goal. This paper reviews the epidemiology, pathophysiology, current treatments, and emerging therapies related to neonatal and pediatric pulmonary hypertension.

  8. Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: Report of twelve cases and discussion of mechanism of action

    Directory of Open Access Journals (Sweden)

    Bok Y. Lee, Noori AL-Waili, Dean Stubbs, Keith Wendell, Glenn Butler, Thia AL-Waili, Ali AL-Waili

    2010-01-01

    Full Text Available Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT device (EPRT Technologies-USA, Simi Valley, CA in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30

  9. 胰岛素促进创面愈合机制研究进展%Advances in the study of mechanism of insulin in promoting wound healing

    Institute of Scientific and Technical Information of China (English)

    杨沛瑯; 章雄; 刘琰

    2014-01-01

    Since its discovery in 1921,insulin has been considered to be the most important hormone in the regulation of glucose and fat metabolism.In recent years,studies have revealed that besides metabolism regulation,insulin can also act as a growth factor like hormone in regulating multiple processes and various eellular activities in the process of wound healing.This review summarizes the role of insulin in wound healing and its underlying mechanism.

  10. Masters Study in Advanced Energy and Fuels Management

    Energy Technology Data Exchange (ETDEWEB)

    Mondal, Kanchan [Southern Illinois Univ., Carbondale, IL (United States)

    2014-12-08

    There are currently three key drivers for the US energy sector a) increasing energy demand and b) environmental stewardship in energy production for sustainability and c) general public and governmental desire for domestic resources. These drivers are also true for energy nation globally. As a result, this sector is rapidly diversifying to alternate sources that would supplement or replace fossil fuels. These changes have created a need for a highly trained workforce with a the understanding of both conventional and emerging energy resources and technology to lead and facilitate the reinvention of the US energy production, rational deployment of alternate energy technologies based on scientific and business criteria while invigorating the overall economy. In addition, the current trends focus on the the need of Science, Technology, Engineering and Math (STEM) graduate education to move beyond academia and be more responsive to the workforce needs of businesses and the industry. The SIUC PSM in Advanced Energy and Fuels Management (AEFM) program was developed in response to the industries stated need for employees who combine technical competencies and workforce skills similar to all PSM degree programs. The SIUC AEFM program was designed to provide the STEM graduates with advanced technical training in energy resources and technology while simultaneously equipping them with the business management skills required by professional employers in the energy sector. Technical training include core skills in energy resources, technology and management for both conventional and emerging energy technologies. Business skills training include financial, personnel and project management. A capstone internship is also built into the program to train students such that they are acclimatized to the real world scenarios in research laboratories, in energy companies and in government agencies. The current curriculum in the SIUC AEFM will help fill the need for training both recent

  11. Moist Exposed Burn Ointment in the Management of Burn Wound%湿润烧伤膏在烧伤创面治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    V·贾亚拉曼

    2012-01-01

      Management of burns remains one of the greatest challenges in burn care. Local management of a burn wound requires early wound debridement and an optimum environment to stimulate epithelialisation and cellular prolifera-tion. Protocol was developed as early as 30 years ago for the management of burns that includes early excision and SSG cov-erage. The results were not perfect. The quality of healed skin as well as the prominence of hypertrophic scar needs to ex-plore the novel approaches. Wound healing assessment was made in burn wounds in 100 patients treated with MEBO cream and in 100 patients with Silver Sulpha Diazine Cream at the Kilpauk Medical College Hospital, Burns Unit. The comparative analysis is presented to assess the wound healing pattern in both the groups. Moist exposed burn ointment has been used with success in the management of deep superficial partial thickness and deep partial thickness burns in our department. The MEBO cream creates a physiological moist environment over the wound inducing an anti-inflammatory effect. It provides a nutritive base for the wound and debrides the wound eschar and expedites wound epithelialisation. The purpose of this study was to prospectively evaluate the outcome of the use of MEBO for second degree burns. Between August 2010 to May 2011 period 100 patients with second degree burns underwent MEBO cream application and were compared with 100 patients who had silver sulphadiazine cream . The result was analysed for the nature of wound debridement, reduction of inflammation, healing pattern, scar and pigmentation, MEBO provides excellent skin pigmentation and minimal visible scar.%  烧伤治疗一直是烧伤领域中的一大难题.烧伤创面的局部治疗要求早期清创,并为创面提供一个适宜的环境刺激上皮形成和细胞的分化.早在30年前,烧伤的标准化治疗方案就已经形成,包括早期切痂及韧厚皮移植,但治疗效果不尽人意.为了改善愈合后的皮

  12. Microgravity fluid management requirements of advanced solar dynamic power systems

    Science.gov (United States)

    Migra, Robert P.

    1987-01-01

    The advanced solar dynamic system (ASDS) program is aimed at developing the technology for highly efficient, lightweight space power systems. The approach is to evaluate Stirling, Brayton and liquid metal Rankine power conversion systems (PCS) over the temperature range of 1025 to 1400K, identify the critical technologies and develop these technologies. Microgravity fluid management technology is required in several areas of this program, namely, thermal energy storage (TES), heat pipe applications and liquid metal, two phase flow Rankine systems. Utilization of the heat of fusion of phase change materials offers potential for smaller, lighter TES systems. The candidate TES materials exhibit large volume change with the phase change. The heat pipe is an energy dense heat transfer device. A high temperature application may transfer heat from the solar receiver to the PCS working fluid and/or TES. A low temperature application may transfer waste heat from the PCS to the radiator. The liquid metal Rankine PCS requires management of the boiling/condensing process typical of two phase flow systems.

  13. Advanced Simulation Capability for Environmental Management: Development and Demonstrations - 12532

    International Nuclear Information System (INIS)

    The U.S. Department of Energy Office of Environmental Management (EM), Technology Innovation and Development is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, which are organized into Platform and Integrated Tool-sets and a High-Performance Computing Multi-process Simulator. The Platform capabilities target a level of functionality to allow end-to-end model development, starting with definition of the conceptual model and management of data for model input. The High-Performance Computing capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The new capabilities are demonstrated through working groups, including one focused on the Hanford Site Deep Vadose Zone. The ASCEM program focused on planning during the first year and executing a prototype tool-set for an early demonstration of individual components. Subsequently, ASCEM has focused on developing and demonstrating an integrated set of capabilities, making progress toward a version of the capabilities that can be used to engage end users. Demonstration of capabilities continues to be implemented through working groups. Three different working groups, one focused on EM problems in the deep vadose zone, another investigating attenuation mechanisms for metals and radionuclides, and a third focusing on waste tank performance assessment, continue to make progress. The project

  14. The assessment and treatment of wound pain.

    Science.gov (United States)

    Brown, Annemarie

    This article is the third in a series on wound management. Poor pain management leads to distress and can impede the healing process. This article describes the different types of pain and the psychological aspects of pain that should be taken into account when deciding on a wound-management strategy. It discusses assessment tools, along with pharmacological and non-pharmacological interventions for pain management.

  15. Engineered Biopolymeric Scaffolds for Chronic Wound Healing.

    Science.gov (United States)

    Dickinson, Laura E; Gerecht, Sharon

    2016-01-01

    Skin regeneration requires the coordinated integration of concomitant biological and molecular events in the extracellular wound environment during overlapping phases of inflammation, proliferation, and matrix remodeling. This process is highly efficient during normal wound healing. However, chronic wounds fail to progress through the ordered and reparative wound healing process and are unable to heal, requiring long-term treatment at high costs. There are many advanced skin substitutes, which mostly comprise bioactive dressings containing mammalian derived matrix components, and/or human cells, in clinical use. However, it is presently hypothesized that no treatment significantly outperforms the others. To address this unmet challenge, recent research has focused on developing innovative acellular biopolymeric scaffolds as more efficacious wound healing therapies. These biomaterial-based skin substitutes are precisely engineered and fine-tuned to recapitulate aspects of the wound healing milieu and target specific events in the wound healing cascade to facilitate complete skin repair with restored function and tissue integrity. This mini-review will provide a brief overview of chronic wound healing and current skin substitute treatment strategies while focusing on recent engineering approaches that regenerate skin using synthetic, biopolymeric scaffolds. We discuss key polymeric scaffold design criteria, including degradation, biocompatibility, and microstructure, and how they translate to inductive microenvironments that stimulate cell infiltration and vascularization to enhance chronic wound healing. As healthcare moves toward precision medicine-based strategies, the potential and therapeutic implications of synthetic, biopolymeric scaffolds as tunable treatment modalities for chronic wounds will be considered. PMID:27547189

  16. Managements of open wounds from an earthquake%地震伤员开放伤口的手术治疗策略

    Institute of Scientific and Technical Information of China (English)

    陈欣; 周业平; 黄富国; 岑石强; 覃凤均; 陈忠

    2012-01-01

    Objective To explore the surgical managements of open wounds from 5 · 12 Wenchuan Earthquake.Methods In this report,fifty one patients with open wounds were treated after transported into West China Hospital from May 12 to 26 in 2008 after 5 · 12 Wenchuan Earthquake.Among 51 cases,open wounds were due to open fractures (n =8),fasciotomy (n =6),exposed bone (n =8) and defects of skin and soft tissue (n =29).All cases had wound infections.Sixty operations were performed,including muscle and myocutaneous flap ( n =4 ),skin grafting ( n =30 ),NPWT ( negative pressure wound therapy ) ( n =2 )and debridement ( n =24 ). Results Four cases of muscle and myocutaneous flaps survived with an excellent blood circulation.And 30 cases of skin grafting had a survival rate of over 90%,2 cases of NPWT and 24 cases of debridement required further treatment.Conclusion With adequate surgical managements,open wound healing from an earthquake may be accelerated and the functions maximally preserved.%目的 探讨地震伤员开放伤口的手术处理方法.方法 总结5· 12汶川地震中于2008年5月12-26口转入华西医院骨科接受手术治疗的51例开放伤口伤员的术前情况、手术治疗方法及术后效果.51例中,开放骨折8例,切开减张创面6例,骨外露8例,单纯皮肤软组织缺损29例.创面感染率100%.共进行60次手术,手术方法:皮瓣、肌皮瓣手术4例,植皮术30例(包括邮票植皮、整张植皮和网状植皮),创面负压引流治疗(NPWT)2例,扩创术24例.结果 4例皮瓣、肌瓣手术后皮瓣、肌瓣成活良好;30例植皮手术皮片成活率均达到90%以上;2例NPWT、24例扩创术后创面感染减轻,继续换药处理或择期手术.结论 恰当的创面手术处理方法可以加速地震伤员开放创面的愈合、最大限度地保存功能.

  17. Recent advances in the understanding and management of delayed puberty.

    Science.gov (United States)

    Wei, Christina; Crowne, Elizabeth Clare

    2016-05-01

    Delayed puberty, especially in boys, is a common presentation in paediatrics. Recent advances have improved our understanding of the neuroendocrine, genetic and environmental factors controlling pubertal development, and hence inform the pathophysiology of delayed puberty. The discovery of kisspeptin signalling through its receptor identified neuroendocrine mechanisms controlling the gonadotrophin-releasing hormone (GnRH) pulse generator at the onset of puberty. Genetic mechanisms from single gene mutations to single nucleotide polymorphism associated with delayed puberty are being identified. Environmental factors, including nutritional factors and endocrine disruptors, have also been implicated in changes in secular trends and abnormal timing of puberty. Despite these advances, the key clinical question is to distinguish delayed puberty associated with an underlying pathology or hypogonadism from constitutional delay in growth and puberty, which remains challenging as biochemical tests are not always discriminatory. The diagnostic accuracies of newer investigations, including 36-hour luteinising hormone releasing hormone (LHRH) tests, GnRH-agonist tests, antimullerian hormone and inhibin-B, require further evaluation. Sex hormone replacement remains the main available treatment for delayed puberty, the choice of which is largely dictated by clinical practice and availability of the various sex steroid preparations. Spontaneous reversal of hypogonadism has been reported in boys with idiopathic hypogonadotrophic hypogonadism after a period of sex steroid treatment, highlighting the importance of reassessment at the end of pubertal induction. Novel therapies with a more physiological basis such as gonadotrophins or kisspeptin-agonist are being investigated for the management of hypogonadotrophic hypogonadism. Careful clinical assessment and appreciation of the normal physiology remain the key approach to patients with delayed puberty. PMID:26353794

  18. Recovery Act. Advanced Load Identification and Management for Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yi [Eaton Corporation, Menomonee Falls, WI (United States); Casey, Patrick [Eaton Corporation, Menomonee Falls, WI (United States); Du, Liang [Eaton Corporation, Menomonee Falls, WI (United States); He, Dawei [Eaton Corporation, Menomonee Falls, WI (United States)

    2014-02-12

    , in particular, advanced power strips (APSs) was studied. The project evaluated the market potential for Smart Power Strips (SPSs) with load identification and the likely impact of a load identification feature on APS adoption and effectiveness. The project also identified other success factors required for widespread APS adoption and market acceptance. Even though the developed technology is applicable for both residential and commercial buildings, this project is focused on effective plug-in load control and management for commercial buildings, accomplished through effective load identification. The project has completed Smart Receptacle (SR) prototype development with integration of Load ID, Control/Management, WiFi communication, and Web Service. Twenty SR units were built, tested, and demonstrated in the Eaton lab; eight SR units were tested in the National Renewable Energy Lab (NREL) for one-month of field testing. Load ID algorithm testing for extended load sets was conducted within the Eaton facility and at local university campuses. This report is to summarize the major achievements, activities, and outcomes under the execution of the project.

  19. Surgical amputation of a digit and vacuum-assisted-closure (V.A.C.) management in a case of osteomyelitis and wound care in an eastern black rhinoceros (Diceros bicornis michaeli).

    Science.gov (United States)

    Harrison, Tara M; Stanley, Bryden J; Sikarskie, James G; Bohart, George; Ames, N Kent; Tomlian, Janice; Marquardt, Mark; Marcum, Annabel; Kiupel, Matti; Sledge, Dodd; Agnew, Dalen

    2011-06-01

    A 14-yr-old female eastern black rhinoceros (Diceros bicornis michaeli) presented with progressive suppurative osteomyelitis in her left hind lateral toe. beta-Hemolytic Streptococcus sp. was isolated. The animal was treated with multiple systemic antibiotics, and topical wound cleansing. Repeated debridements and nail trimmings were performed for 5 mo prior to electing amputation. The toe was surgically amputated under general anesthesia between the first and second phalanges. Analgesia was diffused into the wound topically via a catheter and elastomeric pump. The open amputation site was covered with adherent drapes and a negative-pressure wound therapy device provided vacuum-assisted closure (V.A.C.) for 72 hr. Three months later this animal developed a deep dermal ulcer on the lateral aspect of the right hind limb, at the level of the stifle. Methicillin-resistant Staphylococcus aureus was isolated. The wound was managed by initial daily lavage, followed by 1 mo of V.A.C. therapy, with 72 hr between dressing changes. Clinically, this therapy expedited the formation of healthy granulation tissue and overall healing was accelerated. The animal tolerated the machine and bandage changes well via operant conditioning. The use of negative-pressure wound therapy appeared to shorten time to resolution of slow-healing wounds in black rhinoceros. PMID:22946413

  20. Comparison of conventional gauze therapy with vacuum assisted closure wound therapy in acute traumatic wounds

    International Nuclear Information System (INIS)

    Objective: To compare the Vacuum Assisted Closure (Vac) wound therapy with Conventional Gauze Therapy (CGT) in management of acute traumatic wounds on the basis of time taken to achieve a vital red wound ready for definitive surgical closure. Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery Combined Military Hospital Rawalpindi from Mar 2009 to Sep 2009. Patients and Methods: This study included 82 patients of acute traumatic wounds. Patients were randomly allotted to group A, in which wound was treated with new method of vacuum assisted closure (VAC) wound therapy and to group B, in which wound was managed by conventional gauze therapy (CGT). Outcomes were measured by the presence of vital red wound ready to be closed by surgical intervention. Patients with concomitant systemic pathology were not included in study. Results: Comparison between the two groups revealed mean time for wound healing 13 days in group A and 16.9 days in group B with significant difference (p value =0.029). Conclusion: Vacuum assisted closure wound therapy is an effective method in reducing time of wound healing for definitive surgical closure. (author)

  1. Advanced factory managing technology. Sentan kojo kanri gijuts

    Energy Technology Data Exchange (ETDEWEB)

    Matsushita, M. (Daicel Chemical Industries, Ltd., Osaka (Japan))

    1994-04-05

    With respect to a managing technology of advanced factories in the Japanese chemical industry, this paper enumerates the following three examples to discuss the ways the future factory technologies should be: operation techniques and problems in a newest ethylene plant, operation supports and facility control in chemical factories, and CIM structuring in beer breweries. The paper describes the operation techniques in an ethylene plant that are broken down into the following: measures for safety and material diversification, environment preservation, means to minimize the required labor, adoption of multi-variables, non-interference control technology for ethylene-propylene columns, and operation techniques that have been introduced with such a new technique as an integrated instrumentation room equipped with a gas leakage detection system. Structuring of CIM in the cited beer brewery has followed the transition of IE-TQC-JIT-FMS-CIM. Although a beer brewery may give somewhat different image from an ordinary chemical plant, the beer brewing process resembles a chemical plant in that it operates reacting machines in batch multiple tanks, and uses instrumentations and controllers using sensors. The key point in the future development is an organic link between market fluctuation and production activities. 1 fig.

  2. Informative Top-k Retrieval for Advanced Skill Management

    Science.gov (United States)

    Colucci, Simona; di Noia, Tommaso; Ragone, Azzurra; Ruta, Michele; Straccia, Umberto; Tinelli, Eufemia

    The paper presents a knowledge-based framework for skills and talent management based on an advanced matchmaking between profiles of candidates and available job positions. Interestingly, informative content of top-k retrieval is enriched through semantic capabilities. The proposed approach allows to: (1) express a requested profile in terms of both hard constraints and soft ones; (2) provide a ranking function based also on qualitative attributes of a profile; (3) explain the resulting outcomes (given a job request, a motivation for the obtained score of each selected profile is provided). Top-k retrieval allows to select most promising candidates according to an ontology formalizing the domain knowledge. Such a knowledge is further exploited to provide a semantic-based explanation of missing or conflicting features in retrieved profiles. They also indicate additional profile characteristics emerging by the retrieval procedure for a further request refinement. A concrete case study followed by an exhaustive experimental campaign is reported to prove the approach effectiveness.

  3. Development of a wound healing index for patients with chronic wounds.

    Science.gov (United States)

    Horn, Susan D; Fife, Caroline E; Smout, Randall J; Barrett, Ryan S; Thomson, Brett

    2013-01-01

    Randomized controlled trials in wound care generalize poorly because they exclude patients with significant comorbid conditions. Research using real-world wound care patients is hindered by lack of validated methods to stratify patients according to severity of underlying illnesses. We developed a comprehensive stratification system for patients with wounds that predicts healing likelihood. Complete medical record data on 50,967 wounds from the United States Wound Registry were assigned a clear outcome (healed, amputated, etc.). Factors known to be associated with healing were evaluated using logistic regression models. Significant variables (p wound type. Some variables predicted significantly in nearly all models: wound size, wound age, number of wounds, evidence of bioburden, tissue type exposed (Wagner grade or stage), being nonambulatory, and requiring hospitalization during the course of care. Variables significant in some models included renal failure, renal transplant, malnutrition, autoimmune disease, and cardiovascular disease. All models validated well when applied to the holdout sample. The "Wound Healing Index" can validly predict likelihood of wound healing among real-world patients and can facilitate comparative effectiveness research to identify patients needing advanced therapeutics.

  4. Vacuum-assisted closure therapy for infected perineal wounds after abdominoperineal resection. A retrospective cohort study

    NARCIS (Netherlands)

    Walma, M S; Burbach, J P M; Verheijen, P M; Pronk, A; van Grevenstein, W M U

    2016-01-01

    INTRODUCTION: Perineal wound complications are a main problem after abdominoperineal resection (APR). There is little evidence concerning perineal wound management. This study describes and evaluates the role of vacuum-assisted closure (VAC) therapy in wound management strategies of perineal wound i

  5. Penetrating wounds of the head and neck.

    Science.gov (United States)

    Jahrsdoerfer, R A; Johns, M E; Cantrell, R W

    1979-12-01

    Wounding capability of bullets is primarily releated to velocity. Bullet mass and shape, and specific gravity of body tissues being struck by the missile, are lesser factors. Seventy cases of penetrating wounds of the head and neck were treated during a six-year period. Vascular injuries were more common with neck wounds, while face and head injuries (extracranial) were similar to maxillofacial trauma. It is recognized that hemorrhage at the base of the skull is difficult to treat, and contemporary training in temporal bone and base of skull surgery is mandatory for the critical management of these wounds.

  6. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen;

    2016-01-01

    Background: People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only...... limited research that specifically explores how these occupational difficulties are managed. Objective: To describe and explore how people with advanced cancer manage occupations when living at home. Material and methods: A sub-sample of 73 participants from a larger occupational therapy project took part...... occupations in everyday life and 2) Self-developed strategies to manage occupations. Significance: The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality...

  7. The positive attitudes and perceptions of care managers about advance directives.

    Science.gov (United States)

    Golden, Adam G; Tewary, Sweta; Qadri, Syeda; Zaw, Khin; Ruiz, Jorge G; Roos, Bernard A

    2011-03-01

    In a previous intervention, we found that reminders from care managers failed to increase the number of their homebound older adult clients with advance directives. Thus, in the current study, we looked at the perceptions and attitudes of care managers about the need to discuss advance directives with their clients. Ninety-five care managers serving community-based nursing home-eligible older adults completed an 18-question survey, which found that care managers overwhelmingly believe it is important to address advance directives. Only 3.2% reported that discussing advance directives is time consuming. No attitudinal barriers were identified. Given their positive attitudes about advance directives, care managers need educational interventions that will provide the knowledge and skills to interact effectively with clients who are resistant to addressing end-of-life issues.

  8. Practice and prospect of advanced fuel management and fuel technology application in PWR in China

    International Nuclear Information System (INIS)

    Since Daya Bay nuclear power plant implemented 18-month refueling strategy in 2001, China has completed a series of innovative fuel management and fuel technology projects, including the Ling Ao Advanced Fuel Management (AFM) project (high-burnup quarter core refueling) and the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. First, this paper gives brief introduction to China's advanced fuel management and fuel technology experience. Second, it introduces practices of the advanced fuel management in China in detail, which mainly focuses on the implementation and progress of the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. Finally, the paper introduces the practices of advanced fuel technology in China and gives the outlook of the future advanced fuel management and fuel technology in this field. (author)

  9. Negative pressure wound therapy management of the “open abdomen” following trauma: a prospective study and systematic review

    Directory of Open Access Journals (Sweden)

    Navsaria Pradeep

    2013-01-01

    Full Text Available Abstract Introduction The use of Negative Pressure Wound Therapy (NPWT for temporary abdominal closure of open abdomen (OA wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. Methods A prospective study on trauma patients requiring temporary abdominal closure (TAC with grade 1or 2 OA was carried out. All patients were treated with NPWT (RENASYS AB Smith & Nephew to achieve TAC. The primary outcome measure was time taken to achieve fascial closure and secondary outcomes were complications and mortality. Results A total of 20 patients were included. Thirteen patients (65% achieved fascial closure following a median treatment period of 3 days. Four patients (20% died of causes unrelated to NPWT. Complications included fistula formation in one patient (5% with spontaneous resolution during NPWT, bowel necrosis in a single patient (5% and three cases of infection (15%. No fistulae were present at the end of NPWT. Conclusion This new NPWT kit is safe and effective and results in a high rate of fascial closure and low complication rates in the severely injured trauma patient.

  10. Advancements in the Management of Pancreatic Cancer: 2013

    Directory of Open Access Journals (Sweden)

    Muhammad Wasif Saif

    2013-03-01

    Full Text Available Pancreatic cancer still remains a significant, unresolved therapeutic challenge and is the most lethal type of gastrointestinal cancer with a 5-year survival rate of 5%. Adjuvant chemotherapy remains to be gemcitabine alone, though fluorouracil offers the same survival and role of radiation remains controversial. Nevertheless, only a few patients survive for at least 5 years after R0 resection and adjuvant therapy. Borderline resectable pancreatic cancer remains an area that requires multi-disciplinary approach. Neoadjuvant therapy very likely plays a role to downstage to a resectable state in these subgroup patients. There are different treatment approaches to locally advanced pancreatic cancer management, including single or multi-agent chemotherapy, chemotherapy followed by chemoradiation, or immediate concurrent chemoradiation. Most patients need palliative treatment. Once pancreatic cancer becomes metastatic, it is uniformly fatal with an overall survival of generally 6 months from time of diagnosis. Gemcitabine has been the standard since 1997. FOLFIRINOX (5-fluorouracil, oxaliplatin, irinotecan, leucovorin has already shown superiority over gemcitabine in both progression-free survival and overall survival, but this regimen is suitable only for selected patients in ECOG performance status 0-1. FOLFIRINOX has already trickled down to the clinic in various modifications and in different patient groups, both locally advanced and metastatic. Many targeted agents, including bevacizumab, cetuximab showed negative results, except mild benefit with addition of erlotinib with gemcitabine, which was not considered clinically significant. There is no consensus regarding treatment in the second-line setting. It will be true to say that there was a real medical breakthrough with regards to improving the prognosis of pancreatic cancer as of 2013 with the results of MPACT study. In this study, patients whoreceived nab-paclitaxel plus gemcitabine lived a

  11. The role of stoma & wound team in pressure ulcer management%造口伤口小组在压疮管理中的应用

    Institute of Scientific and Technical Information of China (English)

    夏永梅; 李金凤; 徐丽; 刘凯

    2014-01-01

    目的:探讨造口伤口小组在压疮管理中的作用。方法:成立造口伤口小组,确定小组职责并进行专业化培训及考核,由造口治疗师及小组成员对压疮患者和压疮高危患者进行统一、全程管理。造口伤口小组成立前后,统计院内压疮的发生率、治愈率,调查小组成员对压疮知识的知晓率及压疮高危患者的满意度。结果:造口伤口小组成立后,压疮发生率(1.4‰)低于小组成立前(4.0‰);压疮治愈率(68.7%)、造口伤口小组成员对压疮知识掌握情况(25.6±1.5)及压疮高危患者满意度评分(4.1±0.2)均高于成立前。结论:造口伤口小组的成立,提高了压疮护理质量,减轻了压疮患者痛苦,充分体现了造口伤口专科护理水平。%Objective: To explore the role of stoma & wound team in pressure ulcer management. Methods: The stoma &wound team was established and their responsibilities were clariifed. They implemented specialized staff training and evaluation. Patients and high-risk patients with pressure ulcers were management by Enterostomal Therapists and team members. The incidence and cure rate of pressure ulcer in hospitals, pressure ulcer related knowledge of the team members and patients' satisfaction were collected and compared before and after the stoma & wound team established. Results: The incidence of pressure ulcer was lower than before (1.4‰ vs 4.0‰). The cure rate of pressure ulcer was 68.7%. The pressure ulcer related knowledge of the team members was (25.6±1.5) and patient satisfaction score was (4.1±0.2). Both of them were higher than before. Conclusion: The establishment of stoma & wound team could improve the quality of basic nursing care and relfect the professional level of stoma & wound care.

  12. 造口伤口小组在压疮管理中的应用%The role of stoma & wound team in pressure ulcer management

    Institute of Scientific and Technical Information of China (English)

    夏永梅; 李金凤; 徐丽; 刘凯

    2014-01-01

    Objective: To explore the role of stoma & wound team in pressure ulcer management. Methods: The stoma &wound team was established and their responsibilities were clariifed. They implemented specialized staff training and evaluation. Patients and high-risk patients with pressure ulcers were management by Enterostomal Therapists and team members. The incidence and cure rate of pressure ulcer in hospitals, pressure ulcer related knowledge of the team members and patients' satisfaction were collected and compared before and after the stoma & wound team established. Results: The incidence of pressure ulcer was lower than before (1.4‰ vs 4.0‰). The cure rate of pressure ulcer was 68.7%. The pressure ulcer related knowledge of the team members was (25.6±1.5) and patient satisfaction score was (4.1±0.2). Both of them were higher than before. Conclusion: The establishment of stoma & wound team could improve the quality of basic nursing care and relfect the professional level of stoma & wound care.%目的:探讨造口伤口小组在压疮管理中的作用。方法:成立造口伤口小组,确定小组职责并进行专业化培训及考核,由造口治疗师及小组成员对压疮患者和压疮高危患者进行统一、全程管理。造口伤口小组成立前后,统计院内压疮的发生率、治愈率,调查小组成员对压疮知识的知晓率及压疮高危患者的满意度。结果:造口伤口小组成立后,压疮发生率(1.4‰)低于小组成立前(4.0‰);压疮治愈率(68.7%)、造口伤口小组成员对压疮知识掌握情况(25.6±1.5)及压疮高危患者满意度评分(4.1±0.2)均高于成立前。结论:造口伤口小组的成立,提高了压疮护理质量,减轻了压疮患者痛苦,充分体现了造口伤口专科护理水平。

  13. Biocompatibility of potential wound management products: fungal mycelia as a source of chitin/chitosan and their effect on the proliferation of human F1000 fibroblasts in culture.

    Science.gov (United States)

    Chung, L Y; Schmidt, R J; Hamlyn, P F; Sagar, B F; Andrews, A M; Turner, T D

    1994-04-01

    Aspergillus oryzae, Mucor mucedo, and Phycomyces blakesleeanus cultures were examined as sources of chitin/chitosan. The nitrogen content of the alkali-treated mycelia/sporangiophores of A. oryzae, M. mucedo, and P. blakesleeanus was 2.52, 3.61, and 6.27% w/w, which relates to an estimated chitin content of 37, 52, and 91%, respectively. The effect of these fungal materials on the rate of proliferation of human F1000 fibroblasts in culture was examined. At 0.01% w/v, all three materials exhibited significant (P mucedo produced a significant (P mucedo, possessed cell attractant properties, again correlating with chitin content. If developed for use as wound management materials, the sporangiophores of P. blakesleeanus and the mycelium of M. mucedo could possibly promote the growth of fibroblasts and provide a matrix for their anchorage, thus contributing to the granulation phase of the healing cascade.

  14. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    Science.gov (United States)

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network. PMID:27222729

  15. Wireless Sensor Network for Advanced Energy Management Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Peter J. Theisen; Bin Lu, Charles J. Luebke

    2009-09-23

    Eaton has developed an advanced energy management solution that has been deployed to several Industries of the Future (IoF) sites. This demonstrated energy savings and reduced unscheduled downtime through an improved means for performing predictive diagnostics and energy efficiency estimation. Eaton has developed a suite of online, continuous, and inferential algorithms that utilize motor current signature analysis (MCSA) and motor power signature analysis (MPSA) techniques to detect and predict the health condition and energy usage condition of motors and their connect loads. Eaton has also developed a hardware and software platform that provided a means to develop and test these advanced algorithms in the field. Results from lab validation and field trials have demonstrated that the developed advanced algorithms are able to detect motor and load inefficiency and performance degradation. Eaton investigated the performance of Wireless Sensor Networks (WSN) within various industrial facilities to understand concerns about topology and environmental conditions that have precluded broad adoption by the industry to date. A Wireless Link Assessment System (WLAS), was used to validate wireless performance under a variety of conditions. Results demonstrated that wireless networks can provide adequate performance in most facilities when properly specified and deployed. Customers from various IoF expressed interest in applying wireless more broadly for selected applications, but continue to prefer utilizing existing, wired field bus networks for most sensor based applications that will tie into their existing Computerized Motor Maintenance Systems (CMMS). As a result, wireless technology was de-emphasized within the project, and a greater focus placed on energy efficiency/predictive diagnostics. Commercially available wireless networks were only utilized in field test sites to facilitate collection of motor wellness information, and no wireless sensor network products were

  16. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    OpenAIRE

    Rahmi Yücel; Kayhan Ahmetoğulları

    2015-01-01

    This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

  17. Wound debridement optimisation

    DEFF Research Database (Denmark)

    Ågren, Sven Per Magnus

    2014-01-01

    Wound debridement, the removal of contaminated tissue and senescent cells, is the cornerstone in the care of patients with chronic wounds.......Wound debridement, the removal of contaminated tissue and senescent cells, is the cornerstone in the care of patients with chronic wounds....

  18. Staged Concept for Treatment of Severe Postsaphenectomy Wound Infection

    Directory of Open Access Journals (Sweden)

    Thomas Schroeter

    2011-01-01

    Full Text Available The saphenous vein remains the most commonly used conduit in coronary artery bypass surgery. Vein harvest is a critical component with significant morbidity associated with leg wounds from open technique. Occurring complications are hematoma, postoperative pain, skin changes, neuropathy, and septic or nonseptic wound complications. Within the context of a recent case, we present our approach to postsaphenectomy wound management.

  19. First evidence of sternal wound biofilm following cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Haytham Elgharably

    Full Text Available Management of deep sternal wound infection (SWI, a serious complication after cardiac surgery with high morbidity and mortality incidence, requires invasive procedures such as, debridement with primary closure or myocutaneous flap reconstruction along with use of broad spectrum antibiotics. The purpose of this clinical series is to investigate the presence of biofilm in patients with deep SWI. A biofilm is a complex microbial community in which bacteria attach to a biological or non-biological surface and are embedded in a self-produced extracellular polymeric substance. Biofilm related infections represent a major clinical challenge due to their resistance to both host immune defenses and standard antimicrobial therapies. Candidates for this clinical series were patients scheduled for a debridement procedure of an infected sternal wound after a cardiac surgery. Six patients with SWI were recruited in the study. All cases had marked dehiscence of all layers of the wound down to the sternum with no signs of healing after receiving broad spectrum antibiotics post-surgery. After consenting patients, tissue and/or extracted stainless steel wires were collected during the debridement procedure. Debrided tissues examined by Gram stain showed large aggregations of Gram positive cocci. Immuno-fluorescent staining of the debrided tissues using a specific antibody against staphylococci demonstrated the presence of thick clumps of staphylococci colonizing the wound bed. Evaluation of tissue samples with scanning electron microscope (SEM imaging showed three-dimensional aggregates of these cocci attached to the wound surface. More interestingly, SEM imaging of the extracted wires showed attachment of cocci aggregations to the wire metal surface. These observations along with the clinical presentation of the patients provide the first evidence that supports the presence of biofilm in such cases. Clinical introduction of the biofilm infection concept in deep

  20. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

    Directory of Open Access Journals (Sweden)

    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  1. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen;

    Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties......, there are limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...... “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  2. Advanced Simulation Capability for Environmental Management (ASCEM) Phase II Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hubbard, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Flach, G. [Savannah River National Lab. (SRNL), Aiken, SC (United States); Freedman, V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Agarwal, D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Andre, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bott, Y. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, X. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Davis, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faybishenko, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gorton, I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Murray, C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moulton, D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Meyer, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rockhold, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Shoshani, A. [LBNL; Steefel, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wainwright, H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Waichler, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-09-28

    In 2009, the National Academies of Science (NAS) reviewed and validated the U.S. Department of Energy Office of Environmental Management (EM) Technology Program in its publication, Advice on the Department of Energy’s Cleanup Technology Roadmap: Gaps and Bridges. The NAS report outlined prioritization needs for the Groundwater and Soil Remediation Roadmap, concluded that contaminant behavior in the subsurface is poorly understood, and recommended further research in this area as a high priority. To address this NAS concern, the EM Office of Site Restoration began supporting the development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific approach that uses an integration of toolsets for understanding and predicting contaminant fate and transport in natural and engineered systems. The ASCEM modeling toolset is modular and open source. It is divided into three thrust areas: Multi-Process High Performance Computing (HPC), Platform and Integrated Toolsets, and Site Applications. The ASCEM toolsets will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. During fiscal year 2012, the ASCEM project continued to make significant progress in capabilities development. Capability development occurred in both the Platform and Integrated Toolsets and Multi-Process HPC Simulator areas. The new Platform and Integrated Toolsets capabilities provide the user an interface and the tools necessary for end-to-end model development that includes conceptual model definition, data management for model input, model calibration and uncertainty analysis, and model output processing including visualization. The new HPC Simulator capabilities target increased functionality of process model representations, toolsets for interaction with the Platform, and model confidence testing and verification for

  3. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    Directory of Open Access Journals (Sweden)

    Rahmi Yücel

    2015-10-01

    Full Text Available This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively. Furthermore, there is a positive and significant relation between long-term strategy based on management accounting practices and non-financial company performance and between activity based on management accounting practices and financial performance.

  4. Effect of fibroblast-seeded artificial dermis on wound healing.

    Science.gov (United States)

    Jang, Joon Chul; Choi, Rak-Jun; Han, Seung-Kyu; Jeong, Seong-Ho; Kim, Woo-Kyung

    2015-04-01

    In covering wounds, efforts should include use of the safest and least invasive methods with a goal of achieving optimal functional and cosmetic outcome. The recent development of advanced technology in wound healing has triggered the use of cells and/or biological dermis to improve wound healing conditions. The purpose of the study was to evaluate the effects of fibroblast-seeded artificial dermis on wound healing efficacy.Ten nude mice were used in this study. Four full-thickness 6-mm punch wounds were created on the dorsal surface of each mouse (total, 40 wounds). The wounds were randomly assigned to one of the following 4 treatments: topical application of Dulbecco phosphate-buffered saline (control), human fibroblasts (FB), artificial dermis (AD), and human fibroblast-seeded artificial dermis (AD with FB). On the 14th day after treatment, wound healing rate and wound contraction, which are the 2 main factors determining wound healing efficacy, were evaluated using a stereoimage optical topometer system, histomorphological analysis, and immunohistochemistry.The results of the stereoimage optical topometer system demonstrated that the FB group did not have significant influence on wound healing rate and wound contraction. The AD group showed reduced wound contraction, but wound healing was delayed. The AD with FB group showed decreased wound contraction without significantly delayed wound healing. Histomorphological analysis exhibited that more normal skin structure was regenerated in the AD with FB group. Immunohistochemistry demonstrated that the AD group and the AD with FB group produced less α-smooth muscle actin than the control group, but this was not shown in the FB group.Fibroblast-seeded artificial dermis may minimize wound contraction without significantly delaying wound healing in the treatment of skin and soft tissue defects.

  5. Wound Documentation by Using 3G Mobile as Acquisition Terminal: An Appropriate Proposal for Community Wound Care.

    Science.gov (United States)

    Ge, Kui; Wu, Minjie; Liu, Hu; Gong, Jiahong; Zhang, Yi; Hu, Qiang; Fang, Min; Tao, Yanping; Cai, Minqiang; Chen, Hua; Wang, Jianbo; Xie, Ting; Lu, Shuliang

    2015-06-01

    The increasing numbers of cases of wound disease are now posing a big challenge in China. For more convenience of wound patients, wound management in community health care centers under the supervision of a specialist at general hospitals is an ideal solution. To ensure an accurate diagnosis in community health clinics, it is important that "the same language" for wound description, which may be composed of unified format description, including wound image, must be achieved. We developed a wound information management system that was built up by acquisition terminal, wound description, data bank, and related software. In this system, a 3G mobile phone was applied as acquisition terminal, which could be used to access to the data bank. This documentation system was thought to be an appropriate proposal for community wound care because of its objectivity, uniformity, and facilitation. It also provides possibility for epidemiological study in the future. PMID:25256281

  6. Wound Documentation by Using 3G Mobile as Acquisition Terminal: An Appropriate Proposal for Community Wound Care.

    Science.gov (United States)

    Ge, Kui; Wu, Minjie; Liu, Hu; Gong, Jiahong; Zhang, Yi; Hu, Qiang; Fang, Min; Tao, Yanping; Cai, Minqiang; Chen, Hua; Wang, Jianbo; Xie, Ting; Lu, Shuliang

    2015-06-01

    The increasing numbers of cases of wound disease are now posing a big challenge in China. For more convenience of wound patients, wound management in community health care centers under the supervision of a specialist at general hospitals is an ideal solution. To ensure an accurate diagnosis in community health clinics, it is important that "the same language" for wound description, which may be composed of unified format description, including wound image, must be achieved. We developed a wound information management system that was built up by acquisition terminal, wound description, data bank, and related software. In this system, a 3G mobile phone was applied as acquisition terminal, which could be used to access to the data bank. This documentation system was thought to be an appropriate proposal for community wound care because of its objectivity, uniformity, and facilitation. It also provides possibility for epidemiological study in the future.

  7. Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds

    OpenAIRE

    Stacey, D. Heath

    2013-01-01

    Objectives: Bioengineered skin grafts, including acellular dermal matrices, may be effective in treating lower extremity and trunk wounds that are not responsive to traditional wound management. Acellular dermal wound matrix is derived from human acellular dermal wound matrix (HADWM) tissue and provides a scaffold that supports cellular repopulation and revascularization. The major structural components of the dermis are retained during processing, and a single application has been shown to h...

  8. THE EFFICACY OF CELLULAR ADHESIVE (HISTOACRYL IN THE MANAGEMENT OF LACERATED WOUNDS IN CHILDREN ATTENDING AN OUT-PATIENT SETTING, AN OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Jeya Balaji1

    2014-06-01

    Full Text Available Apart from traditional Traditionally suturing for wound closure, other options for wound closure like staples, adhesive tapes and tissue adhesives came into existence and are gaining popularity in clinical practice in recent times. There is an increasing amount of literature supporting the use of TAs for various minor lacerations, including a number of randomized controlled trials (RCTs. Even though TAs are ideal choice for resource poor settings like India, studies documenting the efficacy of tissue adhesives, especially in pediatric population are rare from India. AIMS & OBJECTIVE: To study the efficacy of wound healing, occurrence of complications and cost of treatment following cellular Adhesive (Histoacryl use in children with laceration wounds. METHODOLOGY: The study was a cross sectional study, conducted in outpatient setting of department of pediatrics , in a tertiary care teaching hospital, between June 2011 to December 2012. RESULTS: A total of 62 children were included in the study. Clean wounds constituted 93.5% of the wounds. Average amount of glue required was 3 to 4 drops. Majority wounds (91.9% started healing well by the third day of follow-up and they healed well after 7 days. The final outcome was good in 88.7% of the subjects and fair in 3.2% of the subjects. Only 11.3% of participants had some complication. The quantity of tissue adhesive glue used per cm of wound surface was 1.77 drops and the expenditure incurred per cm of wound surface was 44.5 INR. CONCLUSIONS: Tissue adhesive glue is effective method of wound closure in pediatric laceration wounds. The complication rates and the need for antibiotic is very minimal with tissue adhesive glue use and it is very economical way of wound closure in pediatric laceration wounds.

  9. Disinfecting wounds with radiation

    Energy Technology Data Exchange (ETDEWEB)

    Cuttler, J.M. [Cuttler and Associates Inc., Mississauga, Ontario (Canada)

    2002-07-01

    Infection with clostridium bacteria, which live in the soil, is most often associated with war wounds, car accidents, complicated abortions, etc. The incidence is highest in areas with poor access to proper wound care. Such infections lead to gas gangrene, a deadly disease that spreads very quickly in the body and causes rapid death. Present-day treatment consists of administering antibiotics and surgical removal of dead, damaged and infected tissue. Amputation is usually necessary to control the spread of the infection, which can advance at the rate of six inches per hour. Before the 1940s, this disease was treated successfully with low doses (50 rad) of radiation (X-rays) in the area of infection. A review of 364 cases treated in this manner, from 1928 until 1940, indicated that patient mortality would be reduced from 50 percent (or higher) to {approx}5 percent if patients were treated reasonably early and with the correct technique. X-ray therapy stopped the infection without the need for amputation to control its spread. Low-dose irradiation (LDI) therapy, given immediately, acted as a prophylaxis to prevent the onset of gas gangrene. This is but one example of the extensive use of radiation treatment of many types of infections, before the advent of antibiotics. Low doses are inadequate to kill invading bacteria directly, however, they will stimulate our defences to destroy the infection. The observed beneficial effects are consistent with the large amount of scientific evidence of radiation hormesis - the stimulation of an organism's own defences by low doses of radiation (to destroy invaders and heal wounds). In view of the ineffectiveness of antibiotics in many cases and the evolution of antibiotic-resistant strains of bacteria, physicians should start to use LDI therapies again. Many patients would benefit greatly. (author)

  10. Advances on Syndromic Management of Sexually Transmitted Diseases

    Institute of Scientific and Technical Information of China (English)

    WANG Qianqiu (王千秋)

    2002-01-01

    Research data showed that syndromic approach could successfully manage gonococcal and chlamydial infections in males and syphilis and chancroid in males and females. However, low sensitivity, specificity and positive predictive value were found in the syndromic management of vaginal discharge. It is recommended that the syndromic algorithm for management of vaginal discharge used when serving high-risk and symptomatic women.

  11. Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds

    OpenAIRE

    Payne, Caroline; Edwards, Daren

    2014-01-01

    Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic,...

  12. Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report

    OpenAIRE

    Chang, CW; Chan, HZ; Lim, SW; Khoo, EH; Zulkiflee, O

    2014-01-01

    Abstract Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT) applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1) vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL) ...

  13. Advances in the effects of pH value of micro-environment on wound healing%微环境pH值对创面愈合的作用研究进展

    Institute of Scientific and Technical Information of China (English)

    田瑞瑞; 李娜; 魏力

    2016-01-01

    Wound healing is a complex regeneration process,which is affected by lots of endogenous and exogenous factors.Researches have confirmed that acid environment could prevent wound infection and accelerate wound healing by inhibiting bacteria proliferation,promoting oxygen release,affecting keratinocyte proliferation and migration,etc.In this article,we review the literature to identify the potential relationship between the pH value of wound micro-environment and the progress of wound healing,and summarize the clinical application of variation of pH value of micro-environment in wound healing,thereby to provide new treatment strategy for wound healing.

  14. Managing the Perception of Advanced Technology Risks in Mission Proposals

    Science.gov (United States)

    Bellisario, Sebastian Nickolai

    2012-01-01

    Through my work in the project proposal office I became interested in how technology advancement efforts affect competitive mission proposals. Technology development allows for new instruments and functionality. However, including technology advancement in a mission proposal often increases perceived risk. Risk mitigation has a major impact on the overall evaluation of the proposal and whether the mission is selected. In order to evaluate the different approaches proposals took I compared the proposals claims of heritage and technology advancement to the sponsor feedback provided in the NASA debriefs. I examined a set of Discovery 2010 Mission proposals to draw patterns in how they were evaluated and come up with a set of recommendations for future mission proposals in how they should approach technology advancement to reduce the perceived risk.

  15. Wireless Sensor Network for Advanced Energy Management Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Peter J. Theisen; Bin Lu, Charles J. Luebke

    2009-09-23

    Eaton has developed an advanced energy management solution that has been deployed to several Industries of the Future (IoF) sites. This demonstrated energy savings and reduced unscheduled downtime through an improved means for performing predictive diagnostics and energy efficiency estimation. Eaton has developed a suite of online, continuous, and inferential algorithms that utilize motor current signature analysis (MCSA) and motor power signature analysis (MPSA) techniques to detect and predict the health condition and energy usage condition of motors and their connect loads. Eaton has also developed a hardware and software platform that provided a means to develop and test these advanced algorithms in the field. Results from lab validation and field trials have demonstrated that the developed advanced algorithms are able to detect motor and load inefficiency and performance degradation. Eaton investigated the performance of Wireless Sensor Networks (WSN) within various industrial facilities to understand concerns about topology and environmental conditions that have precluded broad adoption by the industry to date. A Wireless Link Assessment System (WLAS), was used to validate wireless performance under a variety of conditions. Results demonstrated that wireless networks can provide adequate performance in most facilities when properly specified and deployed. Customers from various IoF expressed interest in applying wireless more broadly for selected applications, but continue to prefer utilizing existing, wired field bus networks for most sensor based applications that will tie into their existing Computerized Motor Maintenance Systems (CMMS). As a result, wireless technology was de-emphasized within the project, and a greater focus placed on energy efficiency/predictive diagnostics. Commercially available wireless networks were only utilized in field test sites to facilitate collection of motor wellness information, and no wireless sensor network products were

  16. [A discussion regarding reconstruction and rehabilitation of patients with deep burn wound].

    Science.gov (United States)

    Hu, Da-hai

    2009-12-01

    With the advances in resuscitation, infection control, and metabolic management, the treatment strategies for burn patients have improved remarkably in the last half century. As a result, more patients with deep burn wound survived, and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treatment strategy making and the new techniques performing. In the present discussion, early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair, the use of composite skin grafting, the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue, etc. Besides these, more attention should be given to the repair and reconstruction in specialized functional parts of the body, such as head and face, neck, hand, female breast, perineum, and joint areas, after a deep burn. The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity. Adequate treatment of deep burn wound demands a number of important measures including the timing of surgery, adoption of essential techniques, suitable types of wound covering materials, motivated rehabilitation, and necessary psychological therapy. The optimal recovery of damaged part of body after burn should depend on the similarity of rebuild tissue structure to simulate the nature of the original tissue in the cellular, histological, anatomic characteristics, which is the aim of all burn wound care and the basis of the appearance and function repair or reconstruction.

  17. Advanced Product Water Removal and Management (APWR) Fuel Cell System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation is a passive, self-regulating, gravity-independent Advanced Product Water Removal and management (APWR) system for incorporation into...

  18. Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Brose, M.S.; Smit, J.W.; Capdevila, J.; Elisei, R.; Nutting, C.; Pitoia, F.; Robinson, B.; Schlumberger, M.; Shong, Y.K.; Takami, H.

    2012-01-01

    For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and nati

  19. Biomarkers for wound healing and their evaluation.

    Science.gov (United States)

    Patel, S; Maheshwari, A; Chandra, A

    2016-01-01

    A biological marker (biomarker) is a substance used as an indicator of biological state. Advances in genomics, proteomics and molecular pathology have generated many candidate biomarkers with potential clinical value. Research has identified several cellular events and mediators associated with wound healing that can serve as biomarkers. Macrophages, neutrophils, fibroblasts and platelets release cytokines molecules including TNF-α, interleukins (ILs) and growth factors, of which platelet-derived growth factor (PDGF) holds the greatest importance. As a result, various white cells and connective tissue cells release both matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs). Studies have demonstrated that IL-1, IL-6, and MMPs, levels above normal, and an abnormally high MMP/TIMP ratio are often present in non-healing wounds. Clinical examination of wounds for these mediators could predict which wounds will heal and which will not, suggesting use of these chemicals as biomarkers of wound healing. There is also evidence that the application of growth factors like PDGF will alleviate the recuperating process of chronic, non-healing wounds. Finding a specific biomarker for wound healing status would be a breakthrough in this field and helping treat impaired wound healing.

  20. Automated Contingency Management for Advanced Propulsion Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Automated Contingency Management (ACM), or the ability to confidently and autonomously adapt to fault conditions with the goal of still achieving mission...

  1. Automated Contingency Management for Advanced Propulsion Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Impact Technologies LLC, in cooperation the Georgia Institute of Technology, proposes to develop and demonstrate an innovative Automated Contingency Management...

  2. Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study

    OpenAIRE

    Rognås, Leif; Hansen, Troels Martin; Kirkegaard, Hans; Tønnesen, Else

    2013-01-01

    Introduction We report data from the first Utstein-style study of physician-provided pre-hospital advanced airway management. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) prospectively registered data according to the template for reporting data from pre-hospital advanced airway management. Data collection took place from February 1st 2011 to October 31st 2012. ...

  3. Advances in the management of differentiated thyroid cancer with follicular cell strain.

    Science.gov (United States)

    Ben Slimène, Faouzi; Mhiri, Aida; Ben Ali, Moez; Slimène, Hédia; Ben Raies, Nouzha; Karboua, Esma; Schlumberger, Martin

    2016-03-01

    The management of nodules and thyroid cancer is evolving. The aim is to individualize the treatment, decreasing aggression in the forms low risk and instead seeking new therapeutic options in advanced disease. This update shows the main recent advances in this field. PMID:27575497

  4. Clinical review: surgical management of locally advanced and recurrent colorectal cancer.

    LENUS (Irish Health Repository)

    Courtney, D

    2014-01-01

    Recurrent and locally advanced colorectal cancers frequently require en bloc resection of involved organs to achieve negative margins. The aim of this review is to evaluate the most current literature related to the surgical management of locally advanced and recurrent colorectal cancer.

  5. Advanced Technologies and Data Management Practices in Environmental Science: Lessons from Academia

    Science.gov (United States)

    Hernandez, Rebecca R.; Mayernik, Matthew S.; Murphy-Mariscal, Michelle L.; Allen, Michael F.

    2012-01-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the…

  6. Advances in Operational Flood Risk Management in the Netherlands

    NARCIS (Netherlands)

    Wojciechowska, K.A.

    2015-01-01

    Operational flood risk management refers to activities that aim to reduce the probability and/or negative consequences of flooding just prior to the expected flood event. An inherent feature of operational flood risk management is that outcomes of decisions taken are uncertain. The main goal of this

  7. How wounds heal

    Science.gov (United States)

    ... PA: Mosby Elsevier; 2010: chap. 7. Richardson M. Acute wounds: an overview of the physiological healing process. Nursing Times . 2004; 100(4): 50. Von Der Heyde RL, Evans RB. Wound classification ...

  8. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: A randomized controlled trial

    NARCIS (Netherlands)

    Braakenburg, A.; Obdeijn, M.C.; Feitz, R.; van Rooij, I.A.L.M.; van Griethuysen, A.J.; Klinkenbijl, J.H.G.

    2006-01-01

    Background: Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity. The authors aimed to investigate the effect of vacuum-assisted closure therapy on wound healing, granulation tissue formation, bacterial clearance, pain, time in

  9. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds : A randomized controlled trial

    NARCIS (Netherlands)

    Braakenburg, Assa; Obdeijn, Miryam C.; Feitz, Reinier; van Rooij, Iris A. L. M.; van Griethuysen, Arjanne J.; Klinkenbijl, Jean H. G.

    2006-01-01

    Background: Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity. The authors aimed to investigate the effect of vacuum-assisted closure therapy on wound healing, granulation tissue formation, bacterial clearance, pain, time in

  10. Improved wound care product

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention pertains to use of sodium diacetate (NaHAc 2) as an antimicrobial agent against bacteria growing in biofilms. The aspects of the invention include a wound care product comprising sodium diacetate, a kit comprising a wound care product,and a methodof treating an infected wound....

  11. Advanced methods of microscope control using μManager software.

    OpenAIRE

    Edelstein, Arthur D.; Tsuchida, Mark A.; Nenad Amodaj; Henry Pinkard; Vale, Ronald D.; Nico Stuurman

    2014-01-01

    µManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, µManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we presen...

  12. Security and Reliability Requirements for Advanced Security Event Management

    OpenAIRE

    RIEKE, Roland; COPPOLINO, Luigi; Hutchinson, Andrew; PRIETO, Elsa; Gaber, Chrystel

    2012-01-01

    This paper addresses security information management in complex application scenarios. Security Information and Event Management (SIEM) systems collect and examine security related events, with the goal of providing a unified view of the monitored systems' security status. While various SIEMs are in production, there is scope to extend the capability and resilience of these systems. The use of SIEM technology in four disparate scenario areas is used in this paper as a catalyst for the develop...

  13. The advancement of regulation fee, budget system, and set-up time management

    Energy Technology Data Exchange (ETDEWEB)

    Jung, J. S.; Choi, E. S.; Cho, J. I.; Jung, S. C.; Lee, J. H. [Caleb and Company, Seoul (Korea, Republic of)

    2001-07-15

    Analyze the government's charging fee amendment and suggest the national regulation fee system. Suggest the future business portfolio based in the current business analysis. Design the advanced budget code structure, the performance management of the project budget and the survice level agreement between divisions. Develop the time management and the methodology of the standard man-hour calculation.

  14. Advances in Financial Risk Management and Economic Policy Uncertainty: An Overview

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ Financial risk management is difficult at the best of times, but especially so in the presence of economic uncertainty and financial crises. The purpose of this special issue on “Advances in Financial Risk Management and Economic Policy Uncertainty” is to highlight some

  15. Management of Advanced-Phase Chronic Myelogenous Leukemia.

    Science.gov (United States)

    Radich, Jerald P

    2016-05-01

    Chronic myelogenous leukemia represents the poster child of successful precision medicine in cancer, with amazing survival results achieved with targeted tyrosine kinase inhibitors (TKIs) in many patients with chronic-phase disease. Unfortunately, however, this good news has not extended to patients in blast crisis, for whom survival has not clearly been improved with TKIs. During his presentation at the NCCN 21st Annual Conference, Jerald P. Radich, MD, briefly explored the biology behind advanced-stage disease and several of the molecular findings in disease progression. He also reviewed some of the therapeutic options in advanced disease, emphasizing that transplantation, although fraught with some difficulties, offers the best long-term prognosis for patients in blast crisis. PMID:27226510

  16. Advanced measurement approach with loss distribution in operational risk management

    OpenAIRE

    Atilla ÇİFTER; Chambers, Nurgül

    2007-01-01

    According to the last proposal by Basel Committee, commercial banks are allowed to use advanced measurement approach for operational risk. Since basic indicator and standard approach considers operational risk as a percentage of gross profit, these methodologies are not satisfactory as real lost or probability of lost are not taken into consideration. In this article, loss distribution approach is applied with simulated data. 20 nonparametric loss distributions and mixing internal and externa...

  17. Recent advances in dengue pathogenesis and clinical management.

    Science.gov (United States)

    Simmons, Cameron P; McPherson, Kirsty; Van Vinh Chau, Nguyen; Hoai Tam, D T; Young, Paul; Mackenzie, Jason; Wills, Bridget

    2015-12-10

    This review describes and commentates on recent advances in the understanding of dengue pathogenesis and immunity, plus clinical research on vaccines and therapeutics. We expand specifically on the role of the dermis in dengue virus infection, the contribution of cellular and humoral immune responses to pathogenesis and immunity, NS1 and mechanisms of virus immune evasion. Additionally we review a series of therapeutic intervention trials for dengue, as well as recent clinical research aimed at improving clinical diagnosis, risk prediction and disease classification.

  18. Advances in Nanotechnology for the Management of Coronary Artery Disease

    OpenAIRE

    Rhee, June-Wha; Wu, Joseph C.

    2012-01-01

    Nanotechnology holds tremendous potential to advance the current treatment of coronary artery disease. Nanotechnology may assist medical therapies by providing a safe and efficacious delivery platform for a variety of drugs aimed at modulating lipid disorders, decreasing inflammation and angiogenesis within atherosclerotic plaques, and preventing plaque thrombosis. Nanotechnology may improve coronary stent applications by promoting endothelial recovery on a stent surface utilizing bio-mimetic...

  19. MANAGEMENT OF INTRINSIC DISCOLORATION - ADVANCED TREATMENT OPTIONS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rashmi G

    2014-01-01

    Full Text Available Aesthetics of the teeth is of great importance to patients , including tooth color. Of the various causes of tooth discoloration fluorosis , enamel hypoplasia , medication staining etc. is commonly encountered. The treatment options for discoloration are varied depending on individual case basis. The purpose of this article is to report the advanced treatment options for generalized intrinsic discoloration encompassing power bleaching to veneers to full mouth rehabilitation w ith porcelain laminates and ceramic crowns

  20. The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing

    OpenAIRE

    Mui Koon Tan; Durriyyah Sharifah Hasan Adli; Mohd Amzari Tumiran; Mahmood Ameen Abdulla; Kamaruddin Mohd Yusoff

    2012-01-01

    Honey is one of the oldest substances used in wound management. Efficacy of Gelam honey in wound healing was evaluated in this paper. Sprague-Dawley rats were randomly divided into four groups of 24 rats each (untreated group, saline group, Intrasite Gel group, and Gelam honey group) with 2 cm by 2 cm full thickness, excisional wound created on neck area. Wounds were dressed topically according to groups. Rats were sacrificed on days 1, 5, 10, and 15 of treatments. Wounds were then processed ...

  1. Advances in the diagnosis and management of lymphoma

    Directory of Open Access Journals (Sweden)

    Matasar MJ

    2012-02-01

    Full Text Available Zachary H Word1, Matthew J Matasar1,21Lymphoma Service, Department of Medicine, Memorial Sloan–Kettering Cancer Center, 2Department of Medicine, New York Presbyterian Hospital, New York, NY, USAAbstract: The lymphomas are a heterogeneous group of cancers that have played a prominent role in the history of oncology, being among the first cancers to respond to radiotherapy or systemic chemotherapy. Progressive improvement in the understanding of the biology and natural history of these diseases has led to changes in both classification and management. Because of the heterogeneity present among the lymphomas, accurate diagnosis and staging are essential prerequisites to their effective management. Lymphoma stage frequently informs treatment decisions, but in contrast with solid tumor malignancies carries limited prognostic value. This has led to the development of prognostic models in lymphoma, which use patient and disease characteristics to stratify patients by risk. Modern approaches to Hodgkin's lymphoma include chemotherapy only, combined-modality therapy with both chemotherapy and radiotherapy, and risk-adapted approaches that modify treatment based on initial response. Management of non-Hodgkin's lymphoma (NHL varies widely depending upon histology. Use of rituximab, the anti-CD20 monoclonal antibody, is included in the management of most B cell lymphomas and has improved outcomes in these diseases. The T cell lymphomas are less common and generally less well understood than the B cell diseases, and their management has only recently become disease-specific. Though effective therapy is available for many types of lymphoma, relapse remains common in a number of subtypes, and management of relapsed and refractory disease remain research priorities.Keywords: lymphoma, diagnosis, treatment

  2. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    Science.gov (United States)

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure.

  3. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    Science.gov (United States)

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure. PMID:26177570

  4. Advances in the research of the role of mesenchymal stem cell in wound healing%间充质干细胞在创面愈合中的作用研究进展

    Institute of Scientific and Technical Information of China (English)

    刘玲英; 柴家科; 郁永辉; 侯玉森

    2014-01-01

    Wound healing is a dynamic and complicated process,which generally takes three overlapping phases:inflammation,proliferation,and remodeling.If wounds complicated by severe trauma,diabetes,vascular dysfunction disease,or a massive burn injury failed to pass through the three normal phases of healing,they might end up as chronic and refractory wounds.Mesenchymal stem cells (MSCs) play different important roles in the regulation of all the phases of wound healing.MSCs can be recruited into wound and differentiated into wound repair cells,as well as promote wound healing by exerting functions like anti-inflammation,anti-apoptosis,and neovascularization.This review focuses on the role and mechanism of MSCs in each phase of the wound healing process.

  5. Advances in the research of promoting healing of chronic wound with platelet-rich plasma%富血小板血浆促进慢性创面愈合研究进展

    Institute of Scientific and Technical Information of China (English)

    刘宸; 章宏伟

    2014-01-01

    Normal wound healing is a well-orchestrated process of inflammatory response,cell proliferation,and tissue remodeling.However,this orderly and precise process is impaired in chronic wounds.A series of complicated pathogenic factors,including enhanced inflammatory response,poor cell proliferation,restrained angiogenesis,restricted collagen deposition,and infection,contribute to the failure of healing of chronic wound.The application of platelet-rich plasma (PRP) has been explored as a treatment for chronic wounds as it can balance wound microenvironment for promoting wound healing.PRP can modulate the inflammatory mediators,growth factors,and cytokines,etc.to correct abnormal biological events and disorderly molecular environment of cell migration and proliferation,and thus promote wound healing appropriately.Yet,the mechanism of PRP in promoting healing of chronic wound is still not elaborated,and the clinical application of PRP needs to be standardized as soon as possible.

  6. Advancing in software product management: An incremental method engineering approach

    NARCIS (Netherlands)

    van de Weerd, I.

    2009-01-01

    Hardly any figures exist on the success of product software companies. What we do know is that a good Software Product Management (SPM) practice pays off. However, not many IT-professionals know how to implement SPM practices in their organization, which causes many companies to not have the proper

  7. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, GA; The ATLAS collaboration

    2011-01-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 55PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations to manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: - Popularity service, which measures usage of data across ATLAS. - Space monitoring and accounting at sites. - Automated blacklisting service. - Cleaning agents, which trigger deletion of unused data at sites. - Deletion agents, to reliably delete unwanted data from sites. We describe the experience of data management operation in ATLAS computing, showing how these serv...

  8. Advances in the management of cerebral malaria in adults

    DEFF Research Database (Denmark)

    Mishra, Saroj K; Wiese, Lothar

    2009-01-01

    of cerebral malaria and the role of adjuvant therapy will be discussed. RECENT FINDINGS: Artemisinin-based therapies have improved antiparasitic treatment, but in-hospital mortality still remains high, as do neurological sequelae. Several recent studies have given new insights in the pathophysiology...... into large clinical trials. SUMMARY: Advances have been made in terms of antiparasitic treatment, but the identification of a well tolerated and effective adjuvant treatment to increase survival and reduce brain damage is still pending. The search for new approaches is a major challenge, not least of which...

  9. Advances in nanotechnology for the management of coronary artery disease.

    Science.gov (United States)

    Rhee, June-Wha; Wu, Joseph C

    2013-02-01

    Nanotechnology holds tremendous potential to advance the current treatment of coronary artery disease. Nanotechnology may assist medical therapies by providing a safe and efficacious delivery platform for a variety of drugs aimed at modulating lipid disorders, decreasing inflammation and angiogenesis within atherosclerotic plaques, and preventing plaque thrombosis. Nanotechnology may improve coronary stent applications by promoting endothelial recovery on a stent surface utilizing bio-mimetic nanofibrous scaffolds, and also by preventing in-stent restenosis using nanoparticle-based delivery of drugs that are decoupled from stents. Additionally, nanotechnology may enhance tissue-engineered graft materials for application in coronary artery bypass grafting by facilitating cellular infiltration and remodeling of a graft matrix.

  10. Wound assessment tools and nurses' needs: an evaluation study.

    Science.gov (United States)

    Greatrex-White, Sheila; Moxey, Helen

    2015-06-01

    The purpose of this study was to ascertain how well different wound assessment tools meet the needs of nurses in carrying out general wound assessment and whether current tools are fit for purpose. The methodology employed was evaluation research. In order to conduct the evaluation, a literature review was undertaken to identify the criteria of an optimal wound assessment tool which would meet nurses' needs. Several freely available wound assessment tools were selected based on predetermined inclusion and exclusion criteria and an audit tool was developed to evaluate the selected tools based on how well they met the criteria of the optimal wound assessment tool. The results provide a measure of how well the selected wound assessment tools meet the criteria of the optimal wound assessment tool. No tool was identified which fulfilled all the criteria, but two (the Applied Wound Management tool and the National Wound Assessment Form) met the most criteria of the optimal tool and were therefore considered to best meet nurses' needs in wound assessment. The study provides a mechanism for the appraisal of wound assessment tools using a set of optimal criteria which could aid practitioners in their search for the best wound assessment tool.

  11. Development of Experimental Facilities for Advanced Spent Fuel Management Technology

    International Nuclear Information System (INIS)

    The Advanced spent fuel Conditioning Process Facility(ACPF) and hotcell system technologies were developed in this program for demonstrating safely and effectively the Advanced spent fuel Conditioning Process(ACP) on a lab-scale. With the analysis of work flow and characteristics of the process, ACP was successively demonstrated on a lab-scale experiments and the performance of process was evaluated. The hotcell system was comprehensively evaluated with those results and the design data for the engineering-scale demonstration was derived to propose the direction for the future research and development. The main items performed in this project were as follows. - The reconstruction of ACPF hotcell and demonstration of the ACP - The design and operation technologies for α-γ type nuclear hot cell facility - The overall evaluation of the performance, safety and operation ability of the hotcell system - The acquisition of the government licences for construction and operation and the IAEA licence for using nuclear materials The results of safety analysis and environmental effects assessment and performance data for ACPF had been used for acquiring the government licence for facility operation. The valuable experiences on pyroprocess facility design and operation knowledges would be applied to new Mock-up Facility being scheduled to be a previous stage facility of Integrated Pyroprocess Facility

  12. Recording wounds: Polaroid's new medically-designed cameras.

    Science.gov (United States)

    Clarke, G

    2000-11-01

    Wound management is an important and increasingly complex area of nursing practice. Community nurses, in particular, spend a considerable amount of time assessing, evaluating and managing chronic, non-healing wounds. The rapid rise in the number of wound care products, combined with the emphasis on clinical governance and risk management, and increases in litigation have meant that accurate documentation and record keeping have become an essential part of care (UKCC, 1992, 1998). A standardized approach to assessment, classification, measurement and evaluation should be adopted to maximize optimal patient outcomes. There are a number of techniques for measuring wounds, ranging from manual measurement using tracing to computer-based imaging. Photography is a simple and quick form of documentation, which provides an accurate and objective record of the wound. This article highlights the benefits of using the new Polaroid Macro 5 SLR camera in wound documentation. PMID:12066058

  13. Diabetic cornea wounds produce significantly weaker electric signals that may contribute to impaired healing

    OpenAIRE

    Yunyun Shen; Trisha Pfluger; Fernando Ferreira; Jiebing Liang; Navedo, Manuel F.; Qunli Zeng; Brian Reid; Min Zhao

    2016-01-01

    Wounds naturally produce electric signals which serve as powerful cues that stimulate and guide cell migration during wound healing. In diabetic patients, impaired wound healing is one of the most challenging complications in diabetes management. A fundamental gap in knowledge is whether diabetic wounds have abnormal electric signaling. Here we used a vibrating probe to demonstrate that diabetic corneas produced significantly weaker wound electric signals than the normal cornea. This was conf...

  14. Role of negative pressure wound therapy in total hip and knee arthroplasty

    OpenAIRE

    Siqueira, Marcelo BP; Ramanathan, Deepak; Klika, Alison K.; Higuera, Carlos A; Barsoum, Wael K.

    2016-01-01

    Negative-pressure wound therapy (NPWT) has been a successful modality of wound management which is in widespread use in several surgical fields. The main mechanisms of action thought to play a role in enhancing wound healing and preventing surgical site infection are macrodeformation and microdeformation of the wound bed, fluid removal, and stabilization of the wound environment. Due to the devastating consequences of infection in the setting of joint arthroplasty, there has been some interes...

  15. A cross-sectional study of chronic wound-related pain and itching.

    Science.gov (United States)

    Paul, Julia

    2013-07-01

    participants (17.6%) across all wound types. Pain and itch on the wound were significantly associated (r = .36, P = 0.043), as were pain and itch around the wound (r = .43, P = 0.002). Because pain and itching can occur with chronic wounds and the presence of one factor can affect the other, clinicians need to assess and manage both symptoms in patients with wounds.

  16. Maggot debridement therapy in chronic wound care

    OpenAIRE

    Patil, NG; Leung, GKK; Chan, DCW; Fong, DHF; Leung, JYY

    2007-01-01

    Objective: To review the current evidence on the mechanism of actions and clinical applications of maggot debridement therapy. Data sources: Literature search of PubMed and Medline was performed up to January 2007. Study selection: Original and major review articles related to maggot debridement therapy were reviewed. Key words used in the literature search were 'maggot debridement therapy', 'wound healing', and 'chronic wound management'. Data extraction: All relevant English and Chinese art...

  17. Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-09-01

    This report describes the application functions for distribution management systems (DMS). The application functions are those surveyed by the IEEE Power and Energy Society’s Task Force on Distribution Management Systems. The description of each DMS application includes functional requirements and the key features and characteristics in current and future deployments, as well as a summary of the major benefits provided by each function to stakeholders — from customers to shareholders. Due consideration is paid to the fact that the realizable benefits of each function may differ by type of utility, whether investor-owned, cooperative, or municipal. This report is sufficient to define the functional requirements of each application for system procurement (request-for-proposal [RFP]) purposes and for developing preliminary high-level use cases for those functions. However, it should not be considered a design document that will enable a vendor or software developer to design and build actual DMS applications.

  18. Advances in Watershed Management: Modeling, Monitoring, and Assessment

    OpenAIRE

    Benham, B. L.; Yagow, G.; Chaubey, I.; Douglas-Mankin, K. R.

    2011-01-01

    This article introduces a special collection of nine articles that address a wide range of topics all related to improving the application of watershed management planning. The articles are grouped into two broadly defined categories.. modeling applications, and monitoring and assessment. The modeling application articles focus on one of two widely used watershed-scale water quality modeling packages: HSPF or SWAT The HSPF article assesses the model's robustness when applied to watersheds acr...

  19. Management of human immunodeficiency virus infection in advanced age

    OpenAIRE

    Greene, M; Justice, AC; Lampiris, HW; Valcour, V

    2013-01-01

    Importance: Human immunodeficiency virus (HIV) - positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients. Objective: To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed. Evi...

  20. Angiogenesis is induced and wound size is reduced by electrical stimulation in an acute wound healing model in human skin.

    Directory of Open Access Journals (Sweden)

    Sara Ud-Din

    Full Text Available Angiogenesis is critical for wound healing. Insufficient angiogenesis can result in impaired wound healing and chronic wound formation. Electrical stimulation (ES has been shown to enhance angiogenesis. We previously showed that ES enhanced angiogenesis in acute wounds at one time point (day 14. The aim of this study was to further evaluate the role of ES in affecting angiogenesis during the acute phase of cutaneous wound healing over multiple time points. We compared the angiogenic response to wounding in 40 healthy volunteers (divided into two groups and randomised, treated with ES (post-ES and compared them to secondary intention wound healing (control. Biopsy time points monitored were days 0, 3, 7, 10, 14. Objective non-invasive measures and H&E analysis were performed in addition to immunohistochemistry (IHC and Western blotting (WB. Wound volume was significantly reduced on D7, 10 and 14 post-ES (p = 0.003, p = 0.002, p0.05 on day 14 in VEGF-A expression post-ES compared to controls. Furthermore, organisation of granulation tissue was improved on day 14 post-ES. This randomised controlled trial has shown that ES enhanced wound healing by reduced wound dimensions and increased VEGF-A and PLGF expression in acute cutaneous wounds, which further substantiates the role of ES in up-regulating angiogenesis as observed over multiple time points. This therapeutic approach may have potential application for clinical management of delayed and chronic wounds.

  1. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, G A; The ATLAS collaboration; Lassnig, M; Molfetas, A; Baristis, M; Zhang, D; Calvet, I; Beermann, T; Barreiro Megino, F; Tykhonov, A; Campana, S; Serfon, C; Oleynik, O; Petrosyan, A

    2012-01-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 70PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: egin{itemize} item hspace{2mm} Popularity service, which measures usage of data across ATLAS. item hspace{2mm} Space monitoring and accounting at sites. item hspace{2mm} Automated exclusion service. item hspace{2mm} Cleaning agents, which trigger deletion of unused data at sites. item hspace{2mm} Deletion agents, to reliably delete unwanted data from sites. end{itemize} We...

  2. Advanced modeling of management processes in information technology

    CERN Document Server

    Kowalczuk, Zdzislaw

    2014-01-01

    This book deals with the issues of modelling management processes of information technology and IT projects while its core is the model of information technology management and its component models (contextual, local) describing initial processing and the maturity capsule as well as a decision-making system represented by a multi-level sequential model of IT technology selection, which acquires a fuzzy rule-based implementation in this work. In terms of applicability, this work may also be useful for diagnosing applicability of IT standards in evaluation of IT organizations. The results of this diagnosis might prove valid for those preparing new standards so that – apart from their own visions – they could, to an even greater extent, take into account the capabilities and needs of the leaders of project and manufacturing teams. The book is intended for IT professionals using the ITIL, COBIT and TOGAF standards in their work. Students of computer science and management who are interested in the issue of IT...

  3. Complement deficiency promotes cutaneous wound healing in mice.

    Science.gov (United States)

    Rafail, Stavros; Kourtzelis, Ioannis; Foukas, Periklis G; Markiewski, Maciej M; DeAngelis, Robert A; Guariento, Mara; Ricklin, Daniel; Grice, Elizabeth A; Lambris, John D

    2015-02-01

    Wound healing is a complex homeostatic response to injury that engages numerous cellular activities, processes, and cell-to-cell interactions. The complement system, an intricate network of proteins with important roles in immune surveillance and homeostasis, has been implicated in many physiological processes; however, its role in wound healing remains largely unexplored. In this study, we employ a murine model of excisional cutaneous wound healing and show that C3(-/-) mice exhibit accelerated early stages of wound healing. Reconstitution of C3(-/-) mice with serum from C3(+/+) mice or purified human C3 abrogated the accelerated wound-healing phenotype. Wound histology of C3(-/-) mice revealed a reduction in inflammatory infiltrate compared with C3(+/+) mice. C3 deficiency also resulted in increased accumulation of mast cells and advanced angiogenesis. We further show that mice deficient in the downstream complement effector C5 exhibit a similar wound-healing phenotype, which is recapitulated in C5aR1(-/-) mice, but not C3aR(-/-) or C5aR2(-/-) mice. Taken together, these data suggest that C5a signaling through C5aR may in part play a pivotal role in recruitment and activation of inflammatory cells to the wound environment, which in turn could delay the early stages of cutaneous wound healing. These findings also suggest a previously underappreciated role for complement in wound healing, and may have therapeutic implications for conditions of delayed wound healing.

  4. The Use Of Negative Pressure Wound Therapy (NPWT In The Management Of Enteroatmospheric Fistula – Case Report And Literature Review

    Directory of Open Access Journals (Sweden)

    Jaguścik Rajmund

    2015-10-01

    Full Text Available An enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions.

  5. The wound/burn guidelines - 5: Guidelines for the management of lower leg ulcers/varicose veins.

    Science.gov (United States)

    Ito, Takaaki; Kukino, Ryuichi; Takahara, Masakazu; Tanioka, Miki; Nakamura, Yasuhiro; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Isei, Taiki; Inoue, Yuji; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kono, Takeshi; Kodera, Masanari; Sakai, Keisuke; Nakanishi, Takeshi; Hashimoto, Akira; Hasegawa, Minoru; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Maekawa, Takeo; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Le Pavoux, Andres; Tachibana, Takao; Ihn, Hironobu

    2016-08-01

    Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions.

  6. Manejo terapéutico inicial de las heridas por arma de fuego en el territorio maxilofacial Initial therapeutic management of firearm wounds in the maxillofacial area

    Directory of Open Access Journals (Sweden)

    L. Ruiz Laza

    2006-10-01

    Full Text Available Introducción. Las heridas por armas de fuego son poco frecuentes en nuestro medio, de ahí que la experiencia en el manejo de las mismas sea limitada. En este artículo mostramos la experiencia de nuestro Servicio en el tratamiento de estas lesiones y realizamos una revisión del tema para intentar protocolizar la actuación inicial ante este tipo de pacientes. Material y Método. Presentamos seis casos tratados en nuestro Servicio durante el año 2002. Estudiamos las características demográficas, etiología, patrón de lesiones y tratamiento recibido. Resultados. Cinco hombres y una mujer presentaron heridas por arma de fuego durante este período, con una edad media de 38 años (Rango 13-74. La etiología más frecuente fue la agresión, seguido del intento de autolisis. Sólo un paciente requirió estabilización urgente de vía aérea mediante traqueotomía. No existieron complicaciones postoperatorias y sólo un enfermo requirió intervenciones secundarias por secuelas. Discusión. El aspecto más controvertido en el tratamiento de estas lesiones es el manejo quirúrgico de pacientes con lesiones extensas de la cara que involucran partes blandas y hueso, ya que pueden tratarse con técnicas reconstructivas complejas en el primer acto operatorio o, por el contrario, esta reconstrucción se puede realizar de forma diferida tras una primera fase de tratamiento quirúrgico de desbridamiento, estabilización de fracturas y cierre de partes blandas con técnicas simples. Pensamos que la elección del tipo de tratamiento debe ser individualizada en cada caso, aunque solemos optar por una reconstrucción diferida de los defectos tan pronto como sea posible.Introduction. The firearm injuries are not very common in our country, and the experience in its management is limited. In this review we show the experience of our Service in this wounds and review the literature to systematize the initial management of the firearm injuries in maxillofacial

  7. Acute and Impaired Wound Healing: Pathophysiology and Current Methods for Drug Delivery, Part 1: Normal and Chronic Wounds: Biology, Causes, and Approaches to Care

    OpenAIRE

    Tatiana N Demidova-Rice; Michael R Hamblin; Herman, Ira M.

    2012-01-01

    This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians’ understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that ini...

  8. New insights into microRNAs in skin wound healing.

    Science.gov (United States)

    Fahs, Fatima; Bi, Xinling; Yu, Fu-Shin; Zhou, Li; Mi, Qing-Sheng

    2015-12-01

    Chronic wounds are a major burden to overall healthcare cost and patient morbidity. Chronic wounds affect a large portion of the US, and billions of healthcare dollars are spent in their treatment and management. microRNAs (miRNAs) are small, noncoding double-stranded RNAs that post-transcriptionally downregulate the expression of protein-coding genes. Studies have identified miRNAs involved in all three phases of wound healing including inflammation, proliferation, and remodeling. Some miRNAs have been demonstrated in vitro with primary keratinocyte wound healing model and in vivo with mouse wound healing model through regulation of miRNA expression to affect the wound healing process. This review updates the current miRNAs involved in wound healing and discusses the future therapeutic implications and research directions.

  9. Advances in Research on Contingency Management for Adolescent Substance Use.

    Science.gov (United States)

    Stanger, Catherine; Lansing, Amy Hughes; Budney, Alan J

    2016-10-01

    Multiple interventions for treating adolescents with substance use disorders have demonstrated efficacy, but a majority of teens do not show an enduring positive response to these treatments. Contingency management (CM)-based strategies provide a promising alternative, and clinical research focused on the development and testing of innovative CM models continues to grow. This article provides an updated review on the progress made in this area. It is important to continue to search for more effective models, focus on post-treatment maintenance (reduce relapse), and strive for high levels of integrity and fidelity during dissemination efforts to optimize outcomes. PMID:27613343

  10. EFFICACY OF VACUUM ASSISTED CLOSURE DRESSINGS WHEN COMPARED TO MOIST WOUND DRESSINGS IN THE MANAGEMENT OF DIABETIC FOOT ULCERS : A PROSPECTIVE COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ballapalli Hari

    2015-10-01

    Full Text Available INTRODUCTION: F oot ulceration is mainly responsible for the morbidity of diabetes mellitus. They deprive the patient of quality working days and add to his financial burden. Several novel methods of wound healing came to vogue among which vacuum assisted dressing is becoming quite popular. Present study aim s to evaluate its efficacy when compared to regular moist wound dressings. OBJECTIVES: To study the effectiveness of vacuum assisted dressings in terms of Rate of wound healing. MATERIALS AND METHODS: we carried out a prospective study at Narayana medical college hospital on two groups (group A and group B of diabetic foot ulcer patients, whom we selected randomly after considering inclusion and exclusion criteria . Vacuum assisted dressings were done in group A patients and normal moist wound dressings in group B. At the start of the treatment and every week thereafter, size and depth of ulcers were recorded and results were compared at complete wound healing or at the end of 12 weeks of treatment whichever is earlier. S trict glycaemic control was maintaine d throughout the treatment period. RESULTS : significant healing was noticed in group A patients (vacuum assisted dressings group both in terms of ulcer size and depth. Wounds appeared more - healthy i.e. with less slough and more red granulation tissue in g roup A patients. CONCLUSION: vacuum assisted dressing is an efficacious method in the treatment of diabetic foot ulcers with significantly reduced hospital stay

  11. Recent advances in omic technologies for meat quality management.

    Science.gov (United States)

    Picard, B; Lebret, B; Cassar-Malek, I; Liaubet, L; Berri, C; Le Bihan-Duval, E; Hocquette, J F; Renand, G

    2015-11-01

    The knowledge of the molecular organization of living organisms evolved considerably during the last years. The methodologies associated also progressed with the development of the high-throughput sequencing (SNP array, RNAseq, etc.) and of genomic tools allowing the simultaneous analysis of hundreds or thousands of genes, proteins or metabolites. In farm animals, some proteins, mRNAs or metabolites whose abundance has been associated with meat quality traits have been detected in pig, cattle, chicken. They constitute biomarkers for the assessment and prediction of qualities of interest in each species, with potential biomarkers across species. The ongoing development of rapid methods will allow their use for decision-making and management tools in slaughterhouses, to better allocate carcasses or cuts to the appropriate markets. Besides, their application on living animals will help to improve genetic selection and to adapt a breeding system to fulfill expected quality level. The ultimate goal is to propose effective molecular tools for the management of product quality in meat production chains.

  12. Autosomal dominant polycystic kidney disease: recent advances in clinical management [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Zhiguo Mao

    2016-08-01

    Full Text Available The first clinical descriptions of autosomal dominant polycystic kidney disease (ADPKD go back at least 500 years to the late 16th century. Advances in understanding disease presentation and pathophysiology have mirrored the progress of clinical medicine in anatomy, pathology, physiology, cell biology, and genetics. The identification of PKD1 and PKD2, the major genes mutated in ADPKD, has stimulated major advances, which in turn have led to the first approved drug for this disorder and a fresh reassessment of patient management in the 21st century. In this commentary, we consider how clinical management is likely to change in the coming decade.

  13. Pazopanib in the management of advanced soft tissue sarcomas

    Science.gov (United States)

    Cranmer, Lee D; Loggers, Elizabeth T; Pollack, Seth M

    2016-01-01

    Therapy of soft tissue sarcomas represents an area of significant unmet need in oncology. Angiogenesis has been explored as a potential target both preclinically and clinically, with suggestions of activity. Pazopanib is a multitargeted tyrosine kinase inhibitor with prominent antiangiogenic effects. In a Phase II study, pazopanib demonstrated activity in strata enrolling patients with leiomyosarcomas, synovial sarcomas, or other sarcomas but not those enrolling adipocytic sarcomas. PALETTE, the pivotal Phase III trial, demonstrated improved progression-free survival versus placebo in pazopanib-treated patients previously treated for advanced soft tissue sarcomas. No survival benefit was observed, and adipocytic sarcomas were excluded. Health-related quality-of-life assessments indicated significant decrements in several areas affected by pazopanib toxicities, but no global deterioration. Cost-effectiveness analyses indicate that pazopanib therapy may or may not be cost-effective in different geographic settings. Pazopanib provides important proof-of-concept for antiangiogenic therapy in soft tissue sarcomas. Its use can be improved by further biological studies of its activity profile in sarcomas, studies of biological rational combinations, and clinicopathologic/biological correlative studies of activity to allow better drug targeting. PMID:27354810

  14. Recent advances in the management of sexual precocity in girls.

    Science.gov (United States)

    Schriock, E A; Martin, M C

    1991-12-01

    Sexual precocity has important psychosocial implications for the prematurely developing child, as well as being associated in some cases with significant pathology. Conscientious evaluation and initiation of effective therapy can have a significant impact on improving long-term outcome. The differentiation between complete sexual precocity with activation of the hypothalamic-pituitary axis and incomplete sexual precocity without activation of the central reproductive system is of paramount importance. In incomplete sexual precocity, the sex steroids are of exogenous, adrenal, or gonadal origin. Premature adrenarche presents with the early development of pubic hair only and must be distinguished from adrenal hyperplasia or an androgen-secreting neoplasm, which may be associated with accelerated growth, advanced bone age, and virilization. When incomplete sexual precocity involves the ovary, ovarian tumors must be considered. Other causes of incomplete sexual precocity include hypothyroidism and gonadotropin-independent precocity such as McCune-Albright syndrome. Complete sexual precocity or precocious puberty of central origin is diagnosed in girls by gonadotropin-releasing hormone challenge yielding a stimulated luteinizing hormone peak greater than 15 IU/L. Radiologic evaluation of the central axis is necessary. Treatment of precocious puberty relies on the use of potent agonists of gonadotropin-releasing hormone that reversibly suppress the prematurely activated pituitary. Depot preparations are efficacious. Early initiation and careful monitoring of treatment can reduce physical signs of development, improve the likelihood for normal adult height, and postpone normal pubertal progression to a more appropriate age. PMID:1818719

  15. Advances in management of type 1 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ravindranath; Aathira; Vandana; Jain

    2014-01-01

    Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise announcements, dual hormone delivery and pramlintide infusion. Islet, pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off. Incorporating insulin gene and secretary apparatus is another ambitious leap to achieve insulin independence though the search for the ideal vector and target cell is still continuing. Finally to stand up to the statement, prevention is better than cure, immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus.

  16. Wound care matrices for chronic leg ulcers: role in therapy

    Directory of Open Access Journals (Sweden)

    Sano H

    2015-07-01

    Full Text Available Hitomi Sano,1 Sachio Kouraba,2 Rei Ogawa11Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan; 2Sapporo Wound Care and Anti-Aging Laboratory, Sapporo, JapanAbstract: Chronic leg ulcers are a significant health care concern. Although deep wounds are usually treated by flap transfers, the operation is invasive and associates with serious complications. Skin grafts may be a less invasive means of covering wounds. However, skin grafts cannot survive on deep defects unless high-quality granulation tissue can first be generated in the defects. Technologies that generate high-quality granulation tissue are needed. One possibility is to use wound care matrices, which are bioengineered skin and soft tissue substitutes. Because they all support the healing process by providing a premade extracellular matrix material, these matrices can be termed “extracellular matrix replacement therapies”. The matrix promotes wound healing by acting as a scaffold for regeneration, attracting host cytokines to the wound, stimulating wound epithelialization and angiogenesis, and providing the wound bed with bioactive components. This therapy has lasting benefits as it not only helps large skin defects to be closed with thin skin grafts or patch grafts but also restores cosmetic appearance and proper function. In particular, since it acts as a layer that slides over the subcutaneous fascia, it provides skin elasticity, tear resistance, and texture. Several therapies and products employing wound care matrices for wound management have been developed recently. Some of these can be applied in combination with negative pressure wound therapy or beneficial materials that promote wound healing and can be incorporated into the matrix. To date, the clinical studies on these approaches suggest that wound care matrices promote spontaneous wound healing or can be used to facilitate skin grafting, thereby avoiding the need to use

  17. Advances in the Management of Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Kamala Swarnam

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN. This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

  18. Advanced Radio Resource Management for Multi Antenna Packet Radio Systems

    CERN Document Server

    Nonchev, Stanislav; 10.5121/ijwmn.2010.2201

    2010-01-01

    In this paper, we propose fairness-oriented packet scheduling (PS) schemes with power-efficient control mechanism for future packet radio systems. In general, the radio resource management functionality plays an important role in new OFDMA based networks. The control of the network resource division among the users is performed by packet scheduling functionality based on maximizing cell coverage and capacity satisfying, and certain quality of service requirements. Moreover, multiantenna transmit-receive schemes provide additional flexibility to packet scheduler functionality. In order to mitigate inter-cell and co-channel interference problems in OFDMA cellular networks soft frequency reuse with different power masks patterns is used. Stemming from the earlier enhanced proportional fair scheduler studies for single-input multiple-output (SIMO) and multiple-input multipleoutput (MIMO) systems, we extend the development of efficient packet scheduling algorithms by adding transmit power considerations in the ove...

  19. Recent Advances in the Clinical Management of Lead Poisoning.

    Directory of Open Access Journals (Sweden)

    Sina Kianoush

    2015-06-01

    Full Text Available Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead exposure is a global health concern in children. Occupational lead poisoning is still a health issue, particularly in developing countries. During the last decades, new methods and medications have been advocated for the prevention and treatment of lead poisoning. This review deals mainly with recent developments in the management of lead poisoning. Sources of lead exposure are introduced, and methods for the primary prevention of lead poisoning are discussed. Details for the screening of adults and children are also explained to serve as a practical guideline for the secondary prevention. Standard chelation therapy in different groups and up-to-date less toxic new medications for the treatment of lead poisoning are finally discussed. Our published clinical research on the therapeutic effects of garlic tablets in mild to moderate occupational lead poisoning will also be discussed.

  20. Factors Affecting Wound Healing

    OpenAIRE

    Guo, S; DiPietro, L. A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

  1. Wound Assessment: Made Easy

    OpenAIRE

    Ousey, Karen; Cook, Leanne

    2012-01-01

    A structured approach to wound assessment is required to maintain a good standard of care. This involves a thorough patient assessment, which should be carried out by skilled and competent practitioners, adhering to local and national guidelines (Harding et al, 2008). Inappropriate or inaccurate assessment can lead to delayed wound healing, pain, increased risk of infection, inappropriate use of wound dressings and a reduction in the quality of life for patients.

  2. Diabetes and wound healing

    OpenAIRE

    Svendsen, Rikke; Irakunda, Gloire; Knudsen List, Karoline Cecilie; Sønderstup-Jensen, Marie; Hölmich Rosca, Mette Maria

    2014-01-01

    Diabetes is a disease where the glucose level in the blood is high, due to either insulin resistance, impaired insulin sensitivity or no insulin production. The high glucose level causes several complications, one of them being an impaired wound healing process, which might lead to chronic wounds, ulcers. Several factors play a role in the development of ulcers, and recent research indicates that microRNA might play a significant role in skin development and wound healing. The purpose of this...

  3. Complex wounds Feridas complexas

    OpenAIRE

    Marcus Castro Ferreira; Paulo Tuma Júnior; Viviane Fernandes de Carvalho; Fábio Kamamoto

    2006-01-01

    Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treat...

  4. Biomass supply management for advanced energy: applications in developing countries

    International Nuclear Information System (INIS)

    Advanced biomass energy systems, including new biomass resource enhancement technologies, should be developed only where compelling situations for investors or communities exist to economically do so. These situations, or minimum viable operating conditions, are assessed from a pragmatic perspective. They are determined by specific circumstances and divergent interests that take time to define and integrate. Customized solutions are necessary and can change quickly with geography and market circumstances New technologies offer more options but are not necessarily the best. The example of energy crop technology is used to demonstrate the interdependencies that exist between new resource enhancement technology and biomass energy systems operations. The ability to genetically increase the energy density of energy crops is compared to other enhancement measures such as increasing the number of tonnes grown per hectare-year, reducing costs per tonne and improving other characteristics. Issues that need to be considered include significant knowledge gaps, lack of commitments in R and D, specificity of conversion system requirements, handling capabilities and opportunity costs. Broader biomass procurement strategies, which may be more important than resource enhancement technologies, are discussed. Biomass cost-supply is utilized as a strong analytical feature to evaluate the effectiveness of biomass procurement strategies and new biomass production technologies. Some past experiences are reviewed. Cost-supply is assessed from the perspective of the whole biomass energy system to expose the interdependencies between production operations, conversion scale and technologies, and community markets and service. Investment limits, for example, may be as important a determinant as the cost-efficiency of a new technology, which, in turn, affects biomass cost-supply-quality requirements. The cost of new technologies can then be compared to the changed performance of the overall

  5. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  6. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but Controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  7. Pathophysiology and recent advances in the management of renal osteodystrophy.

    Science.gov (United States)

    Elder, Grahame

    2002-12-01

    Bone disease is observed in 75-100% of patients with chronic renal failure as the glomerular filtration rate (GFR) falls below 60 ml/minute. Hyperparathyroid (high turnover) bone disease is found most frequently followed by mixed osteodystrophy, low-turnover bone disease, and osteomalacia. With advancing renal impairment, "skeletal resistance" to parathyroid hormone (PTH) occurs. To maintain bone turnover, intact PTH (iPTH) targets from two to four times the upper normal range have been suggested, but whole PTH(1-84) assays indicate that amino-terminally truncated fragments, which accumulate in end-stage renal disease (ESRD), account for up to one-half of the measured iPTH. PTH levels and bone-specific alkaline phosphatase (BSAP) provide some information on bone involvement but bone biopsy and histomorphometry remains the gold standard. Calcitriol and calcium salts can be used to suppress PTH and improve osteomalacia but there is growing concern that these agents predispose to the development of vascular calcification, cardiovascular morbidity, low-turnover bone disease and fracture. Newer therapeutic options include less calcemic vitamin D analogues, calcimimetics and bisphosphonates for hyperparathyroidism, and sevelamer for phosphate control. Calcitriol and hormone-replacement therapy (HRT) have been shown to maintain bone mineral density (BMD) in certain patients with end-stage renal disease (ESRD). After renal transplantation, renal osteodystrophy generally improves but BMD often worsens. Bisphosphonate therapy may be appropriate for some patients at risk of fracture. When renal bone disease is assessed using a combination of biochemical markers, histology and bone densitometry, early intervention and the careful use of an increasing number of effective therapies can reduce the morbidity associated with this common problem. PMID:12469904

  8. Australia's TERN: Advancing Ecosystem Data Management in Australia

    Science.gov (United States)

    Phinn, S. R.; Christensen, R.; Guru, S.

    2013-12-01

    Globally, there is a consistent movement towards more open, collaborative and transparent science, where the publication and citation of data is considered standard practice. Australia's Terrestrial Ecosystem Research Network (TERN) is a national research infrastructure investment designed to support the ecosystem science community through all stages of the data lifecycle. TERN has developed and implemented a comprehensive network of ';hard' and ';soft' infrastructure that enables Australia's ecosystem scientists to collect, publish, store, share, discover and re-use data in ways not previously possible. The aim of this poster is to demonstrate how TERN has successfully delivered infrastructure that is enabling a significant cultural and practical shift in Australia's ecosystem science community towards consistent approaches for data collection, meta-data, data licensing, and data publishing. TERN enables multiple disciplines, within the ecosystem sciences to more effectively and efficiently collect, store and publish their data. A critical part of TERN's approach has been to build on existing data collection activities, networks and skilled people to enable further coordination and collaboration to build each data collection facility and coordinate data publishing. Data collection in TERN is through discipline based facilities, covering long term collection of: (1) systematic plot based measurements of vegetation structure, composition and faunal biodiversity; (2) instrumented towers making systematic measurements of solar, water and gas fluxes; and (3) satellite and airborne maps of biophysical properties of vegetation, soils and the atmosphere. Several other facilities collect and integrate environmental data to produce national products for fauna and vegetation surveys, soils and coastal data, as well as integrated or synthesised products for modelling applications. Data management, publishing and sharing in TERN are implemented through a tailored data

  9. Innovation and wound healing.

    Science.gov (United States)

    Harding, Keith

    2015-04-01

    Innovation in medicine requires unique partnerships between academic research, biotech or pharmaceutical companies, and health-care providers. While innovation in medicine has greatly increased over the past 100 years, innovation in wound care has been slow, despite the fact that chronic wounds are a global health challenge where there is a need for technical, process and social innovation. While novel partnerships between research and the health-care system have been created, we still have much to learn about wound care and the wound-healing processes.

  10. A New Advanced Logistics Supply Chain for Food Management Based on Green Logistics Theory

    OpenAIRE

    Lanqing Liu

    2013-01-01

    The study aims to investigate the advanced logistics supply chain for food management using green logistics. To protect the food logistics environment and prevent the environmental pollution, it is crucial to establish powerful modern supply chains to support the food management in transportation. The construction speed of the food companies is very fast; however, the food supply lags behind the food companies. As a result, the environmental pollution caused in the food logistics becomes seve...

  11. Working towards the advanced management of cultural heritage

    Directory of Open Access Journals (Sweden)

    Giuseppe Farneti

    2012-06-01

    Full Text Available Within the broad framework of public administration reform, the Act of the ministerial directive, 10th May 2001, regarding the “technical/scientific criteria and standards for the functioning and development of museums” constitutes an essential tool in promoting the rapid growth of this sector. In fact, following in the footsteps of Icom's Deontological Code and through the advantageous involvement of regions and local authorities, the document underlines the importance of service quality and defines scopes, criteria and standards for operating and developing museums. On the basis of the subsidiarity principle, regions are the main actors in the implementation of the Directive Act, and in the last few years they have launched progressive plans aimed at increasing quality in museums by implementing standards and initiating accreditation processes. The aim of this study is to analyse the procedure enacted by the region of Emilia-Romagna, referring both to the regulations and the state of the art implementation of standards and its effect on museum management. In implementing the Directive Act, regions must be given more power, so that they are able to foster progressive plans aimed at increasing quality in museums and realizing accreditation processes.

  12. Wireless Sensors and Networks for Advanced Energy Management

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, J.E.

    2005-05-06

    Numerous national studies and working groups have identified low-cost, very low-power wireless sensors and networks as a critical enabling technology for increasing energy efficiency, reducing waste, and optimizing processes. Research areas for developing such sensor and network platforms include microsensor arrays, ultra-low power electronics and signal conditioning, data/control transceivers, and robust wireless networks. A review of some of the research in the following areas will be discussed: (1) Low-cost, flexible multi-sensor array platforms (CO{sub 2}, NO{sub x}, CO, humidity, NH{sub 3}, O{sub 2}, occupancy, etc.) that enable energy and emission reductions in applications such as buildings and manufacturing; (2) Modeling investments (energy usage and savings to drive capital investment decisions) and estimated uptime improvements through pervasive gathering of equipment and process health data and its effects on energy; (3) Robust, self-configuring wireless sensor networks for energy management; and (4) Quality-of-service for secure and reliable data transmission from widely distributed sensors. Wireless communications is poised to support technical innovations in the industrial community, with widespread use of wireless sensors forecasted to improve manufacturing production and energy efficiency and reduce emissions. Progress being made in wireless system components, as described in this paper, is helping bring these projected improvements to reality.

  13. Microgrid Controller and Advanced Distribution Management System Survey Report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Guodong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Starke, Michael R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Herron, Andrew N. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-07-01

    A microgrid controller, which serves as the heart of a microgrid, is responsible for optimally managing the distributed energy resources, energy storage systems, and responsive demand and for ensuring the microgrid is being operated in an efficient, reliable, and resilient way. As the market for microgrids has blossomed in recently years, many vendors have released their own microgrid controllers to meet the various needs of different microgrid clients. However, due to the absence of a recognized standard for such controllers, vendor-supported microgrid controllers have a range of functionalities that are significantly different from each other in many respects. As a result the current state of the industry has been difficult to assess. To remedy this situation the authors conducted a survey of the functions of microgrid controllers developed by vendors and national laboratories. This report presents a clear indication of the state of the microgrid-controller industry based on analysis of the survey results. The results demonstrate that US Department of Energy funded research in microgrid controllers is unique and not competing with that of industry.

  14. Advances in hormone replacement therapy: making the menopause manageable

    Directory of Open Access Journals (Sweden)

    Palacios Santiago

    2008-11-01

    Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.

  15. The use of negative-pressure therapy in the closure of complex head and neck wounds.

    Science.gov (United States)

    Strub, Graham Michael; Moe, Kristen S

    2013-02-01

    The evolution of wound care has seen much technological advancement over many decades. Most recently, negative-pressure therapy, by which a vacuum pressure is applied through a wound bed, has dramatically improved the surgical outcomes of complex wounds. Although initial studies focused on wounds to the abdomen, torso, and extremities, more publications are appearing that demonstrate the efficacy of negative-pressure wound therapy in the head and neck. This article reviews the history and evolution of negative-pressure therapy, highlights the current opinions on its mechanism of action, and summarizes its use in complex head and neck wounds.

  16. AN ADVANCED TOOL FOR APPLIED INTEGRATED SAFETY MANAGEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Potts, T. Todd; Hylko, James M.; Douglas, Terence A.

    2003-02-27

    WESKEM, LLC's Environmental, Safety and Health (ES&H) Department had previously assessed that a lack of consistency, poor communication and using antiquated communication tools could result in varying operating practices, as well as a failure to capture and disseminate appropriate Integrated Safety Management (ISM) information. To address these issues, the ES&H Department established an Activity Hazard Review (AHR)/Activity Hazard Analysis (AHA) process for systematically identifying, assessing, and controlling hazards associated with project work activities during work planning and execution. Depending on the scope of a project, information from field walkdowns and table-top meetings are collected on an AHR form. The AHA then documents the potential failure and consequence scenarios for a particular hazard. Also, the AHA recommends whether the type of mitigation appears appropriate or whether additional controls should be implemented. Since the application is web based, the information is captured into a single system and organized according to the >200 work activities already recorded in the database. Using the streamlined AHA method improved cycle time from over four hours to an average of one hour, allowing more time to analyze unique hazards and develop appropriate controls. Also, the enhanced configuration control created a readily available AHA library to research and utilize along with standardizing hazard analysis and control selection across four separate work sites located in Kentucky and Tennessee. The AHR/AHA system provides an applied example of how the ISM concept evolved into a standardized field-deployed tool yielding considerable efficiency gains in project planning and resource utilization. Employee safety is preserved through detailed planning that now requires only a portion of the time previously necessary. The available resources can then be applied to implementing appropriate engineering, administrative and personal protective equipment

  17. Recent advances in the management of distal ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Ioannis; E; Koutroubakis

    2010-01-01

    The most frequent localization of ulcerative colitis(UC) is the distal colon.In treating patients with active distal UC,efficacy and targeting of the drug to the distal colon are key priorities.Oral and rectal 5-aminosalicylic acid(5-ASA) preparations represent the first line therapy of mild-to-moderate distal UC for both induction and maintenance treatment.It has been reported that many UC patients are not adherent to therapy and that noncompliant patients had a 5-fold risk of experiencing a relapse.These findings led to the introduction of oncedaily oral regimens of 5-ASA as better therapeutic options in clinical practice due to improved adherence.New formulations of mesalazine,including the multimatrix delivery system,and mesalazine granules,which allow once-daily administration,have been developed.They have been demonstrated to be efficacious in inducing and maintaining remission in mild-to-moderate distal UC in large clinical trials.However,existing data for distal UC are rather insufficient to make a comparison between new and classical 5-ASA formulations.It seems that the new formulations are at least as effective as classical oral 5-ASA formulations.Other treatment options,in the case that 5-ASA therapy is not effective,include systemic corticosteroids,thiopurines(azathioprine or 6-mercaptopurine),cyclosporine,infliximab and surgery.The combination of a prompt diagnostic work-up,a correct therapeutic approach and an appropriate follow-up schedule is important in the management of patients with distal UC.This approach can shorten the duration of symptoms,induce a prolonged remission,improve patient’s quality of life,and optimize the use of health resources.

  18. Wounded, Ill, and Injured Challenges.

    Science.gov (United States)

    Jones, Stephen L

    2016-01-01

    The Washington Post articles of February 2007 led to a close examination of the care provided Wounded Warriors at Walter Reed Army Medical Center. Subsequent reports by the President's Commission, Independent Review Group, and Defense Health Board all recommended ways to improve care. Joint Task Force National Capital Region Medical was established to implement the recommended improvements in Warrior care, and the recommendations of the Base Realignment and Closure Commission to close Walter Reed and realign the staff into a new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital. It accomplished these tasks, maintained existing wounded, ill, and injured care, and safely transferred patients during the height of the fighting season in Afghanistan. It successfully accomplished its mission through engaged leadership, establishing an appropriate environment for Warrior care, careful management of casualty flow, and robust communication with all parties affected by the changes. The lessons learned in Warrior care should be considered when planning future military medical operations. PMID:27215871

  19. Highly Automated Module Production Incorporating Advanced Light Management

    Energy Technology Data Exchange (ETDEWEB)

    Perelli-Minetti, Michael [SolarWorld Americas Inc., Hillsboro, OR (United States); Roof, Kyle [SolarWorld Americas Inc., Hillsboro, OR (United States)

    2015-08-11

    The objective was to enable a high volume, cost effective solution for increasing the amount of light captured by PV modules through utilization of an advanced Light Re-directing Film and to follow a phased approach to develop and implement this new technology in order to achieve an expected power gain of up to 12 watts per module. Full size PV modules were manufactured using a new Light Redirecting Film (LRF) material applied to two different areas of PV modules in order to increase the amount of light captured by the modules. One configuration involved applying thin strips of LRF film over the tabbing ribbon on the cells in order to redirect the light that is normally absorbed by the tabbing ribbon to the active areas of the cells. A second configuration involved applying thin strips of LRF film over the white spaces between cells within a module in order to capture some of the light that is normally reflected from the white areas back through the front glass of the modules. Significant power increases of 1.4% (3.9 watts) and 1.0% (3.2 watts), respectively, compared to standard PV modules were measured under standard test conditions. The performance of PV modules with LRF applied to the tabbing ribbon was modeled. The results showed that the power increase provided by LRF depended greatly on the angle of incident light with the optimum performance only occurring when the light was within a narrow range of being perpendicular to the solar module. The modeling showed that most of the performance gain would be lost when the angle of incident light was greater than 28 degrees off axis. This effect made the orientation of modules with LRF applied to tabbing ribbons very important as modules mounted in “portrait” mode were predicted to provide little to no power gain from LRF under real world conditions. Based on these results, modules with LRF on tabbing ribbons would have to be mounted in “landscape” mode to realize a performance advantage. In addition

  20. Advances in the Management of Juvenile Idiopathic Arthritis : The coming of age of biologic treatment

    NARCIS (Netherlands)

    J. Anink (Janneke)

    2015-01-01

    markdownabstract__Abstract__ The main aim of this thesis was the evaluation of advances in the management of JIA. It focused on developments in the biologic treatment of JIA, using data from the ABC register. Additionally, it explored new biomarkers and methods for monitoring the disease activity,

  1. Progress in corneal wound healing.

    Science.gov (United States)

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2015-11-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  2. Progress in corneal wound healing.

    Science.gov (United States)

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2015-11-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  3. Career advancement in Public Employment in Colombia, a look at the Colombian State Management System

    Directory of Open Access Journals (Sweden)

    Mónica Lilly Serrato Moreno

    2014-12-01

    Full Text Available In Colombia, a public employee doesn’t seem to have rights to career advancement based on merit and experience. The current public hiring system seems to ignore experience, interest and effort made by an employee, at the time of considering a potential advancement to an upper-level position, which would assign new tasks and greater responsibilities. That is why there is a need for the implementation of different mechanisms, to increase employees’ career advancement possibilities based on merits accredited with tasks such as academic papers, institutional project management and public policy management, academic degrees, as well as experience, research and time of service. This paper, developed with a critical perspective of the problem, proposes alternatives to overcome this challenge.

  4. Overview of advances in water management in agricultural production:Sensor based irrigation management

    Science.gov (United States)

    Technological advances in irrigated agriculture are crucial to meeting the challenge of increasing demand for agricultural products given limited quality and quantity of water resources for irrigation, impacts of climate variability, and the need to reduce environmental impacts. Multidisciplinary ap...

  5. Understanding methods of wound debridement

    OpenAIRE

    Atkin, Leanne

    2014-01-01

    Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequentl...

  6. Vita 6.2: Advanced visual tool for information management

    International Nuclear Information System (INIS)

    We have developed a knowledge management tool to search and organize disparate and large text corpora and display them in a manner for ease of interpretation. One application would be to uncover and determine the extent of clandestine nuclear supply networks. VITA, a 'Visual Interface for Text Analysis', is a tool used to direct computer-based document searches. It allows a user, via mouse and keyboard action, visually to find, organize, summarize, and present documents of potential interest. It has control features that allow visual clustering of like documents, thus enabling quick refinement of the search process. The visual features of VITA-6.2 support the observation and investigation of the [often unexpected] relationships among documents. Further, it acts to isolate and call attention to otherwise unsuspected documents of importance, in ways that other search tools cannot. The VITA series was developed first as a research testbed to identify better methods to visualize relevant document clusters and identifying their relationships. It has now stabilized into a pre-competitive design, through the interest of users in IAEA and the Government of Canada. VITA sits between the user and an extended set of search engines directed at external [Web] and internal private files The user is easily able to search and then see a conceptual map of documents, arrayed in relationships suggested by the query. The impact for knowledge discovery, summary and presentation can be surprising. The VITA output 1 arises from a nuclear proliferation query to an intelligence related website showed an unexpected outlier. On investigation, it was a highly relevant item [shown on the right] not expected, that would not have stood out nor been described among the search engine's returns in the standard lists. New in the current release VITA-x, the current version, is robust and fast, built on a Cno. platform that requires normal computing equipment and OS. Eight popular search engines are

  7. Diabetic Wound Care

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Diabetic Wound Care What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound ... key factors in the appropriate treatment of a diabetic foot ulcer: Prevention of infection Taking the pressure ...

  8. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  9. A New Advanced Logistics Supply Chain for Food Management Based on Green Logistics Theory

    Directory of Open Access Journals (Sweden)

    Lanqing Liu

    2013-10-01

    Full Text Available The study aims to investigate the advanced logistics supply chain for food management using green logistics. To protect the food logistics environment and prevent the environmental pollution, it is crucial to establish powerful modern supply chains to support the food management in transportation. The construction speed of the food companies is very fast; however, the food supply lags behind the food companies. As a result, the environmental pollution caused in the food logistics becomes severe. To improve this situation, a new logistics supply chain for food management using the environmental logistics theory is proposed in this study. The design and analysis of the proposed food supply chain system has been introduced. By the use of advanced environmental logistics theory, the food supply can be operated in an effective and green manner. Hence, the proposed new logistics supply chain can reduce the environmental pollution of the food logistics and improve the food market environment.

  10. Use of Platelet Rich Plasma Gel on Wound Healing: A Systematic Review and Meta-Analysis

    OpenAIRE

    Marissa J Carter; Fylling, Carelyn P.; Parnell, Laura K.S.

    2011-01-01

    Objective: Autologous platelet rich plasma is an advanced wound therapy used in hard-to-heal acute and chronic wounds. To better understand the use and clinical outcomes of the therapy, a systematic review of the published literature in cutaneous wounds was performed. Methods: Electronic and hand searches for randomized controlled trials and comparative group studies using platelet rich plasma therapy in cutaneous wounds and published over the last 10 years was conducted. Eligible studies com...

  11. Local anesthetic wound infiltration for pain management after periacetabular osteotomy. A randomized, placebo-controlled, double-blind clinical trial with 53 patients

    DEFF Research Database (Denmark)

    Bech, Rune D; Ovesen, Ole; Lindholm, Peter;

    2014-01-01

    BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine) for postop......BACKGROUND AND PURPOSE: To our knowledge, there is no evidence to support the use of local infiltration analgesia (LIA) for postoperative pain relief after periacetabular osteotomy (PAO). We investigated the effect of wound infiltration with a long-acting local anesthetic (ropivacaine...

  12. Wound bed preparation and debridement in management of foot ulcer in diabetes patients%糖尿病足溃疡创面床准备及清创处理

    Institute of Scientific and Technical Information of China (English)

    宋飞; 简华刚

    2011-01-01

    糖尿病患者足部溃疡发病率较高,创面愈合慢,并发症多,截肢发生率高,严重影响患者的生活质量.糖尿病足溃疡的治疗是通过积极治疗感染,评价血管状况及重建血运,减轻患肢伤口压力,清创、改善创面微环境得以实现.本文就糖尿病足溃疡创面床准备及清创处理等相关文献报道做一综述.%Foot ulcers of diabetic patients have characteristics of high prevalence , slow wound healing, more complications and high incidence of amputation , seriously affecting the quality of patients ' life. Foot ulcers in diabetes patients can be treated by actively controlling infection .evaluating vascular status , reconstructing blood sup ply , reducing pressure on the affected limb ,performing debridement and improving the wound microenvironment . In this paper,we reviewed the related literatures on the wound bed preparation and debridement for the management of foot ulcer in diabetic patients.

  13. Developing a toolbox for analysis of warrior wound biopsies: vibrational spectroscopy

    Science.gov (United States)

    Crane, Nicole J.; O'Brien, Frederick P.; Forsberg, Jonathan A.; Potter, Benjamin K.; Elster, Eric A.

    2011-03-01

    The management of modern traumatic war wounds remains a significant challenge for clinicians. This is a reflection of the extensive osseous and soft-tissue damage caused by blasts and high-energy projectiles. The ensuing inflammatory response ultimately dictates the pace of wound healing and tissue regeneration. Consequently, the eventual timing of wound closure or definitive coverage is often subjectively based. Some wounds require an extended period of time to close or fail to remain closed, despite the use and application of novel wound-specific treatment modalities. Aside from impaired wound healing, additional wound complications include wound infection, biofilm formation, and heterotopic ossification (the pathological mineralization of soft tissues). An understanding of the molecular environment of acute wounds throughout the debridement process can provide valuable insight into the mechanisms associated with the eventual wound outcome. The analysis of Raman spectra of ex vivo wound biopsy tissue obtained from serial traumatic wound debridements reveals a decreased 1665 cm-1/1445 cm-1 band area ratio in impaired healing wounds, indicative of an impaired remodeling process, in addition to a decreased 1240 cm-1/1270cm-1. The examination of debrided tissue exhibits mineralization during the early development of heterotopic ossification. Finally, preliminary results suggest that Fourier transform infrared (FT-IR) images of wound effluent may be able to provide early microbiological information about the wound.

  14. Pre-hospital advanced airway management by anaesthesiologists: Is there still room for improvement?

    Directory of Open Access Journals (Sweden)

    Søreide Eldar

    2008-07-01

    Full Text Available Abstract Background Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Method Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Results Of the 17 available respondents, most (88% felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. Conclusion The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  15. Advanced data management for optimising the operation of a full-scale WWTP.

    Science.gov (United States)

    Beltrán, Sergio; Maiza, Mikel; de la Sota, Alejandro; Villanueva, José María; Ayesa, Eduardo

    2012-01-01

    The lack of appropriate data management tools is presently a limiting factor for a broader implementation and a more efficient use of sensors and analysers, monitoring systems and process controllers in wastewater treatment plants (WWTPs). This paper presents a technical solution for advanced data management of a full-scale WWTP. The solution is based on an efficient and intelligent use of the plant data by a standard centralisation of the heterogeneous data acquired from different sources, effective data processing to extract adequate information, and a straightforward connection to other emerging tools focused on the operational optimisation of the plant such as advanced monitoring and control or dynamic simulators. A pilot study of the advanced data manager tool was designed and implemented in the Galindo-Bilbao WWTP. The results of the pilot study showed its potential for agile and intelligent plant data management by generating new enriched information combining data from different plant sources, facilitating the connection of operational support systems, and developing automatic plots and trends of simulated results and actual data for plant performance and diagnosis.

  16. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care.

    Science.gov (United States)

    Demidova-Rice, Tatiana N; Hamblin, Michael R; Herman, Ira M

    2012-07-01

    This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians' understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that initiate cellular and tissue responses after injury, which may be impeded during chronic wound healing.

  17. Vibrational spectroscopy: a tool being developed for the noninvasive monitoring of wound healing

    Science.gov (United States)

    Crane, Nicole J.; Elster, Eric A.

    2012-01-01

    Wound care and management accounted for over 1.8 million hospital discharges in 2009. The complex nature of wound physiology involves hundreds of overlapping processes that we have only begun to understand over the past three decades. The management of wounds remains a significant challenge for inexperienced clinicians. The ensuing inflammatory response ultimately dictates the pace of wound healing and tissue regeneration. Consequently, the eventual timing of wound closure or definitive coverage is often subjective. Some wounds fail to close, or dehisce, despite the use and application of novel wound-specific treatment modalities. An understanding of the molecular environment of acute and chronic wounds throughout the wound-healing process can provide valuable insight into the mechanisms associated with the patient's outcome. Pathologic alterations of wounds are accompanied by fundamental changes in the molecular environment that can be analyzed by vibrational spectroscopy. Vibrational spectroscopy, specifically Raman and Fourier transform infrared spectroscopy, offers the capability to accurately detect and identify the various molecules that compose the extracellular matrix during wound healing in their native state. The identified changes might provide the objective markers of wound healing, which can then be integrated with clinical characteristics to guide the management of wounds.

  18. The role of business information management in advanced integrated environmental management systems

    DEFF Research Database (Denmark)

    Ulhøi, John Parm

    2000-01-01

    investments in the individual company. Secondly, based on the above, to calculate and assess some typical quantifiable savings, e.g. on energy and raw materials, over a period of four years (after the implementation of the integrated environmental management system). In line with other similar investigations......, the study shows that the implementation of systematic and integrated environmental management systems results in significant savings. This supports the general, albeit rarely tested, hypothesis that it pays to be an environmentally responsible enterprise....

  19. Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

    Directory of Open Access Journals (Sweden)

    Lenka Vinklárková

    2015-01-01

    Full Text Available Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT. To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds.

  20. 结核性创面动物模型研究进展%Advances in the research of an animal model of wound due to Mycobacterium tuberculosis infection

    Institute of Scientific and Technical Information of China (English)

    陈领; 贾赤宇

    2015-01-01

    Tuberculosis ranks as the second deadly infectious disease worldwide.The incidence of tuberculosis is high in China.Refractory wound caused by Mycobacterium tuberculosis infection ranks high in misdiagnosis, and it is accompanied by a protracted course, and its pathogenic mechanism is still not so clear.In order to study its pathogenic mechanism, it is necessary to reproduce an appropriate animal model.Up to now the study of the refractory wound caused by Mycobacterium tuberculosis infection is just beginning, and there is still no unimpeachable model for study.This review describes two models which may reproduce a wound similar to the wound caused by Mycobacterium tuberculosis infection, so that they could be used to study the pathogenesis and characteristics of a tuberculosis wound in an animal.

  1. Advancement in the research of the role of macrophages in wound healing%巨噬细胞在创面愈合中的作用研究进展

    Institute of Scientific and Technical Information of China (English)

    薛亮; 刘旭盛

    2013-01-01

    Macrophages play important roles in all stages of wound healing.Changes in micro-environment leads to transformation of macrophages type Ⅰ and type Ⅱ,thereby playing a role in wound healing.During the early inflammatory phase,type Ⅰ macrophages exert pro-inflammatory function such as antigen-presenting,phagocytosis,and the production of inflammatory cytokines and growth factors.While during the wound healing phase,macrophages were transformed into type Ⅱ,which stimulate the proliferation of fibroblasts,keratinocytes,and endothelial cells by expressing growth factors.This results in the formation of granulation tissue,angiogenesis,and the formation of ECM,so as to promote wound healing.This review summarizes the function and change in phenotype of macrophages in different stages of wound healing.

  2. IPAD 2: Advances in Distributed Data Base Management for CAD/CAM

    Science.gov (United States)

    Bostic, S. W. (Compiler)

    1984-01-01

    The Integrated Programs for Aerospace-Vehicle Design (IPAD) Project objective is to improve engineering productivity through better use of computer-aided design and manufacturing (CAD/CAM) technology. The focus is on development of technology and associated software for integrated company-wide management of engineering information. The objectives of this conference are as follows: to provide a greater awareness of the critical need by U.S. industry for advancements in distributed CAD/CAM data management capability; to present industry experiences and current and planned research in distributed data base management; and to summarize IPAD data management contributions and their impact on U.S. industry and computer hardware and software vendors.

  3. Wound biofilms: lessons learned from oral biofilms.

    Science.gov (United States)

    Mancl, Kimberly A; Kirsner, Robert S; Ajdic, Dragana

    2013-01-01

    Biofilms play an important role in the development and pathogenesis of many chronic infections. Oral biofilms, more commonly known as dental plaque, are a primary cause of oral diseases including caries, gingivitis, and periodontitis. Oral biofilms are commonly studied as model biofilm systems as they are easily accessible; thus, biofilm research in oral diseases is advanced with details of biofilm formation and bacterial interactions being well elucidated. In contrast, wound research has relatively recently directed attention to the role biofilms have in chronic wounds. This review discusses the biofilms in periodontal disease and chronic wounds with comparisons focusing on biofilm detection, biofilm formation, the immune response to biofilms, bacterial interaction, and quorum sensing. Current treatment modalities used by both fields and future therapies are also discussed.

  4. Advances in the neurological and neurosurgical management of peripheral nerve trauma.

    Science.gov (United States)

    Simon, Neil G; Spinner, Robert J; Kline, David G; Kliot, Michel

    2016-02-01

    Peripheral nerve trauma frequently affects younger people and may result in significant and long-lasting functional disability. Currently, diagnosis and monitoring of peripheral nerve injury relies on clinical and electrodiagnostic information, supplemented by intraoperative electrophysiological studies. However, in a significant proportion of nerve injuries, the likelihood of spontaneous regeneration resulting in good functional outcome remains uncertain and unnecessary delays to treatment may be faced while monitoring for recovery. Advances in non-invasive imaging techniques to diagnose and monitor nerve injury and regeneration are being developed, and have the potential to streamline the decision-making process. In addition, advances in operative and non-operative treatment strategies may provide more effective ways to maximise functional outcomes following severe peripheral nerve trauma. This review discusses these advances in light of the current state of the art of management of peripheral nerve trauma.

  5. Managing the marketing function for advanced nurse practitioners in a managed care environment.

    Science.gov (United States)

    Pakis, S

    1997-09-01

    Delivering quality, cost-efficient health care is a desired service in the health care market today. Advanced nurse practitioners are positioned to deliver this product. The key in today's market is clearly defining the product, identifying the customers of the product, and crafting the message for each customer. The development of marketing strategies to address each of the above points will assist an organization in targeting resources and evaluating the effectiveness of the message being delivered.

  6. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  7. Advances in Agronomic Management of Indian Mustard (Brassica juncea (L. Czernj. Cosson: An Overview

    Directory of Open Access Journals (Sweden)

    Kapila Shekhawat

    2012-01-01

    Full Text Available India is the fourth largest oilseed economy in the world. Among the seven edible oilseeds cultivated in India, rapeseed-mustard contributes 28.6% in the total oilseeds production and ranks second after groundnut sharing 27.8% in the India’s oilseed economy. The mustard growing areas in India are experiencing the vast diversity in the agro climatic conditions and different species of rapeseed-mustard are grown in some or other part of the country. Under marginal resource situation, cultivation of rapeseed-mustard becomes less remunerative to the farmers. This results in a big gap between requirement and production of mustard in India. Therefore site-specific nutrient management through soil-test recommendation based should be adopted to improve upon the existing yield levels obtained at farmers field. Effective management of natural resources, integrated approach to plant-water, nutrient and pest management and extension of rapeseed-mustard cultivation to newer areas under different cropping systems will play a key role in further increasing and stabilizing the productivity and production of rapeseed-mustard. The paper reviews the advances in proper land and seedbed preparation, optimum seed and sowing, planting technique, crop geometry, plant canopy, appropriate cropping system, integrated nutrient management and so forth to meet the ever growing demand of oil in the country and to realize the goal of production of 24 million tonnes of oilseed by 2020 AD through these advanced management techniques.

  8. Resource management in radio access and IP-based core networks for IMT Advanced and Beyond

    Institute of Scientific and Technical Information of China (English)

    SU Gang; HIDELL Markus; ABRAHAMSSON Henrik; AHLGREN Bengt; LI Dan; SJDIN Peter; TANYINGYONG Voravit; XU Ke

    2013-01-01

    The increased capacity needs, primarily driven by content distribution, and the vision of Internet-of-Things with billions of connected devices pose radically new demands on future wireless and mobile systems. In general the increased diversity and scale result in complex resource management and optimization problems in both radio access networks and the wired core network infrastructure. We summarize results in this area from a collaborative Sino-Swedish project within IMT Advanced and Beyond, covering adaptive radio resource management, energy-aware routing, OpenFlow-based network virtualization, data center networking, and access network caching for TV on demand.

  9. Advanced Power Converter for Universal and Flexible Power Management in Future Electricity Network

    DEFF Research Database (Denmark)

    Iov, Florin; Blaabjerg, Frede; Bassett, R.;

    2007-01-01

    More "green" power provided by Distributed Generation will enter into the European electricity network in the near future. In order to control the power flow and to ensure proper and secure operation of this future grid, with an increased level of the renewable power, new power electronic...... converters for grid connection of renewable sources will be needed. These power converters must be able to provide intelligent power management as well as ancillary services. This paper presents the overall structure and the control aspects of an advanced power converter for universal and flexible power...... management in the future European electricity network....

  10. Operations management system advanced automation: Fault detection isolation and recovery prototyping

    Science.gov (United States)

    Hanson, Matt

    1990-01-01

    The purpose of this project is to address the global fault detection, isolation and recovery (FDIR) requirements for Operation's Management System (OMS) automation within the Space Station Freedom program. This shall be accomplished by developing a selected FDIR prototype for the Space Station Freedom distributed processing systems. The prototype shall be based on advanced automation methodologies in addition to traditional software methods to meet the requirements for automation. A secondary objective is to expand the scope of the prototyping to encompass multiple aspects of station-wide fault management (SWFM) as discussed in OMS requirements documentation.

  11. Cutaneous wound healing in aging small mammals: a systematic review.

    Science.gov (United States)

    Kim, Dong Joo; Mustoe, Thomas; Clark, Richard A F

    2015-01-01

    As the elderly population grows, so do the clinical and socioeconomic burdens of nonhealing cutaneous wounds, the majority of which are seen among persons over 60 years of age. Human studies on how aging effects wound healing will always be the gold standard, but studies have ethical and practical hurdles. Choosing an animal model is dictated by costs and animal lifespan that preclude large animal use. Here, we review the current literature on how aging effects cutaneous wound healing in small animal models and, when possible, compare healing across studies. Using a literature search of MEDLINE/PubMed databases, studies were limited to those that utilized full-thickness wounds and compared the wound-healing parameters of wound closure, reepithelialization, granulation tissue fill, and tensile strength between young and aged cohorts. Overall, wound closure, reepithelialization, and granulation tissue fill were delayed or decreased with aging across different strains of mice and rats. Aging in mice was associated with lower tensile strength early in the wound healing process, but greater tensile strength later in the wound healing process. Similarly, aging in rats was associated with lower tensile strength early in the wound healing process, but no significant tensile strength difference between young and old rats later in healing wounds. From studies in New Zealand White rabbits, we found that reepithelialization and granulation tissue fill were delayed or decreased overall with aging. While similarities and differences in key wound healing parameters were noted between different strains and species, the comparability across the studies was highly questionable, highlighted by wide variability in experimental design and reporting. In future studies, standardized experimental design and reporting would help to establish comparable study groups, and advance the overall knowledge base, facilitating the translatability of animal data to the human clinical condition.

  12. Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions-key messages

    DEFF Research Database (Denmark)

    Gottrup, Finn; Apelqvist, Jan; Bjarnsholt, Thomas;

    2014-01-01

    This article constitutes an extraction of key messages originally presented in the Document: Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions written by the European Wound Management Association (EWMA), and originally published by the Journal of Wound Care in 2013. All...

  13. Advanced transport operating system software upgrade: Flight management/flight controls software description

    Science.gov (United States)

    Clinedinst, Winston C.; Debure, Kelly R.; Dickson, Richard W.; Heaphy, William J.; Parks, Mark A.; Slominski, Christopher J.; Wolverton, David A.

    1988-01-01

    The Flight Management/Flight Controls (FM/FC) software for the Norden 2 (PDP-11/70M) computer installed on the NASA 737 aircraft is described. The software computes the navigation position estimates, guidance commands, those commands to be issued to the control surfaces to direct the aircraft in flight based on the modes selected on the Advanced Guidance Control System (AGSC) mode panel, and the flight path selected via the Navigation Control/Display Unit (NCDU).

  14. Human-system safety methods for development of advanced air traffic management systems

    International Nuclear Information System (INIS)

    The Idaho National Engineering and Environmental Laboratory (INEEL) is supporting the National Aeronautics and Space Administration in the development of advanced air traffic management (ATM) systems as part of the Advanced Air Transportation Technologies program. As part of this program INEEL conducted a survey of human-system safety methods that have been applied to complex technical systems, to identify lessons learned from these applications and provide recommendations for the development of advanced ATM systems. The domains that were surveyed included offshore oil and gas, commercial nuclear power, commercial aviation, and military. The survey showed that widely different approaches are used in these industries, and that the methods used range from very high-level, qualitative approaches to very detailed quantitative methods such as human reliability analysis (HRA) and probabilistic safety assessment (PSA). In addition, the industries varied widely in how effectively they incorporate human-system safety assessment in the design, development, and testing of complex technical systems. In spite of the lack of uniformity in the approaches and methods used, it was found that methods are available that can be combined and adapted to support the development of advanced air traffic management systems (author) (ml)

  15. Etiology of contaminated wounds

    International Nuclear Information System (INIS)

    The US Department of Energy reports of events that occurred in the chemical processing 200 Areas of the Hanford Site during the period from 1972 through 1986 were reviewed to identify the causes of contaminated wounds. Contaminated wounds were reported in 19 events involving 20 workers. The causal agents (high risk operations) and the root causes were characterized. Emergency actions taken and their efficacy were noted. The 19 wound events were compared with 17 events with the potential for inhalation. It was found that the wound events involve a single worker and frequently result in an internal contamination and its resulting dose. Inhalation events involve groups of workers and rarely resulted in detectable internal contamination. The difference is attributed to anticipation of an inhalation event and use of respiratory protection and continuous air monitors to mitigate its effects

  16. Design manual for management of solid by-products from advanced coal technologies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-10-01

    Developing coal conversion technologies face major obstacles in byproduct management. This project has developed several management strategies based on field trials of small-scale landfills in an earlier phase of the project, as well as on published/unpublished sources detailing regulatory issues, current industry practice, and reuse opportunities. Field testing, which forms the basis for several of the disposal alternatives presented in this design manual, was limited to byproducts from Ca-based dry SO{sub 2} control technologies, circulating fluidized bed combustion ash, and bubbling bed fluidized bed combustion ash. Data on byproducts from other advanced coal technologies and on reuse opportunities are drawn from other sources (citations following Chapter 3). Field results from the 5 test cases examined under this project, together with results from other ongoing research, provide a basis for predictive modeling of long-term performance of some advanced coal byproducts on exposure to ambient environment. This manual is intended to provide a reference database and development plan for designing, permitting, and operating facilities where advanced coal technology byproducts are managed.

  17. Establishment and operation of skin care management system for wound, ostomy, and incontinence%造口伤口失禁皮肤护理管理系统的建立与运行

    Institute of Scientific and Technical Information of China (English)

    徐旭娟; 袁宝芳

    2011-01-01

    Objective To establish a skin care management system for wound, ostomy, and incontinence (WOI) , and to explore the effectiveness after implement of the system. Methods We set up a skin care team of WOI, confirmed tertiary management model, clarified responsibilities for all levels, established regulations and processes, trained relevant staff, implemented nursing consulta-tion system, paid important attention to stoma complications, and used network technology for monitoring skin care in whole hos-pital. Results The scores of assessment, documentation, and management of WOI, and nurses proficiency of wound-related knowledge showed significant differences before and after 1 year implement of the system (P<0. 01 for all). Conclusion Skin care management system for WOI is a practical and efficient management model, which improves management of wound and ostomy in members of skin care team.%目的 探讨伤口造口失禁皮肤护理管理系统建立与运行后皮肤护理管理的效果.方法 成立造口伤口失禁皮肤护理小组,确定三级管理体制的运行模式,明确各级人员职责,制定工作制度和流程,对相关人员进行培训,实行护理会诊制度,高度重视造口并发症预防工作,利用网络技术对全院皮肤护理情况进行及时监控.结果 系统建立前后护理人员对造口伤口失禁评估记录处理得分及伤口相关知识掌握情况比较,差异有统计学意义(均P<0.01).结论 系统的建立与运行显著提升了小组成员正确处理造口伤口的能力,是可行、有效的临床专科护理及管理系统.

  18. Use of negative pressure wound therapy in burn patients.

    Science.gov (United States)

    Teng, Shou-Cheng

    2016-09-01

    According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability. PMID:27547959

  19. Arginine metabolism in wounds

    International Nuclear Information System (INIS)

    Arginine metabolism in wounds was investigated in the rat in 1) lambda-carrageenan-wounded skeletal muscle, 2) Schilling chambers, and 3) subcutaneous polyvinyl alcohol sponges. All showed decreased arginine and elevated ornithine contents and high arginase activity. Arginase could be brought to the wound by macrophages, which were found to contain arginase activity. However, arginase was expressed by macrophages only after cell lysis and no arginase was released by viable macrophages in vitro. Thus the extracellular arginase of wounds may derive from dead macrophages within the injured tissue. Wound and peritoneal macrophages exhibited arginase deiminase activity as demonstrated by the conversion of [guanido-14C]arginine to radiolabeled citrulline during culture, the inhibition of this reaction by formamidinium acetate, and the lack of prokaryotic contamination of the cultures. These findings and the known metabolic fates of the products of arginase and arginine deiminase in the cellular populations of the wound suggest the possibility of cooperativity among cells for the production of substrates for collagen synthesis

  20. 干细胞治疗糖尿病难愈创面研究进展%Advances in the research of treating refractory diabetic wounds with stem cells

    Institute of Scientific and Technical Information of China (English)

    弓家弘; 陆树良

    2014-01-01

    With the growth of aging society,China has become the country of population with the highest incidence of diabetes in the world.Diabetes leads to pathological changes in vascular and nervous system,rendering the diabetic skin fragile and hard to heal if wounded; in the end most diabetic wounds tend to become chronic skin ulcers.The refractory diabetic wound is the result of various endogenous and exogenous factors.It is a quite complicated pathophysiologic event which lacks an effective and specific therapeutic method in clinic.The use of stem cells could be a new approach of treating diabetic chronic wounds since they have a potential ability of self-renovation and multi-directional differentiation which will promote angiogenesis and wound healing process,thus be beneficial in the care of ischemia diseases of the lower limb.This article reviews basic theory of treating diabetic wound and the changes in microenvironment,and prompts many successful cases in curing refractory diabetic wounds.

  1. Effects of irrigation with different solution on Incidence of Wound Infection

    OpenAIRE

    Majid Zamani; Fatemeh Sadeghi Panah; Mehrdad Esmailian; Reza Azizkhani; Zahra Yoosefian; Mojtaba soltani

    2015-01-01

    Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups:...

  2. Enzymatic Debriding Agents Are Safe in Wounds With High Bacterial Bioburdens and Stimulate Healing

    OpenAIRE

    Payne, Wyatt G.; Salas, R. Emerick; Ko, Francis; Naidu, Deepak K.; Donate, Guillermo; Wright, Terry E.; Robson, Martin C.

    2008-01-01

    Background: Debridement is essential for successful wound management. Enzymatic debridement is commonly utilized in wound care but has been reported to be unsafe in wounds with significant bacterial bioburden, unless used in conjunction with topical antimicrobials. We examine this hypothesis with 2 commercially available, commonly used preparations of enzymatic debriding agents. Materials and Methods: Using a standard rodent model of a chronically infected granulating wound with bacterial lev...

  3. ROLE OF VACUUM ASSISTED CLOSURE (VAC - IN WOUND HEALING

    Directory of Open Access Journals (Sweden)

    L. Lokanadha Rao

    2016-09-01

    Full Text Available BACKGROUND Large, complicated wounds pose a significant surgical problem. Negative pressure wound therapy is one of several methods enabling to obtain better treatment results in case of open infected wounds.1,2 The use of negative pressure therapy enables to obtain a reduction in the number of bacteria which significantly reduces the number of complications.3,4,5 AIMS AND OBJECTIVES: To review the Role of VAC in wound healing in Orthopaedics. MATERIALS AND METHODS The cases presented in this study are those who were admitted in King George Hospital in the time period from January 2014 to August 2015. This is a prospective interventional study. In this study, 15 patients were assigned to the study group (Negative Pressure Wound Therapy- NPWT based on their willingness for undergoing treatment. OBSERVATIONS AND RESULTS 12 males and 3 females are involved in the study. There is decrease in the mean wound area from 64 cm2 to 38 cm2 . There is decrease in the duration of hospital stay. Finally, wound is closed by SSG or secondary suturing. DISCUSSION NPWT is known to reduce bacterial counts, although they remain colonised with organisms. Wounds covered with NPW dressing are completely isolated from the environment, thereby reduces cross infection. In our series, we had 73.3% (11 cases excellent results and 26.7% (4 cases good results and no poor results. As interpretation with results, VAC therapy is effective mode of adjuvant therapy for the management of infected wounds. CONCLUSION VAC has been proven to be a reliable method of treating a variety of infected wounds. It greatly increases the rate of granulation tissue formation and lowers bacterial counts to accelerate wound healing. It can be used as a temporary dressing to prepare wounds optimally prior to closure or as a definitive treatment for nonsurgical and surgical wounds. VAC is now being used in a multitude of clinical settings, including the treatment of surgical wounds, infected wounds

  4. Wound Healing Effects of Curcumin: A Short Review.

    Science.gov (United States)

    Tejada, Silvia; Manayi, Azadeh; Daglia, Maria; Nabavi, Seyed F; Sureda, Antoni; Hajheydari, Zohreh; Gortzi, Olga; Pazoki-Toroudi, Hamidreza; Nabavi, Seyed M

    2016-01-01

    Wound healing is a complex process that consists of several phases that range from coagulation, inflammation, accumulation of radical substances, to proliferation, formation of fibrous tissues and collagen, contraction of wound with formation of granulation tissue and scar. Since antiquity, vegetable substances have been used as phytotherapeutic agents for wound healing, and more recently natural substances of vegetable origin have been studied with the attempt to show their beneficial effect on wound treatment. Curcumin, the most active component of rhizome of Curcuma longa L. (common name: turmeric), has been studied for many years due to its bio-functional properties, especially antioxidant, radical scavenger, antimicrobial and anti-inflammatory activities, which play a crucial role in the wound healing process. Moreover, curcumin stimulated the production of the growth factors involved in the wound healing process, and so curcumin also accelerated the management of wound restoration. The aim of the present review is collecting and evaluating the literature data regarding curcumin properties potentially relevant for wound healing. Moreover, the investigations on the wound healing effects of curcumin are reported. In order to produce a more complete picture, the chemistry and sources of curcumin are also discussed. PMID:27640646

  5. Correction of MFG-E8 Resolves Inflammation and Promotes Cutaneous Wound Healing in Diabetes.

    Science.gov (United States)

    Das, Amitava; Ghatak, Subhadip; Sinha, Mithun; Chaffee, Scott; Ahmed, Noha S; Parinandi, Narasimham L; Wohleb, Eric S; Sheridan, John F; Sen, Chandan K; Roy, Sashwati

    2016-06-15

    Milk fat globule epidermal growth factor-factor 8 (MFG-E8) is a peripheral glycoprotein that acts as a bridging molecule between the macrophage and apoptotic cells, thus executing a pivotal role in the scavenging of apoptotic cells from affected tissue. We have previously reported that apoptotic cell clearance activity or efferocytosis is compromised in diabetic wound macrophages. In this work, we test the hypothesis that MFG-E8 helps resolve inflammation, supports angiogenesis, and accelerates wound closure. MFG-E8(-/-) mice displayed impaired efferocytosis associated with exaggerated inflammatory response, poor angiogenesis, and wound closure. Wound macrophage-derived MFG-E8 was recognized as a critical driver of wound angiogenesis. Transplantation of MFG-E8(-/-) bone marrow to MFG-E8(+/+) mice resulted in impaired wound closure and compromised wound vascularization. In contrast, MFG-E8(-/-) mice that received wild-type bone marrow showed improved wound closure and improved wound vascularization. Hyperglycemia and exposure to advanced glycated end products inactivated MFG-E8, recognizing a key mechanism that complicates diabetic wound healing. Diabetic db/db mice suffered from impaired efferocytosis accompanied with persistent inflammation and slow wound closure. Topical recombinant MFG-E8 induced resolution of wound inflammation, improvements in angiogenesis, and acceleration of closure, upholding the potential of MFG-E8-directed therapeutics in diabetic wound care. PMID:27194784

  6. Advances in the evaluation and management of children with portal hypertension.

    Science.gov (United States)

    Ling, Simon C

    2012-11-01

    Portal hypertension commonly accompanies advanced liver disease and gives rise to severe and life-threatening complications, including hemorrhage from esophageal varices. Diagnosis of portal hypertension in children currently relies on finding evidence of splenomegaly and the formation of portosystemic collaterals. There is a paucity of pediatric data to support the use of primary prophylaxis against variceal hemorrhage. A combination of vasoactive drug and endoscopic therapy should be used to manage variceal bleeding. Prevention of rebleeding is best achieved by endoscopic variceal ligation. Rex bypass surgery is the optimal therapy for prevention of further bleeding from portal vein thrombosis. Options to manage recurrent bleeding while on preventative therapy include surgical portosystemic shunt, Rex bypass, transjugular intrahepatic portosystemic shunt (TIPS), and liver transplantation. Management of gastric varices may require injection of cyanoacrylate glue or TIPS.

  7. Advances in software development for intelligent interfaces for alarm and emergency management consoles

    International Nuclear Information System (INIS)

    Recent advances in technology allow features like voice synthesis, voice and speech recognition, image understanding, and intelligent data base management to be incorporated in computer driven alarm and emergency management information systems. New software development environments make it possible to do rapid prototyping of custom applications. Three examples using these technologies are discussed. 1) Maximum use is made of high-speed graphics and voice synthesis to implement a state-of-the-art alarm processing and display system with features that make the operator-machine interface efficient and accurate. 2) An application generator which has the capability of ''building'' a specific alarm processing and display application in a matter of a few hours, using the site definition developed in the security planning phase to produce the custom application. 3) A software tool, is described which permits rapid prototyping of human-machine interfaces for a variety of applications including emergency management, alarm display and process information display

  8. Wound pH depends on actual wound size

    CERN Document Server

    Sirkka, T; Apell, S P

    2016-01-01

    Wound healing is an intricate process that involves many types of cells, reaction pathways as well as chemical, physical and electrical cues. Since biochemical reactions and physiological events are pH-dependent we study here pH as an important major characteristic of the wound healing process in the presence of endogenous and exogenous electric fields. Our model gives the spatial pH distribution in a wound. In particular we isolate a number of dimensionless quantities which sets the length, energy and time scales governing the wound healing process and which can be experimentally tested. Most interesting finding is that wound pH depends on actual wound size.

  9. 风险整合管理在伤口护理安全中的应用研究%Application of integrated risk management in safe wound care

    Institute of Scientific and Technical Information of China (English)

    蒋琪霞; 李晓华; 刘云; 彭青; 周昕; 易学明

    2013-01-01

    目的 医疗风险无处不在,伤口护理由于其专业的特殊性而存在高风险,安全管理是确保伤口护理专业健康发展的基础,也是伤口护理中心护教研协调发展的前提.文中探讨风险整合管理(Integrated risk management,IRM)理念和方法在伤口护理安全管理中的应用效果,以提高伤口护理的安全性和患者的满意率.方法 根据IRM理念,设计在伤口护理应用中的方法为评估(assessment,A)-识别(recognize,R)-报告(report,R)-确认(determine,D)-分析(analyze,A)-计划(plan,P)-告知(imformation,I)-实施(Implement,I)-评价(evaluation,E),简称ARRDAPIIE程序,培训护士掌握并应用.2008年1月至2009年12月为尝试观察期,2010年1月至2011年12月为改良实施期.评价指标:患者满意率、不良事件发生数和等级.结果 2008年1月至2011年12月,4年共入选风险伤口患者491例,伤口护理量14730人次,满意率调查表发出491份,当场回收491份,回收率100%.尝试期248例计伤口护理量7440人次,不良事件7人次,其中2人次为Ⅱ级,5人次为Ⅳ级,发生率0.094%;患者平均满意率(97.36±0.97)%.改良期243例计伤口护理量7290人次,不良事件3人次均为Ⅳ级,发生率0.041%;患者平均满意率(99.88±0.30)%,高于尝试期.2组不良事件发生率和等级比较差异无统计学意义(P=0.214和0.356).结论 IRM对提高患者满意率、降低不良事件发生率及等级有积极作用.%Objective Wound care invites high risks due to its special characteristics , and safe management is the key to its healthy development as well as to the harmonious construction of the wound care center . This study aims to evaluate integrated risk management (IRM) in the safe management of wound care in order to improve the safety of wound care and satisfaction of the patients . Methods Based on the idea of IRM , we designed the method of ARRDAPIIE , which stands for assess , recognize, report, determine, analyze, plan, inform

  10. Skin wound healing and phytomedicine: a review.

    Science.gov (United States)

    Pazyar, Nader; Yaghoobi, Reza; Rafiee, Esmail; Mehrabian, Abolfath; Feily, Amir

    2014-01-01

    Skin integrity is restored by a physiological process aimed at repairing the damaged tissues. The healing process proceeds in four phases: hemostasis, inflammation, proliferation and remodeling. Phytomedicine presents remedies, which possess significant pharmacological effects. It is popular amongst the general population in regions all over the world. Phytotherapeutic agents have been largely used for cutaneous wound healing. These include Aloe vera, mimosa, grape vine, Echinacea, chamomile, ginseng, green tea, jojoba, tea tree oil, rosemary, lemon, soybean, comfrey, papaya, oat, garlic, ginkgo, olive oil and ocimum. Phytotherapy may open new avenues for therapeutic intervention on cutaneous wounds. This article provides a review of the common beneficial medicinal plants in the management of skin wounds with an attempt to explain their mechanisms.

  11. Advanced practice nursing for enduring health needs management: a global perspective.

    Science.gov (United States)

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552

  12. Quo Vadis Radiotherapy? Technological Advances and the Rising Problems in Cancer Management

    Directory of Open Access Journals (Sweden)

    Barry J. Allen

    2013-01-01

    Full Text Available Purpose. Despite the latest technological advances in radiotherapy, cancer control is still challenging for several tumour sites. The survival rates for the most deadly cancers, such as ovarian and pancreatic, have not changed over the last decades. The solution to the problem lies in the change of focus: from local treatment to systemic therapy. The aim of this paper is to present the current status as well as the gaps in radiotherapy and, at the same time, to look into potential solutions to improve cancer control and survival. Methods. The currently available advanced radiotherapy treatment techniques have been analysed and their cost-effectiveness discussed. The problem of systemic disease management was specifically targeted. Results. Clinical studies show limited benefit in cancer control from hadron therapy. However, targeted therapies together with molecular imaging could improve treatment outcome for several tumour sites while controlling the systemic disease. Conclusion. The advances in photon therapy continue to be competitive with the much more expensive hadron therapy. To justify the cost effectiveness of proton/heavy ion therapy, there is a need for phase III randomised clinical trials. Furthermore, the success of systemic disease management lies in the fusion between radiation oncology technology and microbiology.

  13. Advanced practice nursing for enduring health needs management: a global perspective.

    Science.gov (United States)

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation.

  14. Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

    Science.gov (United States)

    McCallon, Stanley K.; Weir, Dorothy; Lantis, John C.

    2015-01-01

    Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%–50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation. PMID:26442207

  15. Deep sternal wound infection after cardiac surgery: Evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo; Barbero, Cristina; Rinaldi, Mauro

    2015-11-01

    Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at high-risk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors - when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. PMID:26557476

  16. Influence of optimization process management on the wound infection incidence in the dressing room patients%优化流程管理对换药室患者伤口感染率的影响研究

    Institute of Scientific and Technical Information of China (English)

    龚俊霞

    2013-01-01

    Objective To explore clinic dressing room optimization process management on reducing patients wound infection rate and improve the influence on the quality of management.Methods The original dressing process management defects and shortages of the original process management in 2010 were assessment and optimized.And optimization process management was implemented in January 2011 to December.Then,before and after optimization process management implementation,wound infection rate of clean the wound dressing and debridement suture wound dressing,patients' satisfaction,and management quality were observed and compared.Results Before and after optimization process management implementation,wound infection rate (1.39% vs 0.39%) and patients' satisfaction (92.8% vs 99.9%) were significantly improved (x2 =6.23,5.67,respectively;P < 0.01).The project quality management environment layout,operating rules,disinfection and isolation,aseptic technique,medical waste disposal,health education coverage average comparison,after the implementation,[(99.13 ± 1.64),(98.06 ± 1.27),(99.95 ± 1.04),(99.75 ± 2.12),(99.25 ±1.33),(99.96 ±0.21)] were higher than that before the implementation [(91.65 ±2.10),(91.21 ±2.73),(93.82 ± 1.35),(93.58 ± 3.89),(90.34 ± 2.14),(90.27 ± 1.55)],and the differences were statistically significant (t =6.47,4.73,4.96,5.131,4.89,6.35,respectively;P < 0.01).Conclusions Optimization process management can effectively control patients' wound infection in outpatient dressing room,and improve their satisfaction and quality of nursing management.%目的 探讨门诊换药室优化流程管理对减少患者伤口感染发生率和提高管理质量的影响.方法 评估2010年门诊换药室换药流程管理的缺陷和不足,对流程管理进行优化,并于2011年实施,比较优化流程管理前后清洁伤口换药、清创缝合伤口换药的伤口感染发生率,患者对换药室工作满意度以及管理质量.结果 2010年

  17. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections.

    Science.gov (United States)

    Ng, Shiow-Fern; Leow, Hon-Lunn

    2015-01-01

    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection. PMID:25758412

  18. High-grade glioma management and response assessment—recent advances and current challenges

    Science.gov (United States)

    Khan, M.N.; Sharma, A.M.; Pitz, M.; Loewen, S.K.; Quon, H.; Poulin, A.; Essig, M.

    2016-01-01

    The management of high-grade gliomas (hggs) is complex and ever-evolving. The standard of care for the treatment of hggs consists of surgery, chemotherapy, and radiotherapy. However, treatment options are influenced by multiple factors such as patient age and performance status, extent of tumour resection, biomarker profile, and tumour histology and grade. Follow-up cranial magnetic resonance imaging (mri) to differentiate treatment response from treatment effect can be challenging and affects clinical decision-making. An assortment of advanced radiologic techniques—including perfusion imaging with dynamic susceptibility contrast mri, dynamic contrast-enhanced mri, diffusion-weighted imaging, proton spectroscopy, mri subtraction imaging, and amino acid radiotracer imaging—can now incorporate novel physiologic data, providing new methods to help characterize tumour progression, pseudoprogression, and pseudoresponse. In the present review, we provide an overview of current treatment options for hgg and summarize recent advances and challenges in imaging technology. PMID:27536188

  19. Advances in the management of MS symptoms: recently proposed clinical management algorithms.

    Science.gov (United States)

    Vermersch, Patrick

    2015-01-01

    Guidelines from both the German and Spanish Neurology Societies for managing patients with multiple sclerosis (MS) spasticity emphasize the importance of setting clear objectives and use evidence levels and grades to support their recommendations. Swedish guidelines for MS spasticity also reflect the need to establish treatment aims and recommend use of validated scales to measure symptom changes. Treatment of generalized MS spasticity, beyond physiotherapy, tends to begin with baclofen, tizanidine and/or diazepam, adding Sativex (THC:CBD) oromucosal spray for moderate-to-severe cases. The European Federation of Neurological Societies/European Academy of Neurology Taskforce on Spasticity in Multiple Sclerosis is currently reviewing the literature supporting the pharmacological treatment of MS spasticity and aims to publish recommendations in the near future to guide clinicians in their treatment choices. PMID:26611268

  20. Wound Coverage Technologies in Burn Care: Established Techniques

    Science.gov (United States)

    Jeschke, Marc G.; Shahrokhi, Shahriar; Finnerty, Celeste C.; Branski, Ludwik K.; Dibildox, Manuel

    2013-01-01

    Major advances in burn care have reduced post-burn morbidity and mortality. The development and incorporation of new wound healing modalities into the clinical arena have contributed to this improvement by allowing standard-of-care regimens to be established. These regimens range from early excision to the use of cultured epithelial autograft. Here, we review the wound care options that are now well established and used by many burn surgeons. PMID:24165670