WorldWideScience

Sample records for chronic nonhealing wounds

  1. NeutroPhase® in chronic non-healing wounds

    Science.gov (United States)

    Crew, John; Varilla, Randell; Rocas, Thomas Allandale; Debabov, Dmitri; Wang, Lu; Najafi, Azar; Rani, Suriani Abdul; Najafi, Ramin (Ron); Anderson, Mark

    2012-01-01

    Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient’s morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase® as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase® is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase® with and without NPWT. NeutroPhase® was non-toxic to living tissues. PMID:23272294

  2. NeutroPhase(®) in chronic non-healing wounds.

    Science.gov (United States)

    Crew, John; Varilla, Randell; Rocas, Thomas Allandale; Debabov, Dmitri; Wang, Lu; Najafi, Azar; Rani, Suriani Abdul; Najafi, Ramin Ron; Anderson, Mark

    2012-01-01

    Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient's morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase(®) as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase(®) is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase(®) with and without NPWT. NeutroPhase(®) was non-toxic to living tissues. PMID:23272294

  3. Stan scheller: the forerunner of clinical studies on using propolis for poor and chronic nonhealing wounds.

    Science.gov (United States)

    Kucharzewski, M; Kubacka, S; Urbanek, T; Wilemska-Kucharzewska, K; Morawiec, T

    2013-01-01

    For hundreds of years poor and chronic nonhealing wounds have constituted a serious problem to medicine. What is more, treating such wounds is an expensive let alone a long-lasting process. The following paper describes Professor Scheller's achievements in using propolis for poor and chronic non-healing wounds. The authors' intention was to present the results connected with the use of the ethanolic extract propolis, in the treatment of patients suffering from burns, venous crural ulceration, local sacral bone pressure ulcers, suppurative osteitis and arthritis, suppurative postoperative local wound complications, and infected traumatic wounds.

  4. The Use of Biologic Scaffolds in the Treatment of Chronic Nonhealing Wounds

    OpenAIRE

    Turner, Neill J.; Badylak, Stephen F.

    2015-01-01

    Significance: Injuries to the skin as a result of illness or injury, particularly chronic nonhealing wounds, present a major healthcare problem. Traditional wound care approaches attempt to control the underlying causes, such as infection and ischemia, while the application of wound dressings aims to modify a poorly healing wound environment into a microenvironment more closely resembling an acute wound allowing the body to heal the wound naturally.

  5. A STUDY OF NEGATIVE PRESSURE WOUND THERAPY: VACUUM ASSISTED CLOSURE IN CHRONIC NON-HEALING ULCERS

    Directory of Open Access Journals (Sweden)

    Dhamotharan Senraman

    2016-06-01

    Full Text Available BACKGROUND This study evaluates the advantage of Negative Pressure Wound Therapy-Vacuum Assisted Closure over Conventional Dressing in the management of chronic non-healing ulcers. METHODS From June 2014 to June 2015, 50 patients were selected (25 cases and 25 controls. After wound debridement, VAC dressing is applied. Pre VAC and post VAC culture and sensitivity is taken. Dressing is given for 72 hours and intermittent suction is given for 10 mins. in an hour, daily for 12 hours with negative pressure ranging from 100 to 125 mmHg. Rest of the time drain of the VAC dressing is connected to the Romovac suction drain. Doppler study to assess the vascularity of the limb before the procedure and X-ray is taken to rule out osteomyelitis. Control group patients are given conventional dressings. RESULTS The gender, age and ulcer distributions were almost equal in the case and control groups and were found to be statistically insignificant. Duration of hospital stay in days was found to be statistically significant between groups. Majority (52% of cases left hospital within 3 weeks’ time, while a major chunk (88% of control population stayed more than 3 weeks. VAC dressing shows better results in patients with normal Doppler study. VAC dressing have better results in patients with 48% undergoing split skin grafting and less rate (8% of amputation as against none undergoing split skin grafting and 24% needing amputation in the control group. Patients with sterile pre-VAC culture were not turning unsterile after VAC, but 90% unsterile turns sterile after VAC. CONCLUSION NPWT is a novel technique for managing an open wound by submitting the wound either to intermittent or continuous subatmospheric pressure. Here, we did a study to study the advantage of vacuum assisted closure over conventional dressing in the management of chronic non-healing ulcers and concluded that VAC decreases hospital stay, improves pus culture sterility, has better result in

  6. Assessment and documentation of non-healing, chronic wounds in inpatient health care facilities in the Czech Republic: an evaluation study.

    Science.gov (United States)

    Pokorná, Andrea; Leaper, David

    2015-04-01

    The foundation of health care management of patients with non-healing, chronic wounds needs accurate evaluation followed by the selection of an appropriate therapeutic strategy. Assessment of non-healing, chronic wounds in clinical practice in the Czech Republic is not standardised. The aim of this study was to analyse the methods being used to assess non-healing, chronic wounds in inpatient facilities in the Czech Republic. The research was carried out at 77 inpatient medical facilities (8 university/faculty hospitals, 63 hospitals and 6 long- term hospitals) across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The results of this research have corroborated the suspicion of inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of a wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were significantly improved when a consultant for wound healing was present (P = 0·047). The same applied to facilities possessing a certificate of quality issued by the Czech Wound Management Association (P = 0·010). In conclusion, an effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of a 'non-healing, chronic wound assessment' algorithm.

  7. Cotton Study: Albumin Binding and its Effect on Elastase Activity in the Chronic Non-Healing Wound

    Energy Technology Data Exchange (ETDEWEB)

    Castro, N.; Goheen, S.

    2005-01-01

    Cotton, as it is used in wound dressings is composed of nearly pure cellulose. During the wound-healing process, cotton is exposed to various blood components including water, salts, cells, and blood proteins. Albumin is the most prominent protein in blood. Elastase is an enzyme secreted by white blood cells and takes an active role in tissue reconstruction. In the chronic non-healing wound, elastase is often over-expressed such that this enzyme digests tissue and growth factors, and interferes with the normal healing process. Our goal is to design a cotton wound dressing that will sequester elastase or assist in reducing elastase activity in the presence of other blood proteins such as albumin. The ability of cotton and various cotton derivatives to sequester elastase and albumin has been studied by examining the adsorption of these two proteins separately. We undertook the present work to confirm the binding of albumin to cotton and to quantify the activity of elastase in the presence of various derivatives of cotton. We previously observed a slight increase in elastase activity when exposed to cotton. We also observed a continuous accumulation of albumin on cotton using high-performance liquid chromatography methods. In the present study, we used an open-column-absorption technique coupled with a colorimetric protein assay to confirm losses of albumin to cotton. We have also confirmed increased elastase activity after exposure to cotton. The results are discussed in relation to the porosity of cotton and the use of cotton for treating chronic non-healing wounds.

  8. Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft.

    Science.gov (United States)

    Mrugala, Andrew; Sui, Audrey; Plummer, Malgorzata; Altman, Igor; Papineau, Elaine; Frandsen, Devn; Hill, Danielle; Ennis, William J

    2016-08-01

    A case series of five patients with a total of six chronic non-healing wounds (>30 day duration) were non-randomly selected to evaluate the performance, safety and handling properties of dehydrated human amnion/chorion membrane allograft, an amniotic membrane scaffolding product. The patients had lower extremity wounds that had previously failed standard of care within a university outpatient/inpatient wound healing programme. Five wounds treated with dehydrated amnion/chorion membrane allograft showed a mean 43% area reduction from baseline (51% median) at 3 weeks into treatment and completely healed with a 64-day median time to closure (SD ±27·6 days). One wound worsened at 3 weeks and was found to have a complete central vein obstruction that was treated with long-term mild compression but still eventually healed at 6 months. Removing this outlier, the four responding wounds had a 72% mean and 69% median change in area from baseline, at the 3 week point. All five patients received only one application of dehydrated human amnion/chorion membrane allograft, and there were no adverse events. The product was easy to use, administer and handle. In summary, dehydrated human amnion/chorion membrane allograft appears to be a safe, effective and easy to use therapy for chronic non-healing wounds. This study describes the details of these clinical cases and provides an overview of the current evidence on the use of amniotic tissue in clinical practice. PMID:25974156

  9. Detection of platelet-derived growth factor (PDGF)-AA in actively healing human wounds treated with recombinant PDGF-BB and absence of PDGF in chronic nonhealing wounds.

    OpenAIRE

    Pierce, G F; Tarpley, J. E.; Tseng, J; Bready, J; Chang, D.; Kenney, W C; Rudolph, R; Robson, M. C.; Vande Berg, J.; Reid, P.

    1995-01-01

    Some human chronic dermal wounds treated with recombinant platelet-derived growth factor-BB (rPDGF-BB) show increased healing coupled with fibroblast activation and granulation tissue formation. To determine whether endogenous PDGF is associated with healing and nonhealing dermal ulcer phenotypes, we developed monoclonal antibodies capable of recognizing the three isoforms of PDGF, AA, AB, and BB dimers, and capable of discriminating between two alternatively spliced A chain transcripts. We d...

  10. 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.

  11. A PROSPECTIVE RANDOMIZED TRIAL OF VACUUM-ASSISTED CLOSURE VERSUS STANDARD THERAPY OF CHRONIC NON-HEALING WOUNDS

    Directory of Open Access Journals (Sweden)

    Raghupathy

    2016-06-01

    Full Text Available BACKGROUND The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. The optimum level of negative pressure appears to be around 125 mmHg below ambient and there is evidence that this is most effective if applied in a cyclical fashion of five minutes on and two minutes off. It is believed that the negative pressure assists with removal of interstitial fluid, decreasing localised oedema and increasing blood flow. This in turn decreases tissue bacterial levels. Additionally, mechanical deformation of cells is thought to result in protein and matrix molecule synthesis, which increases the rate of cell proliferation. Despite the significant costs involved, the technique is said to compare favourably in financial terms with conventional treatments in the management of difficult to heal wounds. METHODS VAC therapy using facilities available in government. RESULTS Study group of 20 members with 98-100% graft uptake for most used VAC therapy of 1 to 2 settings. CONCLUSION Negative-Pressure Wound Therapy (NPWT is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds and enhance healing of second and third degree burns. The therapy involves the controlled application of subatmospheric pressure to the local wound environment using a sealed wound dressing connected to a vacuum pump. The use of this technique in wound management increased dramatically over the 1990s and 2000s and a large number of studies have been published examining NPWT. NPWT appears to be useful for diabetic wound and management of the open abdomen (Laparotomy, but further research is required for other wound types, always superior to normal saline dressing.

  12. Effect of Neem oil and Haridra on non-healing wounds

    OpenAIRE

    Singh, Anjali; Singh, Anil Kumar; Narayan, G.; Singh, Teja B.; Shukla, Vijay Kumar

    2014-01-01

    Background: In Ayurveda, Vrana (wound) has stated as tissue destruction and discoloration of viable tissue due to various etiology. In Sushruta Samhita, Sushruta described Vrana as a main subject. Most commonly Vrana can be classified into Shuddha and Dushta Vrana (chronic wound/nonhealing ulcers). Among the various drugs mentioned for Dushta Vrana, two of them, Neem (Azadirechta indica A. Juss) oil and Haridra (Curcuma longa Linn.) powder are selected for their wide spectrum action on wound....

  13. Contact dermatitis presenting as non-healing wound: case report

    OpenAIRE

    Leelavathi M; Le YY; Tohid H; Hasliza AH

    2011-01-01

    Abstract Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-def...

  14. Contact dermatitis presenting as non-healing wound: case report

    Directory of Open Access Journals (Sweden)

    Leelavathi M

    2011-05-01

    Full Text Available Abstract Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+ to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies.

  15. 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...

  16. [Treatment of trophic ulcers and non-healing wounds with CO2 laser].

    Science.gov (United States)

    Koshelev, V N; Glukhov, E I; Barkhatov, L N

    1985-02-01

    The authors used high and low intensity CO2 lasers for the treatment of 140 patients with trophic ulcers and continuously non-healing wounds. Choice of the method of treatment, parameters of laser radiation are based on concrete values of indices of the regeneration processes in the wounds and ulcers. In 83,6% of patients there was a complete recovery of the wounds, in 16,4% the recovery was partial. PMID:3923679

  17. Stability of the cathelicidin peptide LL-37 in a non-healing wound environment

    DEFF Research Database (Denmark)

    Grönberg, Alvar; Zettergren, Louise; Ågren, Sven Per Magnus

    2011-01-01

    aeruginosa that produce elastase, which degrades LL-37. This study investigated the stability of synthetic LL-37 against two types of proteinases in the presence or absence of wound fluid samples (diluted to 10-20%) from nine non-healing venous leg ulcers. Incubation of LL-37 (10 µg/ml) at 37°C for 6 h...

  18. Case 5: non-healing traumatic wound colonised with MRSA.

    Science.gov (United States)

    Simon, Deborah

    2016-03-01

    A traumatic wound colonised with MRSA failed to respond to topical antimicrobial dressings. Following the combined use of octenilin Wound Gel and octenilin Wound Irrigation Solution, the MRSA was removed in 4 weeks, the necrotic tissue was debrided and the wound started healing. PMID:26949849

  19. Case report of non-healing surgical wound treated with dehydrated human amniotic membrane

    OpenAIRE

    Riordan, Neil H; George, Ben A; Chandler, Troy B; McKenna, Randall W

    2015-01-01

    Introduction Non-healing wounds can pose a medical challenge as in the case of vasculopathic venostasis resulting in a surgical ulcer. When traditional approaches to wound care fail, an amniotic patch (a dehydrated tissue allograft derived from human amnion) can function as a biologic scaffold to facilitate and enhance tissue regeneration and rehabilitation. Background Amniotic AlphaPatches contain concentrated molecules of PGE2, WNT4, and GDF-11 which have angiogenic, trophic, and anti-infla...

  20. 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.

  1. Citric acid treatment of chronic nonhealing ulcerated tophaceous gout with bursitis.

    Science.gov (United States)

    Nagoba, Basavaraj S; Punpale, Ajay; Poddar, Ashok; Suryawanshi, Namdev M; Swami, Ganesh A; Selkar, Sohan P

    2013-12-01

    The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.

  2. The role of nurses in the care of chronic wounds by using alternative methods and materials of moist wound healing

    OpenAIRE

    SKŘÍŠOVSKÁ, Martina

    2013-01-01

    This bachelor?s thesis deals with the actual classification of wounds and the issue of the chronic wound treatment. In the preface of the theoretical part of the thesis, the term wound is defined and the wounds are subcategorized in the terms of their pathological traumatological origin. In the next chapters, the process of the wound healing is analysed from molecular biological aspect, the terms acute and chronic wound are defined and newly introduces the term non-healing wound for the chron...

  3. Treatment of non-healing sternum wound after open-heart surgery with allogenic platelet-rich plasma and fibrin glue-preliminary outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasi Tashnizi

    2013-01-01

    Full Text Available Introduction: Non-healing wound in the sternal region after coronary arteries bypass graft surgery is a serious complication. For healing a chronic wound, several novel approaches have been proposed recently such as using bone marrow stem cells, platelets and fibrin glue (PFG; but a non-invasive method is highly desirable in the first approach for treatment. The current study was undertaken to evaluate the effect of the combination of PFG in one treatment. Materials and Methods: We report on the treatment of six patients with life-threatening chronic sternum wounds, which caused septicemia with multi-drug resistant pathogens. The ulcers were extensively debrided initially and were measured and photographed at weekly intervals. The combination of PFG was applied topically on the wound after every 2 days. Results: The wounds were completely closed in five patients and significantly reduced in size in one. There was no evidence of local or systemic complications and any abnormal tissue formation, keloid or hypertrophic scarring. Conclusions: Our study suggests, in the first approach, PFG can be used safely in order to heal a non healing sternum wound following coronary artery bypass surgery.

  4. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

    Directory of Open Access Journals (Sweden)

    Shwetha Suryanarayan

    2014-09-01

    Full Text Available Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP in the treatment of chronic nonhealing ulcers. Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume was assessed. Results: The mean age of the patients was 42.5 years (standard deviation [SD] 12.48. Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to pyoderma gangrenosum, 2 diabetic ulcers, 2 trophic ulcers, and 1 vasculitic ulcer. The mean duration of healing of the ulcers was 5.6 weeks (SD 3.23. The mean percentage of reduction in area and volume of the ulcers was 91.7% (SD 18.4% and 95% (SD 14%, respectively. About 100% resolution in the area was seen in 25 (76% of the ulcers and 100% reduction in volume was seen in 24 (73% of the ulcers at the end of the 6th treatment. Conclusion: Conventional therapies do not provide satisfactory healing for chronic nonhealing ulcers as they are not able to provide the necessary growth factors (GFs (platelet-derived GF, epidermal GF, vascular endothelial GF, etc. which are essential for the healing process. PRP is a safe, affordable, biocompatible, and simple office-based procedure for the treatment of nonhealing ulcers.

  5. Activity of mesenchymal stem cells in therapies for chronic skin wound healing

    OpenAIRE

    Nuschke, Austin

    2013-01-01

    Chronic or non-healing skin wounds present an ongoing challenge in advanced wound care, particularly as the number of patients increases while technology aimed at stimulating wound healing in these cases remains inefficient. Mesenchymal stem cells (MSCs) have proved to be an attractive cell type for various cell therapies due to their ability to differentiate into various cell lineages, multiple donor tissue types, and relative resilience in ex-vivo expansion, as well as immunomodulatory effe...

  6. 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...

  7. Modern therapy of chronic wounds with respect to radiation

    International Nuclear Information System (INIS)

    Background: Descriptions of wound care techniques have been found in some of the oldest archeological findings and chronic wounds have been threading man thousands of years. However, only in the last few decades substantial progress has been made in understanding the cellular and biochemical processes relevant in normal healing. Pathophysiology: Wound healing is a complex process involving a variety of different cells, proteins, chemoattractants, proteinases and growth factors. The normal repair process is a coordinated cellular and biochemical event and can be characterized by 3 different healing phases (inflammatory, proliferative, and remodeling phase). Certain pathophysiologic conditions and metabolic disorders alter this preprogrammed course, leading to delayed healing or chronic nonhealing wounds. Disturbance of wound healing after radiation: Especially irradiation can complicate tissue repair and surgical wound healing. Therefore this article will review the basic understanding of the wound healing process and the knowledge of modern surgical and conservative wound therapy from a surgical point of view, which is essential to surpass pathophysiological situations and avoid chronic wounds. (orig.)

  8. Chronic Wounds, Biofilms and Use of Medicinal Larvae

    Directory of Open Access Journals (Sweden)

    Linda J. Cowan

    2013-01-01

    Full Text Available Chronic wounds are a significant health problem in the United States, with annual associated costs exceeding $20 billion annually. Traditional wound care consists of surgical debridement, manual irrigation, moisture retentive dressings, and topical and/or systemic antimicrobial therapy. However, despite progress in the science of wound healing, the prevalence and incidence of chronic wounds and their complications are escalating. The presence & complexity of bacterial biofilms in chronic wounds has recently been recognized as a key aspect of non-healing wounds. Bacterial biofilms are sessile colonies of polymicrobial organisms (bacteria, fungus, etc. enclosed within a self-produced exopolymeric matrix that provides high levels of tolerance to host defenses, antibiotics and antiseptics. Thus, there is a need for alternative therapies to reduce biofilms in chronic wounds. In this report, we present initial findings from in vitro experiments which show that larval debridement therapy with disinfected blow fly larvae (Phaenicia sericata reduced total CFUs (6-logs of planktonic and mature biofilms of Pseudomonas aeruginosa or Staphylococcus aureus grown on dermal pig skin explants by 5-logs after 24 hours of exposure, and eliminated biofilms (no measurable CFUs after 48 hours of exposure.

  9. Flap surgery in a green iguana (Iguana iguana with a non-healing palmar wound – a case presentation

    Directory of Open Access Journals (Sweden)

    Rudolf Kocsis

    2014-12-01

    Full Text Available In this clinical tutorial report for young vets, there is presented the clinical efficiency of a common surgery technique in a non-healing decubitus inflammatory crusted and pyogenic wound to a nine years male green iguana (Iguana iguana. The wound appeared two months before the reptile was presented to control and the bacteriologic culture made revealed a massive bacterial association where Enterococcus faecalis and Staphylococcus epidermidis were dominant. Consequently, the antibiogram was accomplished, the results indicating resistance to penicillin and chloramphenicol and respectively, efficacy to gentamicin, erythromycin and tetracycline. The initial treatment with gentamicin 5%, as topical application was started, but though the massive tissue destruction, the surgical way was chosen. Under anaesthesia, the area was scratched and the wound was debrided with scalpel until the bleeding occurred and skin was primarily closed with a surgical skin stapler, but this technique proven to be totally unsuited to green iguana, because of the skin’s tension developed consequently the intervention. Following, the “twisted flap” surgical technique was accomplished, we considering this way as a choice one in iguana’s case, and skin was sutured with no absorbable 2/0 nylon. After the local and general antibiotic treatment with enrofloxacin, animal was fully recovered, the suture points being removed after five weeks.

  10. 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

  11. 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.

  12. Biochemical association of metabolic profile and microbiome in chronic pressure ulcer wounds.

    Directory of Open Access Journals (Sweden)

    Mary Cloud B Ammons

    Full Text Available Chronic, non-healing wounds contribute significantly to the suffering of patients with co-morbidities in the clinical population with mild to severely compromised immune systems. Normal wound healing proceeds through a well-described process. However, in chronic wounds this process seems to become dysregulated at the transition between resolution of inflammation and re-epithelialization. Bioburden in the form of colonizing bacteria is a major contributor to the delayed headlining in chronic wounds such as pressure ulcers. However how the microbiome influences the wound metabolic landscape is unknown. Here, we have used a Systems Biology approach to determine the biochemical associations between the taxonomic and metabolomic profiles of wounds colonized by bacteria. Pressure ulcer biopsies were harvested from primary chronic wounds and bisected into top and bottom sections prior to analysis of microbiome by pyrosequencing and analysis of metabolome using 1H nuclear magnetic resonance (NMR spectroscopy. Bacterial taxonomy revealed that wounds were colonized predominantly by three main phyla, but differed significantly at the genus level. While taxonomic profiles demonstrated significant variability between wounds, metabolic profiles shared significant similarity based on the depth of the wound biopsy. Biochemical association between taxonomy and metabolic landscape indicated significant wound-to-wound similarity in metabolite enrichment sets and metabolic pathway impacts, especially with regard to amino acid metabolism. To our knowledge, this is the first demonstration of a statistically robust correlation between bacterial colonization and metabolic landscape within the chronic wound environment.

  13. 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...

  14. Distribution, organization and ecology of bacteria in chronic wounds

    DEFF Research Database (Denmark)

    Kirketerp-Møller, Klaus; Jensen, Peter Ø.; Fazli, Mustafa;

    2008-01-01

    contained P. aeruginosa. Furthermore, PNA FISH revealed the structural organization of bacteria in the samples. It appeared that P. aeruginosa aggregated as microcolonies imbedded in the matrix component alginate, which is a characteristic hallmark of the biofilm mode of growth. The present investigation...... suggests that bacteria present within these wounds tend to be aggregated in microcolonies imbedded in a self-produced matrix, characteristic of the biofilm mode of growth. Additionally, we must conclude that there exists no good correlation between bacteria detected by standard culturing methods and those......Between 1 and 2% of the population in the developed world experiences a nonhealing or chronic wound characterized by an apparent arrest in a stage dominated by inflammatory processes. Lately, research groups have proposed that bacteria might be involved in and contribute to the lack of healing...

  15. Pre-clinical evaluation of soybean-based wound dressings and dermal substitute formulations in pig healing and non-healing in vivo models

    Directory of Open Access Journals (Sweden)

    Rostislav V Shevchenko

    2014-10-01

    Full Text Available In the last decade, a new class of natural biomaterials derived from de-fatted soybean flour processed by either thermoset or extraction procedures has been developed. These biomaterials uniquely combine adaptability to various clinical applications to proven tissue regeneration properties. In the present work, the biomaterials were formulated either as hydrogel or as paste formulation and their potential as wound dressing material or as dermal substitute was assessed by two in vivo models in pig skin: The healing full-thickness punch biopsy model and the non-healing full-thickness polytetrafluoroethylene (PTFE chamber model. The results clearly show that collagen deposition is induced by the presence of these biomaterials. A unique pattern of early inflammatory response, eliciting neutrophils and controlling macrophage infiltration, is followed by tissue cell colonization of the wound bed with a significant deposition of collagen fibers. The study also highlighted the importance in the use of optimal formulations and appropriate handling upon implantation. In large size, non-healing wounds, wound dermis was best obtained with the paste formulation as hydrogels appeared to be too loose to ensure lasting scaffolding properties. On the contrary, packing of the granules during the application of paste reduced biomaterial degradation rate and prevent the penetration of newly vascularized tissue, thus impeding grafting of split-thickness autologous skin grafts on the dermal substitute base.

  16. Pre-clinical evaluation of soybean-based wound dressings and dermal substitute formulations in pig healing and non-healing in vivo models.

    Science.gov (United States)

    Shevchenko, Rostislav V; Santin, Matteo

    2014-01-01

    In the last decade, a new class of natural biomaterials derived from de-fatted soybean flour processed by either thermoset or extraction procedures has been developed. These biomaterials uniquely combine adaptability to various clinical applications to proven tissue regeneration properties. In the present work, the biomaterials were formulated either as hydrogel or as paste formulation and their potential as wound dressing material or as dermal substitute was assessed by two in vivo models in pig skin: The healing full-thickness punch biopsy model and the non-healing full-thickness polytetrafluoroethylene (PTFE) chamber model. The results clearly show that collagen deposition is induced by the presence of these biomaterials. A unique pattern of early inflammatory response, eliciting neutrophils and controlling macrophage infiltration, is followed by tissue cell colonization of the wound bed with a significant deposition of collagen fibers. The study also highlighted the importance in the use of optimal formulations and appropriate handling upon implantation. In large size, non-healing wounds, wound dermis was best obtained with the paste formulation as hydrogels appeared to be too loose to ensure lasting scaffolding properties. On the contrary, packing of the granules during the application of paste reduced biomaterial degradation rate and prevent the penetration of newly vascularized tissue, thus impeding grafting of split-thickness autologous skin grafts on the dermal substitute base.

  17. Community analysis of chronic wound bacteria using 16S rRNA gene-based pyrosequencing: impact of diabetes and antibiotics on chronic wound microbiota.

    Directory of Open Access Journals (Sweden)

    Lance B Price

    Full Text Available BACKGROUND: Bacterial colonization is hypothesized to play a pathogenic role in the non-healing state of chronic wounds. We characterized wound bacteria from a cohort of chronic wound patients using a 16S rRNA gene-based pyrosequencing approach and assessed the impact of diabetes and antibiotics on chronic wound microbiota. METHODOLOGY/PRINCIPAL FINDINGS: We prospectively enrolled 24 patients at a referral wound center in Baltimore, MD; sampled patients' wounds by curette; cultured samples under aerobic and anaerobic conditions; and pyrosequenced the 16S rRNA V3 hypervariable region. The 16S rRNA gene-based analyses revealed an average of 10 different bacterial families in wounds--approximately 4 times more than estimated by culture-based analyses. Fastidious anaerobic bacteria belonging to the Clostridiales family XI were among the most prevalent bacteria identified exclusively by 16S rRNA gene-based analyses. Community-scale analyses showed that wound microbiota from antibiotic treated patients were significantly different from untreated patients (p = 0.007 and were characterized by increased Pseudomonadaceae abundance. These analyses also revealed that antibiotic use was associated with decreased Streptococcaceae among diabetics and that Streptococcaceae was more abundant among diabetics as compared to non-diabetics. CONCLUSIONS/SIGNIFICANCE: The 16S rRNA gene-based analyses revealed complex bacterial communities including anaerobic bacteria that may play causative roles in the non-healing state of some chronic wounds. Our data suggest that antimicrobial therapy alters community structure--reducing some bacteria while selecting for others.

  18. Topical application of Katupila (Securinega leucopyrus) in Dushta Vrana (chronic wound) showing excellent healing effect: A case study

    OpenAIRE

    Ajmeer, Ahamed Shahan; Dudhamal, Tukaram S.; Gupta, Sanjay Kumar; Mahanta, Vyasadeva

    2014-01-01

    Securinega leucopyrus (Willd.) Muell. is known as Humari in India, Katupila in Sri Lanka and Spinous fluggea in English. It is a desert climatic plant used topically in paste form for healing of chronic and non-healing wounds. Application of Katupila Kalka (paste) is used commonly in the management of acute as well as chronic wounds in Sri Lanka as a folklore medicine. The aim of this study is to evaluate the role of herbal paste of Katupila in the treatment of Dushta Vrana (chronic wound). I...

  19. 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,...

  20. New trends in healing chronic wounds

    OpenAIRE

    KREJSKOVÁ, Kamila

    2013-01-01

    Basic theoretical bases As a chronic wound is called a secondarily healing wound which despite adequate therapy does not tend to heal for a period of 6-9 weeks. The cause of the chronic wound occurrence and its transformation into an acute wound can be infection, influence of associated diseases, skin top layer microtraumatization or skin necrosis cavity. Among the most frequent types of chronic wounds there are aligned venous ulcerations, arterial rodent ulcers, decubitus ulcers and neuropat...

  1. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    Directory of Open Access Journals (Sweden)

    Wieg

    2015-06-01

    Full Text Available Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using the same wound dressing during the entire healing period is no longer reasonable. Instead, multiple types of dressings may be needed for a single wound over its healing trajectory. Selection of the most appropriate dressing should be based on wound phase, depth, signs of infection, and level of exudate. Moisture balance is critical in wound care; dryness will hamper epithelial cell migration while excessive generation of fluid causes maceration at the wound margins. Hence, exudate management is a key issue in chronic wound therapy, particularly given that exudate from chronic wounds has a composition different from that of acute wound fluid. Several studies have shown that exudates from non-healing wounds contain significantly elevated levels of protease activity, increased formation of free radicals, and abundant amounts of proinflammatory cytokines, while concentrations of growth factors and protease inhibitors are markedly decreased. Application of dressings that remove and sequester excess amounts of wound fluid may not only help in restoring the correct balance of moisture, but also support the wound healing process by preventing tissue deterioration caused by abundant protease activity. Several types of dressings, such as hydrogels, hydrocolloids, alginates, hydrofibers, foams, and superabsorbent dressings, are reviewed here and evaluated with regard to their efficacy for highly exuding wounds. Keywords: chronic wounds, exuding, dressings, clinical efficacy 

  2. Analysis of the chronic wound microbiota of 2,963 patients by 16S rDNA pyrosequencing.

    Science.gov (United States)

    Wolcott, Randall D; Hanson, John D; Rees, Eric J; Koenig, Lawrence D; Phillips, Caleb D; Wolcott, Richard A; Cox, Stephen B; White, Jennifer S

    2016-01-01

    The extent to which microorganisms impair wound healing is an ongoing controversy in the management of chronic wounds. Because the high diversity and extreme variability of the microbiota between individual chronic wounds lead to inconsistent findings in small cohort studies, evaluation of a large number of chronic wounds using identical sequencing and bioinformatics methods is necessary for clinicians to be able to select appropriate empiric therapies. In this study, we utilized 16S rDNA pyrosequencing to analyze the composition of the bacterial communities present in samples obtained from patients with chronic diabetic foot ulcers (N = 910), venous leg ulcers (N = 916), decubitus ulcers (N = 767), and nonhealing surgical wounds (N = 370). The wound samples contained a high proportion of Staphylococcus and Pseudomonas species in 63 and 25% of all wounds, respectively; however, a high prevalence of anaerobic bacteria and bacteria traditionally considered commensalistic was also observed. Our results suggest that neither patient demographics nor wound type influenced the bacterial composition of the chronic wound microbiome. Collectively, these findings indicate that empiric antibiotic selection need not be based on nor altered for wound type. Furthermore, the results provide a much clearer understanding of chronic wound microbiota in general; clinical application of this new knowledge over time may help in its translation to improved wound healing outcomes. PMID:26463872

  3. 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.

  4. Wound healing and treating wounds: Differential diagnosis and evaluation of chronic wounds.

    Science.gov (United States)

    Morton, Laurel M; Phillips, Tania J

    2016-04-01

    Wounds are an excellent example of how the field of dermatology represents a cross-section of many medical disciplines. For instance, wounds may be caused by trauma, vascular insufficiency, and underlying medical conditions, such as diabetes, hypertension, and rheumatologic and inflammatory disease. This continuing medical education article provides an overview of wound healing and the pathophysiology of chronic wounds and reviews the broad differential diagnosis of chronic wounds. It also describes the initial steps necessary in evaluating a chronic wound and determining its underlying etiology.

  5. The chronic wound in early neurological rehabilitation

    OpenAIRE

    Rollnik, Jens Dieter; Wolff, Brigitte; Bertomeu-Knopp, Andreas

    2006-01-01

    Chronic wounds, especially decubitus ulcers, present a substantial problem in early neurological rehabilitation. Although many of these problem wounds are avoidable through appropriate nursing care (positioning techniques), a cross-sectional examination of our group of patients revealed a prevalence of chronic wounds of 9.2%. This chiefly included older (average age ca. 65 years), severely affected patients (average early-rehabilitation Barthel's total index of -208.0 (± 47.7) points), i.e., ...

  6. [Interdisciplinary treatment concepts in chronic wounds].

    Science.gov (United States)

    Coerper, S; Kerber, A; Schäffer, M; Becker, H D

    1998-01-01

    Interdisciplinary concepts for the treatment of chronic wounds are mandatory because of the multifactorial reasons causing ulceration. This is a report on 6 years' experience at the wound care unit in Tübingen. Patients with chronic wounds (mainly diabetic, venous, and ischemic ulcers) were treated primarily as outpatients according to a standardised and interdisciplinary wound care protocol. Quality control was guaranteed by a standardised wound documentation system. The evaluation of this data demonstrates an overall healing rate of 69% within 52 weeks (mean). Before patients were referred to Tübingen, unsuccessful therapy was characterised by a mean wound duration of 35 weeks. The results presented justify this interdisciplinary wound care unit. PMID:9931704

  7. 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

  8. Vasculogenic Cytokines in Wound Healing

    OpenAIRE

    Wong, Victor W.; Crawford, Jeffrey D.

    2013-01-01

    Chronic wounds represent a growing healthcare burden that particularly afflicts aged, diabetic, vasculopathic, and obese patients. Studies have shown that nonhealing wounds are characterized by dysregulated cytokine networks that impair blood vessel formation. Two distinct forms of neovascularization have been described: vasculogenesis (driven by bone-marrow-derived circulating endothelial progenitor cells) and angiogenesis (local endothelial cell sprouting from existing vasculature). Researc...

  9. 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.

  10. ADAM12: a potential target for the treatment of chronic wounds

    DEFF Research Database (Denmark)

    Harsha, Asheesh; Stojadinovic, Olivera; Brem, Harold;

    2008-01-01

    Wound healing is a complex process involving multiple cellular events, including cell proliferation, migration, and tissue remodeling. A disintegrin and metalloprotease 12 (ADAM12) is a membrane-anchored metalloprotease, which has been implicated in activation-inactivation of growth factors...... that play an important role in wound healing, including heparin-binding epidermal growth factor (EGF)-like growth factor (HB-EGF) and insulin growth factor (IGF) binding proteins. Here, we report that expression of ADAM12 is fivefold upregulated in the nonhealing edge of chronic ulcers compared to healthy...... skin, based on microarrays of biopsies taken from five patients and from healthy controls (p = 0.013). The increase in ADAM12 expression in chronic ulcers was confirmed by quantitative real-time polymerase chain reaction (RT-PCR). Moreover, immunohistochemical analysis demonstrated a pronounced...

  11. Maggot debridement therapy as primary tool to treat chronic wound of animals.

    Science.gov (United States)

    Choudhary, Vijayata; Choudhary, Mukesh; Pandey, Sunanda; Chauhan, Vandip D; Hasnani, J J

    2016-04-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method ofhealing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefernecrotic tissues over healthy for feeding. Since centuries, MDT is used in humanbeings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.

  12. Maggot debridement therapy as primary tool to treat chronic wound of animals

    Directory of Open Access Journals (Sweden)

    Vijayata Choudhary

    2016-04-01

    Full Text Available Maggot debridement therapy (MDT is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia sericata are used, as they prefer necrotic tissues over healthy for feeding. Since centuries, MDT is used in human beings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies are few. However, with the increasing antibiotic resistance and chronic wound infections in veterinary medicine, maggot therapy may even become the first line of treatment for some infections. This paper will present a brief discussion of MDT and its role in veterinary medicine that may add one more treatment method to utilize in non-healing wounds of animals and overcome the use of amputation and euthanasia. The objective of this review paper is to assemble relevant literature on maggot therapy to form a theoretical foundation from which further steps toward clinical use of maggot therapy in animals for chronic wounds can be taken.

  13. A prospective pilot study to evaluate wound outcomes and levels of serum C-reactive protein and interleukin-6 in the wound fluid of patients with trauma-related chronic wounds.

    Science.gov (United States)

    Liu, Tao; Yang, Fan; Li, Zhanfei; Yi, Chengla; Bai, Xiangjun

    2014-06-01

    If surgical closure of chronic wounds is an option, choosing an appropriate time to definitely close these wounds remains a challenge. Although the underlying mechanisms of nonhealing are not completely understood, serum C-reactive protein (CRP) and interleukin-6 (IL-6) in wound fluid have been found to be markers of the systemic and local inflammation state of chronic wounds. The purpose of this prospective, descriptive pilot study was to evaluate the effect of debridement, systemic antibiotics, and negative pressure wound therapy (NPWT) on the outcomes of trauma-related chronic wounds and changes in local inflammation responses, measured using CRP and IL-6 levels as indicators of cytokine regulation. Between June 2012 and May 2013, 20 consecutive patients (14 men, six women, mean age 40 [range 17-56] years) with various trauma-related, nonhealing chronic wounds were enrolled in the study after failing to heal for an average of 8.5 (range 6-16) weeks using a protocol of regular debridement and gauze dressings. Before the start of the study, wounds were cultured, and laboratory values for white blood cell count (WBC), neutrophils, and levels of serum CRP and IL-6 in the wound fluid obtained. Wounds were surgically debrided and NPWT (continuous at 125 mm Hg) applied. All patients were prescribed systemic antibiotics, and mean time interval between NPWT dressing changes was 5 (range 3-7) days. During an average mean NPWT treatment time of 13 (range 5-20) days, CRP and IL-6 concentrations decreased from 66.4 mg/L to 10.4 mg/L and 44.1 pg/mL to 8.6 pg/mL, respectively (P <0.001). The presence/absence of bacteria, WBC, and neutrophil counts did not change. No complications were noted, and all wounds were successfully closed using various surgical procedures. In this study, clinical wound improvement and a significant decrease in wound fluid CRP and IL-6 levels were observed. Studies with a larger sample size and a more robust study design may help elucidate the

  14. 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.

  15. 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...

  16. 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...

  17. 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...

  18. Cold plasma inactivation of chronic wound bacteria.

    Science.gov (United States)

    Mohd Nasir, N; Lee, B K; Yap, S S; Thong, K L; Yap, S L

    2016-09-01

    Cold plasma is partly ionized non-thermal plasma generated at atmospheric pressure. It has been recognized as an alternative approach in medicine for sterilization of wounds, promotion of wound healing, topical treatment of skin diseases with microbial involvement and treatment of cancer. Cold plasma used in wound therapy inhibits microbes in chronic wound due to its antiseptic effects, while promoting healing by stimulation of cell proliferation and migration of wound relating skin cells. In this study, two types of plasma systems are employed to generate cold plasma: a parallel plate dielectric barrier discharge and a capillary-guided corona discharge. Parameters such as applied voltage, discharge frequency, treatment time and the flow of the carrier gas influence the cold plasma chemistry and therefore change the composition and concentration of plasma species that react with the target sample. Chronic wound that fails to heal often infected by multidrug resistant organisms makes them recalcitrant to healing. Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) are two common bacteria in infected and clinically non-infected wounds. The efficacies of the cold plasma generated by the two designs on the inactivation of three different isolates of MRSA and four isolates of P. aeruginosa are reported here.

  19. Cold plasma inactivation of chronic wound bacteria.

    Science.gov (United States)

    Mohd Nasir, N; Lee, B K; Yap, S S; Thong, K L; Yap, S L

    2016-09-01

    Cold plasma is partly ionized non-thermal plasma generated at atmospheric pressure. It has been recognized as an alternative approach in medicine for sterilization of wounds, promotion of wound healing, topical treatment of skin diseases with microbial involvement and treatment of cancer. Cold plasma used in wound therapy inhibits microbes in chronic wound due to its antiseptic effects, while promoting healing by stimulation of cell proliferation and migration of wound relating skin cells. In this study, two types of plasma systems are employed to generate cold plasma: a parallel plate dielectric barrier discharge and a capillary-guided corona discharge. Parameters such as applied voltage, discharge frequency, treatment time and the flow of the carrier gas influence the cold plasma chemistry and therefore change the composition and concentration of plasma species that react with the target sample. Chronic wound that fails to heal often infected by multidrug resistant organisms makes them recalcitrant to healing. Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) are two common bacteria in infected and clinically non-infected wounds. The efficacies of the cold plasma generated by the two designs on the inactivation of three different isolates of MRSA and four isolates of P. aeruginosa are reported here. PMID:27046340

  20. Nutrition and Chronic Wounds: Improving Clinical Outcomes.

    Science.gov (United States)

    Molnar, Joseph A; Vlad, Lucian G; Gumus, Tuna

    2016-09-01

    There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished. We suggest the assumption that all geriatric wound patients are malnourished until proved otherwise. Evaluation should include complete history and physical and a formal nutritional evaluation should be obtained. Laboratory studies can be used in conjunction with this clinical information to confirm the assessment. While extensive studies are available in relation to prevention and treatment of pressure ulcers and perioperative nutrition, less is known of the effect of nutritional deficits and supplementation of the diabetic foot ulcer and venous stasis ulcer patient. This does not necessarily mean that nutritional support of these patients is not helpful. In the pursuit of wound healing, we provide systemic support of cardiac and pulmonary function and cessation of smoking, improve vascular inflow, improve venous outflow, decrease edema, and treat with hyperbaric oxygen. If we address all of these other conditions, why would we not wish to support the most basic of organismal needs in the form of nutrition? PMID:27556777

  1. Nonhealing Ulcer: Acroangiodermatitis of Mali

    Directory of Open Access Journals (Sweden)

    Neeraj Varyani

    2011-01-01

    Full Text Available An 18-year-old male presented with a nonhealing wound on left lower limb, pain and swelling over multiple joints, weight loss, and yellowish discoloration of eyes and urine for the past 4 years. On examination, the patient had pallor, icterus, and generalized lymphadenopathy with a nonhealing unhealthy ulcer over left medial malleolus. He had deformed joints with hepatomegaly and splenomegaly. His laboratory investigations were positive for antinuclear antibody (ANA and anticardiolipin antibody (ACLA. Synovial fluid analysis showed inflammatory findings. Biopsy of margin of the ulcer showed findings consistent with Acroangiodermatitis of Mali. The patient was treated with disease-modifying antirheumatic drugs (DMARDs and aspirin for juvenile idiopathic arthritis and secondary antiphospholipid antibody syndrome (APS, respectively. The ulcer was managed conservatively with systemic antibiotics and topical steroids along with limb elevation and compression elastic stockings. The patient's symptoms improved significantly, and he is in our followup.

  2. Biologic Therapeutics and Molecular Profiling to Optimize Wound Healing

    OpenAIRE

    Menke, Marie N.; Menke, Nathan B.; Boardman, Cecelia H.; Diegelmann, Robert F

    2008-01-01

    Non-healing wounds represent a significant cause of morbidity and mortality for a large portion of the adult population. Wounds that fail to heal are entrapped in a self-sustaining cycle of chronic inflammation leading to the destruction of the extracellular matrix. Among cancer patients, malnutrition, radiation, physical dehabilitation, chemotherapy, and the malignancy itself increase the likelihood of chronic wound formation, and these co-morbidity factors inhibit the normal wound healing p...

  3. Microbiology of equine wounds and evidence of bacterial biofilms

    OpenAIRE

    Westgate, S.J.; Percival, S. L.; Knottenbelt, D.C.; Clegg, P. D.; Cochrane, C.A.

    2011-01-01

    Abstract Horse wounds have a high risk of becoming infected due to their environment. Infected wounds harbour diverse populations of microorganisms, however in some cases these microorganisms can be difficult to identify and fail to respond to antibiotic treatment, resulting in chronic non-healing wounds. In human wounds this has been attributed to the ability of bacteria to survive in a biofilm phenotypic state. Biofilms are known to delay wound healing, principally due to their r...

  4. 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. ...

  5. [An example of a hub and spoke network system in Plastic Surgery: the Regional reference center for non-healing wounds in Ancona (Italy)].

    Science.gov (United States)

    Scalise, Alessandro; Pierangeli, Marina; Calamita, Roberto; Tartaglione, Caterina; Bolletta, Elisa; Grassetti, Luca; Di Benedetto, Giovanni

    2015-01-01

    Chronic wounds cause morbidity due to local infections, sepsis, osteomyelitis, but also increase mortality in the most severe cases and in patients with multiple comorbidities. Their increasing prevalence, associated disabilities and relevant health costs make chronic wounds a real social disease. At a time in which we hear more and more about spending reviews and reduction of health care costs, the natural evolution of Medicine and Health Care is increasingly directed towards the achievement of high quality standards while at the same time, reducing costs. It is in this framework that a hub and spoke model was used for organizing Plastic Surgery services in Ancona (Italy). In order to ensure appropriate clinical and organizational management of services, the activities of reference centres need to be widely integrated, by functional interconnections with activities of peripheral hospitals and local centres. Through a careful analysis of the Regional Reference Center for non - healing wounds in Ancona, the authors make some considerations regarding appropriate diagnostic-therapeutic-healthcare pathways and the correct use of human, material and technological resources in the area of wound healing.

  6. Expression of Hepatocyte Growth Factor-Like Protein in Human Wound Tissue and Its Biological Functionality in Human Keratinocytes

    OpenAIRE

    James C. Glasbey; Sanders, Andrew J.; David C. Bosanquet; Fiona Ruge; HARDING, KEITH G.; Jiang, Wen G

    2015-01-01

    Hepatocyte growth factor-like protein (HGFl) and its receptor, Recepteur d'Origine Nantais (RON), have been implicated in the development of wound chronicity. HGFl and RON expression was detected in acute wound tissue, chronic wound tissue and in normal skin using quantitative polymerase chain reaction (Q-PCR). HGFl and RON expression was also assessed in chronic healing and chronic non-healing wound tissues using Q-PCR and immunohistochemical staining. Expression was similarly detected in th...

  7. Exercise, Obesity, and Cutaneous Wound Healing: Evidence from Rodent and Human Studies

    OpenAIRE

    Pence, Brandt D.; Jeffrey A Woods

    2014-01-01

    Significance: Impaired cutaneous wound healing is a major health concern. Obesity has been shown in a number of studies to impair wound healing, and chronic nonhealing wounds in obesity and diabetes are a major cause of limb amputations in the United States.

  8. Citric Acid Treatment of Chronic Wounds in Animals

    OpenAIRE

    B.S. Nagoba,; B.J. Wadher and S.P. Selkar

    2011-01-01

    Chronic wound infections in animals not responding to conventional treatment modality are the important cause of morbidity. Infection is responsible for delayed wound healing. In the present study, an attempt was made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control chronic wound infections in animals. Thirty eight cases of chronic wounds not responding to conventional treatment modalities were divided into two groups. Each group...

  9. Chronic Wounds, Biofilms and Use of Medicinal Larvae

    OpenAIRE

    Cowan, Linda J.; Joyce K. Stechmiller; Priscilla Phillips; Qingping Yang; Gregory Schultz

    2013-01-01

    Chronic wounds are a significant health problem in the United States, with annual associated costs exceeding $20 billion annually. Traditional wound care consists of surgical debridement, manual irrigation, moisture retentive dressings, and topical and/or systemic antimicrobial therapy. However, despite progress in the science of wound healing, the prevalence and incidence of chronic wounds and their complications are escalating. The presence & complexity of bacterial biofilms in chronic wo...

  10. Modern wound care - practical aspects of non-interventional topical treatment of patients with chronic wounds.

    Science.gov (United States)

    Dissemond, Joachim; Augustin, Matthias; Eming, Sabine A; Goerge, Tobias; Horn, Thomas; Karrer, Sigrid; Schumann, Hauke; Stücker, Markus

    2014-07-01

    The treatment of patients with chronic wounds is becoming increasingly complex. It was therefore the aim of the members of the working group for wound healing (AGW) of the German Society of Dermatology (DDG) to report on the currently relevant aspects of non-interventional, topical wound treatment for daily practice. -Beside necessary procedures, such as wound cleansing and débridement, we describe commonly used wound dressings, their indications and practical use. Modern antiseptics, which are currently used in wound therapy, usually contain polyhexanide or octenidine. Physical methods, such as negative-pressure treatment, are also interesting options. It is always important to objectify and adequately treat pain symptoms which often affect these patients. Modern moist wound therapy may promote healing, reduce complications, and improve the quality of life in patients with chronic wounds. Together with the improvement of the underlying causes, modern wound therapy is an important aspect in the overall treatment regime for patients with chronic wounds.

  11. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    Science.gov (United States)

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures.

  12. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    Science.gov (United States)

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures. PMID:17679848

  13. [Application of modern wound dressings in the treatment of chronic wounds].

    Science.gov (United States)

    Triller, Ciril; Huljev, Dubravko; Smrke, Dragica Maja

    2012-10-01

    Chronic and acute infected wounds can pose a major clinical problem because of associated complications and slow healing. In addition to classic preparations for wound treatment, an array of modern dressings for chronic wound care are currently available on the market. These dressings are intended for the wounds due to intralesional physiological, pathophysiological and pathological causes and which failed to heal as expected upon the use of standard procedures. Classic materials such as gauze and bandage are now considered obsolete and of just historical relevance because modern materials employed in wound treatment, such as moisture, warmth and appropriate pH are known to ensure optimal conditions for wound healing. Modern wound dressings absorb wound discharge, reduce bacterial contamination, while protecting wound surrounding from secondary infection and preventing transfer of infection from the surrounding area onto the wound surface. The use of modern wound dressings is only justified when the cause of wound development has been established or chronic wound due to the underlying disease has been diagnosed. Wound dressing is chosen according to wound characteristics and by experience. We believe that the main advantages of modern wound dressings versus classic materials include more efficient wound cleaning, simpler placement of the dressing, reduced pain to touch, decreased sticking to the wound surface, and increased capacity of absorbing wound exudate. Modern wound dressings accelerate the formation of granulation tissue, reduce the length of possible hospital stay and facilitate personnel work. Thus, the overall cost of treatment is reduced, although the price of modern wound dressings is higher than that of classic materials. All types of modern wound dressings, their characteristics and indications for use are described.

  14. Primary cultured fibroblasts derived from patients with chronic wounds: a methodology to produce human cell lines and test putative growth factor therapy such as GMCSF

    Directory of Open Access Journals (Sweden)

    Coppock Donald L

    2008-12-01

    Full Text Available Abstract Background Multiple physiologic impairments are responsible for chronic wounds. A cell line grown which retains its phenotype from patient wounds would provide means of testing new therapies. Clinical information on patients from whom cells were grown can provide insights into mechanisms of specific disease such as diabetes or biological processes such as aging. The objective of this study was 1 To culture human cells derived from patients with chronic wounds and to test the effects of putative therapies, Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF on these cells. 2 To describe a methodology to create fibroblast cell lines from patients with chronic wounds. Methods Patient biopsies were obtained from 3 distinct locations on venous ulcers. Fibroblasts derived from different wound locations were tested for their migration capacities without stimulators and in response to GM-CSF. Another portion of the patient biopsy was used to develop primary fibroblast cultures after rigorous passage and antimicrobial testing. Results Fibroblasts from the non-healing edge had almost no migration capacity, wound base fibroblasts were intermediate, and fibroblasts derived from the healing edge had a capacity to migrate similar to healthy, normal, primary dermal fibroblasts. Non-healing edge fibroblasts did not respond to GM-CSF. Six fibroblast cell lines are currently available at the National Institute on Aging (NIA Cell Repository. Conclusion We conclude that primary cells from chronic ulcers can be established in culture and that they maintain their in vivo phenotype. These cells can be utilized for evaluating the effects of wound healing stimulators in vitro.

  15. Citric Acid Treatment of Chronic Wounds in Animals

    Directory of Open Access Journals (Sweden)

    B.S. Nagoba,

    2011-02-01

    Full Text Available Chronic wound infections in animals not responding to conventional treatment modality are the important cause of morbidity. Infection is responsible for delayed wound healing. In the present study, an attempt was made to develop simple and effective treatment modality by using citric acid as a sole antimicrobial agent to control chronic wound infections in animals. Thirty eight cases of chronic wounds not responding to conventional treatment modalities were divided into two groups. Each group included 19 cases. In group 1, 3% citric acid solution and in group 2, 5% citric acid solution was used for local application to find out its efficacy in the treatment of chronic wound infections in animals. Citric acid was found effective in the control of all 38 cases in 7 to 20 applications. In group 1, the wounds healed in 10-20 applications. In group 2, the wounds healed in 7-15 applications. Citric acid treatment was found most effective and economical approach for the successful treatment of chronic infected wounds in animals not responding to conventional antibiotic treatment and local wound care. These results suggest that when healing of chronic wounds in animals is a matter of great concern, the value of topical agents like citric acid should not be forgotten.

  16. [Local treatment of chronic skin wounds in a Swiss out-patient wound centre 2010].

    Science.gov (United States)

    Baumgartner, Marc; Tanner, Daniel; Hunziker, Thomas

    2011-03-01

    In Switzerland around 30,000 patients suffer from chronic skin wounds. Appropriate topical wound care along with treatment of the causes of the wounds enables to heal a lot of these patients and to avoid secondary disease such as infections. Thereby, the final goal of wound care is stable reepithelisation. Based on experience with chronic leg ulcers mainly in our out-patient wound centre, we give a survey of the wound dressings we actually use and discuss their wound-phase adapted application. Furthermore, we address the two tissue engineering products reimbursed in Switzerland, Apligraf and EpiDex, as well as the biological matrix product Oasis. The crucial question, which treatment options will be offered in future to the wound patients by our health regulatory and insurance systems, is open to debate.

  17. Healing of Chronic Wounds through Systemic Effects of Electromagnetic Fields

    Science.gov (United States)

    Cañedo, L.; Trigos, I.; García-Cantú, R.; Godina-Nava, J. J.; Serrano, G.

    2002-08-01

    Extremely low frequency electromagnetic fields (ELF) were configured to interact with peripheral blood mononuclear cells (PBMC). These ELF were applied in the arm to five patients with chronic wounds resistant to medical and surgical treatment. Wound healing began in all patients during the first two weeks after ELF exposure permiting their previously unresponsive chronic wounds to function as internal controls. All lesions were cured or healed >70% in less than four months. Systemic effects were explained by ELF activation of PBMC and their transportation through the blood to the affected site. This therapy is effective in selected patients with chronic wounds.

  18. Secretome of Peripheral Blood Mononuclear Cells Enhances Wound Healing

    OpenAIRE

    Mildner, Michael; Hacker, Stefan; Haider, Thomas; Gschwandtner, Maria; Werba, Gregor; Barresi, Caterina; Zimmermann, Matthias; Golabi, Bahar; Tschachler, Erwin; Ankersmit, Hendrik Jan

    2013-01-01

    Non-healing skin ulcers are often resistant to most common therapies. Treatment with growth factors has been demonstrated to improve closure of chronic wounds. Here we investigate whether lyophilized culture supernatant of freshly isolated peripheral blood mononuclear cells (PBMC) is able to enhance wound healing. PBMC from healthy human individuals were prepared and cultured for 24 hours. Supernatants were collected, dialyzed and lyophilized (SECPBMC). Six mm punch biopsy wounds were set on ...

  19. Stem Cells in Skin Regeneration, Wound Healing, and Their Clinical Applications

    OpenAIRE

    Nkemcho Ojeh; Irena Pastar; Marjana Tomic-Canic; Olivera Stojadinovic

    2015-01-01

    The skin is the largest organ of the body and has an array of functions. Skin compartments, epidermis, and hair follicles house stem cells that are indispensable for skin homeostasis and regeneration. These stem cells also contribute to wound repair, resulting in restoration of tissue integrity and function of damaged tissue. Unsuccessful wound healing processes often lead to non-healing wounds. Chronic wounds are caused by depletion of stem cells and a variety of other cellular and molecular...

  20. Assessment of chronic wounds by three-dimensional optical imaging based on integrating geometrical, chromatic, and thermal data.

    Science.gov (United States)

    Barone, S; Paoli, A; Razionale, A V

    2011-02-01

    Chronic wounds represent a particular debilitating health care problem, mainly affecting elderly people. A full and correct diagnosis of tissue damage should be carried out considering both dimensional, chromatic, and thermal parameters. A great variety of methods have been proposed with the aim of producing objective assessment of skin lesions, but none of the existing technologies seem to be robust enough to work for all ulcer typologies. This paper describes an innovative and non-invasive system that allows the automatic measurement of non-healing chronic wounds. The methodology involves the integration of a three-dimensional (3D) optical scanner, based on a structured light approach, with a thermal imager. The system enables the acquisition of geometrical data, which are directly related to chromatic and temperature patterns through a mapping procedure. Damaged skin areas are detected by combining visible and thermal imaging. This approach allows for the automatic measurement of extension and depth of ulcers, even in the absence of significant and well-defined chromatic patterns. The proposed technology has been tested in the measurement of ulcers on human legs. Clinical tests have demonstrated the effectiveness of this methodology in supporting medical experts for the assessment of chronic wounds. PMID:21428152

  1. 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

  2. [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

  3. Cellular events and biomarkers of wound healing

    Directory of Open Access Journals (Sweden)

    Shah Jumaat Mohd. Yussof

    2012-01-01

    Full Text Available Researchers have identified several of the cellular events associated with wound healing. Platelets, neutrophils, macrophages, and fibroblasts primarily contribute to the process. They release cytokines including interleukins (ILs and TNF-α, and growth factors, of which platelet-derived growth factor (PDGF is perhaps the most important. The cytokines and growth factors manipulate the inflammatory phase of healing. Cytokines are chemotactic for white cells and fibroblasts, while the growth factors initiate fibroblast and keratinocyte proliferation. Inflammation is followed by the proliferation of fibroblasts, which lay down the extracellular matrix. Simultaneously, various white cells and other connective tissue cells release both the matrix metalloproteinases (MMPs and the tissue inhibitors of these metalloproteinases (TIMPs. MMPs remove damaged structural proteins such as collagen, while the fibroblasts lay down fresh extracellular matrix proteins. Fluid collected from acute, healing wounds contains growth factors, and stimulates fibroblast proliferation, but fluid collected from chronic, nonhealing wounds does not. Fibroblasts from chronic wounds do not respond to chronic wound fluid, probably because the fibroblasts of these wounds have lost the receptors that respond to cytokines and growth factors. Nonhealing wounds contain high levels of IL1, IL6, and MMPs, and an abnormally high MMP/TIMP ratio. Clinical examination of wounds inconsistently predicts which wounds will heal when procedures like secondary closure are planned. Surgeons therefore hope that these chemicals can be used as biomarkers of wounds which have impaired ability to heal. There is also evidence that the application of growth factors like PDGF will help the healing of chronic, nonhealing wounds.

  4. 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

  5. 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...

  6. Stem cells and chronic wound healing: state of the art

    Directory of Open Access Journals (Sweden)

    Leavitt T

    2016-03-01

    Full Text Available Tripp Leavitt, Michael S Hu, Clement D Marshall, Leandra A Barnes, Michael T Longaker, H Peter Lorenz Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA Abstract: Currently available treatments for chronic wounds are inadequate. A clearly effective therapy does not exist, and treatment is often supportive. This is largely because the cellular and molecular processes underlying failure of wound repair are still poorly understood. With an increase in comorbidities, such as diabetes and vascular disease, as well as an aging population, the incidence of these intractable wounds is expected to rise. As such, chronic wounds, which are already costly, are rapidly growing as a tremendous burden to the health-care system. Stem cells have garnered much interest as a therapy for chronic wounds due to their inherent ability to differentiate into multiple lineages and promote regeneration. Herein, we discuss the types of stem cells used for chronic wound therapy, as well as the proposed means by which they do so. In particular, we highlight mesenchymal stem cells (including adipose-derived stem cells, endothelial progenitor cells, and induced pluripotent stem cells. We include the results of recent in vitro and in vivo studies in both animal models and human clinical trials. Finally, we discuss the current studies to improve stem cell therapies and the limitations of stem cell-based therapeutics. Stem cells promise improved therapies for healing chronic wounds, but further studies that are well-designed with standardized protocols are necessary for fruition. Keywords: stem cells, chronic wounds, cell therapy, wound healing

  7. [The wound care center in surgery: an interdisciplinary concept for diagnostic and treatment of chronic wounds].

    Science.gov (United States)

    Coerper, S; Schäffer, M; Enderle, M; Schott, U; Köveker, G; Becker, H D

    1999-04-01

    In Germany there is no standardized wound care for patients with chronic wounds in specialized centers. We have established a wound care unit for the past 6 years. The principal concept of therapy was characterized by standardized local surgery, moist wound dressings and concomitant treatment of the underlying disease. We performed local therapy, coordinated the interdisciplinary treatment and developed a new wound documentation system for quality control. We established a close network, integrating general practitioners and home care organizations to realize a mainly outpatient treatment supported by short hospital therapy. Exclusive outpatient treatment was performed in 42% of all patients. According to our prospective data, we achieved an improvement in wound care: 69% of the wounds resistant to therapy for a mean of 30 months healed within 12 months after therapy according to our protocol. Our data strongly supported the importance of local surgery: neither wound depth nor wound infection had any influence on the healing rate, presumably due to radical excisional debridement of necrotic tissue. The presented data justify on medical and economic grounds the establishment of such wound care centers in Germany. PMID:10354850

  8. Mesenchymal Stromal Cells as Cell-Based Therapeutics for Wound Healing

    OpenAIRE

    Samir Malhotra; Hu, Michael S.; Marshall, Clement D.; Tripp Leavitt; Alexander T. M. Cheung; Gonzalez, Jennifer G.; Harleen Kaur; Peter Lorenz, H.; Longaker, Michael T.

    2016-01-01

    Chronic wounds are a source of substantial morbidity for patients and are a major financial burden for the healthcare system. There are no current therapies that reliably improve nonhealing wounds or reverse pathological scarring. Mesenchymal stromal cells (MSCs) are a promising source of novel cell-based therapies due to the ease of their harvest and their integral role in the native wound repair process. Recent work has addressed the problems of loss of plasticity and off-target delivery th...

  9. Persistent Inflammation and Angiogenesis during Wound Healing in K14-directed Hoxb13 Transgenic Mice

    OpenAIRE

    Mack, Judith A.; Maytin, Edward V.

    2009-01-01

    Chronic, non-healing wounds and inadequate tissue repair characterized by excessive fibrosis continue to have a major negative impact on health and quality of life. Understanding the molecular events required for adequate healing, including the transcriptional control of wound repair, will be important for the development of future therapies. We previously showed that loss of Hoxb13 from murine skin results in enhanced cutaneous wound healing, suggesting that Hoxb13 has a negative effect on w...

  10. Clinical Application of Growth Factors and Cytokines in Wound Healing

    OpenAIRE

    Barrientos, Stephan; Brem, Harold; Stojadinovic, Olivera; Tomic-Canic, Marjana

    2014-01-01

    Wound healing is a complex and dynamic biological process that involves the coordinated efforts of multiple cell types and is executed and regulated by numerous growth factors and cytokines. There has been a drive in the past two decades to study the therapeutic effects of various growth factors in the clinical management of non-healing wounds (e.g. pressure ulcers, chronic venous ulcers, diabetic foot ulcers). For this review, we conducted a nonline search of Medline and Pub Medical and crit...

  11. Negative pressure wound therapy technologies for chronic wound care in the home setting: A systematic review.

    Science.gov (United States)

    Rhee, Susan M; Valle, M Frances; Wilson, Lisa M; Lazarus, Gerald; Zenilman, Jonathan M; Robinson, Karen A

    2015-01-01

    The use of negative pressure wound therapy (NPWT) is increasing in both the inpatient and outpatient settings. We conducted a systematic review on the efficacy and safety of NPWT for the treatment of chronic wounds in the home setting. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature, up to June 2014. Two independent reviewers screened search results. Seven studies met our criteria for inclusion. Six of the studies compared NPWT devices to other wound care methods and one study compared two different NPWT technologies. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. We were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence. Consensus is needed on the methods of conducting and reporting wound care research so that future studies are able inform decisions about the use of NPWT in the home environment for chronic wounds.

  12. Guest Editorial: Evidence-based practice in wound care: Toward addressing our knowledge gaps

    OpenAIRE

    Kath M. Bogie, DPhil

    2011-01-01

    Chronic nonhealing wounds are a major complication for many veterans. Particularly at risk are veterans with reduced mobility, such as those who have suffered a spinal cord injury (SCI). Chronic wounds cause significant suffering, including profound negative effects on general physical health, socialization, financial status, body image, level of independence, and control. For individuals with SCI, the development of a pressure ulcer is one of the leading causes of readmission to the hospital...

  13. Electrospun 3D Fibrous Scaffolds for Chronic Wound Repair

    Directory of Open Access Journals (Sweden)

    Huizhi Chen

    2016-04-01

    Full Text Available Chronic wounds are difficult to heal spontaneously largely due to the corrupted extracellular matrix (ECM where cell ingrowth is obstructed. Thus, the objective of this study was to develop a three-dimensional (3D biodegradable scaffold mimicking native ECM to replace the missing or dysfunctional ECM, which may be an essential strategy for wound healing. The 3D fibrous scaffolds of poly(lactic acid-co-glycolic acid (PLGA were successfully fabricated by liquid-collecting electrospinning, with 5~20 µm interconnected pores. Surface modification with the native ECM component aims at providing biological recognition for cell growth. Human dermal fibroblasts (HDFs successfully infiltrated into scaffolds at a depth of ~1400 µm after seven days of culturing, and showed significant progressive proliferation on scaffolds immobilized with collagen type I. In vivo models showed that chronic wounds treated with scaffolds had a faster healing rate. These results indicate that the 3D fibrous scaffolds may be a potential wound dressing for chronic wound repair.

  14. Armpits, Belly Buttons and Chronic Wounds: The ABCs of Our Body Bacteria

    Science.gov (United States)

    ... and Chronic Wounds: The ABCs of Our Body Bacteria By Alisa Machalek and Allison MacLachlan Posted April ... treating skin and other conditions. Chronic Wounds and Bacteria Bacteria from human skin grown on agar in ...

  15. A review of maggot debridement therapy to treat chronic wounds.

    Science.gov (United States)

    Hall, Sarah

    This literature review aims to clarify whether using maggot debridement therapy (MDT) for the removal of devitalized and infected tissue in chronic wounds is a valuable tool for healing. To undertake a literature review, the British Nursing Index, Ovid-Medline and the CINAHL databases were searched from January 1960 to June 2010 using the following terms: maggot debridement therapy, chronic wounds, granulation, infection, and cost-effective. The evidence suggests that MDT is more effective than other methods of debridement for wound bed preparation, although it has not been proven to eliminate problems associated with recurrent infections. This therapy has also not been proven to accelerate the healing process; however, more research needs to be undertaken into this and the cost-effectiveness of treatment.

  16. Why chronic wounds will not heal: a novel hypothesis

    DEFF Research Database (Denmark)

    Bjarnsholt, Thomas; Kirketerp-Moller, K.; Jensen, P.O.;

    2008-01-01

    The present paper presents a hypothesis aimed at explaining why venous leg ulcers, pressure ulcers, and diabetic foot ulcers develop into a chronic state. We propose that the lack of proper wound healing is at least in part caused by inefficient eradication of infecting, opportunistic pathogens...

  17. Local Treatment of Chronic Wounds in Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

    NARCIS (Netherlands)

    Ruettermann, Mike; Maier-Hasselmann, Andreas; Nink-Grebe, Brigitte; Burckhardt, Marion

    2013-01-01

    Background: A chronic wound is defined as an area where the skin is not intact that fails to heal within eight weeks. Such wounds usually develop on the lower limbs as a complication of diabetes, venous insufficiency, or inadequate arterial perfusion. Most of the roughly 45 000 limb amputations perf

  18. Vasculogenic Cytokines in Wound Healing

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2013-01-01

    Full Text Available Chronic wounds represent a growing healthcare burden that particularly afflicts aged, diabetic, vasculopathic, and obese patients. Studies have shown that nonhealing wounds are characterized by dysregulated cytokine networks that impair blood vessel formation. Two distinct forms of neovascularization have been described: vasculogenesis (driven by bone-marrow-derived circulating endothelial progenitor cells and angiogenesis (local endothelial cell sprouting from existing vasculature. Researchers have traditionally focused on angiogenesis but defects in vasculogenesis are increasingly recognized to impact diseases including wound healing. A more comprehensive understanding of vasculogenic cytokine networks may facilitate the development of novel strategies to treat recalcitrant wounds. Further, the clinical success of endothelial progenitor cell-based therapies will depend not only on the delivery of the cells themselves but also on the appropriate cytokine milieu to promote tissue regeneration. This paper will highlight major cytokines involved in vasculogenesis within the context of cutaneous wound healing.

  19. Automated Tissue Classification Framework for Reproducible Chronic Wound Assessment

    Directory of Open Access Journals (Sweden)

    Rashmi Mukherjee

    2014-01-01

    Full Text Available The aim of this paper was to develop a computer assisted tissue classification (granulation, necrotic, and slough scheme for chronic wound (CW evaluation using medical image processing and statistical machine learning techniques. The red-green-blue (RGB wound images grabbed by normal digital camera were first transformed into HSI (hue, saturation, and intensity color space and subsequently the “S” component of HSI color channels was selected as it provided higher contrast. Wound areas from 6 different types of CW were segmented from whole images using fuzzy divergence based thresholding by minimizing edge ambiguity. A set of color and textural features describing granulation, necrotic, and slough tissues in the segmented wound area were extracted using various mathematical techniques. Finally, statistical learning algorithms, namely, Bayesian classification and support vector machine (SVM, were trained and tested for wound tissue classification in different CW images. The performance of the wound area segmentation protocol was further validated by ground truth images labeled by clinical experts. It was observed that SVM with 3rd order polynomial kernel provided the highest accuracies, that is, 86.94%, 90.47%, and 75.53%, for classifying granulation, slough, and necrotic tissues, respectively. The proposed automated tissue classification technique achieved the highest overall accuracy, that is, 87.61%, with highest kappa statistic value (0.793.

  20. Automated tissue classification framework for reproducible chronic wound assessment.

    Science.gov (United States)

    Mukherjee, Rashmi; Manohar, Dhiraj Dhane; Das, Dev Kumar; Achar, Arun; Mitra, Analava; Chakraborty, Chandan

    2014-01-01

    The aim of this paper was to develop a computer assisted tissue classification (granulation, necrotic, and slough) scheme for chronic wound (CW) evaluation using medical image processing and statistical machine learning techniques. The red-green-blue (RGB) wound images grabbed by normal digital camera were first transformed into HSI (hue, saturation, and intensity) color space and subsequently the "S" component of HSI color channels was selected as it provided higher contrast. Wound areas from 6 different types of CW were segmented from whole images using fuzzy divergence based thresholding by minimizing edge ambiguity. A set of color and textural features describing granulation, necrotic, and slough tissues in the segmented wound area were extracted using various mathematical techniques. Finally, statistical learning algorithms, namely, Bayesian classification and support vector machine (SVM), were trained and tested for wound tissue classification in different CW images. The performance of the wound area segmentation protocol was further validated by ground truth images labeled by clinical experts. It was observed that SVM with 3rd order polynomial kernel provided the highest accuracies, that is, 86.94%, 90.47%, and 75.53%, for classifying granulation, slough, and necrotic tissues, respectively. The proposed automated tissue classification technique achieved the highest overall accuracy, that is, 87.61%, with highest kappa statistic value (0.793).

  1. Effectiveness of a Short-Term Treatment of Oxygen-Ozone Therapy into Healing in a Posttraumatic Wound

    Directory of Open Access Journals (Sweden)

    Irene Degli Agosti

    2016-01-01

    Full Text Available Introduction. A number of studies suggest that oxygen-ozone therapy may have a role in the treatment of chronic, nonhealing, or ischemic wounds for its disinfectant and antibacterial properties. Nonhealing wounds are a significant cause of morbidity. Here we present a case of subcutaneous oxygen-ozone therapy used to treat a nonhealing postoperative wound in a young man during a period of 5 weeks. Case Presentation. A 46-year-old man had a motorcycle accident and underwent amputation of the right tibia and fibula. At the discharge he came to our attention to start rehabilitation treatment. At that time the wound was ulcerated but it was afebrile with no signs of inflammation and negativity to blood tests. At 2 months from the trauma despite appropriate treatment and dressing, the wound was slowly improving and the patient complained of pain. For this reason in addition to standard dressing he underwent oxygen-ozone therapy. After 5 weeks of treatment the wound had healed. Conclusion. In patients with nonhealing wounds, oxygen-ozone therapy could be helpful in speeding the healing and reducing the pain thanks to its disinfectant property and by the increase of endogenous oxygen free radicals’ scavenging properties. Compared to standard dressing and other treatments reported in the literature it showed a shorter time of action.

  2. Effectiveness of a Short-Term Treatment of Oxygen-Ozone Therapy into Healing in a Posttraumatic Wound

    Science.gov (United States)

    Degli Agosti, Irene; Mazzacane, Bruno; Peroni, Gabriella; Bianco, Sandra; Guerriero, Fabio; Ricevuti, Giovanni

    2016-01-01

    Introduction. A number of studies suggest that oxygen-ozone therapy may have a role in the treatment of chronic, nonhealing, or ischemic wounds for its disinfectant and antibacterial properties. Nonhealing wounds are a significant cause of morbidity. Here we present a case of subcutaneous oxygen-ozone therapy used to treat a nonhealing postoperative wound in a young man during a period of 5 weeks. Case Presentation. A 46-year-old man had a motorcycle accident and underwent amputation of the right tibia and fibula. At the discharge he came to our attention to start rehabilitation treatment. At that time the wound was ulcerated but it was afebrile with no signs of inflammation and negativity to blood tests. At 2 months from the trauma despite appropriate treatment and dressing, the wound was slowly improving and the patient complained of pain. For this reason in addition to standard dressing he underwent oxygen-ozone therapy. After 5 weeks of treatment the wound had healed. Conclusion. In patients with nonhealing wounds, oxygen-ozone therapy could be helpful in speeding the healing and reducing the pain thanks to its disinfectant property and by the increase of endogenous oxygen free radicals' scavenging properties. Compared to standard dressing and other treatments reported in the literature it showed a shorter time of action.

  3. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny;

    2006-01-01

    The aim of the study was to investigate the bacterial profile of chronic venous leg ulcers and the importance of the profile to ulcer development. Patients with persisting venous leg ulcers were included and followed for 8 weeks. Every second week, ulcer samples were collected and the bacterial s...

  4. Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice

    OpenAIRE

    McDaniel, Jodi C.; Browning, Kristine K.

    2014-01-01

    Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologi...

  5. 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.

  6. Telemedicine Supported Chronic Wound Tissue Prediction Using Classification Approaches.

    Science.gov (United States)

    Chakraborty, Chinmay; Gupta, Bharat; Ghosh, Soumya K; Das, Dev K; Chakraborty, Chandan

    2016-03-01

    Telemedicine helps to deliver health services electronically to patients with the advancement of communication systems and health informatics. Chronic wound (CW) detection and its healing rate assessment at remote distance is very much difficult due to unavailability of expert doctors. This problem generally affects older ageing people. So there is a need of better assessment facility to the remote people in telemedicine framework. Here we have proposed a CW tissue prediction and diagnosis under telemedicine framework to classify the tissue types using linear discriminant analysis (LDA). The proposed telemedicine based wound tissue prediction (TWTP) model is able to identify wound tissue and correctly predict the wound status with a good degree of accuracy. The overall performance of the proposed wound tissue prediction methodology has been measured based on ground truth images. The proposed methodology will assist the clinicians to take better decision towards diagnosis of CW in terms of quantitative information of three types of tissue composition at low-resource set-up.

  7. Guest Editorial: Evidence-based practice in wound care: Toward addressing our knowledge gaps

    Directory of Open Access Journals (Sweden)

    Kath M. Bogie, DPhil

    2011-03-01

    Full Text Available Chronic nonhealing wounds are a major complication for many veterans. Particularly at risk are veterans with reduced mobility, such as those who have suffered a spinal cord injury (SCI. Chronic wounds cause significant suffering, including profound negative effects on general physical health, socialization, financial status, body image, level of independence, and control. For individuals with SCI, the development of a pressure ulcer is one of the leading causes of readmission to the hospital after acute rehabilitation and a major source of morbidity and even mortality. The management of chronic wounds is also extremely costly for clinical facilities, from the acute care setting to long-term care.

  8. SOLAR THERAPY: A BOON FOR NON-HEALING ULCERS

    Directory of Open Access Journals (Sweden)

    Varunjikar

    2014-04-01

    Full Text Available : Compound fractures are common following road traffic accidents. It leads to open wound which needs treatment by plastic repairs such as rotation flaps, cross leg flaps, and skin grafting. Similarly, raw wounds and non-healing ulcers especially in osteomyelitis is a challenge to Orthopaedicians. Wounds with infection heal slowly and this often results in prolonged hospitalization. Standard treatment includes dressing and use of antibiotics which leads to financial burden on poor patients. Irrational use of antibiotics has lead to increasing resistance of bacteria to antibiotics. So far, sunlight has been utilized in treatment of rickets and osteomalacia. We have tried to utilize this mode of ecological treatment in an alternate way. Infected, non-healing wounds and ulcers were treated with exposure to sunlight which lead to scab formation and epithelisation leading to healing of wound due to UV rays. The purpose of this study was to determine the effects of ultraviolet radiation (UVR on the healing of ulcers. METHODS: Our patients having non healing ulcers were subjected to this type of treatment. RESULTS: In selected patients having non- healing ulcers on extremities of various sizes were treated previously with routine line of treatment such as dressing and oral or parenteral antibiotics. Patients were explained mode of treatment and underwent solar therapy after receiving informed consent. Epithelisation on ulcer took place following UV therapy within average duration of 23 days. CONCLUSION: It was concluded that ultraviolet radiation had significant effects in destroying bacteria and also promoting wound healing

  9. A novel model of chronic wounds: importance of redox imbalance and biofilm-forming bacteria for establishment of chronicity.

    Directory of Open Access Journals (Sweden)

    Sandeep Dhall

    Full Text Available Chronic wounds have a large impact on health, affecting ∼6.5 M people and costing ∼$25B/year in the US alone. We previously discovered that a genetically modified mouse model displays impaired healing similar to problematic wounds in humans and that sometimes the wounds become chronic. Here we show how and why these impaired wounds become chronic, describe a way whereby we can drive impaired wounds to chronicity at will and propose that the same processes are involved in chronic wound development in humans. We hypothesize that exacerbated levels of oxidative stress are critical for initiation of chronicity. We show that, very early after injury, wounds with impaired healing contain elevated levels of reactive oxygen and nitrogen species and, much like in humans, these levels increase with age. Moreover, the activity of anti-oxidant enzymes is not elevated, leading to buildup of oxidative stress in the wound environment. To induce chronicity, we exacerbated the redox imbalance by further inhibiting the antioxidant enzymes and by infecting the wounds with biofilm-forming bacteria isolated from the chronic wounds that developed naturally in these mice. These wounds do not re-epithelialize, the granulation tissue lacks vascularization and interstitial collagen fibers, they contain an antibiotic-resistant mixed bioflora with biofilm-forming capacity, and they stay open for several weeks. These findings are highly significant because they show for the first time that chronic wounds can be generated in an animal model effectively and consistently. The availability of such a model will significantly propel the field forward because it can be used to develop strategies to regain redox balance that may result in inhibition of biofilm formation and result in restoration of healthy wound tissue. Furthermore, the model can lead to the understanding of other fundamental mechanisms of chronic wound development that can potentially lead to novel therapies.

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

    Science.gov (United States)

    Paul, Julia

    2013-07-01

    Persons with chronic wounds may experience wound-related itch (pruritus) and pain. A cross-sectional study was conducted to examine the occurrence of itch and pain in chronic wounds and the relationship of the intensity between these factors. Patients in an outpatient wound care center, 18 years and older with an open wound, were recruited consecutively over a 5-month period. The 199 participants (112 [56%] men) had a mean age of 67 years (range 21-98 years); one wound per person was addressed and included venous (31), arterial (23), neuropathic (31), pressure-related (33), traumatic (37), and "other" (41) wounds. Wound-related pain and itch data were obtained using a modified Paul-Pieper Itching Questionnaire and Characteristics of Itch Questionnaire. Responses were hand-recorded and coded without personal identifiers and analyzed using descriptive statistics, and associations among data were assessed using Pearson chi-square, Mantel-Haenszel chi-square, and Cochran-Armitage trend tests. Wound-related itch was significantly associated with participant age (P = 0.011) and employment status (P = 0.003). Wound-related pain was significantly associated only with education level (P = 0.048). Persons with venous wounds had both the largest proportion with wound-related itch (45.2%) and the largest proportion with wound-related pain (61.2%) out of all of the wound types. Persons with diabetic neuropathy had both the smallest proportion with wound-related itch (16.1%) and the smallest proportion with wound-related pain (35.4%) among all of the wound types. Associations between wound type and wound-related itch or pain were not significant. When venous wounds were compared to all other wound types combined, wound-related itch was significantly associated (P = 0.021) with wound type - ie, venous wound type and itch was statistically significant when venous wounds were compared to a combination of all other wound types. Wound-related pain and itch occurred together in 35

  11. Negative pressure wound therapy with polyvinyl alcohol for repeated non-healing sinus of spinal tuberculosis after surgery%聚乙烯醇泡沫负压伤口疗法在脊柱结核术后反复窦道不愈合中的应用

    Institute of Scientific and Technical Information of China (English)

    罗小波; 马远征; 李宏伟; 薛海滨; 鲍达; 胡明

    2012-01-01

    Objective To evaluate the therapeutic effect of negative pressure wound therapy (NPWT) by filling polyvinyl alcohol (PVA) foam in the deep cavity for repeated non-healing sinus of spinal tuberculosis. Methods From January 2008 to January 2011, 17 cases of repeated non-healing sinus of spinal tuberculosis after surgery were treated by sinus debridement and NPWT by filling PVA foam in deep cavity. Therapeutic efficacy and prognosis were observed. Results The wounds of patients were placed PVA foam for 10-25 d (15.7 d on average) and completely healed after 17-29 d (21.5 d on average). All patients were followed up from 6 to 30 months, and no recurrence of tuberculosis existed. Conclusion NPWT is an important healing tool for repeated non-healing sinus of spinal tuberculosis after surgery; and it plays a significant role in promoting healing wound, exhausting tuberculosis abscesses, and eliminating dead space.%目的 评价深腔填塞聚乙烯醇(polyvinyl alcohol,PVA)泡沫行负压伤口疗法(negative pressure wound therapy,NPWT)在脊柱结核术后治疗窦道不愈合中的效果.方法对2008年1月-2011年1月临床收治的17例脊柱结核术后反复窦道不愈合的病例,延窦遂行病灶清除联合深腔填塞PVA泡沫行NPWT,观察在院治疗效果和愈后复发情况.结果患者伤口安置PVA泡沫10-25 d,平均安置15.7 d,伤口完全愈合17-29 d,平均21.5 d.随访6—30个月,无结核病灶复发.结论 NPWT是脊柱结核术后反复窦道不愈合治疗中一项重要的手段,它在促进伤口愈合、结核脓肿排空、消灭脓肿死腔等方面起到了不可忽视的作用.

  12. Expression of Hepatocyte Growth Factor-Like Protein in Human Wound Tissue and Its Biological Functionality in Human Keratinocytes

    Directory of Open Access Journals (Sweden)

    James C. Glasbey

    2015-02-01

    Full Text Available Hepatocyte growth factor-like protein (HGFl and its receptor, Recepteur d'Origine Nantais (RON, have been implicated in the development of wound chronicity. HGFl and RON expression was detected in acute wound tissue, chronic wound tissue and in normal skin using quantitative polymerase chain reaction (Q-PCR. HGFl and RON expression was also assessed in chronic healing and chronic non-healing wound tissues using Q-PCR and immunohistochemical staining. Expression was similarly detected in the HaCaT immortalized human keratinocyte cell line using reverse transcription polymerase chain reaction (RT-PCR. rhHGFl was used to assess the impact of this molecule on HaCaT cell functionality using in vitro growth assays and electric cell-substrate impendence sensing (ECIS migration assays. HGFl and RON transcript expression were significantly increased in acute wound tissue compared to chronic wound tissue and were also elevated, though non-significantly, in comparison to normal skin. Minimal expression was seen in both healing and non-healing chronic wounds. Treatment of HaCaT cells with rhHGFl had no effect on growth rates but did enhance cell migration. This effect was abolished by the addition of a phospholipase C gamma (PLCγ small molecule inhibitor. The increased expression of HGFl and RON in acute, healing wounds and the pro-migratory effect of HGFl in an in vitro human keratinocyte model, may indicate a role for HGFl in active wound healing.

  13. 循环纤维细胞与慢性创面愈合%Circulating fibrocytes and chronic wound healing

    Institute of Scientific and Technical Information of China (English)

    鲍济洪; 杨靖; 陈斌

    2015-01-01

    BACKGROUND:Circulating fibrocytes originated from the peripheral blood are a fibroblast-like cel subpopulation of leukocytes. Circulating fibrocytes play an essential role in wound repair by secreting extracel ular matrix proteins and cytokines, initiating antigen-specific immunity, accelerating wound contraction as wel as promoting angiogenesis. However, the potential role for improving chronic wound healing and its mechanism is stil unclear. OBJECTIVE:To summarize the biological features of circulating fibrocytes and its potential role and mechanism in accelerating chronic wound healing. METHODS:A computer-based search of CNKI database from 2000 to 2014, PubMed database from 1994 to 2014 and Foreign Medical Journal Ful-Text Service database from 2000 to 2014 was performed using“circulating fibrocytes, non-healing wounds, diabetic foot ulcer, wound healing, cel therapy”in Chinese and English as the keywords to retrieve articles related to circulating fibrocytes, refractory mechanism of chronic wound healing and cel therapy for chronic wounds. Total y 54 articles meeting the inclusive criteria were included in result analysis. RESULTS AND CONCLUSION:Cel therapy with circulating fibrocytes is a safe and effective treatment for improving wound healing and has been used to repair various chronic wounds in the recent decades. Circulating fibrocytes are a distinct subpopulation of fibroblast-like leukocytes in the peripheral blood. It is able to migrate into wound sites at the early stage of wound repair and plays an active role in the wound healing process by secreting extracel ular matrix proteins, cytokines, presenting antigens, contracting wound and promoting neovascularization. Recently, it has been proved in animal experiments that circulating fibrocytes can accelerate chronic wound healing, especial y diabetic chronic wound.%背景:循环纤维细胞是近些年来在外周血液发现的具有成纤维细胞特性的一种白细胞亚群,由于具有

  14. 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.

  15. The effectiveness of negative-pressure wound therapy versus standard wound care in the non-healing wounds: A Meta-analysis of randomized trials%负压伤口引流技术用于治疗慢性伤口效果的Meta分析

    Institute of Scientific and Technical Information of China (English)

    叶增杰; 唐芳; 邓宝贵; 傅妤; 全小明; 罗正; 万超; 杜长春

    2014-01-01

    Objective To systematically examine the clinical effectiveness and safety of negative pressure wound therapy (NPWT) for chronic wounds.Methods A systematic search of the major electronic databases PubMed,CINAHL,Cochrane,MEDLINE,British Nursing Index,EBSCO,OCLC,Proquest,Nursing Consult,OVID and Elsevier between 2000 to 2014 was conducted.Measures of wound size and time to heahng were extracted from the randomized controlled trials.The credibility of the outcome of each study was evaluated using a specially constructed instrument.Results We identified 28 RCTs,NPWT showed a significant effect on the wound areas reduction and healing time compared with conventional dressings,though no significant difference on complete wound healing or complication rate.Conclusions There is now sufficient evidence to show that NPWT will accelerate healing,to justify its use in the treatment of diabetes-associated chronic leg wounds.%目的 系统评价负压伤口引流技术(NPWT)应用于慢性伤口治疗的效果.方法 计算机检索2000年至2014年PubMed,CINAHL,Cochrane,MEDLINE,British Nursing Index,EBSCO,OCLC,Proquest,Nursing Consult,OVID,Elsevier,CALIS,CNKI,CBM以及万方数据库关于NPWT应用于慢性伤口治疗的随机对照实验,通过专门的评价工具对文献质量进行严格评价,对符合质量标准的研究进行Meta分析.结果 共完成了28篇RCT的分析,NPWT相对于传统的敷料在减少伤口面积和伤口愈合时间上差异有统计学意义,在伤口痊愈率以及并发症发生率上差异无统计学意义.结论 NPWT在缩短慢性伤口愈合时间以及减少伤口面积上优于传统敷料,特别是下肢动静脉性的溃疡以及糖尿病足.

  16. Chitosan-based dressings loaded with neurotensin—an efficient strategy to improve early diabetic wound healing

    OpenAIRE

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

    2014-01-01

    One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our ...

  17. Chemokines as Therapeutic Targets to Improve Healing Efficiency of Chronic Wounds

    OpenAIRE

    Satish, Latha

    2015-01-01

    Significance: Impaired wound healing leading to chronic wounds is an important clinical problem that needs immediate attention to develop new effective therapies. Members of the chemokine family seem to be attractive and amenable to stimulate the healing process in chronic wounds. Targeting specific chemokines and/or their receptors has the potential to modify chronic inflammation to acute inflammation, which will hasten the healing process.

  18. [IMPACT OF BIOFILM ON HEALING AND A METHOD FOR IDENTIFYING IT IN THE WOUND].

    Science.gov (United States)

    Skrlin, Jasenka

    2016-03-01

    The skin microbiome is the aggregate of microorganisms that reside on the surface and in deep layers of the skin. Skin is colonized by bacteria, fungi, viruses and mites, maintaining a balance. Disruption in the ecosystem results in skin infections. Chronic wounds in diabetics, elderly and immobile individuals are at risk of skin organisms to invade and become pathogenic upon breach of the skin barrier. The bacteria of the skin microbiome may contribute to delayed healing and persistent inflammation. Staphylococcus epidermidis is an invasive skin organism that causes infection, i.e. hospital acquired infection (HAl) on medical devices and form biofilm. At the most basic level, biofilm can be described as bacteria embedded in a thick, slimy barrier of sugars and proteins. The biofilm barrier protects the microorganisms from external threats. Biofilms provide a reservoir of potentially infectious microorganisms that are resistant to antimicrobial agents, and their importance in the failure of medical devices and chronic inflammatory condition is increasingly being recognized. Particular research interest exists in the association of biofilms with wound infection and non-healing, i.e. chronic wounds. There is now strong evidence that biofilm is present in the majority of chronic wounds. Specialized microscopic techniques used since 2008 have allowed several research groups to demonstrate that 60% to 90% of chronic wounds have biofilm versus only 6% of acute wounds. While many studies confirm that chronic wounds often contain a polymicrobial flora, controversy remains with regard to whether these organisms directly contribute to non-healing. It seems most likely that individual bacteria themselves are not directly responsible for non-healing wounds. Rather, there is direct correlation between the presence of four or more distinct bacterial species in a wound and non-healing, suggesting that mixed microbial populations are the cause of pathology. The most reliable

  19. 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...

  20. 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.

  1. Redox mechanisms in hepatic chronic wound healing and fibrogenesis

    Directory of Open Access Journals (Sweden)

    Novo Erica

    2008-10-01

    Full Text Available Abstract Reactive oxygen species (ROS generated within cells or, more generally, in a tissue environment, may easily turn into a source of cell and tissue injury. Aerobic organisms have developed evolutionarily conserved mechanisms and strategies to carefully control the generation of ROS and other oxidative stress-related radical or non-radical reactive intermediates (that is, to maintain redox homeostasis, as well as to 'make use' of these molecules under physiological conditions as tools to modulate signal transduction, gene expression and cellular functional responses (that is, redox signalling. However, a derangement in redox homeostasis, resulting in sustained levels of oxidative stress and related mediators, can play a significant role in the pathogenesis of major human diseases characterized by chronic inflammation, chronic activation of wound healing and tissue fibrogenesis. This review has been designed to first offer a critical introduction to current knowledge in the field of redox research in order to introduce readers to the complexity of redox signalling and redox homeostasis. This will include ready-to-use key information and concepts on ROS, free radicals and oxidative stress-related reactive intermediates and reactions, sources of ROS in mammalian cells and tissues, antioxidant defences, redox sensors and, more generally, the major principles of redox signalling and redox-dependent transcriptional regulation of mammalian cells. This information will serve as a basis of knowledge to introduce the role of ROS and other oxidative stress-related intermediates in contributing to essential events, such as the induction of cell death, the perpetuation of chronic inflammatory responses, fibrogenesis and much more, with a major focus on hepatic chronic wound healing and liver fibrogenesis.

  2. Quantitative analysis of the cellular inflammatory response against biofilm bacteria in chronic wounds

    DEFF Research Database (Denmark)

    Fazli, Mustafa; Bjarnsholt, Thomas; Kirketerp-Møller, Klaus;

    2011-01-01

    counting on the tissue sections from wounds containing either Pseudomonas aeruginosa or Staphylococcus aureus. The P. aeruginosa-containing wounds had significantly higher numbers of neutrophils accumulated compared with the S. aureus-containing wounds. These results are discussed in relation...... to the wound. One such stimulus might be the presence of bacterial biofilms in chronic wounds. In the present study, biopsy specimens from chronic venous leg ulcers were investigated for the detection of bacteria using peptide nucleic acid-based fluorescence in situ hybridization (PNA-FISH) and confocal laser...... to the hypothesis that the presence of P. aeruginosa biofilms in chronic wounds may be one of the main factors leading to a persistent inflammatory response and impaired wound healing....

  3. Significance and assessments of impaired microcirculation in chronic wounds%慢性创面微循环障碍的作用及评估

    Institute of Scientific and Technical Information of China (English)

    Rajgopal Mani; 缪明远

    2012-01-01

    慢性创面是指经过正确诊断和规范治疗8周后,伤口面积缩小不足50%的创面疾病(译者注:此为欧洲标准).慢性创面可发生在身体任何部位,其中80%发生在下肢.尽管多种疾病可导致下肢创面的发生,但静脉压力增高、糖尿病和局部组织受压仍然是皮肤损害和愈合延迟的主要原因.所谓慢性创面包括延迟愈合的外科伤口(如伤口裂开导致的创面愈合延迟),坏疽性脓皮病,感染所致的创面(如Buruli溃疡),外伤所致的创面,瘢痕溃疡,钙过敏、大疱性表皮松解症和服用羟基脲类药物导致的非典型性创面,放射性溃疡等.不同的慢性创面往往有不同的病理生理过程,但共同的结局是创面难愈,表现为创面愈合缓慢、愈合后复发或两者兼而有之.鉴于血管相关病变是慢性创面发生的诱因,本文将探讨微循环因素在慢性创面发生中的重要性及评估方法.%Chronic wounds pose a clinical challenge.Such wounds may present all over the body although the majority appear on the lower extremities.In the main,wounds are caused by hypertension(venous or arterial),diabetes,although infection, trauma, and animal bites can result in non-healing wounds.It is vital to have a reliable diagnosis in order to plan treatment.Despite advances in diagnostics and the development of standard care packages,chronic wounds present a growing burden to all societies.One of the problems faced is the poor understanding of the pathophysiology of wounds; it is commonly accepted that microcirculation is impaired in lower extremity chronic wounds.This paper is focused on the significance and assessment of impaired microcirculation.

  4. Acute and chronic wound fluids inversely influence adipose-derived stem cell function: molecular insights into impaired wound healing.

    Science.gov (United States)

    Koenen, Paola; Spanholtz, Timo A; Maegele, Marc; Stürmer, Ewa; Brockamp, Thomas; Neugebauer, Edmund; Thamm, Oliver C

    2015-02-01

    Wound healing is a complex biological process that requires a well-orchestrated interaction of mediators as well as resident and infiltrating cells. In this context, mesenchymal stem cells play a crucial role as they are attracted to the wound site and influence tissue regeneration by various mechanisms. In chronic wounds, these processes are disturbed. In a comparative approach, adipose-derived stem cells (ASC) were treated with acute and chronic wound fluids (AWF and CWF, respectively). Proliferation and migration were investigated using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test and transwell migration assay. Gene expression changes were analysed using quantitative real time-polymerase chain reaction. AWF had a significantly stronger chemotactic impact on ASC than CWF (77·5% versus 59·8% migrated cells). While proliferation was stimulated by AWF up to 136·3%, CWF had a negative effect on proliferation over time (80·3%). Expression of b-FGF, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 was strongly induced by CWF compared with a mild induction by AWF. These results give an insight into impaired ASC function in chronic wounds. The detected effect of CWF on proliferation and migration of ASC might be one reason for an insufficient healing process in chronic wounds.

  5. Inhibition of Pseudomonas aeruginosa biofilm formation on wound dressings.

    Science.gov (United States)

    Brandenburg, Kenneth S; Calderon, Diego F; Kierski, Patricia R; Brown, Amanda L; Shah, Nihar M; Abbott, Nicholas L; Schurr, Michael J; Murphy, Christopher J; McAnulty, Jonathan F; Czuprynski, Charles J

    2015-01-01

    Chronic nonhealing skin wounds often contain bacterial biofilms that prevent normal wound healing and closure and present challenges to the use of conventional wound dressings. We investigated inhibition of Pseudomonas aeruginosa biofilm formation, a common pathogen of chronic skin wounds, on a commercially available biological wound dressing. Building on prior reports, we examined whether the amino acid tryptophan would inhibit P. aeruginosa biofilm formation on the three-dimensional surface of the biological dressing. Bacterial biomass and biofilm polysaccharides were quantified using crystal violet staining or an enzyme linked lectin, respectively. Bacterial cells and biofilm matrix adherent to the wound dressing were visualized through scanning electron microscopy. D-/L-tryptophan inhibited P. aeruginosa biofilm formation on the wound dressing in a dose dependent manner and was not directly cytotoxic to immortalized human keratinocytes although there was some reduction in cellular metabolism or enzymatic activity. More importantly, D-/L-tryptophan did not impair wound healing in a splinted skin wound murine model. Furthermore, wound closure was improved when D-/L-tryptophan treated wound dressing with P. aeruginosa biofilms were compared with untreated dressings. These findings indicate that tryptophan may prove useful for integration into wound dressings to inhibit biofilm formation and promote wound healing.

  6. 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

  7. Optimizing Technology Use for Chronic Lower-Extremity Wound Healing: A Consensus Document.

    Science.gov (United States)

    Mani, Raj; Margolis, David J; Shukla, Vijay; Akita, Sadanori; Lazarides, Miltos; Piaggesi, Alberto; Falanga, Vincent; Teot, Luc; Xie, Ting; Bing, Fu Xiao; Romanelli, Marco; Attinger, Chris; Han, Chun Mao; Lu, Shuliang; Meaume, Sylvie; Xu, Zhangrong; Viswanathan, Vijay

    2016-06-01

    Innovations in technology are used in managing chronic wounds. Despite the wide range of technologies available, healing of chronic wounds remains variable. In this paper, the authors offer an evidence based approach to the use of technology for diagnosis and management based on the concept of standardised care.

  8. Wound care challenges in children and adults with spina bifida: an open-cohort study.

    Science.gov (United States)

    Ottolini, Katherine; Harris, Amy B; Amling, June K; Kennelly, Ann M; Phillips, Leslie A; Tosi, Laura L

    2013-01-01

    Skin breakdown is a frequent concern for individuals with spina bifida. We explored wound incidence in patients with spina bifida and how it varies across a person's life span and functional neurologic level. We examined the settings in which skin breakdown most commonly occurred, looking for evidence of chronic, non-healing wounds. We also sought to develop criteria to improve wound monitoring. We identified reported wound episodes in an open-cohort study over a 13-year period, examining the hospital and outpatient clinical records of spina bifida patients at Children's National Medical Center (CNMC). Current age, age at wound presentation, sex, weight, functional neurologic level, wound location, setting in which the wound was acquired, the development of a chronic wound, and presence of a shunt were recorded. Of the 376 patients in our clinical population, 123 (average age: 18.8 years, range: infancy-56 years) developed a total of 375 wounds; the majority of patients who developed one wound went on to develop one or more additional wounds, and 20 patients developed chronic wounds. Our data suggest that age bracket (adolescents), wheelchair use, and bare feet, as well as possibly obesity and reduced executive functioning, are key risk factors for wound development. These findings have led to a focused effort to increase wound education and prevention. In addition we report on our early experience using a wound care specialist to champion this initiative.

  9. Clinical challenges of chronic wounds: searching for an optimal animal model to recapitulate their complexity

    Directory of Open Access Journals (Sweden)

    Robert Nunan

    2014-11-01

    Full Text Available The efficient healing of a skin wound is something that most of us take for granted but is essential for surviving day-to-day knocks and cuts, and is absolutely relied on clinically whenever a patient receives surgical intervention. However, the management of a chronic wound – defined as a barrier defect that has not healed in 3 months – has become a major therapeutic challenge throughout the Western world, and it is a problem that will only escalate with the increasing incidence of conditions that impede wound healing, such as diabetes, obesity and vascular disorders. Despite being clinically and molecularly heterogeneous, all chronic wounds are generally assigned to one of three major clinical categories: leg ulcers, diabetic foot ulcers or pressure ulcers. Although we have gleaned much knowledge about the fundamental cellular and molecular mechanisms that underpin healthy, acute wound healing from various animal models, we have learned much less about chronic wound repair pathology from these models. This might largely be because the animal models being used in this field of research have failed to recapitulate the clinical features of chronic wounds. In this Clinical Puzzle article, we discuss the clinical complexity of chronic wounds and describe the best currently available models for investigating chronic wound pathology. We also assess how such models could be optimised to become more useful tools for uncovering pathological mechanisms and potential therapeutic treatments.

  10. The effect of a silver-containing Hydrofiber dressing on superficial wound bed and bacterial balance of chronic wounds.

    Science.gov (United States)

    Coutts, Pat; Sibbald, R Gary

    2005-12-01

    The treatment of chronic wounds represents a major cost to society and has a profound effect on the participant's quality of life. Chronic wounds may have an increased bacterial burden that can impair healing without all the clinical signs of infection. Silver dressings may provide an alternative topical method to control bacterial burden. The primary aim of this study was to evaluate the clinical improvement in chronic wounds through the effect on wound size, maceration, resolution of surface slough and conversion to healthy granulation during a 4-week application of the silver-containing Hydrofiber dressing. This was a single centre, open-label case series study which included a total of 30 evaluable participants: four with diabetic neuropathic foot ulcers, 13 venous stasis ulcers, four pressure ulcers and nine miscellaneous wounds that did not fit any of the previous categories. All participants had adequate vascular supply, indicating the potential to heal. The wounds were stalled or had the signs and symptoms consistent with critical colonisation. The underlying cause of the ulceration was identified and corrected, or the symptoms and signs were treated. This was followed by the application of silver-containing Hydrofiber dressings for a period of 4 weeks. The majority of wounds treated decreased in size (70%) with decreased exudate, decreased purulence and resolution of surface slough (75%). There was an increased quality and quantity of healthy granulation tissue. Unlike some silver dressings, the Hydrofiber and silver combination dressing was unlikely to cause burning and stinging on application. Peri-wound maceration was present in 54% of participants at baseline, and 85% of these resolved with this dressing. A desloughing action was seen in those patients with pre-existing slough at baseline and its removal will lower the bacterial burden of the wound. PMID:16618321

  11. Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing

    Directory of Open Access Journals (Sweden)

    Wolcott Benjamin M

    2008-03-01

    Full Text Available Abstract Background Chronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species. These bacterial populations cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the bacterial populations that occur within different types of chronic wound biofilms. The use of 3 separate16S-based molecular amplifications followed by pyrosequencing, shotgun Sanger sequencing, and denaturing gradient gel electrophoresis were utilized to survey the major populations of bacteria that occur in the pathogenic biofilms of three types of chronic wound types: diabetic foot ulcers (D, venous leg ulcers (V, and pressure ulcers (P. Results There are specific major populations of bacteria that were evident in the biofilms of all chronic wound types, including Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia spp. Each of the wound types reveals marked differences in bacterial populations, such as pressure ulcers in which 62% of the populations were identified as obligate anaerobes. There were also populations of bacteria that were identified but not recognized as wound pathogens, such as Abiotrophia para-adiacens and Rhodopseudomonas spp. Results of molecular analyses were also compared to those obtained using traditional culture-based diagnostics. Only in one wound type did culture methods correctly identify the primary bacterial population indicating the need for improved diagnostic methods. Conclusion If clinicians can gain a better understanding of the wound's microbiota, it will give them a greater understanding of the wound's ecology and will allow them to better manage healing of the wound improving the prognosis of patients. This research highlights the necessity to begin evaluating, studying, and treating chronic wound pathogenic biofilms as multi-species entities in

  12. Wound Chronicity, Inpatient Care, and Chronic Kidney Disease Predispose to MRSA Infection in Diabetic Foot Ulcers

    Science.gov (United States)

    Yates, Christopher; May, Kerry; Hale, Thomas; Allard, Bernard; Rowlings, Naomi; Freeman, Amy; Harrison, Jessica; McCann, Jane; Wraight, Paul

    2009-01-01

    OBJECTIVE To determine the microbiological profile of diabetes-related foot infections (DRFIs) and the impact of wound duration, inpatient treatment, and chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS Postdebridement microbiological samples were collected from individuals presenting with DRFIs from 1 January 2005 to 31 December 2007. RESULTS A total of 653 specimens were collected from 379 individuals with 36% identifying only one isolate. Of the total isolates, 77% were gram-positive bacteria (staphylococci 43%, streptococci 13%). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 23%; risk factors for MRSA included prolonged wound duration (odds ratio 2.31), inpatient management (2.19), and CKD (OR 1.49). Gram-negative infections were more prevalent with inpatient management (P = 0.002) and prolonged wound duration (P < 0.001). Pseudomonal isolates were more common in chronic wounds (P < 0.001). CONCLUSIONS DRFIs are predominantly due to gram-positive aerobes but are usually polymicrobial and increase in complexity with inpatient care and ulcer duration. In the presence of prolonged duration, inpatient management, or CKD, empiric MRSA antibiotic cover should be considered. PMID:19587371

  13. The Effect of NIR Light and the Light-Activated Antimicrobial Agent on Wound Pathogenic Biofilms; Implication for Nonpharmacologic Chronic Wound Treatment

    DEFF Research Database (Denmark)

    Omar, Ghada Said Mohammed

    2015-01-01

    Baggrund / Background Chronic infected wounds represent a significant cause of morbidity in developed countries and are estimated to affect 1-2 % of the population. In Denmark, 2–3% of the health care budget is used on wound treatment and the socioeconomic problem will keep growing worldwide due...... to the increase of lifestyle diseases, as diabetes, obesity, and cardiovascular diseases. The presence of bacterial biofilms is considered an important factor responsible for wounds chronicity. Therefore, this study investigates the efficacy of near-infrared (NIR) laser in vitro, in disrupting wound pathogenic...... present in chronic wounds....

  14. Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing

    OpenAIRE

    Wolcott Benjamin M; Rhoads Daniel D; Secor Patrick R; Sun Yan; Dowd Scot E; James Garth A; Wolcott Randall D

    2008-01-01

    Abstract Background Chronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species. These bacterial populations cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the bacterial populations that occur within different types of chronic wound biofilms. The use of 3 separate16S-based molecular amplifications followed by pyrosequencing, shotgun Sanger ...

  15. A Real World, Observational Registry of Chronic Wounds and Ulcers

    Science.gov (United States)

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  16. 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...

  17. Aseptic tissue necrosis and chronic inflammation after irrigation of penetrating hand wounds using Octenisept®.

    Science.gov (United States)

    Franz, T; Vögelin, E

    2012-01-01

    Penetrating hand wounds are common and these are managed by thorough debridement. However, stab wounds without evidence of divided structures are often treated with irrigation using antiseptic substances, antibiotic therapy, and immobilization. Octenisept® (Schülke & Mayr Ltd) is a widely used antiseptic agent for disinfection of acute or chronic wounds. It has a broad spectrum of antiseptic efficacy and has become an antiseptic of first choice in many hospitals. Within a few months, four patients presented to us with chronic inflammation and severe tissue necrosis after irrigation of penetrating hand wounds with Octenisept®. Repeated surgery and debridement was required in all patients. Wound healing was prolonged and patients had persisting oedema. Penetrating hand wounds must not be irrigated with Octenisept®.

  18. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy

    Science.gov (United States)

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P.; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24–48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  19. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy.

    Science.gov (United States)

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24-48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  20. Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds

    KAUST Repository

    Farooqui, Muhammad Fahad

    2016-06-29

    Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications.

  1. Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds

    Science.gov (United States)

    Farooqui, Muhammad Fahad; Shamim, Atif

    2016-06-01

    Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications.

  2. Low Cost Inkjet Printed Smart Bandage for Wireless Monitoring of Chronic Wounds.

    Science.gov (United States)

    Farooqui, Muhammad Fahad; Shamim, Atif

    2016-01-01

    Chronic wounds affect millions of patients around the world and their treatment is challenging as the early signs indicating their development are subtle. In addition, a type of chronic wound, known as pressure ulcer, develops in patients with limited mobility. Infection and frequent bleeding are indicators of chronic wound development. In this article, we present an unprecedented low cost continuous wireless monitoring system, realized through inkjet printing on a standard bandage, which can send early warnings for the parameters like irregular bleeding, variations in pH levels and external pressure at wound site. In addition to the early warnings, this smart bandage concept can provide long term wound progression data to the health care providers. The smart bandage comprises a disposable part which has the inkjet printed sensors and a reusable part constituting the wireless electronics. This work is an important step towards futuristic wearable sensors for remote health care applications. PMID:27353200

  3. CURRENT STATE OF CHRONIC WOUND CARE IN KAZAKHSTAN: FOCUS ON TOPICAL TREATMENTS

    OpenAIRE

    Alma Akhmetova; Timur Saliev; Gulsim Kulsharova; Talgat Nurgozhin; Sergey Mikhalovsky

    2015-01-01

    Background — The presence of chronic hard-to-heal wounds significantly affects patients’ quality of life causing pain, discomfort, decrease of mobility and consequently leads to social isolation and depression. This type of wound is more prevalent among older population. It has been estimated that up to 1-2% of the world population have this condition. The treatment of hard-to-heal wounds is expensive and long-term process, and, stresses healthcare systems of every country. Unfortunately, lim...

  4. 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.

  5. 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.

  6. Epidemiology of chronic wound patients and relation to serum levels of mannan-binding lectin

    DEFF Research Database (Denmark)

    Bitsch, Mikael; Laursen, Inga; Engel, Anne-Mari;

    2009-01-01

    consecutive patients with chronic foot and leg ulcers. A clinical classification of wound- aetiology was performed, and mannan-binding lectin was measured in the sera of patients and healthy controls. The patients presented with 639 wounds altogether; diabetic foot ulcers (309), venous leg ulcers (188...

  7. [THE ROLE OF ANTISEPTICS AND STRATEGY OF BIOFILM REMOVAL IN CHRONIC WOUND].

    Science.gov (United States)

    Kucisec-Tepes, Nastja

    2016-03-01

    Chronic wound does not heal within the expected time frame because it remains in the inflammation phase of healing. The reason for this is the presence of necrotic tissue and a large number of microorganisms, primarily bacteria that secrete the biofilm, along with ischemia, hypoxia and edema. Biofilm is present in 90% of chronic wounds and 6% of the acute ones. Biofilm is a corporative association of microbes which adhere to the surface of the wound, guided by quorum sensing molecules. The association is surrounded by a moisturizing matrix of extracellular polymeric substances (slime) which protect the microbes from the impact of antibiotics, antiseptics, macro-organism defense and stress. Biofilm is the primary cause of the wound chronicity because it causes permanent inflammation, delayed granulation tissue formation and migration of epithelium cells, thus providing a reservoir of microbes that lead to infection of the chronic wound. The aim of good clinical practice is to enable healing of a chronic wound within the expected time frame. In order to achieve this aim, it is necessary to reduce and thoroughly remove the biofilm from the wound and prevent its reappearance. This is achieved by the application of active anti-biofilm compounds and procedures that disintegrate the quorum sensing molecules, degrade the extracellular polymeric substances and block adherence to the surfaces. Recent researches have shown that the application of antiseptics is effective in the prevention of infection and is a support to targeted treatment. However, the fact is that only some antiseptics are applicable to chronic wounds and can have an impact on biofilms of the primary infective agents such as Staphylococcus spp., Streptococcus spp., and Pseudomonas aeruginosa. Effective antiseptics are octenidine dihydrochloride, polyhexanides, povidone and cadexomer iodine, nanocrystal silver and Manuka-type honey. Immobile biofilm is a persistent problem of chronic and chronic infected

  8. 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...

  9. Chemical Composition and Anti-Candidiasis Mediated Wound Healing Property of Cymbopogon nardus Essential Oil on Chronic Diabetic Wounds.

    Science.gov (United States)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Dash, Suvakanta; Kalita, Kasturi; Kotoky, Jibon

    2016-01-01

    Poor wound healing is one of the major complication of diabetic patients which arises due to different factors like hyperglycemia, oxidative stress, vascular insufficiency and microbial infections. Candidiasis of diabetic wounds is a difficult to treat condition and potentially can lead to organ amputation. There are a few number of medications available in market to treat this chronic condition; which demands for alternative treatment options. In traditional system of medicine like Ayurveda, essential oil extracted from leaves of Cymbopogon nardus L. (Poaceae) has been using for the treatment of microbial infections, inflammation and pain. In this regard, we have evaluated anti-Candida and anti-inflammatory activity mediated wound healing property of C. nardus essential oil (EO-CN) on candidiasis of diabetic wounds. EO-CN was obtained through hydro-distillation and subjected to Gas chromatography-mass spectroscopy (GC-MS) analysis for chemical profiling. Anti-Candida activity of EO-CN was tested against Candida albicans, C. glabrata and C. tropicalis by in vitro zone of inhibition and minimum inhibitory concentration (MIC) assays. Anti-candidiasis ability of EO-CN was evaluated on C. albicans infected diabetic wounds of mice through measuring candida load on the 7th, 14th, and 21st day of treatment. Further progression in wound healing was confirmed by measuring the inflammatory marker levels and histopathology of wounded tissues on last day of EO-CN treatment. A total of 95 compounds were identified through GC-MS analysis, with major compounds like citral, 2,6-octadienal-, 3,7-dimethyl-, geranyl acetate, citronellal, geraniol, and citronellol. In vitro test results demonstrated strong anti-Candida activity of EO-CN with a MIC value of 25 μg/ml against C. albicans, 50 μg/ml against C. glabrata and C. tropicalis. EO-CN treatment resulted in significant reduction of candida load on diabetic wounds. Acceleration in wound healing was indicated by declined levels of

  10. Chemical Composition and Anti-Candidiasis Mediated Wound Healing Property of Cymbopogon nardus Essential Oil on Chronic Diabetic Wounds

    Science.gov (United States)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Dash, Suvakanta; Kalita, Kasturi; Kotoky, Jibon

    2016-01-01

    Poor wound healing is one of the major complication of diabetic patients which arises due to different factors like hyperglycemia, oxidative stress, vascular insufficiency and microbial infections. Candidiasis of diabetic wounds is a difficult to treat condition and potentially can lead to organ amputation. There are a few number of medications available in market to treat this chronic condition; which demands for alternative treatment options. In traditional system of medicine like Ayurveda, essential oil extracted from leaves of Cymbopogon nardus L. (Poaceae) has been using for the treatment of microbial infections, inflammation and pain. In this regard, we have evaluated anti-Candida and anti-inflammatory activity mediated wound healing property of C. nardus essential oil (EO-CN) on candidiasis of diabetic wounds. EO-CN was obtained through hydro-distillation and subjected to Gas chromatography–mass spectroscopy (GC–MS) analysis for chemical profiling. Anti-Candida activity of EO-CN was tested against Candida albicans, C. glabrata and C. tropicalis by in vitro zone of inhibition and minimum inhibitory concentration (MIC) assays. Anti-candidiasis ability of EO-CN was evaluated on C. albicans infected diabetic wounds of mice through measuring candida load on the 7th, 14th, and 21st day of treatment. Further progression in wound healing was confirmed by measuring the inflammatory marker levels and histopathology of wounded tissues on last day of EO-CN treatment. A total of 95 compounds were identified through GC–MS analysis, with major compounds like citral, 2,6-octadienal-, 3,7-dimethyl-, geranyl acetate, citronellal, geraniol, and citronellol. In vitro test results demonstrated strong anti-Candida activity of EO-CN with a MIC value of 25 μg/ml against C. albicans, 50 μg/ml against C. glabrata and C. tropicalis. EO-CN treatment resulted in significant reduction of candida load on diabetic wounds. Acceleration in wound healing was indicated by declined

  11. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    OpenAIRE

    Wiegand, Cornelia; Hipler,Uta-Christina; Elsner, Peter; Tittelbach,Jörg

    2015-01-01

    Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of us...

  12. Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

    OpenAIRE

    Wieg; C.; Tittelbach J; Hipler UC; Elsner P

    2015-01-01

    Cornelia Wiegand, Jörg Tittelbach, Uta-Christina Hipler, Peter Elsner Department of Dermatology, University Hospital Jena, Jena, Germany Abstract: The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using ...

  13. A new generation of topical chronic wound treatments containing specific MMP inhibitors

    OpenAIRE

    Shrivastava R; Cucuat N; Rousse M; Weig; T; Neto P; Janicot C; Shrivastava C

    2014-01-01

    Ravi Shrivastava, Nathalie Cucuat, Monika Rousse, Thomas Weigand, Pedro Neto, Claire Janicot, Christiane Shrivastava VITROBIO Research Institute, Issoire, France Purpose: Incidence of chronic wounds is constantly rising worldwide, but all currently available treatments are intended either to provide symptomatic relief or to assist cicatrization to some extent, but not to directly stimulate cellular growth. Physiologically, chronic wound healing simply requires cell growth to fill the injured...

  14. Platelet-Rich Plasma Combined With Skin Substitute for Chronic Wound Healing: A Case Report

    OpenAIRE

    Knox, Rebecca L.; Hunt, Allen R.; Collins, John C.; DeSmet, Marie; Barnes, Sara

    2006-01-01

    Contemporary management of chronic wounds focuses on improving natural healing and individualization of treatment. Incorporating multiple therapies has become increasingly common. Of interest are autologous growth factors, which are especially important in chronic wound healing and may contribute to tissue formation and epithelialization. Autologous platelet concentrate or platelet-rich plasma (PRP) is a concentration of at least five autologous growth factors and has been shown to accelerate...

  15. Maggot debridement therapy as primary tool to treat chronic wound of animals

    OpenAIRE

    Vijayata Choudhary; Mukesh Choudhary; Sunanda Pandey; Chauhan, Vandip D.; Hasnani, J. J.

    2016-01-01

    Maggot debridement therapy (MDT) is a safe, effective, and controlled method of healing of chronic wounds by debridement and disinfection. In this therapy live, sterile maggots of green bottle fly, Lucilia (Phaenicia) sericata are used, as they prefer necrotic tissues over healthy for feeding. Since centuries, MDT is used in human beings to treat chronic wounds. Lately, MDT came out as a potent medical aid in animals. In animals, although, this therapy is still limited and clinical studies ar...

  16. A young man with nonhealing venous ulcers

    NARCIS (Netherlands)

    Vloedbeld, M. G.; Venema, A. W.; Smit, A. J.

    2006-01-01

    A 35-year-old man presented with nonhealing ulcers at an atypical location on his left foot, caused by a combination of venous insufficiency (after deep venous thrombosis) and arterial insufficiency. The underlying cause was Buerger's disease.

  17. Topical Administration of a Connexin43-based peptide Augments Healing of Chronic Neuropathic Diabetic Foot Ulcers: A Multicenter, Randomized Trial

    OpenAIRE

    Grek, Christina L.; Prasad, G.M.; Viswanathan, Vijay; Armstrong, David G.; Gourdie, Robert G.; Ghatnekar, Gautam S.

    2015-01-01

    Nonhealing neuropathic foot ulcers remain a significant problem in individuals with diabetes. The gap-junctional protein connexin43 (Cx43) has roles in dermal wound healing and targeting Cx43 signaling accelerates wound reepithelialization. In a prospective, randomized, multi-center clinical trial we evaluated the efficacy and safety of a peptide mimetic of the C-terminus of Cx43, ACT1, in accelerating the healing of chronic diabetic foot ulcers (DFUs) when incorporated into standard of care ...

  18. Microsensor and transcriptomic signatures of oxygen depletion in biofilms associated with chronic wounds

    Energy Technology Data Exchange (ETDEWEB)

    James, Garth A.; Zhao, Alice G.; Usui, Marcia; Underwood, Robert A.; Nguyen, Hung D.; Beyenal, Haluk; Pulcini, Elinor; Agostinho, Alessandra; Bernstein, Hans C.; Fleckman, Philip; Olerud, John; Williamson, Kerry S.; Franklin, Michael J.; Stewart, Philip S.

    2016-01-07

    Polymicrobial biofilms have been implicated in delayed wound healing, although the mechanisms by which biofilms impair wound healing are poorly understood. Many species of bacteria produce exotoxins and exoenzymes that may inhibit healing. In addition, oxygen consumption by biofilms may impede wound healing. In this study, we used oxygen microsensors to measure oxygen transects through in vitro-cultured biofilms, biofilms formed in vivo in a diabetic (db/db) mouse model, and ex vivo human chronic wound specimens. The results show that oxygen levels within both euthanized and live mouse wounds had steep gradients that reached minima ranging from 19 to 61% oxygen partial pressure, compared to atmospheric oxygen levels. The oxygen gradients in the mouse wounds were similar to those observed for clinical isolates cultured in vitro and for human ex vivo scabs. No oxygen gradients were observed for heat-killed scabs, suggesting that active metabolism by the viable bacteria contributed to the reduced oxygen partial pressure of the wounds. To characterize the metabolic activities of the bacteria in the mouse wounds, we performed transcriptomics analyses of Pseudomonas aeruginosa biofilms associated with the db/db mice wounds using Affymetrix microarrays. The results demonstrated that the bacteria expressed genes for metabolic activities associated with cell growth. Interestingly, the transcriptome results indicated that the bacteria within the wounds also experienced oxygen-limitation stress. Among the bacterial genes that were expressed in vivo were genes associated with the Anr-mediated hypoxia-stress response. Other bacterial stress response genes highly expressed in vivo were genes associated with stationary-phase growth, osmotic stress, and RpoH-mediated heat shock stress. Overall, the results support the hypothesis that the metabolic activities of bacteria in biofilms act as oxygen sinks in chronic wounds and that the depletion of oxygen contributes to the

  19. Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing.

    Science.gov (United States)

    Background: Chronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species that cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the different populat...

  20. Current state of chronic wound care in Kazakhstan: focus on topical treatments

    Directory of Open Access Journals (Sweden)

    Alma Akhmetova

    2015-02-01

    Full Text Available Background — The presence of chronic hard-to-heal wounds significantly affects patients’ quality of life causing pain, discomfort, decrease of mobility and consequently leads to social isolation and depression. This type of wound is more prevalent among older population. It has been estimated that up to 1-2% of the world population have this condition. The treatment of hard-to-heal wounds is expensive and long-term process, and, stresses healthcare systems of every country. Unfortunately, limited information is available about the situation with chronic wounds in Kazakhstan as the statistical data on such patients is not monitored and not registered in this country. Methods — The search was conducted by using available electronic sources, including Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and Cochrane Library databases as well as hard copy versions of peer-reviewed publications in Russian, Kazakh, and English languages. Results — We have identified and analyzed current situation with wound care in the Republic of Kazakhstan. Research has demonstrated a variety of types of treatments utilized in the country, particularly the treatment of the diabetic foot.It also indicates the lack of statistics on wound care. Conclusions — The review highlights the mechanisms of wound healing process, methods for wound care, and encompasses the information available on wound healing in Republic of Kazakhstan. The article emphasizes the necessity of establishing the systemic monitoring of wound care and formation of electronic database. Apart from that, the importance of developing and manufacturing of domestic novel wound treatments have been also stressed out.

  1. 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

  2. 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.

  3. 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

  4. Stem Cells in Skin Regeneration, Wound Healing, and Their Clinical Applications

    Directory of Open Access Journals (Sweden)

    Nkemcho Ojeh

    2015-10-01

    Full Text Available The skin is the largest organ of the body and has an array of functions. Skin compartments, epidermis, and hair follicles house stem cells that are indispensable for skin homeostasis and regeneration. These stem cells also contribute to wound repair, resulting in restoration of tissue integrity and function of damaged tissue. Unsuccessful wound healing processes often lead to non-healing wounds. Chronic wounds are caused by depletion of stem cells and a variety of other cellular and molecular mechanisms, many of which are still poorly understood. Current chronic wound therapies are limited, so the search to develop better therapeutic strategies is ongoing. Adult stem cells are gaining recognition as potential candidates for numerous skin pathologies. In this review, we will discuss epidermal and other stem cells present in the skin, and highlight some of the therapeutic applications of epidermal stem cells and other adult stem cells as tools for cell/scaffold-based therapies for non-healing wounds and other skin disorders. We will also discuss emerging concepts and offer some perspectives on how skin tissue-engineered products can be optimized to provide efficacious therapy in cutaneous repair and regeneration.

  5. Chitosan-aluminum monostearate composite sponge dressing containing asiaticoside for wound healing and angiogenesis promotion in chronic wound.

    Science.gov (United States)

    Phaechamud, Thawatchai; Yodkhum, Kotchamon; Charoenteeraboon, Juree; Tabata, Yasuhiko

    2015-05-01

    There are many factors that delay healing in chronic wounds including lowering level of growth factors and increasing exudate level comprising high amount of tissue destructive enzymes. Asiaticoside possesses interesting wound healing and angiogenic activities that are employed to stimulate tissue regeneration in wound healing application. This study attempted to develop chitosan-aluminum monostearate (Alst) composite sponge containing asiaticoside for use as an absorbent medical dressing in chronic wound. N-methyl-2-pyrrolidone (NMP) was used to enhance homogeneity of asiaticoside in the polymer composite matrix. The sponge dressings were prepared by lyophilization and dehydrothermal treatment (DHT). Functional group interaction, crystallinity, and morphology of the prepared sponges were investigated using FT-IR, PXRD, and SEM, respectively. Physicochemical properties, porosity, hydrophilic/hydrophobic properties and mechanical property, were evaluated. Wound dressing properties, water vapor transmission rate (WVTR), fluid absorbency, oxygen permeation (OP), and bio-adhesive property, were investigated. In vitro asiaticoside release study was conducted using immersion method. Cytotoxicity was studied in normal human dermal fibroblast (NHDF) and normal human epidermal keratinocyte (NHEK). Angiogenic activity of asiaticoside was evaluated using chick-chorioallantoic membrane (CAM) assay. FT-IR and PXRD results revealed the amidation after DHT to enhance the crystallinity of the prepared sponges. The prepared sponges had high porosity comprising high Alst-loaded amount that exhibited more compact structure. Alst enhanced hydrophobicity therefore it reduced the fluid absorption and WVTR together with bio-adhesion of the prepared sponge dressings. Porosity of all sponges was more than 85% therefore resulting in their high OP. Enhancing hydrophobicity of the material by Alst and more homogeneity caused by NMP eventually retarded the asiaticoside release for 7 days. The

  6. A new generation of topical chronic wound treatments containing specific MMP inhibitors

    Directory of Open Access Journals (Sweden)

    Shrivastava R

    2014-09-01

    Full Text Available Ravi Shrivastava, Nathalie Cucuat, Monika Rousse, Thomas Weigand, Pedro Neto, Claire Janicot, Christiane Shrivastava VITROBIO Research Institute, Issoire, France Purpose: Incidence of chronic wounds is constantly rising worldwide, but all currently available treatments are intended either to provide symptomatic relief or to assist cicatrization to some extent, but not to directly stimulate cellular growth. Physiologically, chronic wound healing simply requires cell growth to fill the injured cavity. To grow, our cells need to attach onto a cushion, called extracellular matrix (ECM, secreted by the mother cells and composed of multiple proteins. Recent scientific works prove that the concentration of certain matrix metalloproteinases (MMPs is extremely high in all chronic wounds and, because of their proteolytic nature, some MMPs completely degrade the ECM, hindering cell attachment and cell growth. The aim of this study was to identify, neutralize, and eliminate these MMPs from the wound surface so as to design an effective treatment for chronic wounds. Methods: Acute and chronic models of human epithelial and fibroblast cells were prepared on a defined ECM cushion in vitro and MMPs were added in the culture medium to identify the MMPs causing ECM disintegration for each cell type. ECM-degrading MMPs were then incubated with selected procyanidin-rich plant extracts (PCDs and cell growth was reanalyzed. Results: It was observed that: 1 multiple MMPs are involved in cellular matrix destruction; 2 ECM-destroying MMPs are specific with respect to cell type; and 3 specific PCDs may bind and neutralize selected MMPs. Conclusion: Topical application of specific plant PCDs to selectively neutralize ECM-destroying MMPs in acute and chronic wounds represents a novel approach for the treatment of superficial and deep skin wounds. Keywords: extra cellular matrix (ECM, matrix metalloproteinases, procyanidins (PCDs, tannins, ulcers

  7. COLLAGEN DRESSING: A PROSPECTIVE RANDOMIZED TRIAL OF COLLAGEN SHEET AS A BIOLOGICAL DRESSING AND ITS ROLE IN THE CHRONIC NON-HEALING WOUNDS

    Directory of Open Access Journals (Sweden)

    M. Ramula

    2016-07-01

    Full Text Available BACKGROUND Collagen is the most abundantly present connective tissue. In higher animals, primarily as extracellular insoluble fibres and the fibres account for large part of organic mass of skin, tendon, blood vessel, bone teeth, cornea and vitreous humour. Collagen also provides the framework of parenchymal organs and basement membrane. The collagens constitute a family of proteins selected during evolution for the execution of several (mainly structural functions. During the process of evolution of multicellular organisms, a family of structural proteins was selected by both environmental influences and the functional requirements of the animal organism and developed to acquire varying degrees of rigidity, elasticity and strength. These proteins are known collectively as collagen and the chief examples among its various types are present in the skin, bone, cartilage, smooth muscle and basal lamina. Collagen is the most abundant protein in the human body representing 30% of its dry weight. The collagens are produced by several cell types and are distinguishable by their molecular compositions, morphologic characteristics, distribution, functions and pathologies. More than 20 types of collagen have been identified and designated with Roman numerals; the most important of these are listed in Table 5–3. They are classified into the following four categories according to their structure and general functions. METHODS Collagen dressing with facilities available in government setup. RESULTS The overall healing rate with collagen sheet is 70.14% within a relatively short period. CONCLUSION Collagen dressing is superior to conventional dressing.

  8. Effective Delivery of Doxycycline and Epidermal Growth Factor for Expedited Healing of Chronic Wounds

    Science.gov (United States)

    Kulkarni, Abhilash

    The problems and high medical costs associated with chronic wounds necessitate an economical bioactive wound dressing. A new strategy was investigated to inhibit MMP-9 proteases and to release epidermal growth factor (EGF) to enhance healing. Doxycycline (DOX) and EGF were encapsulated on polyacrylic acid modified polyurethane film (PAA-PU) using Layer-by-Layer (LbL) assembly. The number of bilayers tuned the concentration of DOX and EGF released over time with over 94% bioactivity of EGF retained over 4 days. A simple wound model in which MMP-9 proteases were added to cell culture containing fibroblast cells demonstrated that DOX inhibited the proteases providing a protective environment for the released EGF to stimulate cell migration and proliferation at a faster healing rate. In the presence of DOX, only small amounts of the highly bioactive EGF are sufficient to close the wound. Results show that this is new and promising bioactive dressing for effective wound management.

  9. Keratinocyte Migration, Proliferation, and Differentiation in Chronic Ulcers From Patients With Diabetes and Normal Wounds

    OpenAIRE

    Usui, Marcia L.; Mansbridge, Jonathan N.; Carter, William G.; Fujita, Mayumi; Olerud, John E

    2008-01-01

    Epithelialization of normal acute wounds occurs by an orderly series of events whereby keratinocytes migrate, proliferate, and differentiate to restore barrier function. The keratinocytes in the epidermis of chronic ulcers fail to execute this series of events. To better understand the epithelial dynamics of chronic ulcers, we used immunohistochemistry to evaluate proliferation, differentiation, adhesion, and migration in keratinocytes along the margin of chronic ulcers from patients with dia...

  10. How precise is the evaluation of chronic wounds by health care professionals?

    Science.gov (United States)

    Stremitzer, Stefan; Wild, Thomas; Hoelzenbein, Thomas

    2007-06-01

    Chronic wounds are a growing challenge for physicians and health insurance agencies. The burden of affected patients is enormous, because of pain but also because of long-lasting therapies and dependence on nursing services. In other areas of medicine, computer-based diagnostics is established, yet, accurate wound documentation is rarely conducted and is often limited to size measurement with a ruler and a rough photo documentation. Objective assessment of lesions by evaluation of granulation tissue, fibrin coverage and necrosis is not performed. The aim of this study was to investigate the spread and variety in judgement of a chronic wound. A diabetic ulcer was described by 16 wound therapists (eight physicians and eight nurses). Granulation tissue, fibrin coverage, necrosis, size and depth of the lesion, wound exudate and wound edges were judged, and the therapeutical consequences were determined. Study data show an extensive inhomogeneity and a wide spread of the results, like in no other field of medical diagnostics. This could be shown in the group of physicians, as well as in the group of nursing personnel. As the choice of treatment by a specialist is based upon the assessment of the wound, it is possible that in practice it can lead to suboptimal therapy. This is a consequence of varying treating physicians and subsequent changes in treatment regimens. This results in a prolongation of treatment and burden for the patient. Circumstances like this contribute to rising of costs in this area of the health care system. The goal is to apply objective wound diagnostic technologies in the field of chronic wounds to catch up with other diagnostic procedures. PMID:17651230

  11. Chitosan–aluminum monostearate composite sponge dressing containing asiaticoside for wound healing and angiogenesis promotion in chronic wound

    Energy Technology Data Exchange (ETDEWEB)

    Phaechamud, Thawatchai, E-mail: thawatchaienator@gmail.com [Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000 (Thailand); Yodkhum, Kotchamon, E-mail: marskotchamon@gmail.com [Department of Pharmaceutical Technology, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000 (Thailand); Charoenteeraboon, Juree, E-mail: juree@su.ac.th [Department of Biopharmacy, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom 73000 (Thailand); Tabata, Yasuhiko, E-mail: yasuhiko@frontier.kyoto-u.ac.jp [Department of Biomaterials, Field of tissue engineering, Institute for Frontier Medical Science, Kyoto University, Kyoto 606-8507 (Japan)

    2015-05-01

    There are many factors that delay healing in chronic wounds including lowering level of growth factors and increasing exudate level comprising high amount of tissue destructive enzymes. Asiaticoside possesses interesting wound healing and angiogenic activities that are employed to stimulate tissue regeneration in wound healing application. This study attempted to develop chitosan–aluminum monostearate (Alst) composite sponge containing asiaticoside for use as an absorbent medical dressing in chronic wound. N-methyl-2-pyrrolidone (NMP) was used to enhance homogeneity of asiaticoside in the polymer composite matrix. The sponge dressings were prepared by lyophilization and dehydrothermal treatment (DHT). Functional group interaction, crystallinity, and morphology of the prepared sponges were investigated using FT-IR, PXRD, and SEM, respectively. Physicochemical properties, porosity, hydrophilic/hydrophobic properties and mechanical property, were evaluated. Wound dressing properties, water vapor transmission rate (WVTR), fluid absorbency, oxygen permeation (OP), and bio-adhesive property, were investigated. In vitro asiaticoside release study was conducted using immersion method. Cytotoxicity was studied in normal human dermal fibroblast (NHDF) and normal human epidermal keratinocyte (NHEK). Angiogenic activity of asiaticoside was evaluated using chick-chorioallantoic membrane (CAM) assay. FT-IR and PXRD results revealed the amidation after DHT to enhance the crystallinity of the prepared sponges. The prepared sponges had high porosity comprising high Alst-loaded amount that exhibited more compact structure. Alst enhanced hydrophobicity therefore it reduced the fluid absorption and WVTR together with bio-adhesion of the prepared sponge dressings. Porosity of all sponges was more than 85% therefore resulting in their high OP. Enhancing hydrophobicity of the material by Alst and more homogeneity caused by NMP eventually retarded the asiaticoside release for 7 days

  12. Cellular and molecular mechanisms of repair in acute and chronic wound healing

    OpenAIRE

    Martin, P.; Nunan, R

    2015-01-01

    Summary A considerable understanding of the fundamental cellular and molecular mechanisms underpinning healthy acute wound healing has been gleaned from studying various animal models, and we are now unravelling the mechanisms that lead to chronic wounds and pathological healing including fibrosis. A small cut will normally heal in days through tight orchestration of cell migration and appropriate levels of inflammation, innervation and angiogenesis. Major surgeries may take several weeks to ...

  13. Requirements for Pseudomonas aeruginosa acute burn and chronic surgical wound infection.

    Directory of Open Access Journals (Sweden)

    Keith H Turner

    2014-07-01

    Full Text Available Opportunistic infections caused by Pseudomonas aeruginosa can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in most P. aeruginosa strains. To investigate the genetic requirements for acute and chronic pathogenesis in P. aeruginosa infections, we combined high-throughput sequencing-mediated transcriptome profiling (RNA-seq and genome-wide insertion mutant fitness profiling (Tn-seq to characterize gene expression and fitness determinants in murine models of burn and non-diabetic chronic wound infection. Generally we discovered that expression of a gene in vivo is not correlated with its importance for fitness, with the exception of metabolic genes. By combining metabolic models generated from in vivo gene expression data with mutant fitness profiles, we determined the nutritional requirements for colonization and persistence in these infections. Specifically, we found that long-chain fatty acids represent a major carbon source in both chronic and acute wounds, and P. aeruginosa must biosynthesize purines, several amino acids, and most cofactors during infection. In addition, we determined that P. aeruginosa requires chemotactic flagellar motility for fitness and virulence in acute burn wound infections, but not in non-diabetic chronic wound infections. Our results provide novel insight into the genetic requirements for acute and chronic P. aeruginosa wound infections and demonstrate the power of using both gene expression and fitness profiling for probing bacterial virulence.

  14. Microsensor and transcriptomic signatures of oxygen depletion in biofilms associated with chronic wounds.

    Science.gov (United States)

    James, Garth A; Ge Zhao, Alice; Usui, Marcia; Underwood, Robert A; Nguyen, Hung; Beyenal, Haluk; deLancey Pulcini, Elinor; Agostinho Hunt, Alessandra; Bernstein, Hans C; Fleckman, Philip; Olerud, John; Williamson, Kerry S; Franklin, Michael J; Stewart, Philip S

    2016-03-01

    Biofilms have been implicated in delayed wound healing, although the mechanisms by which biofilms impair wound healing are poorly understood. Many species of bacteria produce exotoxins and exoenzymes that may inhibit healing. In addition, oxygen consumption by biofilms and by the responding leukocytes, may impede wound healing by depleting the oxygen that is required for healing. In this study, oxygen microsensors to measure oxygen transects through in vitro cultured biofilms, biofilms formed in vivo within scabs from a diabetic (db/db) mouse wound model, and ex vivo human chronic wound specimens was used. The results showed that oxygen levels within mouse scabs had steep gradients that reached minima ranging from 17 to 72 mmHg on live mice and from 6.4 to 1.1 mmHg on euthanized mice. The oxygen gradients in the mouse scabs were similar to those observed for clinical isolates cultured in vitro and for human ex vivo specimens. To characterize the metabolic activities of the bacteria in the mouse scabs, transcriptomics analyses of Pseudomonas aeruginosa biofilms associated with the db/db mice wounds was performed. The results demonstrated that the bacteria expressed genes for metabolic activities associated with cell growth. Interestingly, the transcriptome results also indicated that the bacteria within the wounds experienced oxygen-limitation stress. Among the bacterial genes that were expressed in vivo were genes associated with the Anr-mediated hypoxia-stress response. Other bacterial stress response genes highly expressed in vivo were genes associated with stationary-phase growth, osmotic stress, and RpoH-mediated heat shock stress. Overall, the results supported the hypothesis that bacterial biofilms in chronic wounds promote chronicity by contributing to the maintenance of localized low oxygen tensions, through their metabolic activities and through their recruitment of cells that consume oxygen for host defensive processes. PMID:26748963

  15. Split-Thickness Skin Grafts Remain the Gold Standard for the Closure of Large Acute and Chronic Wounds

    OpenAIRE

    Simman, Richard; Phavixay, Laemthong

    2012-01-01

    Healing large chronic and acute wounds is a challenging task for wound care providers. It requires numerous visits and frequent dressing changes and often involves expensive therapeutic modalities. Our primary and ultimate goal is to heal these wounds as quickly as possible. In a prepared wound bed, covered with granulation tissue and free of infection, skin graft is the gold standard procedure to achieve this goal. One should keep in mind that not all patients are good candidates for surgery.

  16. Changes of anabolic processes at the cellular and molecular level in chronic wounds under topical negative pressure can be revealed by transcriptome analysis

    OpenAIRE

    Leffler, Mareike; Derrick, Kathleen L.; McNulty, Amy; Malsiner, Caye; Dragu, Adrian; Horch, Raymund E.

    2011-01-01

    Abstract Chronic wounds – as defined by the World Union of Wound Healing Societies (WUWHS) – are a considerable worldwide health care expense and impair quality of life. In order for chronic wounds to heal, these wounds must be transformed to a more acute state to begin the healing process. Topical negative pressure (TNP) with reticulated open cell foam (ROCF) is known to promote healing in certain types of chronic wounds. However, little is known about changes at the cellular or molecular le...

  17. Pseudomonas aeruginosa biofilm aggravates skin inflammatory response in BALB/c mice in a novel chronic wound model

    DEFF Research Database (Denmark)

    Trøstrup, Hannah; Thomsen, Kim; Christophersen, Lars J;

    2013-01-01

    Chronic wounds are presumed to persist in the inflammatory state, preventing healing. Emerging evidence indicates a clinical impact of bacterial biofilms in soft tissues, including Pseudomonas aeruginosa (PA) biofilms. To further investigate this, we developed a chronic PA biofilm wound infection...

  18. Assessing chronic wound perfusion in the lower extremity: current and emerging approaches

    Directory of Open Access Journals (Sweden)

    Woo KY

    2015-10-01

    Full Text Available Kevin Y Woo,1 Timothy M Brandys,2 Joseph A Marin1 1School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, 2Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada Abstract: Current evidence suggests that vascular and wound bed perfusion assessment should be integral to the care of people with chronic wounds in the lower extremities. Peripheral artery diseases can be insidious, with many affected individuals unaware of circulation issues and failing to seek medical help until they develop foot ulcers, gangrene, and other related complications. Measuring tissue perfusion is a useful diagnostic marker for chronic wounds and may help determine a wound's potential for healing. A complete patient history and physical examination is imperative to help determine the correct diagnosis of lower extremity ulcers. This article aims to discuss current and emerging wound perfusion assessment techniques, including ankle–brachial index, toe–brachial index, transcutaneous oxygen pressure, near-infrared spectroscopy, digital subtraction angiography, magnetic resonance angiography, computed tomographic angiography, and indocyanine green angiography. Keywords: tissue perfusion, peripheral arterial disease, oxygen, wound healing

  19. 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.

  20. Negative pressure wound therapy versus standard wound care in chronic diabetic foot wounds: study protocol for a randomized controlled trial

    OpenAIRE

    Seidel, Dörthe; Mathes, Tim; Lefering, Rolf; Storck, Martin; Lawall, Holger; Neugebauer, Edmund A. M.

    2014-01-01

    Background In August 2010, the Federal Joint Committee (G-BA) decided that negative pressure wound therapy (NPWT) would not be reimbursable in German ambulatory care. This decision was based on reports from the Institute for Quality and Efficiency in Health Care (IQWiG), which concluded that there is no convincing evidence in favor of NPWT. The aim of this diabetic foot study (DiaFu study) is to evaluate whether the clinical, safety and economic results of NPWT are superior to the results of ...

  1. The Visualization of Biofilms in Chronic Diabetic Foot Wounds Using Routine Diagnostic Microscopy Methods

    Directory of Open Access Journals (Sweden)

    Angela Oates

    2014-01-01

    Full Text Available Diabetic foot wounds are commonly colonised by taxonomically diverse microbial communities and may additionally be infected with specific pathogens. Since biofilms are demonstrably less susceptible to antimicrobial agents than are planktonic bacteria, and may be present in chronic wounds, there is increasing interest in their aetiological role. In the current investigation, the presence of structured microbial assemblages in chronic diabetic foot wounds is demonstrated using several visualization methods. Debridement samples, collected from the foot wounds of diabetic patients, were histologically sectioned and examined using bright-field, fluorescence, and environmental scanning electron microscopy and assessed by quantitative differential viable counting. All samples (n = 26 harboured bioburdens in excess of 5 log10 CFU/g. Microcolonies were identified in 4/4 samples by all three microscopy methods, although bright-field and fluorescence microscopy were more effective at highlighting putative biofilm morphology than ESEM. Results in this pilot study indicate that bacterial microcolonies and putative biofilm matrix can be visualized in chronic wounds using florescence microscopy and ESEM, but also using the simple Gram stain.

  2. Excisional wound healing is delayed in a murine model of chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Akhil K Seth

    Full Text Available BACKGROUND: Approximately 15% of the United States population suffers from chronic kidney disease (CKD, often demonstrating an associated impairment in wound healing. This study outlines the development of a surgical murine model of CKD in order to investigate the mechanisms underlying this impairment. METHODS: CKD was induced in mice by partial cauterization of one kidney cortex and contralateral nephrectomy, modifying a previously published technique. After a minimum of 6-weeks, splinted, dorsal excisional wounds were created to permit assessment of wound healing parameters. Wounds were harvested on postoperative days (POD 0, 3, 7, and 14 for histological, immunofluorescent, and quantitative PCR (qPCR. RESULTS: CKD mice exhibited deranged blood chemistry and hematology profiles, including profound uremia and anemia. Significant decreases in re-epithelialization and granulation tissue deposition rates were found in uremic mice wounds relative to controls. On immunofluorescent analysis, uremic mice demonstrated significant reductions in cellular proliferation (BrdU and angiogenesis (CD31, with a concurrent increase in inflammation (CD45 as compared to controls. CKD mice also displayed differential expression of wound healing-related genes (VEGF, IL-1β, eNOS, iNOS on qPCR. CONCLUSIONS: These findings represent the first reported investigation of cutaneous healing in a CKD animal model. Ongoing studies of this significantly delayed wound healing phenotype include the establishment of renal failure model in diabetic strains to study the combined effects of CKD and diabetes.

  3. Novel topical formulation for ischemic chronic wounds. Technological design, quality control and safety evaluation.

    Science.gov (United States)

    Cabrera, Carla Agostina; Ramos, Alberto Nicolas; Loandos, María Del Huerto; Valdez, Juan Carlos; Sesto Cabral, Maria Eugenia

    2016-01-01

    Ulceration of the foot in diabetes is common and disabling, and frequently leads to amputation of the leg. The pathogenesis of foot ulceration is complex, clinical presentation variable and management requires early expert assessment. Despite treatment, ulcers readily become chronic wounds. Chronic wounds are those that remain in a chronic inflammatory state failing a normal healing process patterns. This is partially caused by inefficient eradication of opportunistic pathogens like Pseudomonas aeruginosa. We propose its control or eradication will promote wound healing. Lactobacillus plantarum cultures supernatants (LAPS) shows antipathogenic and pro-healing properties. The main objective was to design two pharmaceutical dosage forms by using LAPS as active pharmaceutical ingredient and to perform its quality control, in vitro activity conservation tests and human trials (safety evaluation). Both selected formulations reach the technological quality expected for 120 days, shows adequate occlusive characteristics and proper adhesion to human skin. From the in vitro release assays were found that LAPS shows adequate release from matrix and maintain its antimicrobial and anti-biofilm activity. First human trials were developed and neither edema nor erythema on healthy skin voluntaries was found. We conclude that C80 and C100 are adequate for their use in future clinical trials to demonstrate a comprehensive therapeutic effectiveness in ischemic chronic wounds.

  4. A mHealth Application for Chronic Wound Care: Findings of a User Trial

    Directory of Open Access Journals (Sweden)

    Marcia R. Friesen

    2013-11-01

    Full Text Available This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses’ paper-based charting and is positioned for integration with facility’s larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1 the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities, (2 data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3 tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application’s design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software’s telehealth capacities.

  5. Case 3: chronic venous leg ulcer.

    Science.gov (United States)

    Hämmerle, Gilbert

    2016-03-01

    A non-healing, sloughy venous leg ulcer quickly responded to topical treatment including octenilin Wound Gel and octenilin Wound Irrigation Solution. Full healing occurred within 6 weeks. PMID:26949848

  6. Use of a new silver barrier dressing, ALLEVYN Ag in exuding chronic wounds.

    LENUS (Irish Health Repository)

    Kotz, Paula

    2009-06-01

    Recognising and managing wounds at risk of infection is vital in wound management. ALLEVYN Ag dressings have been designed to manage exudate in chronic wounds that are at risk of infection; are displaying signs of local infection; or where a suspected increase in bacterial colonisation is delaying healing. They combine an absorbent silver sulfadiazine containing hydrocellular foam layer, with a perforated wound contact layer and highly breathable top film. The results presented are from a multi-centre clinical evaluation of 126 patients conducted to assess the performance of ALLEVYN Ag (Adhesive, Non Adhesive and Sacrum dressings) in a range of indications. Clinicians rated the dressings as acceptable for use in various wound types in 88% of patients. The majority of clinical signs of infection reduced between the initial and the final assessment. The condition of wound tissue and surrounding skin was observed to improve, and there was significant evidence of a reduction in the level of exudate from initial to final assessment (p < 0.001). Clinicians rated ALLEVYN Ag as satisfying or exceeding expectations in over 90% of patients. The evaluation showed the dressings to offer real benefits to patients and clinicians across multiple indications when used in conjunction with local protocols.

  7. 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

  8. Clinical challenges of chronic wounds: searching for an optimal animal model to recapitulate their complexity

    OpenAIRE

    Robert Nunan; HARDING, KEITH G.; Paul Martin

    2014-01-01

    The efficient healing of a skin wound is something that most of us take for granted but is essential for surviving day-to-day knocks and cuts, and is absolutely relied on clinically whenever a patient receives surgical intervention. However, the management of a chronic wound – defined as a barrier defect that has not healed in 3 months – has become a major therapeutic challenge throughout the Western world, and it is a problem that will only escalate with the increasing incidence of condition...

  9. The Increasing Problem of Wound Bacterial Burden and Infection in Acute and Chronic Soft-Tissue Wounds Caused by Methicillin-Resistant Staphylococcus aureus

    OpenAIRE

    Demling, Robert H.; Waterhouse, Barbara

    2007-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become a leading cause of colonization and infection in both acute and chronic soft-tissue wounds. Objective: Our objective is to define this current epidemic problem caused by both community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), focusing on the similarities and differences between these 2 isolates as well as the impact on wound management decisions. Methods: Methods used include a literature review on the growth o...

  10. Glove and PICO: a novel technique for treatment of chronic wound due to osteomyelitis of the hand.

    Science.gov (United States)

    Narayan, Nitisha; Edwards, Daren; Ragoowansi, Raj H

    2014-06-02

    Chronic wounds on the dorsum of the hand are often challenging to treat. Vacuum-assisted closure has enjoyed widespread use in recent years for many difficult chronic wounds as an alternative to surgery. Unfortunately, owing to the unique anatomy of the hand, it is usually very difficult to get a seal without significantly immobilising the hand. We report a case of a chronic wound on the dorsum of the hand as a result of osteomyelitis in a 37-year-old man, which was treated with Single Use Negative Pressure Wound Therapy, 'PICO' (Smith and Nephew Co, UK). We combined the PICO dressing with a rubber glove to get a good seal enabling appropriate suction without immobilising the hand. Once the wound bed was ready, the defect was covered with a reverse forearm flap.

  11. EXPERIENCE IN LOCAL IMMUNOCORRECTION IN TREATMENT OF CHRONIC WOUNDS

    Directory of Open Access Journals (Sweden)

    I. A. Novikova

    2010-01-01

    Full Text Available At present time, immunotyping of lymphocyte subpopulations is an obligatory test, if an acquired immunodeficiency state is suspected, e.g., in chronic recurrent furunculosis. However, the data obtained are sometimes difficult to interprete, due to of insignificant and or multidirectional changes of parameters determined in the patients undergoing immunological testing. In present study, some basic features of immune status were examined in the patients with chronic recurrent furunculosis, being in remission state. A detailed analysis of separate immunological indices is presented, taking into account duration of the disease, periodicity of recurrencies, and individual clinical features of furunculosis. Dynamics of immunological test values in the course of disease and upon clinical exacerbations were subject to special analysis. Altered relationships between lymphocyte subpopulation are described in patients with furunculosis.

  12. Sub-bandage sensing system for remote monitoring of chronic wounds in healthcare

    Science.gov (United States)

    Hariz, Alex; Mehmood, Nasir; Voelcker, Nico

    2015-12-01

    Chronic wounds, such as venous leg ulcers, can be monitored non-invasively by using modern sensing devices and wireless technologies. The development of such wireless diagnostic tools may improve chronic wound management by providing evidence on efficacy of treatments being provided. In this paper we present a low-power portable telemetric system for wound condition sensing and monitoring. The system aims at measuring and transmitting real-time information of wound-site temperature, sub-bandage pressure and moisture level from within the wound dressing. The system comprises commercially available non-invasive temperature, moisture, and pressure sensors, which are interfaced with a telemetry device on a flexible 0.15 mm thick printed circuit material, making up a lightweight biocompatible sensing device. The real-time data obtained is transmitted wirelessly to a portable receiver which displays the measured values. The performance of the whole telemetric sensing system is validated on a mannequin leg using commercial compression bandages and dressings. A number of trials on a healthy human volunteer are performed where treatment conditions were emulated using various compression bandage configurations. A reliable and repeatable performance of the system is achieved under compression bandage and with minimal discomfort to the volunteer. The system is capable of reporting instantaneous changes in bandage pressure, moisture level and local temperature at wound site with average measurement resolutions of 0.5 mmHg, 3.0 %RH, and 0.2 °C respectively. Effective range of data transmission is 4-5 m in an open environment.

  13. Protease Inhibition by Oleic Acid Transfer From Chronic Wound Dressings to Albumin

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, J. V.; Howley, Phyllis; Davis, Rachel M.; Mashchak, Andrew D.; Goheen, Steven C.

    2007-08-01

    High elastase and cathepsin G activities have been observed in chronic wounds. These levels can inhibit healing through degradation of growth factors, cytokines, and extracellular matrix proteins. Oleic acid (18:1) is a non-toxic elastase inhibitor with some potential for redressing the imbalance of elastase activity found in chronic wounds. Cotton wound dressing material was characterized as a transfer carrier for affinity uptake of 18:1 by albumin under conditions mimicking chronic wounds. 18:1-treated cotton was examined for its ability to bind and release the fatty acid in the presence of albumin. The mechanism of 18:1 uptake from cotton and binding by albumin was examined with both intact dressings and cotton fiber-designed chromatography. Raman spectra of the albumin-18:1 complexes under liquid-liquid equilibrium conditions revealed fully saturated albumin-18:1 complexes with a 1:1 weight ratio of albumin:18:1. Cotton chromatography under liquid-solid equilibrium conditions revealed oleic acid transfer from cotton to albumin at 27 mole equivalents of 18:1 per mole albumin. Cotton was contrasted with hydrogel, and hydrocolloid wound dressing for its comparative ability to lower elastase activity. Each dressing material evaluated was found to release 18:1 in the presence of albumin with significant inhibition of elastase activity. The 18:1-formulated wound dressings lowered elastase activity in a dose dependent manner in the order cotton gauze > hydrogel > hydrocolloid. In contrast the cationic serine protease Cathepsin G was inihibited by 18:1 within a narrow range of 18:1-cotton formulations. Four per cent Albumin solutions were most effective in binding cotton bound-18:1. However, 2% albumin was sufficient to transfer quantities of 18:1 necessary to achieve a significant elastase-lowering effect. Formulations with 128 mg 18:1/g cotton gauze had equivalent elastase lowering with 1 - 4% albumin. 18:1 bound to cotton wound dressings may have promise in the

  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. Duration of wound fluid secretion from chronic venous leg ulcers is critical for interleukin-1α, interleukin-1β, interleukin-8 levels and fibroblast activation

    DEFF Research Database (Denmark)

    Zillmer, Rikke; Trøstrup, Hannah; Karlsmark, Tonny;

    2011-01-01

    Wound fluid collected from chronic wounds may be used as a simple gauge of the processes taking place in the tissue. There is lack of information on the optimal conditions for wound fluid procurement. We have studied possible diurnal variations and duration of wound fluid accumulation using reten...

  16. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

    OpenAIRE

    Angela Della Corte; Ferdinando Campitiello; Raffaele Canonico; Antonello Petrella; Pasquale Petronella; Franca Ferraraccio; Pasquale Gualdiero; Vincenzo Padovano; Ornella Carbonara; Michelangela Barbieri; Pasquale Paolisso; Maria Rosaria Rizzo; Ferdinando Carlo Sasso; Raffaele Marfella; Giuseppe Paolisso

    2012-01-01

    The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it...

  17. Acceleration of diabetic wound healing using a novel protease-anti-protease combination therapy.

    Science.gov (United States)

    Gao, Ming; Nguyen, Trung T; Suckow, Mark A; Wolter, William R; Gooyit, Major; Mobashery, Shahriar; Chang, Mayland

    2015-12-01

    Nonhealing chronic wounds are major complications of diabetes resulting in >70,000 annual lower-limb amputations in the United States alone. The reasons the diabetic wound is recalcitrant to healing are not fully understood, and there are limited therapeutic agents that could accelerate or facilitate its repair. We previously identified two active forms of matrix metalloproteinases (MMPs), MMP-8 and MMP-9, in the wounds of db/db mice. We argued that the former might play a role in the body's response to wound healing and that the latter is the pathological consequence of the disease with detrimental effects. Here we demonstrate that the use of compound ND-336, a novel highly selective inhibitor of gelatinases (MMP-2 and MMP-9) and MMP-14, accelerates diabetic wound healing by lowering inflammation and by enhancing angiogenesis and re-epithelialization of the wound, thereby reversing the pathological condition. The detrimental role of MMP-9 in the pathology of diabetic wounds was confirmed further by the study of diabetic MMP-9-knockout mice, which exhibited wounds more prone to healing. Furthermore, topical administration of active recombinant MMP-8 also accelerated diabetic wound healing as a consequence of complete re-epithelialization, diminished inflammation, and enhanced angiogenesis. The combined topical application of ND-336 (a small molecule) and the active recombinant MMP-8 (an enzyme) enhanced healing even more, in a strategy that holds considerable promise in healing of diabetic wounds.

  18. In Vitro Studies of Bacterial Cellulose and Magnetic Nanoparticles Smart Nanocomposites for Efficient Chronic Wounds Healing

    OpenAIRE

    Bianca Galateanu; Mihaela-Cristina Bunea; Paul Stanescu; Eugenia Vasile; Angela Casarica; Horia Iovu; Anca Hermenean; Catalin Zaharia; Marieta Costache

    2015-01-01

    The quality of life of patients with chronic wounds can be extremely poor and, therefore, over the past decades, great efforts have been made to develop efficient strategies to improve the healing process and the social impact associated with these conditions. Cell based therapy, as a modern tissue engineering strategy, involves the design of 3D cell-scaffold bioconstructs obtained by preseeding drug loaded scaffolds with undifferentiated cells in order to achieve in situ functional de novo t...

  19. Dressing-related pain in patients with chronic wounds: an international patient perspective.

    Science.gov (United States)

    Price, Patricia E; Fagervik-Morton, Hilde; Mudge, Elizabeth J; Beele, Hilde; Ruiz, Jose Contreras; Nystrøm, Theis Huldt; Lindholm, Christina; Maume, Sylvie; Melby-Østergaard, Britta; Peter, Yolanda; Romanelli, Marco; Seppänen, Salla; Serena, Thomas E; Sibbald, Gary; Soriano, Jose Verdú; White, Wendy; Wollina, Uwe; Woo, Kevin Y; Wyndham-White, Carolyn; Harding, Keith G

    2008-06-01

    This cross-sectional international survey assessed patients' perceptions of their wound pain. A total of 2018 patients (57% female) from 15 different countries with a mean age of 68.6 years (SD = 15.4) participated. The wounds were categorised into ten different types with a mean wound duration of 19.6 months (SD = 51.8). For 2018 patients, 3361 dressings/compression systems were being used, with antimicrobials being reported most frequently (n= 605). Frequency of wound-related pain was reported as 32.2%, 'never' or 'rarely', 31.1%, 'quite often' and 36.6%, 'most' or 'all of the time', with venous and arterial ulcers associated with more frequent pain (P= 0.002). All patients reported that 'the wound itself' was the most painful location (n= 1840). When asked if they experienced dressing-related pain, 286 (14.7%) replied 'most of the time' and 334 (17.2%) reported pain 'all of the time'; venous, mixed and arterial ulcers were associated with more frequent pain at dressing change (P dressing change, for 449 (22.2%) it took 1-2 hours, for 192 (9.5%) it took 3-5 hours and for 154 (7.6%) patients it took more than 5 hours. Pain intensity was measured using a visual analogue scale (VAS) (0-100) giving a mean score of 44.5 (SD = 30.5, n= 1981). Of the 1141 who reported that they generally took pain relief, 21% indicated that they did not feel it was effective. Patients were asked to rate six symptoms associated with living with a chronic wound; 'pain' was given the highest mean score of 3.1 (n= 1898). In terms of different types of daily activities, 'overdoing things' was associated with the highest mean score (mean = 2.6, n= 1916). During the stages of the dressing change procedure; 'touching/handling the wound' was given the highest mean score of 2.9, followed by cleansing and dressing removal (n= 1944). One thousand four hundred and eighty-five (80.15%) patients responded that they liked to be actively involved in their dressing changes, 1141 (58.15%) responded that

  20. 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.

  1. Effects of limited access dressing in chronic wounds: A biochemical and histological study

    Directory of Open Access Journals (Sweden)

    Thittamaranahalli Muguregowda Honnegowda

    2015-01-01

    Full Text Available Background: Negative pressure wound therapy has emerged as an attractive treatment modality for the management and healing of chronic ulcers. Though numerous clinical studies are available, there is a lack of biochemical and histological studies evaluating the healing of chronic wounds. Materials and Methods: In the present study, a total 60 patients were divided into two groups: Limited access dressing (LAD group (n = 30 and conventional dressing group (n = 30. Various biochemical parameters such as hydroxyproline, total protein and antioxidants such as reduced glutathione (GSH, glutathione peroxidase (GPx, catalase (CAT and oxidative biomarker malondialdhyde (MDA are measured in the granulation tissue. Histologically amount of inflammatory infiltrate, angiogenesis, and collagen deposition are studied to assess wound healing. Results: Patients treated with LAD have shown significant increase in the mean (±standard deviation hydroxyproline (77.3 ± 30.1 vs. 32.3 ± 16.18; P = 0.026, total protein (13.89 ± 9.0 vs. 8.9 ± 4.59; P = 0.004, GSH (7.4 ± 1.91 vs. 5.1 ± 1.28; P = 0.039, GPx (122.3 ± 59.3 vs. 88.7 ± 34.11; P = 0.030, CAT (1.80 ± 1.14 vs. 0.9 ± 0.71; P = 0.002 and decrease in MDA (13.4 ± 5.5 vs. 8.6 ± 3.8; P = 0.004. Histological study showed comparatively fewer inflammatory cells, increased and well organised collagen bundles, and more angiogenesis in the LAD group when compared with that with conventional dressing after 10 days of treatment. Conclusion: In the present study, we have found beneficial effect of newer intermittent negative pressure therapy in combination with moist environment (LAD on chronic wound healing by increasing collagen deposition and angiogenesis; and reducing oxidative stress and inflammatory infiltrate.

  2. Clinical identification of bacteria in human chronic wound infections: culturing vs. 16S ribosomal DNA sequencing

    Directory of Open Access Journals (Sweden)

    Rhoads Daniel D

    2012-11-01

    Full Text Available Abstract Background Chronic wounds affect millions of people and cost billions of dollars in the United States each year. These wounds harbor polymicrobial biofilm communities, which can be difficult to elucidate using culturing methods. Clinical molecular microbiological methods are increasingly being employed to investigate the microbiota of chronic infections, including wounds, as part of standard patient care. However, molecular testing is more sensitive than culturing, which results in markedly different results being reported to clinicians. This study compares the results of aerobic culturing and molecular testing (culture-free 16S ribosomal DNA sequencing, and it examines the relative abundance score that is generated by the molecular test and the usefulness of the relative abundance score in predicting the likelihood that the same organism would be detected by culture. Methods Parallel samples from 51 chronic wounds were studied using aerobic culturing and 16S DNA sequencing for the identification of bacteria. Results One hundred forty-five (145 unique genera were identified using molecular methods, and 68 of these genera were aerotolerant. Fourteen (14 unique genera were identified using aerobic culture methods. One-third (31/92 of the cultures were determined to be Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis with higher relative abundance scores were more likely to be detected by culture as demonstrated with regression modeling. Conclusion Discordance between molecular and culture testing is often observed. However, culture-free 16S ribosomal DNA sequencing and its relative abundance score can provide clinicians with insight into which bacteria are most abundant in a sample and which are most likely to be detected by culture.

  3. 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

  4. Identification of the critical therapeutic entity in secreted Hsp90α that promotes wound healing in newly re-standardized healthy and diabetic pig models.

    Directory of Open Access Journals (Sweden)

    Kathryn O'Brien

    Full Text Available Chronic and non-healing skin wounds represent a significant clinical, economic and social problem worldwide. Currently, there are few effective treatments. Lack of well-defined animal models to investigate wound healing mechanisms and furthermore to identify new and more effective therapeutic agents still remains a major challenge. Pig skin wound healing is close to humans. However, standardized pig wound healing models with demonstrated validity for testing new wound healing candidates are unavailable. Here we report a systematic evaluation and establishment of both acute and diabetic wound healing models in pigs, including wound-creating pattern for drug treatment versus control, measurements of diabetic parameters and the time for detecting delayed wound healing. We find that treatment and control wounds should be on the opposite and corresponding sides of a pig. We demonstrate a strong correlation between duration of diabetic conditions and the length of delay in wound closure. Using these new models, we narrow down the minimum therapeutic entity of secreted Hsp90α to a 27-amino acid peptide, called fragment-8 (F-8. In addition, results of histochemistry and immunohistochemistry analyses reveal more organized epidermis and dermis in Hsp90α-healed wounds than the control. Finally, Hsp90α uses a similar signaling mechanism to promote migration of isolated pig and human keratinocytes and dermal fibroblasts. This is the first report that shows standardized pig models for acute and diabetic wound healing studies and proves its usefulness with both an approved drug and a new therapeutic agent.

  5. 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

  6. Immunodepletion of high-abundant proteins from acute and chronic wound fluids to elucidate low-abundant regulators in wound healing

    Directory of Open Access Journals (Sweden)

    Chojnacki Caroline

    2010-12-01

    Full Text Available Abstract Background The process of wound healing consists of several well distinguishable and finely tuned phases. For most of these phases specific proteins have been characterized, although the underlying mechanisms of regulation are not yet fully understood. It is an open question as to whether deficits in wound healing can be traced back to chronic illnesses such as diabetes mellitus. Previous research efforts in this field focus largely on a restricted set of marker proteins due to the limitations detection by antibodies imposes. For mechanistic purposes the elucidation of differences in acute and chronic wounds can be addressed by a less restricted proteome study. Mass spectrometric (MS methods, e.g. multi dimensional protein identification technology (MudPIT, are well suitable for this complex theme of interest. The human wound fluid proteome is extremely complex, as is human plasma. Therefore, high-abundant proteins often mask the mass spectrometric detection of lower-abundant ones, which makes a depletion step of such predominant proteins inevitable. Findings In this study a commercially available immunodepletion kit was evaluated for the detection of low-abundant proteins from wound fluids. The dynamic range of the entire workflow was significantly increased to 5-6 orders of magnitude, which makes low-abundant regulatory proteins involved in wound healing accessible for MS detection. Conclusion The depletion of abundant proteins is absolutely necessary in order to analyze highly complex protein mixtures such as wound fluids using mass spectrometry. For this the used immunodepletion kit is a first but important step in order to represent the entire dynamic range of highly complex protein mixtures in the future.

  7. Water-filtered infrared-A (wIRA) in acute and chronic wounds

    OpenAIRE

    Hoffmann, Gerd

    2009-01-01

    Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA increases tissue temperature (+2.7°C at a tissue depth of 2 cm), tissue oxygen partial pressure (+32% at a tissue depth of 2 cm) and tissue perfusion. These three factors are decisive for a sufficient supply of tissu...

  8. [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.

  9. The Use of Amnion-Derived Cellular Cytokine Solution to Improve Healing in Acute and Chronic Wound Models

    OpenAIRE

    Franz, Michael G.; Payne, Wyatt G.; Xing, Liyu; Naidu, D. K; Salas, R. E; Marshall, Vivienne S.; Trumpower, C. J; Smith, Charlotte A; Steed, David L.; Robson, M. C.

    2008-01-01

    Objective: Growth factors demonstrate mixed results improving wound healing. Amnion-derived multipotent cells release physiologic levels of growth factors and tissue inhibitors of metalloproteinases. This solution was tested in models of acute and chronic wound healing. Methods: Acute model: Sprague-Dawley rats underwent laparotomy incisions. The midline fascia was primed with phosphate-buffered saline, unconditioned media, or amnion-derived cellular cytokine suspension prior to incision. Bre...

  10. Low-cost uncalibrated video-based tool for tridimensional reconstruction oriented to assessment of chronic wounds

    Science.gov (United States)

    Casas, Leslie; Treuillet, Sylvie; Valencia, Braulio; Llanos, Alejandro; Castañeda, Benjamín.

    2015-01-01

    Chronic wounds are a major problem worldwide which mainly affects to the geriatric population or patients with limited mobility. In tropical countries, Cutaneous Leishmaniasis(CL)s is also a cause for chronic wounds,being endemic in Peru in the 75% of the country. Therefore, the monitoring of these wounds represents a big challenge due to the remote location of the patients. This papers aims to develop a low-cost user-friendly technique to obtain a 3D reconstruction for chronic wounds oriented to clinical monitoring and assessment. The video is taken using a commercial hand-held video camera without the need of a rig. The algorithm has been specially designed for skin wounds which have certain characteristics in texture where techniques used in regular SFM applications with undefined edges wouldn't work. In addition, the technique has been developed using open source libraries. The 3D cloud point estimated allows the computation of metrics as volume, depth, superficial area which recently have been used by CL specialists showing good results in clinical assessment. Initial results in cork phantoms and CL wounds show an average distance error of less than 1mm when compared against models obtained with a industrial 3D laser scanner.

  11. Wound healing angiogenesis: The clinical implications of a simple mathematical model

    KAUST Repository

    Flegg, Jennifer A.

    2012-05-01

    Nonhealing wounds are a major burden for health care systems worldwide. In addition, a patient who suffers from this type of wound usually has a reduced quality of life. While the wound healing process is undoubtedly complex, in this paper we develop a deterministic mathematical model, formulated as a system of partial differential equations, that focusses on an important aspect of successful healing: oxygen supply to the wound bed by a combination of diffusion from the surrounding unwounded tissue and delivery from newly formed blood vessels. While the model equations can be solved numerically, the emphasis here is on the use of asymptotic methods to establish conditions under which new blood vessel growth can be initiated and wound-bed angiogenesis can progress. These conditions are given in terms of key model parameters including the rate of oxygen supply and its rate of consumption in the wound. We use our model to discuss the clinical use of treatments such as hyperbaric oxygen therapy, wound bed debridement, and revascularisation therapy that have the potential to initiate healing in chronic, stalled wounds. © 2012 Elsevier Ltd.

  12. The efficacy of moisture retentive ointment in the mangement of cutaneous wounds and ulcers: A multicenter clinical trial

    Directory of Open Access Journals (Sweden)

    Atiyeh B

    2003-01-01

    Full Text Available Local management of chronic wounds and ulcers remains one of the most costly unsolved problems in health care today. With proper clinical management, most chronic wound healing problems can be resolved and healing expected, though recurrence may be common. The recent logarithmic growth in our knowledge about wound healing and the appreciation of the importance of a moist environment in optimal wound healing has led to the introduction of new and exciting therapeutic modalities. In view of the many practical disadvantages as well as the serious complications of currently available moisture retentive dressings when applied to chronic contaminated wounds, a prospective multicenter clinical trial was conducted from December 1999 to November 2000 to evaluate the safety and efficacy of a newly introduced moisture retentive ointment (MEBO: Moist Exposed Burn Ointment (Julphar - Gulf Pharmaceutical Industries, UAE in the local wound care of problematic non-healing wounds. The active component of the ointment is β-sitosterol in a base of beeswax, sesame oil and other components. Though it was not a comparative study, the ointment was found to induce rapid reduction in ulcer size even after a prolonged stagnant state with other therapeutic modalities without complications such as skin maceration, unmanageable excessive exudation, and wound infection. As expected with such chronic wounds, the healing potential of local ointment application is limited by the mere size of the original defect and the underlying pathologies and associated diseases. however, the safety and practicality of simple ointment application was found to be a valid alternative treatment for local management of chronic wounds.

  13. 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.

  14. Proresolution therapy for the treatment of delayed healing of diabetic wounds.

    Science.gov (United States)

    Tang, Yunan; Zhang, Michael J; Hellmann, Jason; Kosuri, Madhavi; Bhatnagar, Aruni; Spite, Matthew

    2013-02-01

    Obesity and type 2 diabetes are emerging global epidemics associated with chronic, low-grade inflammation. A characteristic feature of type 2 diabetes is delayed wound healing, which increases the risk of recurrent infections, tissue necrosis, and limb amputation. In health, inflammation is actively resolved by endogenous mediators, such as the resolvins. D-series resolvins are generated from docosahexaenoic acid (DHA) and promote macrophage-mediated clearance of microbes and apoptotic cells. However, it is not clear how type 2 diabetes affects the resolution of inflammation. Here, we report that resolution of acute peritonitis is delayed in obese diabetic (db/db) mice. Altered resolution was associated with decreased apoptotic cell and Fc receptor-mediated macrophage clearance. Treatment with resolvin D1 (RvD1) enhanced resolution of peritonitis, decreased accumulation of apoptotic thymocytes in diabetic mice, and stimulated diabetic macrophage phagocytosis. Conversion of DHA to monohydroxydocosanoids, markers of resolvin biosynthesis, was attenuated in diabetic wounds, and local application of RvD1 accelerated wound closure and decreased accumulation of apoptotic cells and macrophages in the wounds. These findings support the notion that diabetes impairs resolution of wound healing and demonstrate that stimulating resolution with proresolving lipid mediators could be a novel approach to treating chronic, nonhealing wounds in patients with diabetes.

  15. 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.

  16. 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.

  17. Biomedical evaluation of a novel nitrogen oxides releasing wound dressing.

    Science.gov (United States)

    Dave, Rachna N; Joshi, Hiren M; Venugopalan, Vayalam P

    2012-12-01

    Chronic wounds are a major cause for both suffering and economical losses. Management of chronic non-healing wounds requires multipronged approach. They are polymicrobial and agonizing for the patient due to associated pain. Moist dressing providing antimicrobial action is a highly desirable chronic wound management option. Here we report a hydrogel based dressing that possesses the antimicrobial properties of acidified sodium nitrite and the homeostatic property of a hydrogel. The dressing was developed by combining citric acid cross-linked cotton gauze and sodium nitrite loaded gelatin. The cotton gauze was cross-linked with citric acid by pad-dry-curing in presence of nano-titania catalyst. The cotton gauze-gelatin hydrogel combination was gamma-irradiated and freeze-dried. At the time of application, the freeze-dried dressing is wetted by sodium nitrite solution. The dressing has a fluid uptake ability of 90 % (w/v) and the water vapour evaporation rate was estimated to be 2,809 ± 20 g/m(2)/day. The dressing showed significant antimicrobial activity against both planktonic and biofilm forms and was effective during consecutive re-uses. Cytotoxicity study showed inhibition of fibroblasts, but to a lesser extent than clinically administered concentrations of antiseptic like povidone iodine. Storage at 37 °C over a 3 month period resulted in no significant loss of its antimicrobial activity.

  18. 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....

  19. An Unusual Case of Nonhealing Granulomatous Keratitis Caused by Mycobacterium chelonae in a Healthy Middle Aged Adult

    Directory of Open Access Journals (Sweden)

    Vipul Bhandari

    2015-01-01

    Full Text Available Purpose. To report a rare presentation of culture positive Mycobacterium chelonae (M. chelonae corneal ulcer and its management. Case Report. We report a rare case with history of chronic pain and blurriness of vision. Examination revealed chronic nonhealing paracentral corneal ulcer inferiorly at 5 to 7 o’clock meridian with anterior chamber cells 1+ unresponsive to routine antibiotic and antifungal medications with Mantoux test (MT positivity in a middle aged nondiabetic patient with no prior obvious history of trauma, ocular surgery, and contact lens usage. Discussion. Ziehl Neelsen (ZN staining in nonhealing ulcer revealed acid fast bacilli typical of M. chelonae with subsequent culture positivity in Lowenstein Jensen (LJ medium. Subsequent treatment with topical fortified amikacin and tobramycin resulted in rapid healing of corneal ulcer. Conclusion. M. chelonae presenting as a chronic nonhealing corneal ulcer spontaneously occurring in a healthy young adult with no predisposing factor draws the need to have a good index of suspicion by performing ZN stain and culture and its subsequent successful management with topical fortified amikacin and tobramycin.

  20. Health Technology Assessment of the Negative Pressure Wound Therapy for the treatment of acute and chronic wounds: efficacy, safety, cost effectiveness, organizational and ethical impact

    Directory of Open Access Journals (Sweden)

    Paolo Giorgi Rossi

    2012-06-01

    Full Text Available

    Background: the aim of the study was to assess the safety, efficacy and cost-effectiveness of negative Pressure wound therapy (nPT for people with chronic and acute wounds.

    Methods: the scope and the final draft of the report have been submitted to the stakeholders (producers, payers and patients. safety issues were addressed through a systematic review of the meta-literature. efficacy was addressed through a systematic review and meta-analysis of randomized controlled trials (rcTs comparing nPT and other standard therapies in patients with chronic or acute lesions. cost-consequence was analyzed through a systematic review of the existing studies.

    Results: we retrieved 19 studies, 13 of which were included in the meta-analysis. Many studies had biases that may have resulted in a better performance for nPT. nPT showed: a slightly shorter healing time (-10.4 days, p=0.001, with no heterogeneity, apart from one small study with very positive results, and 40% more patients healed (p=0.002, no heterogeneity.We identified 15 original research papers on nPT costs and cost per outcome. The costs-per-patient- treated varied from +29% to -60%, with several studies reporting savings for nPT.

    Conclusions: despite serious methodological flaws, the body of evidence available was sufficient to prove some clinical benefit of nPT in severe chronic and acute wound treatment. There is a need for independent and contextualized cost analyses....

  1. A pilot study to evaluate the safety and clinical performance of Leucopatch, an autologous, additive-free, platelet-rich fibrin for the treatment of recalcitrant chronic wounds

    DEFF Research Database (Denmark)

    Jørgensen, Bo; Karlsmark, Tonny; Vogensen, Hanne;

    2011-01-01

    This prospective, uncontrolled pilot study evaluated the safety and clinical performance of Leucopatch an additive-free, autologous platelet-rich fibrin in the treatment of recalcitrant chronic wounds. Fifteen patients, with 16 lower extremity chronic wounds of varying etiologies were treated...... events. Two adverse events, one of noncompliance and one infection, were observed; neither was considered to be related to treatment. The results indicate that Leucopatch is easy to prepare and apply in the clinic, is safe, and may be a clinically effective treatment of recalcitrant chronic wounds....

  2. Clinical application of growth factors and cytokines in wound healing.

    Science.gov (United States)

    Barrientos, Stephan; Brem, Harold; Stojadinovic, Olivera; Tomic-Canic, Marjana

    2014-01-01

    Wound healing is a complex and dynamic biological process that involves the coordinated efforts of multiple cell types and is executed and regulated by numerous growth factors and cytokines. There has been a drive in the past two decades to study the therapeutic effects of various growth factors in the clinical management of nonhealing wounds (e.g., pressure ulcers, chronic venous ulcers, diabetic foot ulcers). For this review, we conducted an online search of Medline/PubMed and critically analyzed the literature regarding the role of growth factors and cytokines in the management of these wounds. We focused on currently approved therapies, emerging therapies, and future research possibilities. In this review, we discuss four growth factors and cytokines currently being used on and off label for the healing of wounds. These include granulocyte-macrophage colony-stimulating factor, platelet-derived growth factor, vascular endothelial growth factor, and basic fibroblast growth factor. While the clinical results of using growth factors and cytokines are encouraging, many studies involved a small sample size and are disparate in measured endpoints. Therefore, further research is required to provide definitive evidence of efficacy.

  3. PA01.24. A literature study on the medicinal preparations mentioned in Sri Lankan indigenous medicine for chronic wound healing

    OpenAIRE

    Karandugoda, K.K.I.E.; Perera, B.S.R.; Pushpakumara, A.A.J.; ,

    2012-01-01

    Purpose: Chronic wounds are a challenge to the modern medical science since there is no proper medication to correct this imbalance as to stimulate and enhance the growth of healthy granulation tissue making the wound fill up. When Sri Lankan traditional medicine is concerned it has been strewn with a large number of medicinal formulas for wound healing especially for granulation tissue formation. The primary intention of this study was to collect these formulas and analyse them to come up wi...

  4. Dual-functional Polyurea Microcapsules for Chronic Wound Care Dressings: Sustained Drug Delivery and Non-leaching Infection Control

    Science.gov (United States)

    He, Wei

    A new design of dual-functional polyurea microcapsules was proposed for chronic wound dressings to provide both non-leaching infection control and sustained topical drug delivery functionalities. Quaternary ammonium functionalized polyurea microcapsules (MCQs) were synthesized under mild conditions through an interfacial crosslinking reaction between branched polyethylenimine (PEI) and 2,4-toluene diisocyanate (TDI) in a dimethylformamide/cyclohexane emulsion. An in-situ modification method was developed to endow non-leaching surface antimicrobial properties to MCQs via bonding antimicrobial surfactants to surface isocyanate residues on the polyurea shells. The resultant robust MCQs with both non-leaching antimicrobial properties and sustained drug releasing properties have potential applications in medical textiles, such as chronic wound dressings, for infection control and drug delivery.

  5. The Debrisoft® Monofilament Debridement Pad for Use in Acute or Chronic Wounds: A NICE Medical Technology Guidance

    OpenAIRE

    Meads, C; Lovato, E; Longworth, L

    2015-01-01

    As part of its Medical Technology Evaluation Programme, the National Institute for Health and Care Excellence (NICE) invited a manufacturer to provide clinical and economic evidence for the evaluation of the Debrisoft ® monofilament debridement pad for use in acute or chronic wounds. The University of Birmingham and Brunel University, acting as a consortium, was commissioned to act as an External Assessment Centre (EAC) for NICE, independently appraising the submission. This article is an ove...

  6. The Application of Negative Pressure Wound Therapy in the Treatment of Chronic Venous Leg Ulceration: Authors Experience

    Directory of Open Access Journals (Sweden)

    Marek Kucharzewski

    2014-01-01

    Full Text Available The aim of the study was to use negative pressure wound therapy (NPWT in patients with chronic venous leg ulceration. The authors present their experience in treatment of 15 patients whose average ulceration surface area was 62.6 cm2. In 10 patients, the ulcers healed within 6 weeks and in the remaining patients within 20 weeks. Based on the results obtained, the authors imply that NPWT is an effective method in the treatment of chronic venous leg.

  7. 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.

  8. Negative pressure and nanocrystalline silver dressings for nonhealing ulcer: A randomized pilot study.

    Science.gov (United States)

    Sáez-Martín, Luis C; García-Martínez, Lourdes; Román-Curto, Concepción; Sánchez-Hernández, Miguel V; Suárez-Fernández, Ricardo M

    2015-01-01

    Chronic wounds have a high prevalence and wound care, treatment, and prevention consume large quantities of resources. Chronic wounds are a growing challenge for clinicians. A prospective randomized pilot study was conducted to assess the effectiveness in terms of reduction in area and safety of the combined use of negative-pressure wound therapy and nanocrystalline silver dressings as compared to negative pressure wound therapy (NPWT) alone in the management of outpatients with chronic wounds. A total of 17 patients were included in the study, 10 were treated with the combined method and 7 with NPWT. Patients were followed for 6 weeks, with a final assessment at 3 months. Clinical improvement, microbiologic data, and toxicity of silver were evaluated. The antibacterial effects of ionic silver together with the development of granulation tissue promoted by NPWT reduced significantly the median extension of the wound between weeks 3 and 6 of treatment. The combination with silver also reduced bacterial colonization with Pseudomonas aeruginosa and the bacterial load on the surface of the wound. The silver levels correlated positively with the extension of the wound, although in none of the patients' toxic levels were reached. The combination of NPWT with nanocrystalline silver dressings was safe and as effective as NPWT alone. PMID:26299899

  9. Nonrandom distribution of Pseudomonas aeruginosa and Staphylococcus aureus in chronic wounds

    DEFF Research Database (Denmark)

    Fazli, Mustafa; Bjarnsholt, Thomas; Kirketerp-Møller, Klaus;

    2009-01-01

    by the use of peptide nucleic acid-based fluorescence in situ hybridization and confocal laser scanning microscopy (CLSM). We acquired CLSM images of multiple regions in multiple sections cut from five wounds containing P. aeruginosa and five wounds containing S. aureus and measured the distance...

  10. Role of vacuum assisted closure therapy in chronic wounds: for some cases in Navi Mumbai

    Directory of Open Access Journals (Sweden)

    Shitiz Gupta

    2016-01-01

    Conclusions: Vacuum assisted closure (VAC therapy provides sterile and controlled environment to large, exudating wound surfaces and is treatment of choice in infected / non and ndash; healing wounds, not responding to standard treatment. [Int J Res Med Sci 2016; 4(1.000: 95-99

  11. Autologous stem cell therapy to treat chronic ulcer in heifer- A case study

    Directory of Open Access Journals (Sweden)

    Jayakrushna Das

    Full Text Available Aim: The study was conducted to reveal the efficacy of Bone marrow derived mesenchymal stem cells (BM-MSCs based therapy in healing of chronic non-healing and ulcerative wound in bovine species. Materials and Methods: One 2 years old Jersey heifer affected with chronic ulcerative wound involving full thickness skin and under lying muscle at dorsal side of lumbar region since four months at the time of presentation. Bone marrow was collected from tibia, cultured and grown and after achievement of optimum confluence it was applied at the site. Different parameters of clinical, physiological, haematological, biochemical, histochemical, histological, tensile strength and photographic evaluations were done during the study period. Results: The estimated values of above mentioned parameters on zero day and after healing (18 days showed significant difference (P<0.05 in relation to collagen content, tensile strength and physical characteristics of wound like extent of wound, size of wound, type of exudates and photography. But clinical, haematological and biochemical data showed no significant difference. Conclusion: The BM-MSCs were the main pioneers to bring the chronic ulcerative wound towards healing. The procedure is simple, safe and effective in bringing out healing without showing any adverse effect on host. [Vet World 2012; 5(12.000: 771-774

  12. 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

  13. Acellular Dermal Matrix Combined with Autologous Skin Grafts for Closure of Chronic Wounds after Reconstruction of Skull Defects with Titanium Mesh.

    Science.gov (United States)

    Luo, Xu; Lin, Cai; Wang, Xinling; Lin, Xiangwei; He, Sunyue; Liu, Yunfeng; Zhang, Yong; Yang, Ruijin; Zhu, Xinguo

    2016-07-01

    Objective The closure of chronic wounds after skull defect reconstruction with titanium mesh is one of the most challenging problems for plastic and reconstructive surgeons. Current approaches are disappointing. Methods In 10 patients, we explored the role of acellular dermal matrix (ADM) in combination with autologous skin grafts (ASGs) for closure of chronic wounds after skull reconstruction with titanium. Results ADM and ASG survived in all patients. Grade A healing (healing well without defect) was achieved. The average operating time was 30 to 45 minutes, and the average blood loss 30 to 50 mL. After 3 months, the wound was still closed in all patients. Conclusion The combination of ADM plus ASG obtained a high wound closure rate. ADM plus ASG allows avoiding other procedures such as rotational flaps and free flaps that require more operating time, special equipment, and adequate training. PMID:27088591

  14. L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic wounds.

    Science.gov (United States)

    Cieslik-Bielecka, Agata; Choukroun, Joseph; Odin, Guillaume; Dohan Ehrenfest, David M

    2012-06-01

    The use of platelet concentrates for topical use is of particular interest for the promotion of skin wound healing. Fibrin-based surgical adjuvants are indeed widely used in plastic surgery since many years in order to improve scar healing and wound closure. However, the addition of platelets and their associated growth factors opened a new range of possibilities, particularly for the treatment of chronic skin ulcers and other applications of regenerative medicine on the covering tissues. In the 4 families of platelet concentrates available, 2 families were particularly used and tested in this clinical field: L-PRP (Leukocyte- and Platelet-rich Plasma) and L-PRF (Leukocyte- and Platelet-Rich Fibrin). These 2 families have in common the presence of significant concentrations of leukocytes, and these cells are important in the local cleaning and immune regulation of the wound healing process. The main difference between them is the fibrin architecture, and this parameter considerably influences the healing potential and the therapeutical protocol associated to each platelet concentrate technology. In this article, we describe the historical evolutions of these techniques from the fibrin glues to the current L-PRP and L-PRF, and discuss the important functions of the platelet growth factors, the leukocyte content and the fibrin architecture in order to optimize the numerous potential applications of these products in regenerative medicine of the skin. Many outstanding perspectives are appearing in this field and require further research.

  15. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available Background If a chronically infected abdominal wound develops, complications such asperitonitis and an abdominal wall defect could occur. This could prolong the patient’s hospitalstay and increase the possibility of re-operation or another infection as well. For this reason,a solution for infection control is necessary. In this study, surgery using a rectus abdominismuscle myofascial splitting flap was performed on an abdominal wall defect.Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture,cesarean section, or uterine myoma were chosen. In each case, during the first week afteroperation, the wound showed signs of infection. Surgery was chosen because the wounds didnot resolve with dressing. Debridement was performed along the previous operation woundand dissection of the skin was performed to separate the skin and subcutaneous tissue fromthe attenuated rectus muscle and Scarpa’s fascial layers. Once the anterior rectus sheath andmuscle were adequately mobilized, the fascia and muscle flap were advanced medially sothat the skin defect could be covered for reconstruction.Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation,no major complication occurred. In addition, all of the patients showed satisfaction in termsof function and esthetics at 3 to 6 months post-surgery.Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic andfunctional benefits over previous methods of abdominal defect treatment, and notably, itenabled infection control by reconstruction using muscle.

  16. Coniferous resin salve, ancient and effective treatment for chronic wounds : laboratory and clinical studies

    OpenAIRE

    Sipponen, Arno

    2013-01-01

    Natural coniferous resins and other terpenic wood extracts have been raw materials for various products in industry, and have been used as traditional medicines in Finland for hundreds of years, particularly as a home-made salve for skin wounds and infections. Due to the authorÂŽs own positive empirical experiences of natural coniferous resin salve in wound care, the present resin-project was set up in order to investigate (1) the antimicrobial properties of the resin and resin salve by mic...

  17. 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...

  18. Closure of chronic non healing ankle ulcer with low level laser therapy in a patient presenting with thalassemia intermedia: Case report

    Directory of Open Access Journals (Sweden)

    Snehil Dixit

    2014-01-01

    Full Text Available In this single case study, the possible effect of low-level laser therapy (LLLT was explored in the form of light emitting diodes on a chronic non-healing wound of 6 months duration in an 18-year-old male patient suffering from thalassemia intermedia. After irradiation, with LLLT dosage of 17.3 J/cm 2 for 8 min for 2 weeks duration followed by proliferative dosage of 8.65-4.33 J/cm 2 for 4 min from 3 rd week to 6 th week for 2 min along with antibiotics vancomycin (15 mg/kg and a combination of amoxicillin and clavulanic acid (1 g. Proliferation of healthy granulation tissue was observed with decrease in score of pressure ulcer scale with complete re-epithelialization eventually LLLT irradiation could be a novel method of treatment for chronic non-healing wound in a thalassemia intermedia patient and an useful adjunct to standard care of treatment of pressure ulcers. It is postulated that LED irradiation augments wound healing with an early closure and no recurrence at the irradiated site even after follow up of 6 months.

  19. The Role of Nutrition and Edible Medicinal Plants in the Treatment of Chronic Wounds Based on the Principles of Iranian Traditional Medicine

    Science.gov (United States)

    Shirbeigi, Leila; Mohebbi, Mina; Karami, Soodeh; Nejatbakhsh, Fatemeh

    2016-01-01

    Background: Skin is the body’s first defense against stressful factors. Skin wounds are caused by the loss of connection in the skin and recovery requires cellular and biochemical reactions. Chronic wounds arise from the lack of physiological processes and the disease due to complications (e.g. infection and amputation) has devastating consequences on societies. According to the principles of Iranian traditional medicine (ITM), these disorders can be treated in a step-by-step procedure. Methods: This is a systematic review study that involved gathering data from three traditional medical textbooks, namely Canon of Medicine, Tib-e-Akbari and Exir-e-Azam with the keyword “chronic wound” or “ghorha”. In the next step, few tables were developed for nutrition measures as well as edible and topical medicinal herbs. Electronic databases such as PubMed, Scopus, Web of Science, and Cochrane library were searched for relevant articles and those related to effective medicinal herbs in the treatment of wounds were obtained. Results: Depending on appearance and secretions, wounds are divided into two categories, namely simple and compound wounds. The prognostic factors are based on the age, weight, accompanied disease, as well as the quality and quantity of the wound secretions. Wound treatments include medical nutrition therapy, edible medications, and manipulation therapies. Patient’s diet is very important and oral medications have a major role in the whole body detoxification. Topical medications are used together with the above-mentioned treatments; noting that without detoxification, these medications are not effective entirely. Conclusion: Wound healing requires physiological processes within the body. From the perspective of ITM, body detoxification is the first medical step, after which topical medications could lead to a better wound healing result.

  20. Clustering siRNA conjugates for MMP-responsive therapeutics in chronic wounds of diabetic animals

    Science.gov (United States)

    Kim, Hye Sung; Son, Young Ju; Yoo, Hyuk Sang

    2016-07-01

    The MMP-responsive breakdown of siRNA clusters was translated to site-specific gene transfection and enhanced wound healing in diabetic ulcers. MMP-2 siRNA was chemically tethered to the end of multi-armed PEG via MMP-cleavable linkers (4PEG-siRNA) and subsequently clustered into submicron particles complexed with LPEI. 4PEG-siRNA was more tightly complexed with LPEI and the associated cluster showed higher resistance against RNase attack, in comparison to naked siRNA. Because the size of the clusters increased depending on the increase in charge ratio of LPEI to siRNA, cellular uptake of the 4PEG-siRNA/LPEI cluster was significantly attenuated due to the huge size of the cluster. However, upon MMP treatment, the cluster dissociated into smaller particles and was efficiently endocytosed by cells. An in vivo fluorescence resonance energy transfer (FRET) study also revealed that the clusters were effectively dissociated in MMP-rich environments of dorsal wounds in diabetic animals. In addition, diabetic ulcers treated with the clusters showed a faster wound closure rate and the recovered tissue expressed a larger amount of cytokeratin along with a lower expression level of MMP-2 compared to the other groups.The MMP-responsive breakdown of siRNA clusters was translated to site-specific gene transfection and enhanced wound healing in diabetic ulcers. MMP-2 siRNA was chemically tethered to the end of multi-armed PEG via MMP-cleavable linkers (4PEG-siRNA) and subsequently clustered into submicron particles complexed with LPEI. 4PEG-siRNA was more tightly complexed with LPEI and the associated cluster showed higher resistance against RNase attack, in comparison to naked siRNA. Because the size of the clusters increased depending on the increase in charge ratio of LPEI to siRNA, cellular uptake of the 4PEG-siRNA/LPEI cluster was significantly attenuated due to the huge size of the cluster. However, upon MMP treatment, the cluster dissociated into smaller particles and was

  1. 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.

  2. A pilot study to evaluate the safety and clinical performance of Leucopatch, an autologous, additive-free, platelet-rich fibrin for the treatment of recalcitrant chronic wounds

    DEFF Research Database (Denmark)

    Jørgensen, Bo; Karlsmark, Tonny; Vogensen, Hanne;

    2011-01-01

    weekly with Leucopatch, prepared at the point of care from a donation of the patients' blood, for 6 weeks, or until healing was complete. The wounds had been present for 2 to 108 months (median 24 months) and ranged in size from 0.4 to 15.7 cm(2) (median 2.3 cm(2)) and had not responded to previous......This prospective, uncontrolled pilot study evaluated the safety and clinical performance of Leucopatch an additive-free, autologous platelet-rich fibrin in the treatment of recalcitrant chronic wounds. Fifteen patients, with 16 lower extremity chronic wounds of varying etiologies were treated...... treatments. Of the 13 wounds (12 patients) included in the per-protocol efficacy analysis, 4 healed completely (31%). Mean wound area decreased significantly by 65% (95% confidence interval = 45.6% to 83.8%) resulting in a median wound size of 0.9 cm(2) (range = 0-9.6cm(2)). There were no serious adverse...

  3. 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...

  4. Review of animal models used to study effects of bee products on wound healing: findings and applications

    OpenAIRE

    Hananeh Wael M.; Ismail Zuhair Bani; Alshehabat Musa A.; Ali Ja’afar

    2015-01-01

    Non-healing wounds are associated with high morbidity and might greatly impact a patient’s well-being and economic status. For many years, scientific research has focused on developing and testing several natural and synthetic materials that enhance the rate of wound healing or eliminate healing complications. Honey has been used for thousands of years as a traditional remedy for many ailments. Recently, honey has reemerged as a promising wound care product especially for infected wounds and ...

  5. Requirements for Pseudomonas aeruginosa Acute Burn and Chronic Surgical Wound Infection

    OpenAIRE

    Turner, Keith H.; Jake Everett; Urvish Trivedi; Rumbaugh, Kendra P.; Marvin Whiteley

    2014-01-01

    Opportunistic infections caused by Pseudomonas aeruginosa can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in ...

  6. 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...

  7. 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...

  8. 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 ...

  9. Chronic Osteomyelitis of Clavicle in a Neonate: Report of Morbid Complication of Adjoining MRSA Abscess.

    Science.gov (United States)

    Suranigi, Shishir Murugharaj; Joshi, Manoj; Deniese, Pascal Noel; Rangasamy, Kanagasabai; Najimudeen, Syed; Gnanadoss, James J

    2016-01-01

    Osteomyelitis of clavicle is rare in neonates. Acute osteomyelitis of clavicle accounts for less than 3% of all osteomyelitis cases. It may occur due to contiguous spread, due to hematogenous spread, or secondary to subclavian catheterization. Chronic osteomyelitis may occur as a complication of residual adjoining abscess due to methicillin resistant staphylococcus aureus (MRSA) sepsis. We report a newborn female with right shoulder abscess that developed chronic clavicular osteomyelitis in follow-up period after drainage. She required multiple drainage procedures and was later successfully managed with bone curettage and debridement. We report this case to highlight that a MRSA abscess may recur due to residual infection from a chronic osteomyelitis sinus. It may be misdiagnosed as hypergranulation tissue of nonhealing wound leading to inappropriate delay in treatment. High index of suspicion, aggressive initial management, and regular follow-up are imperative to prevent this morbid complication. PMID:27051549

  10. Chronic Osteomyelitis of Clavicle in a Neonate: Report of Morbid Complication of Adjoining MRSA Abscess

    Directory of Open Access Journals (Sweden)

    Shishir Murugharaj Suranigi

    2016-01-01

    Full Text Available Osteomyelitis of clavicle is rare in neonates. Acute osteomyelitis of clavicle accounts for less than 3% of all osteomyelitis cases. It may occur due to contiguous spread, due to hematogenous spread, or secondary to subclavian catheterization. Chronic osteomyelitis may occur as a complication of residual adjoining abscess due to methicillin resistant staphylococcus aureus (MRSA sepsis. We report a newborn female with right shoulder abscess that developed chronic clavicular osteomyelitis in follow-up period after drainage. She required multiple drainage procedures and was later successfully managed with bone curettage and debridement. We report this case to highlight that a MRSA abscess may recur due to residual infection from a chronic osteomyelitis sinus. It may be misdiagnosed as hypergranulation tissue of nonhealing wound leading to inappropriate delay in treatment. High index of suspicion, aggressive initial management, and regular follow-up are imperative to prevent this morbid complication.

  11. Effects of hyperbaric oxygen therapy in the management of chronic wounds and its correlation with CD34 ± endothelial progenitor cells%高压氧治疗下肢慢性创面愈合与外周血内皮祖细胞的相关性

    Institute of Scientific and Technical Information of China (English)

    马辕华; 雷永红; 周敏; 李雪; 赵宏宇

    2011-01-01

    Objective To evaluate the effects of hyperbaric oxygen(HBO)therapy in the management of chronic wound and observe the correlation between wound healing and CD34 + endothelial progenitor cells(EPCs).Methods A total of 119 patients with chronic wound in lower extremities lasting >3 months were recruited for this randomized,single-center,placebo-controlled clinical trial.The changes of CD34 + average count before and after HBO therapy were detected by flow cytometry(FACS).There were 97 patients on long-term HBO therapy and in 22 patients on hyperbaric air therapy as control group.The CD34/Scal-1 + and CD34/CXCR4 dual-positive populations of gated cell were determined respectively by FACs.The outcomes of two groups were compared.Treatment was administered within a single-place hyperbaric chamber for 90-main daily(session duration 120 main)for 5 days a week for 4 weeks (20 treatment sessions).Results The wound size decreased at the4-week end point(62.7% +22.3% in the HBO group vs 34.4% +20.6% in the control group,P <0.05).Mter 10 episodes of HBO therapies for chronic non-healing wound,the peripheral CD34 + EPCs average count rose from 0.24% + 0.03% at pretreatment to 1.32% ±0.05% while the number was 1.75% + 0.17% after 20 episodes of HBO(P < 0.05)Both were significantly different from that of the patients at pre-treatment.However the overall circulating white cell count was not significantly elevated.The CD34/Scal-1 + and CD34/CXCR4 dual-positive populations of gated cell in HBO group were 5.8 and 5.2 folds than those at pre-treatment respectively.The number of EPCs was positively correlated with wound healing in lower extremities(correlation coefficient 0.84 ; P < 0.01).Conclusion Adjunctive treatment of HBO facilitates the healing of chronic non-healing wound in selected patients through the mobilization of EPCs.%目的 探讨高压氧(HBO)对中国人下肢创伤后小腿部慢性创面愈合的影响,以及创

  12. Accelerated healing of diabetic wound using artificial dermis constructed with adipose stem cells and poly(L-glutamic acid)/chitosan scaffold

    Institute of Scientific and Technical Information of China (English)

    SHEN Ting; PAN Zhi-gang; ZHOU Xiao; HONG Chao-yang

    2013-01-01

    Background Diabetic wound is one of the most serious complications of diabetes mellitus.There are no significantly effective therapies for chronic non-healing diabetes ulcer so far.This study aimed to explore the feasibility of healing impaired wound using artificial dermis constructed with human adipose derived stem cells (ASCs) and poly(L-glutamic acid)/chitosan (PLGA/CS) scaffold in streptozotocin-induced diabetic mice.Methods ASCs were isolated from fresh human lipoaspirates and expanded ex vivo for three passages,and then cells were seeded onto PLGA/CS scaffold to form artificial dermis.Expression of VEGF and TGFβ1 by ASCs presented in artificial dermis was determined.The artificial dermis was transplanted to treat the 20 mm × 20 mm full-thickness cutaneous wound created on the back of diabetic mice.Wound treated with scaffold alone and without treatment,and wound in normal non-diabetic mice served as control.Results Cells growing within scaffold showed great proliferation potential,depositing abundant collagen matrix.Meanwhile,expression of VEGF and TGF-β1 by seeded ASCs maintained at a consistent high level.After treated with ASC based artificial dermis,diabetic wounds exhibited significantly higher healing rate compared with wounds treated with scaffold alone or without treatment.Histological examination also demonstrated an improvement in cutaneous restoration with matrix deposition and organization.Further quantitative analysis showed that there was a significant increase in dermis thickness and collagen content on artificial dermis treated wounds.Conclusion ASC/PLGA artificial dermis can effectively accelerate diabetic wound healing by promoting angiogenic growth factors and dermal collagen synthesis.

  13. 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.

  14. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial.

    Science.gov (United States)

    Rahmani, N; Khademloo, M; Vosoughi, K; Assadpour, S

    2014-01-01

    Aloe vera is a medicinal plant that promotes wound healing in burn injuries. A prospective clinical trial was conducted to evaluate the effects of a topical cream containing 0.5% Aloe vera juice powder in the treatment of chronic anal fissures. The aloe cream was applied by the patients to the wound site 3 times per day for 6 weeks following the instructions of a physician. Pain was assessed with a visual analog scale before treatment and at the end of each week of treatment. Wound healing and the amount and severity of bleeding were examined and evaluated before and at the end of each week of treatment. There were statistically significant differences in chronic anal fissure pain, hemorrhaging upon defection and wound healing before and at the end of the first week of treatment also in comparison with control group (p aloe vera juice was an effective treatment for chronic anal fissures. This is a promising result indicating that further comparative studies are justified.

  15. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial.

    Science.gov (United States)

    Rahmani, N; Khademloo, M; Vosoughi, K; Assadpour, S

    2014-01-01

    Aloe vera is a medicinal plant that promotes wound healing in burn injuries. A prospective clinical trial was conducted to evaluate the effects of a topical cream containing 0.5% Aloe vera juice powder in the treatment of chronic anal fissures. The aloe cream was applied by the patients to the wound site 3 times per day for 6 weeks following the instructions of a physician. Pain was assessed with a visual analog scale before treatment and at the end of each week of treatment. Wound healing and the amount and severity of bleeding were examined and evaluated before and at the end of each week of treatment. There were statistically significant differences in chronic anal fissure pain, hemorrhaging upon defection and wound healing before and at the end of the first week of treatment also in comparison with control group (p aloe vera juice was an effective treatment for chronic anal fissures. This is a promising result indicating that further comparative studies are justified. PMID:24763890

  16. 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...

  17. 人工真皮修复慢性创面疗效观察%The efficacy of artificial dermis in the repair of chronic wounds

    Institute of Scientific and Technical Information of China (English)

    余继超; 邱加崇; 彭文要; 陈柏秋; 刘冰峰; 梁健勤; 刘旭盛

    2012-01-01

    目的 探索慢性创面治疗方法.方法 回顾性分析我院2008年至2011年62例慢性创面患者的治疗方法.将其随机分成两组:对照组32例,予抗感染,改善微循环,聚维酮纱外敷,经换药治疗创面未愈者行植皮或皮瓣修复术;观察组30例,予抗感染,改善微循环,早期清创,感染控制后外敷人工真皮(皮耐克),诱导真皮重建,促进肉芽组织生长和创面愈合,创面较大者待其肉芽生长满意后行植皮术.结果 对照组平均住院天数( 58.2±1.3)d,其中植皮或皮瓣修复术修复18例,创面换药愈合者14例,创面愈合后疤痕增生明显.观察组平均住院天数( 31.4±1.1)d,其中7例患者创面较大,经外敷人工真皮,肉芽生长满意后予植皮手术,其余患者经外敷人工真皮、换药,创面治愈后外观满意,疤痕增生轻或不明显.结论 应用人工真皮可促进慢性创面愈合,减少疤痕增生,有效缩短住院天数,降低手术率和手术风险,值得借鉴、推广.%Objective To explore therapies for chronic wounds.Methods The therapies for chronic wounds in 62 patients who had been hospitalized during 2008 to 2011 were retrospectively analyzed.The patients were randomly divided into control group ( 32 patients ) and study group ( 30 patients ).The control group received anti-infection,microcirculation improvement and their wounds were covered by gauze soaked with povidone iodine cream with regular dressing change; the study group received anti-infection,microcirculation improvement and early debridement and their wounds were covered by artificial dermis ( PELNAC ) to induce dermal reconstruction after infection control and to promote granulation tissue regeneration and/or scar formation a nd wound healing.Some bigger wounds were treated by skin grafting after satisfied growth of granulation tissues.Results In the control group,the average length of hospital stay was ( 58.2 ± 1.3 )days; 18 patients were treated by skin grafting

  18. Evaluation of acute and sub-chronic toxicity of Semelil (ANGIPARSTM, a new phytotherapeutic drug for wound healing in rodents

    Directory of Open Access Journals (Sweden)

    Abdollahi M

    2008-04-01

    Full Text Available Semelil (ANGIPARSTM, an herbal formulation containing Melilotus officinalis extract, is a novel compound being developed for treatment of chronic wounds, particularly diabetic foot ulcers. The purpose of this study was to investigate toxicological, pharmacological, and pathomorphological effects of I.M. and I.P. administration of Semelil in animals."nThe acute toxicity parameters of Semelil diluted in normal saline (1:10 or 1:5 were determined after a single injection into BALB/c mice and Wistar rats in two steps. First, the LD50 was approximately assessed and then the precise lethal dose indices were estimated by the probit-analysis method. Specific single-dose effects of Semelil were monitored for clinical signs of toxicity, including general state of the animals, changes in their behavior, hematological and biochemical parameters for 14 days after drug administration. Then, subacute-chronic toxicity was evaluated in rats treated with Semelil for 3 months. "nIn acute toxicity study, the calculated LD50 for drug diluted at 1:5 was in the range of 44-52 ml/kg. The adverse effects at drug doses close to the LD50 included depressed mood, narcosis, and sleep. No adverse pharmacological or toxicological effects of the drug diluted at 1:10 and administered in the single-dose (25-50 ml/kg body wt. or chronically (daily doses of 0.07 and 0.21 ml/kg body wt. were noted. Thus, the animal studies demonstrated a favorable safety profile for the phytotherapeutic Semelil.

  19. The Debrisoft(®) Monofilament Debridement Pad for Use in Acute or Chronic Wounds: A NICE Medical Technology Guidance.

    Science.gov (United States)

    Meads, Catherine; Lovato, Eleonora; Longworth, Louise

    2015-12-01

    As part of its Medical Technology Evaluation Programme, the National Institute for Health and Care Excellence (NICE) invited a manufacturer to provide clinical and economic evidence for the evaluation of the Debrisoft(®) monofilament debridement pad for use in acute or chronic wounds. The University of Birmingham and Brunel University, acting as a consortium, was commissioned to act as an External Assessment Centre (EAC) for NICE, independently appraising the submission. This article is an overview of the original evidence submitted, the EAC's findings and the final NICE guidance issued. The sponsor submitted a simple cost analysis to estimate the costs of using Debrisoft(®) to debride wounds compared with saline and gauze, hydrogel and larvae. Separate analyses were conducted for applications in home and applications in a clinic setting. The analysis took an UK National Health Service (NHS) perspective. It incorporated the costs of the technologies and supplementary technologies (such as dressings) and the costs of their application by a district nurse. The sponsor concluded that Debrisoft(®) was cost saving relative to the comparators. The EAC made amendments to the sponsor analysis to correct for errors and to reflect alternative assumptions. Debrisoft(®) remained cost saving in most analyses and savings ranged from £77 to £222 per patient compared with hydrogel, from £97 to £347 compared with saline and gauze, and from £180 to £484 compared with larvae depending on the assumptions included in the analysis and whether debridement took place in a home or clinic setting. All analyses were severely limited by the available data on effectiveness, in particular a lack of comparative studies and that the effectiveness data for the comparators came from studies reporting different clinical endpoints compared with Debrisoft(®). The Medical Technologies Advisory Committee made a positive recommendation for adoption of Debrisoft(®) and this has been published

  20. Wound Dressings and Comparative Effectiveness Data

    OpenAIRE

    Sood, Aditya; Granick, Mark S.; Tomaselli, Nancy L.

    2014-01-01

    Significance: Injury to the skin provides a unique challenge, as wound healing is a complex and intricate process. Acute wounds have the potential to move from the acute wound to chronic wounds, requiring the physician to have a thorough understanding of outside interventions to bring these wounds back into the healing cascade.

  1. Hipergranulación en heridas crónicas: un problema ocasional pero no infrecuente Hypergranulation of chronic wounds: an occasional but not infrequent problem

    Directory of Open Access Journals (Sweden)

    Daniel Chaverri Fierro

    2007-09-01

    Full Text Available La hipergranulación es un problema ocasional, pero a la vez no infrecuente, con el que se enfrentan muchos clínicos responsables del tratamiento de heridas en su práctica diaria. Este fenómeno ocurre en un amplio abanico de heridas que incluyen las incisiones y heridas posquirúrgicas, los estomas (gastrostomías, traqueostomías, etc. y las heridas crónicas. El objetivo del presente artículo es cuantificar y analizar la evidencia generada en torno al tema de la hipergranulación en las heridas crónicas, mediante la búsqueda bibliográfica en diversas bases de datos. Tras el análisis y revisión de los diferentes documentos recuperados se evidencia, tanto cuantitativa como cualitativamente hablando, una escasez importante de investigación en torno a la hipergranulación en heridas crónicas. Esto hace que el problema no se halle lo suficientemente explicado y que no existan evidencias sólidas que justifiquen el uso de un tratamiento sobre otro.Hypergranulation is an occasional but no infrequent problem, which many clinicians face in their daily practice. This phenomenon occurs in a variety of wounds that includes post-surgical incisions and wounds, stomas (gastrostomies, tracheotomies… and chronic wounds. The objective of the present article is to quantify and to analyze the evidence generated around the topic of the hypergranulation in chronic wounds, through the bibliographical search in diverse data bases. After the analysis and revision of the different recovered documents it is demonstrated, both in terms of quantity and quality, an important shortage of investigation around the hypergranulation in chronic wounds. Therefore, the problem is not sufficiently explained and solid evidences do not exist to justify the use of a treatment over another one.

  2. Evaluating the Effect of Sarconesiopsis magellanica (Diptera: Calliphoridae) Larvae-Derived Haemolymph and Fat Body Extracts on Chronic Wounds in Diabetic Rabbits

    Science.gov (United States)

    Góngora, Jennifher; Díaz-Roa, Andrea; Ramírez-Hernández, Alejandro; Cortés-Vecino, Jesús A.; Gaona, María A.; Patarroyo, Manuel A.

    2015-01-01

    We evaluated extracts taken from S. magellanica third instar larvae fat body and haemolymph using a diabetic rabbit model and compared this to the effect obtained with the same substances taken from Lucilia sericata larvae. Alloxan (a toxic glucose analogue) was used to induce experimental diabetes in twelve rabbits. Dorsal wounds were made in each animal and they were infected with Staphylococcus aureus and Pseudomonas aeruginosa. They were then treated with haemolymph and lyophilized extracts taken from the selected blowflies' larvae fat bodies. Each wound was then evaluated by using rating scales and histological analysis. More favourable scores were recorded on the PUSH and WBS scales for the wounds treated with fat body derived from the larvae of both species compared to that obtained with haemolymph; however, wounds treated with the substances taken from S. magellanica had better evolution. Histological analysis revealed that treatment led to tissue proliferation and more effective neovascularisation in less time with both species' fat body extracts compared to treatment with just haemolymph. The results suggest the effectiveness of the substances evaluated and validate them in the animal model being used here as topical agents in treating chronic wounds. PMID:25866825

  3. Healing effect of aloe vera gel,in non-healed ulcers

    Institute of Scientific and Technical Information of China (English)

    Majid Avijgan; Victoria Beigi Broujeni; Ali Akbar Beigi; Hojatollah Rohi Borojeni; Seyyed Ka-myar Mostafavizadeh; Iraj Karimi; Abbas Ali Javadi

    2009-01-01

    Objective:Aloe Vera gel (AVG)has a prominent role as a contemporary folk remedy.The Non-healed chron-ic ulcers of 16 non-responders to conventional treatment were treated with AVG for which the clinical efficacy was studied.Methods:This study included 16 patients having chronic ulcer (9 males and 7 females)with mean age of 41.8 ±14.6 who following failure treatment to conventional therapy,were dispensed AVG to ap-ply.AVG is consisted from gel part of Aloe Vera plant plus one preservative material,in this study ECG jelly. The patients were assessed as responder whenever intensity of inflammation,the number and /or the size of ul-cers have been reduced.Results:The period of time till healing (complete or reduction in size of ulcer), were from 5 to 160 days with mean of 31.2 ±36.4 days.The mean time of decreasing for secreting,swelling and redness was from 5-11 days.Spearman coefficient of correlation,showed no significant correlation between first size and depth of ulcer and timing till 50% reduction in size of ulcer.Conclusion:All patients had been treated with conventional treatment all to no avail.There were some full thickness ulcer which at the end of treatment we observed an improvement and normal skin for those ulcers.There was a minor complication like itching in one patient but no leading to stop treatment.These findings suggest that AVG is an excellent and sa-fer choice than current conventional therapeutic management of chronic ulcers.

  4. 银离子敷料促慢性创面愈合效应%Silver ion dressing effects on healing of chronic wound

    Institute of Scientific and Technical Information of China (English)

    刘韬; 徐海栋

    2013-01-01

    背景:银离子敷料应用的理论基础是湿性愈合理论,利用创面的湿润环境减少组织坏死、加速新生上皮形成、减轻治疗过程中病患的疼痛、强化各种生长因子对伤口内组织细胞的修复,因此具有抗感染、促进创面肉芽形成、上皮增生的作用,有利于慢性创面的愈合。  目的:对比观察银离子敷料与常规消毒敷料在慢性创面治疗中的作用。  方法:选择解放军南京军区南京总医院汤山分院住院的慢性创面未愈合患者40例,采用随机数字表法分两组治疗,在预防及控制感染、改善组织循环等常规处理后,试验组给予银离子敷料换药处理,对照组采用常规消毒敷料换药。于治疗前及治疗后7,14,21 d进行创面分泌物细菌培养,观察创面愈合情况,以疼痛目测类比评分评估疼痛感。  结果与结论:与对照组比较,试验组创面细菌检出率明显降低(P0.05)。两组均未发生任何不良反应。结果表明银离子敷料在慢性创面治疗中的作用明确,可有效抗菌,促进创面肉芽、上皮增生,促进创面愈合,减轻病患治疗过程中的痛苦且无不良反应。%BACKGROUND:Silver ion dressing can reduce tissue necrosis, accelerate the epithelial formation, relieve the patient’s pain during the treatment, and strengthen various growth factors for wound repair, which is based on the theory of wet healing theory. It has obvious advantages for chronic wound healing, such as anti-infection and promoting wound granulation and epithelial hyperplasia. OBJECTIVE:To observe the efficacy of silver ion dressing used in healing of chronic wound. METHODS:A total of 40 patients who had chronic wounds were selected from Tangshan Branch Hospital of Nanjing General Hospital of Nanjing Military Command. Al cases were divided into two groups. The treatment group was treated with silver ion dressing, and the control group

  5. Evaluation of soft tissue coverage over porous polymethylmethacrylate space maintainers within nonhealing alveolar bone defects.

    Science.gov (United States)

    Kretlow, James D; Shi, Meng; Young, Simon; Spicer, Patrick P; Demian, Nagi; Jansen, John A; Wong, Mark E; Kasper, F Kurtis; Mikos, Antonios G

    2010-12-01

    Current treatment of traumatic craniofacial injuries often involves early free tissue transfer, even if the recipient site is contaminated or lacks soft tissue coverage. There are no current tissue engineering strategies to definitively regenerate tissues in such an environment at an early time point. For a tissue engineering approach to be employed in the treatment of such injuries, a two-stage approach could potentially be used. The present study describes methods for fabrication, characterization, and processing of porous polymethylmethacrylate (PMMA) space maintainers for temporary retention of space in bony craniofacial defects. Carboxymethylcellulose hydrogels were used as a porogen. Implants with controlled porosity and pore interconnectivity were fabricated by varying the ratio of hydrogel:polymer and the amount of carboxymethylcellulose within the hydrogel. The in vivo tissue response to the implants was observed by implanting solid, low-porosity, and high-porosity implants (n = 6) within a nonhealing rabbit mandibular defect that included an oral mucosal defect to allow open communication between the oral cavity and the mandibular defect. Oral mucosal wound healing was observed after 12 weeks and was complete in 3/6 defects filled with solid PMMA implants and 5/6 defects filled with either a low- or high-porosity PMMA implant. The tissue response around and within the pores of the two formulations of porous implants tested in vivo was characterized, with the low-porosity implants surrounded by a minimal but well-formed fibrous capsule in contrast to the high-porosity implants, which were surrounded and invaded by almost exclusively inflammatory tissue. On the basis of these results, PMMA implants with limited porosity hold promise for temporary implantation and space maintenance within clean/contaminated bone defects. PMID:20524844

  6. Evaluation of soft tissue coverage over porous polymethylmethacrylate space maintainers within nonhealing alveolar bone defects.

    Science.gov (United States)

    Kretlow, James D; Shi, Meng; Young, Simon; Spicer, Patrick P; Demian, Nagi; Jansen, John A; Wong, Mark E; Kasper, F Kurtis; Mikos, Antonios G

    2010-12-01

    Current treatment of traumatic craniofacial injuries often involves early free tissue transfer, even if the recipient site is contaminated or lacks soft tissue coverage. There are no current tissue engineering strategies to definitively regenerate tissues in such an environment at an early time point. For a tissue engineering approach to be employed in the treatment of such injuries, a two-stage approach could potentially be used. The present study describes methods for fabrication, characterization, and processing of porous polymethylmethacrylate (PMMA) space maintainers for temporary retention of space in bony craniofacial defects. Carboxymethylcellulose hydrogels were used as a porogen. Implants with controlled porosity and pore interconnectivity were fabricated by varying the ratio of hydrogel:polymer and the amount of carboxymethylcellulose within the hydrogel. The in vivo tissue response to the implants was observed by implanting solid, low-porosity, and high-porosity implants (n = 6) within a nonhealing rabbit mandibular defect that included an oral mucosal defect to allow open communication between the oral cavity and the mandibular defect. Oral mucosal wound healing was observed after 12 weeks and was complete in 3/6 defects filled with solid PMMA implants and 5/6 defects filled with either a low- or high-porosity PMMA implant. The tissue response around and within the pores of the two formulations of porous implants tested in vivo was characterized, with the low-porosity implants surrounded by a minimal but well-formed fibrous capsule in contrast to the high-porosity implants, which were surrounded and invaded by almost exclusively inflammatory tissue. On the basis of these results, PMMA implants with limited porosity hold promise for temporary implantation and space maintenance within clean/contaminated bone defects.

  7. 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...

  8. 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...

  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. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    OpenAIRE

    Burçin Abud; Kemal Karaarslan; Işıl Kılınç Karaarslan; Süreyya Talay; Soysal Turhan

    2014-01-01

    Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the prese...

  11. Punica granatum L. Hydrogel for Wound Care Treatment: From Case Study to Phytomedicine Standardization

    Directory of Open Access Journals (Sweden)

    Aline Fleck

    2016-08-01

    Full Text Available The pharmacological activities of many Punica granatum L. components suggest a wide range of clinical applications for the prevention and treatment of diseases where chronic inflammation is believed to play an essential etiologic role. The current work reports a case study analyzing the effect produced by a magistral formulation of ethanolic extracts of Punica granatum peels on a non-healing chronic ulcer. The complete closure of the chronic ulcer that was initially not responsive to standard medical care was observed. A 2% (w/w P. granatum peels ethanolic extract hydrogel-based formulation (PGHF was standardized and subjected to physicochemical studies to establish the quality control parameters using, among others, assessment criteria such as optimum appearance, pH range, viscosity and hydrogel disintegration. The stability and quantitative chromatographic data was assessed in storage for six months under two temperature regimes. An efficient HPLC-DAD method was established distinguishing the biomarkers punicalin and punicalagin simultaneously in a single 8 min run. PGHF presented suitable sensorial and physicochemical performance, showing that punicalagin was not significantly affected by storage (p > 0.05. Formulations containing extracts with not less than 0.49% (w/w total punicalagin might find good use in wound healing therapy.

  12. 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.

  13. 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...

  14. Wound Care in Burn Patients

    OpenAIRE

    Orhan Çizmeci; Samet Vasfi Kuvat

    2011-01-01

    Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are generea...

  15. Different expression of mu-opiate receptor in chronic and acute wounds and the effect of beta-endorphin on transforming growth factor beta type II receptor and cytokeratin 16 expression.

    Science.gov (United States)

    Bigliardi, P L; Sumanovski, L T; Büchner, S; Rufli, T; Bigliardi-Qi, M

    2003-01-01

    There is evidence that neuropeptides, especially the opiate receptor agonists, are involved in wound healing. We have previously observed that beta-endorphin, the endogenous ligand for the mu-opiate receptor, stimulates the expression of cytokeratin 16 in a dose-dependent manner in human skin organ cultures. Cytokeratin 16 is expressed in hyperproliferative epidermis such as psoriasis and wound healing. Therefore we were interested to study whether epidermal mu-opiate receptor expression is changed at the wound margins in acute and chronic wounds. Using classical and confocal microscopy, we were able to compare the expression level of mu-opiate receptors and the influence of beta-endorphin on transforming growth factor beta type II receptor in organ culture. Our results show indeed a significantly decreased expression of mu-opiate receptors on keratinocytes close to the wound margin of chronic wounds compared to acute wounds. Additionally beta-endorphin upregulates the expression of transforming growth factor beta type II receptor in human skin organ cultures. These results suggest a crucial role of opioid peptides not only in pain control but also in wound healing. Opioid peptides have already been used in animal models in treatment of wounds; they induce fibroblast proliferation and growth of capillaries, and accelerate the maturation of granulation tissue and the epithelization of the defect. Furthermore opioid peptides may fine-tune pain and the inflammatory response while healing takes place. This new knowledge could potentially be used to design new locally applied drugs to improve the healing of painful chronic wounds.

  16. Analysis of Risk Factors in Chronic Wound and Nursing Intervention%慢性伤口的风险评估和护理干预

    Institute of Scientific and Technical Information of China (English)

    许绵绵

    2014-01-01

    目的探讨护士处理慢性伤口的风险因素及护理干预措施,保障伤口护理质量和患者的安全。方法选择2013年7月~2014年6月我院伤口门诊接受治疗的慢性伤口患者120例,制定风险管理目标,从完善制度入手,规范操作流程,以患者安全为目标,做好全程风险管理。结果患者伤口的愈合率及对治疗效果、护士操作、服务态度、治疗环境的满意率均较以往提高(<0.01)。结论风险管理不但提高了伤口护理质量,确保了患者安全,也为医院赢得了良好形象。%Objective To explore ef ects and strategies of risk management for chronic wound treatment and quality nursing for patients . Methods In accordance with the inclusion and exclusion criteria,120 cases of patients with chronic wounds from July 2013 to June 2014 were chosen as experiment group. Measures were taken for managemengt of the nursing principles,flow sheet and process as wel as environmental surveillance. Results The experimental group was superior to the control group (before the performance)in the aspects of wound healing rate and patient's salisfaction( <0.01).Conclusion Risk management not only improves the quality of wound care ensures patient safety ,but also establishes a good image and market share for the hospital.

  17. Chitosan-shelled oxygen-loaded nanodroplets abrogate hypoxia dysregulation of human keratinocyte gelatinases and inhibitors: New insights for chronic wound healing

    Energy Technology Data Exchange (ETDEWEB)

    Khadjavi, Amina [Dipartimento di Neuroscienze, Università di Torino, Torino (Italy); Magnetto, Chiara [Istituto Nazionale di Ricerca Metrologica (INRIM), Torino (Italy); Panariti, Alice [Dipartimento di Scienze della Salute, Università di Milano Bicocca, Monza (Italy); Argenziano, Monica [Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Torino (Italy); Gulino, Giulia Rossana [Dipartimento di Oncologia, Università di Torino, Torino (Italy); Rivolta, Ilaria [Dipartimento di Scienze della Salute, Università di Milano Bicocca, Monza (Italy); Cavalli, Roberta [Dipartimento di Scienza e Tecnologia del Farmaco, Università di Torino, Torino (Italy); Giribaldi, Giuliana [Dipartimento di Oncologia, Università di Torino, Torino (Italy); Guiot, Caterina [Dipartimento di Neuroscienze, Università di Torino, Torino (Italy); Prato, Mauro, E-mail: mauro.prato@unito.it [Dipartimento di Neuroscienze, Università di Torino, Torino (Italy); Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università di Torino, Torino (Italy)

    2015-08-01

    Background: : In chronic wounds, efficient epithelial tissue repair is hampered by hypoxia, and balances between the molecules involved in matrix turn-over such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are seriously impaired. Intriguingly, new oxygenating nanocarriers such as 2H,3H-decafluoropentane-based oxygen-loaded nanodroplets (OLNs) might effectively target chronic wounds. Objective: : To investigate hypoxia and chitosan-shelled OLN effects on MMP/TIMP production by human keratinocytes. Methods: : HaCaT cells were treated for 24 h with 10% v/v OLNs both in normoxia or hypoxia. Cytotoxicity and cell viability were measured through biochemical assays; cellular uptake by confocal microscopy; and MMP and TIMP production by enzyme-linked immunosorbent assay or gelatin zymography. Results: : Normoxic HaCaT cells constitutively released MMP-2, MMP-9, TIMP-1 and TIMP-2. Hypoxia strongly impaired MMP/TIMP balances by reducing MMP-2, MMP-9, and TIMP-2, without affecting TIMP-1 release. After cellular uptake by keratinocytes, nontoxic OLNs abrogated all hypoxia effects on MMP/TIMP secretion, restoring physiological balances. OLN abilities were specifically dependent on time-sustained oxygen diffusion from OLN core. Conclusion: : Chitosan-shelled OLNs effectively counteract hypoxia-dependent dysregulation of MMP/TIMP balances in human keratinocytes. Therefore, topical administration of exogenous oxygen, properly encapsulated in nanodroplet formulations, might be a promising adjuvant approach to promote healing processes in hypoxic wounds. - Highlights: • Hypoxia impairs MMP9/TIMP1 and MMP2/TIMP2 balances in HaCaT human keratinocytes. • Chitosan-shelled oxygen-loaded nanodroplets (OLNs) are internalised by HaCaT cells. • OLNs are not toxic to HaCaT cells. • OLNs effectively counteract hypoxia effects on MMP/TIMP balances in HaCaT cells. • OLNs appear as promising and cost-effective therapeutic tools for hypoxic

  18. Diagnostic technologies for wound monitoring

    OpenAIRE

    Trill, Helen

    2006-01-01

    Chronic wound infections represent a worldwide problem, generating high morbidity and medical expense. Failure to control infections such as MRSA in the reparative process of a wound can cause disruption of normal anatomical structure and function, resulting in a chronic wound. Existing approaches to identifying infection largely involve surveying a range of physical parameters, and a limited use of non-invasive technologies. Evaluation is time consuming, and often results in inconsistenci...

  19. 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.

  20. Honey as an effective antimicrobial treatment for chronic wounds: is there a place for it in modern medicine?

    OpenAIRE

    Cooper R

    2014-01-01

    Rose Cooper Centre for Biomedical Sciences, Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK Abstract: Honey has a long history in the treatment of wounds, where claims of its therapeutic properties include the inhibition of a wide range of infectious agents as well as an ability to promote rapid wound healing. However, honey is not a uniform product, and its chemical composition can be influenced by multiple factors. The availability of modern, licensed...

  1. Calidad de vida relacionada con heridas crónicas Quality of life related with chronic wounds

    Directory of Open Access Journals (Sweden)

    Renata Virginia González-Consuegra

    2010-09-01

    widely as it is conceived personal health status that contains implicitly wellbeing. So, this paradigm has allowed developing measures (instruments to capture the multipledimensions of health, such as perceived health or health related quality of life (HRQOL. The measurement of HRQOL has proven useful in research, in clinical practice, in health services evaluation and in public health, contributing toenhance and improve health care management. With time evolution and technological progress, life expectancy has increased, resulting in an aging population with frequent presence of chronic and metabolic diseases which, in many cases,bring with chronic wounds, very difficult to manage and significantly negatively affecting the HRQOL of aged population, especially women. The recent literature is profuse on several instruments for measuring HRQL, so it's necessary to learn and to use the right tool, in regard to health conditions, in order to approximate to people real needs of care. Most HRQL measurement tools have been developed in Europe and U.S., So, if you would to be used in different population from the original ones it's need adaptation and validation respectively to the new population to reflect the real perception of population.

  2. PLATELET-RICH PLASMA (PRP AND ITS APPLICATION IN THE TREATMENT OF CHRONIC AND HARD-TO-HEAL SKIN WOUNDS. A Review.

    Directory of Open Access Journals (Sweden)

    Tsvetan Sokolov

    2015-12-01

    Full Text Available In the last few years various methods are being applied in the use of platelet-rich plasma (PRP during treatment in different orthopedic disease. They allow improvement of local biological condition and regeneration of different types of tissues. PRP is a modern treatment strategy with worldwide recognition. There is a high concentration of platelet growth factors in small amounts of plasma. PRP and its various forms have become one of the best methods to support the healing process of various tissues. PRP is used in regenerative medicine, because it provides two of three components (growth factors and scaffolds necessary for complete tissue regeneration. The particular reason for the appearance of lesions is important in order to select an appropriate treatment method and technical application. PRP may be used for treatment of various chronic and hard-to-heal cutaneous wounds, especially when standard conventional therapy is not good enough and surgical treatment is not possible. It reduces the duration, cost of treatment and the hospital stay. There is reduction of wound pain after starting the treatment, reduced risk of blood-borne disease transmission, wound healing is restored, and local immunity is activated.

  3. Honey as an effective antimicrobial treatment for chronic wounds: is there a place for it in modern medicine?

    Directory of Open Access Journals (Sweden)

    Cooper R

    2014-08-01

    Full Text Available Rose Cooper Centre for Biomedical Sciences, Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK Abstract: Honey has a long history in the treatment of wounds, where claims of its therapeutic properties include the inhibition of a wide range of infectious agents as well as an ability to promote rapid wound healing. However, honey is not a uniform product, and its chemical composition can be influenced by multiple factors. The availability of modern, licensed dressings containing medical grade honey has garnered renewed interest in its clinical potential for conventional wound care. Laboratory investigations are beginning to explain at a cellular and molecular level the effects of specific honeys on certain microorganisms, but the clinical evidence of its antimicrobial effects is limited at present. The aim of this review is to demonstrate the chemical complexity of honey, to describe the mechanisms of antibacterial action reported to date, and to collate the evidence that provides insight into antimicrobial claims for honey. Keywords: medical grade honey, wound infection, antibacterial activity, antibiofilm activity, wound healing

  4. 澳门护士慢性伤口护理知识调查研究%A study of nursing knowledge on chronic wound care in Macao

    Institute of Scientific and Technical Information of China (English)

    刘明; 殷磊; 古勤

    2013-01-01

    [目的]了解澳门特别行政区就读护理学位后深造文凭课程护士(PGDNs)及新毕业护士(NGNs)对慢性伤口护理知识认知情况,以便为今后同类课程的内容设计提供参考.[方法]采用横断面描述性研究设计,采用方便抽样法选择PGDNs 69人、NGNs 38人,应用Ayello等研制的慢性伤口护理知识问卷进行测量.[结果]除问题14,19,20,21(“是”或“否”题)外,其他17个问题正确回答率分别为PGDNs 62.3%~95.7%、NGNs 23.7%~94.7%.[结论]PGDNs的慢性伤口护理知识平均水平明显高于NGNs,提示应加强护理学士学位学生有关慢性伤口护理方面的教学内容;此外,两组护士在确定伤口的严重程度及现行慢性伤口护理指引方面均略显欠缺,因此,在本科教育及持续教育中,应加强这方面的内容.%Objective:To assess the nursing knowledge of chronic wound care among postgraduate diploma nurses and new graduate nurses in Macao in order to obtain the reference information for future curriculum design.Methods:A cross-sectional descriptive study with convenient sampling method was used to recruit 69 postgraduate diploma nurses (PGDNs) and 38 newly graduated nurses (NGNs).Questionnaire on chronic wound care by Ayello and Meaney in 2005 was used.Chi-square analysis was performed to exam the discrepancy of nursing knowledge on chronic wound care between groups.Results:Excluding questions number 14,19,20 and 21 (not true or false answer questions),the percentage of correct answer for the other17 questions is from 62.3% to 95.7% and from 23.7% to 94.7% for PGDNs and NGNs participants,respectively.Chisquare analysis demonstrates the difference of most questions between the two groups is statistically significant.Conclusions:The survey highlights a higher standard of wound care knowledge among PGDNs than NGNs,which propose the need of strengthening wound care content in the current basic nursing education programs.The findings

  5. 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

  6. Desarrollo de un índice de medida de la evolución hacia la cicatrización de las heridas crónicas Development of a wound healing index for chronic wounds

    Directory of Open Access Journals (Sweden)

    Juan Carlos Restrepo-Medrano

    2011-12-01

    Full Text Available Objetivos: revisar sistemáticamente la literatura sobre instrumentos de medida de la cicatrización. Adaptar y/o desarrollar una escala de medida de la evolución hacia la cicatrización de todo tipo de heridas crónicas. Material y método: el Estudio se lleva a cabo en dos fases: Fase 1: Revisión sistemática de la literatura en las principales bases de datos de ciencias de la salud (MEDLINE, CINAHL, CUIDEN, SCIELO, LILACS, COCHRANE, IME desde el inicio de las bases de datos hasta el año 2009. Las palabras incluidas en la estrategia de búsqueda fueron: instrument, tool, ulcer, chronic wound, healing, assessment, validation, reliability, así como las mismas en español, con sus correspondientes formulaciones booleanas utilizando AND, OR y el término de truncamiento para algunas de ellas. La búsqueda se llevó a cabo inicialmente en los tesauros y si la palabra no existía en texto libre. No se tuvo en cuenta para la inclusión el diseño del estudio. Se utilizó el sistema GRADE para evaluar la calidad de las publicaciones. Fase 2: Estudio Delphi modificado con un grupo de expertos en heridas crónicas, para llegar al consenso sobre las variables que pudieran medir la dimensión "evolución hacia la cicatrización". En la primera ronda se partió con todas las variables de la herida y el paciente encontradas en los diferentes instrumentos de la revisión sistemática. En la segunda ronda se enviaron los ítems que habían obtenido mayor puntuación. Finalmente, se envió la versión final y se preguntó a los expertos que puntuaran en una escala del 1 al 4 para obtener el índice de validez de contenido (CVI. Aquellas variables que hubieran obtenido un CVI superior al 80% fueron incluidas. Resultados: la revisión sistemática revela un número de ocho instrumentos de medida de cicatrización recogidos en 20 artículos (10 artículos sobre el PUSH, tres del PSST, uno de DESIGN, uno de PWAT, uno de la Escala Sessing, uno de la Escala

  7. Pleural effusion associated with acute and chronic pleuropneumonia and pleuritis secondary to thoracic wounds in horses: 43 cases (1982-1992).

    Science.gov (United States)

    Collins, M B; Hodgson, D R; Hutchins, D R

    1994-12-15

    Case records of 43 horses with pleural effusion associated with acute pleuropneumonia, chronic pleuropneumonia, or pleuritis secondary to a penetrating thoracic wound were reviewed to determine the predisposing factors, diagnosis, and treatment of this condition. Acute pleuropneumonia was diagnosed in 36 horses, the majority of which were Thoroughbreds (89%). Of 22 (61%) horses that were in race training at the onset of illness, 11 (31%) had been recently transported a long distance and 4 (11%) had evidence of exercise-induced pulmonary hemorrhage. Physical examination findings and hematologic data were nonspecific. The most consistent abnormality was hyperfibrino-genemia. Affected horses were treated with antibiotics, thoracic drainage, nonsteroidal anti-inflammatory drugs, and supportive care. Twenty-two (61%) horses were discharged from the hospital, with the mean duration of hospitalization for those discharged being 23 days. Nine (25%) horses were euthanatized and 5 (14%) died. Bacterial culturing of thoracic fluid resulted in growth in 30 of the 36 (83%) horses. The finding of anaerobic bacteria in thoracic fluid was not associated with a lower survival rate (62%) than the overall survival rate (61%). Four horses with chronic pleuropneumonia had a history of lethargy and inappetence for > 2 weeks. Actinobacillus equuli was isolated, either alone or in combination with other bacteria, from thoracic fluid of these 4 horses. Each horse was treated with broad spectrum antibiotics and made a rapid recovery. Three horses with acute pleuritis secondary to penetrating thoracic wounds also had nonspecific clinical signs, apart from the wound and a large volume of pleural effusion. Bacteriologic isolates from these horses differed slightly from those of horses with acute pleuropneumonia. PMID:7744650

  8. The effects of grounding (earthing on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases

    Directory of Open Access Journals (Sweden)

    Oschman JL

    2015-03-01

    Full Text Available James L Oschman,1 Gaétan Chevalier,2 Richard Brown3 1Nature’s Own Research Association, Dover, NH, USA; 2Developmental and Cell Biology Department, University of California at Irvine, Irvine, CA, USA; 3Human Physiology Department, University of Oregon, Eugene, OR, USA Abstract: Multi-disciplinary research has revealed that electrically conductive contact of the human body with the surface of the Earth (grounding or earthing produces intriguing effects on physiology and health. Such effects relate to inflammation, immune responses, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. The purpose of this report is two-fold: to 1 inform researchers about what appears to be a new perspective to the study of inflammation, and 2 alert researchers that the length of time and degree (resistance to ground of grounding of experimental animals is an important but usually overlooked factor that can influence outcomes of studies of inflammation, wound healing, and tumorigenesis. Specifically, grounding an organism produces measurable differences in the concentrations of white blood cells, cytokines, and other molecules involved in the inflammatory response. We present several hypotheses to explain observed effects, based on current research results and our understanding of the electronic aspects of cell and tissue physiology, cell biology, biophysics, and biochemistry. An experimental injury to muscles, known as delayed onset muscle soreness, has been used to monitor the immune response under grounded versus ungrounded conditions. Grounding reduces pain and alters the numbers of circulating neutrophils and lymphocytes, and also affects various circulating chemical factors related to inflammation. Keywords: chronic inflammation, immune system, wound repair, white blood cells, macrophages, autoimmune disorders

  9. Chemokine Regulation of Angiogenesis During Wound Healing

    OpenAIRE

    Bodnar, Richard J.

    2015-01-01

    Significance: Angiogenesis plays a critical role in wound healing. A defect in the formation of a neovasculature induces ulcer formation. One of the challenges faced by the clinician when devising strategies to promote healing of chronic wounds is the initiation of angiogenesis and the formation of a stable vasculature to support tissue regeneration. Understanding the molecular factors regulating angiogenesis during wound healing will lead to better therapies for healing chronic wounds.

  10. 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...

  11. Wound size measurement of lower extremity ulcers using segmentation algorithms

    Science.gov (United States)

    Dadkhah, Arash; Pang, Xing; Solis, Elizabeth; Fang, Ruogu; Godavarty, Anuradha

    2016-03-01

    Lower extremity ulcers are one of the most common complications that not only affect many people around the world but also have huge impact on economy since a large amount of resources are spent for treatment and prevention of the diseases. Clinical studies have shown that reduction in the wound size of 40% within 4 weeks is an acceptable progress in the healing process. Quantification of the wound size plays a crucial role in assessing the extent of healing and determining the treatment process. To date, wound healing is visually inspected and the wound size is measured from surface images. The extent of wound healing internally may vary from the surface. A near-infrared (NIR) optical imaging approach has been developed for non-contact imaging of wounds internally and differentiating healing from non-healing wounds. Herein, quantitative wound size measurements from NIR and white light images are estimated using a graph cuts and region growing image segmentation algorithms. The extent of the wound healing from NIR imaging of lower extremity ulcers in diabetic subjects are quantified and compared across NIR and white light images. NIR imaging and wound size measurements can play a significant role in potentially predicting the extent of internal healing, thus allowing better treatment plans when implemented for periodic imaging in future.

  12. 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

  13. The importance of growth factors for the treatment of chronic wounds in the case of diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Ehm, Alexandra

    2010-01-01

    Full Text Available Introduction: Ulcers as a result of diabetes mellitus are a serious problem with an enormous impact on the overall global disease burden due to the increasing prevalence of diabetes. Because of long hospital stays, rehabilitation, often required home care and the use of social services diabetic foot complications are costly. Therapy with growth factors could be an effective and innovative add-on to standard wound care. Research questions: What is the benefit of therapies with growth factors alone or in combination with other technologies in the treatment of diabetic foot ulcer assessed regarding medical, economical, social, ethical and juridical aspects? Methods: We systematically searched relevant databases limited to English and German language and publications since 1990. Cost values were adjusted to the price level of 2008 and converted into Euro. A review and an assessment of the quality of publications were conducted following approved methodical standards conforming to evidence-based medicine and health economics. Results: We identified 25 studies (14 randomized controlled trials (RCT, nine cost-effectiveness analyses, two meta-analyses. The RCT compared an add-on therapy to standard wound care with standard wound care/placebo alone or extracellular wound matrix: in six studies becaplermin, in two rhEGF, in one bFGF, and in five studies the metabolically active skin grafts Dermagraft and Apligraf. The study duration ranged from twelve to 20 weeks and the study population included between 17 to 382 patients, average 130 patients. The treatment with becaplermin, rhEGF and skin implants Dermagraft and Apligraf showed in eight out of 13 studies an advantage concerning complete wound closure and the time to complete wound healing. Evidence for a benefit of treatment with bFGF could not be found. In four out of 14 studies the proportion of adverse events was 30% per study group with no difference between the treatment groups. The methodological

  14. Quantitative wound healing studies using a portable, low cost, handheld near-infrared optical scanner: preliminary sensitivity and specificity analysis

    Science.gov (United States)

    Lei, Jiali; Rodriguez, Suset; Jayachandran, Maanasa; Solis, Elizabeth; Gonzalez, Stephanie; Perez-Clavijo, Francesco; Wigley, Stephen; Godavarty, Anuradha

    2016-03-01

    Lower extremity ulcers are devastating complications that are still un-recognized. To date, clinicians employ visual inspection of the wound site during its standard 4-week of healing process via monitoring of surface granulation. A novel ultra-portable near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory that can perform non-contact 2D area imaging of the wound site. From preliminary studies it was observed that the nonhealing wounds had a greater absorption contrast with respect to the normal site, unlike in the healing wounds. Currently, non-contact near-infrared (NIR) imaging studies were carried out on 22 lower extremity wounds at two podiatric clinics, and the sensitivity and specificity of the scanner evaluated. A quantitative optical biometric was developed that differentiates healing from non-healing wounds, based on the threshold values obtained during ROC analysis. In addition, optical images of the wound obtained from weekly imaging studies are also assessed to determine the ability of the device to predict wound healing consistently on a periodic basis. This can potentially impact early intervention in the treatment of lower extremity ulcers when an objective and quantitative wound healing approach is developed. Lastly, the incorporation of MATLAB graphical user interface (GUI) to automate the process of image acquisition, image processing and image analysis realizes the potential of NIROS to perform non-contact and real-time imaging on lower extremity wounds.

  15. The impact of noncontact, nonthermal, low-frequency ultrasound on bacterial counts in experimental and chronic wounds.

    Science.gov (United States)

    Serena, Thomas; Lee, S Kwon; Lam, Kan; Attar, Paul; Meneses, Patricio; Ennis, William

    2009-01-01

    Preventing wound infection and the development of resistant bacteria are important concerns in wound management. To determine if noncontact, nonthermal, low-frequency ultrasound therapy is effective in controlling wound bacterial colony counts, a series of four related experiments was conducted. First, ultrasound penetration in both wounded and intact skin was assessed in vitro. Compared to sham, noncontact ultrasound penetrated farther into both wounded (3 mm to 3.5 mm versus 0.35 mm to 0.50 mm) and intact (2.0 mm to 2.5 mm versus 0.05 mm to 0.07 mm, respectively) pig skin. Second, using an in vitro model to stain and count live/dead bacteria, 0% of sham treated and 33% of Pseudomonas aeruginosa, 40% of Escherichia coli and 27% of Enterococcus faecalis were dead after one ultrasound application. Minimal effects on methicillin-resistant Staphylococcus aureus and S. aureus were observed. Third, using an in vivo model, after 1 week, while differences between different bacterial species were observed, overall bacterial quantity decreased with ultrasound treatment (from 7.2 +/- 0.79 to 6.7 +/- 0.91 colony forming units per gram of tissue [CFU/g]) and silver antimicrobial dressings (from 7.2 +/- 0.79 to 5.7 +/- 0.6 CFU/g) but increased to 8.6 +/- 0.15 CFU/g for sham and 8.6 +/- 0.06 CFU/g for water-moistened gauze. Fourth, 11 patients (average age 60 years) with pressure ulcers containing bacterial counts >10(5) CFU/g of tissue received 2 weeks of noncontact ultrasound therapy. The quantities of seven bacterial organisms were reduced substantially from baseline to 2 weeks post treatment. None of the wounds exhibited signs of a clinical infection during the treatment period and no adverse events were observed. Taken together, these four studies indicate that noncontact ultrasound can be used to reduce bacterial quantity. Controlled clinical studies are warranted to ascertain the efficacy of this treatment and to further elucidate its effects on various Gram-negative and

  16. The effect of local anaesthetic wound infiltration on chronic pain after lower limb joint replacement: A protocol for a double-blind randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Alison J

    2011-02-01

    Full Text Available Abstract Background For the majority of patients with osteoarthritis (OA, joint replacement is a successful intervention for relieving chronic joint pain. However, between 10-30% of patients continue to experience chronic pain after joint replacement. Evidence suggests that a risk factor for chronic pain after joint replacement is the severity of acute post-operative pain. The aim of this randomised controlled trial (RCT is to determine if intra-operative local anaesthethic wound infiltration additional to a standard anaethesia regimen can reduce the severity of joint pain at 12-months after total knee replacement (TKR and total hip replacement (THR for OA. Methods 300 TKR patients and 300 THR patients are being recruited into this single-centre double-blind RCT. Participants are recruited before surgery and randomised to either the standard care group or the intervention group. Participants and outcome assessors are blind to treatment allocation throughout the study. The intervention consists of an intra-operative local anaesthetic wound infiltration, consisting of 60 mls of 0.25% bupivacaine with 1 in 200,000 adrenaline. Participants are assessed on the first 5 days post-operative, and then at 3-months, 6-months and 12-months. The primary outcome is the WOMAC Pain Scale, a validated measure of joint pain at 12-months. Secondary outcomes include pain severity during the in-patient stay, post-operative nausea and vomiting, satisfaction with pain relief, length of hospital stay, joint pain and disability, pain sensitivity, complications and cost-effectiveness. A nested qualitative study within the RCT will examine the acceptability and feasibility of the intervention for both patients and healthcare professionals. Discussion Large-scale RCTs assessing the effectiveness of a surgical intervention are uncommon, particulary in orthopaedics. The results from this trial will inform evidence-based recommendations for both short-term and long-term pain

  17. Application of modern network technology in nursing care of chronic wound%现代网络技术在慢性伤口护理中的应用

    Institute of Scientific and Technical Information of China (English)

    赵彩均; 丁福

    2016-01-01

    从伤口护理模式的变迁、对“网络”的理解、对我国伤口护理的启示3个方面,就现代网络技术在慢性伤口护理中的应用进行分析,提出要善于跟踪现代技术发展,完善伤口护理的网络平台。%It analyzed the application of modern network technology in the chronic wound care from three as-pects including change of wound care mode,understanding of “network”,enlightenment of wound care in our country.And it put forward we should be good at tracking the development of modern technology and perfect network platform of wound care.

  18. Diabetes induces stable intrinsic changes to myeloid cells that contribute to chronic inflammation during wound healing in mice

    OpenAIRE

    Pauline Bannon; Sally Wood; Terry Restivo; Laura Campbell; Hardman, Matthew J.; Mace, Kimberly A

    2013-01-01

    SUMMARY Acute inflammation in response to injury is a tightly regulated process by which subsets of leukocytes are recruited to the injured tissue and undergo behavioural changes that are essential for effective tissue repair and regeneration. The diabetic wound environment is characterised by excessive and prolonged inflammation that is linked to poor progression of healing and, in humans, the development of diabetic foot ulcers. However, the underlying mechanisms contributing to excessive i...

  19. 392例慢性创面患者的病因与疗效分析%Clinical analysis of chronic wounds

    Institute of Scientific and Technical Information of China (English)

    陈文海; 果磊; 王灿; 蒲晓姝; 魏东山

    2012-01-01

    目的 总结慢性创面临床特征与治疗经验.方法 回顾性分析2000年1月~2010年12月重庆医科大学附属第一医院收治392例慢性创面患者的临床资料.结果 慢性创面患者以创伤性(85例)、压疮(58例)、术后(50例)、糖尿病性(48例)、烧伤性(35例)、血管性(31例)等为主;占78.32% (307/392).其中对237例行创面细菌培养,结果阳性205例,共培养出353株细菌,以金黄色葡萄球菌(52株)、大肠埃希菌(45株)、铜绿假单胞属(46株)、肺炎克雷伯(27株)等为主.对332例行手术治疗,皮片移植191例,皮瓣修复82例,皮片移植+皮瓣修复19例,清创缝合40例.392例中365例治愈(49例行再手术),25例因经济等原因未愈出院,2例压疮因并发症死亡.结论 慢性创面主要受严重创伤、感染、血液和神经营养以及细胞功能障碍等因素影响,重视病因分析,加强创面床准备,选择最佳治疗方案,早期适时运用整形外科技术封闭创面,能显著促进创面愈合.%Objective To sum up the clinical characteristics and experience in the treatment of chronic wounds. Methods A retrospective analysis of clinical characteristics and therapy in 392 patients were performed. Results There were main 85 traumatic ulcers,58 pressure ulcers ,50 postoperative ulcers,48 diabetes ulcers,35 burn ulcers,31 Vascular ulcers in this grup. Bacterial cultures in 237 cases were taken, 205 cases were positive, 353 strains of pathogenic bacteria of positive cultures, The Mainly pathogens were Staphylococcus aureus (52) , Escherichia coli (45) , Pseudomonas aerug-inosa (46) ,Klebsiella pneumonia (27) ;332 patients underwent operations, 191 Skin grafting,82 skin flap,19 Skin grafting combining skin flap ,40 debridement and suturing;365 patiens were recovery (49 patiens underwent re-operation), 25 pa-tiens had to leave hospital because economic burden, 2 patients with pressure ulcers died of complications. Conclusion Healing of chronic wounds was

  20. 慢性伤口患者营养状况及其影响因素的调查分析%The nutritional status and inlfuencing factors among patients with chronic wound

    Institute of Scientific and Technical Information of China (English)

    丁郭平; 路潜

    2013-01-01

    Objective:To explore the nutritional status and influencing factors,among patients with chronic wounds. Methods:We assessed 102 patients with chronic wounds.by anthropometric nutritional status evaluation, laboratory tests and subjective global assessment (SGA). Results:The malnourished incidence among patients with chronic wounds was from 10.8 to 40.2%. The malnutrition incidence was associated with age, comorbidity index, and dietary intake adequacy. Conclusion:Some patients with chronic wounds have malnutrition. We should take effective intervention according to the patients' influencing factors.%目的:了解慢性伤口患者的营养状况及其影响因素。方法:采用人体测量、实验室检查以及主观全面评定法(SGA)对102例慢性伤口患者进行营养状况评估。结果:慢性伤口患者中营养不良发生率为10.8%~40.2%,年龄、合并症指数、膳食摄入是否充分是营养不良发生的影响因素。结论:部分慢性伤口患者存在营养不良,应针对营养状况的影响因素给予护理干预。

  1. Trends in Surgical Wound Healing

    DEFF Research Database (Denmark)

    Gottrup, F.

    2008-01-01

    The understanding of acute and chronic wound pathophysiology has progressed considerably over the past decades. Unfortunately, improvement in clinical practice has not followed suit, although new trends and developments have improved the outcome of wound treatment in many ways. This review focuses...

  2. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

    Directory of Open Access Journals (Sweden)

    Ting Zhang

    2016-01-01

    Full Text Available Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT. Results. The primary diseases were herpes simplex keratitis (8 eyes, corneal graft ulcer (2 eyes, and Stevens-Johnson syndrome (1 eye. All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8±3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P=0.001. A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

  3. The Microbiome in Wound Repair and Tissue Fibrosis

    OpenAIRE

    Brittan S Scales; Huffnagle, Gary B.

    2012-01-01

    Bacterial colonization occurs in all wounds, chronic or acute and the break in epithelium integrity that defines a wound impairs the forces that shape and constrain the microbiome at that site. This review highlights the interactions between bacterial communities in the wound and the ultimate resolution of the wound or development of fibrotic lesions. Chronic wounds support complex microbial communities comprised of a wide variety of bacterial phyla, genera and species, including some fastidi...

  4. Influence of negative pressure wound therapy on granulation tissue formation and interleukin-6 variation in chronic wound%负压创面疗法对慢性创面肉芽组织生长及白细胞介素-6的影响

    Institute of Scientific and Technical Information of China (English)

    李虎山; 雷晋; 郝振明

    2011-01-01

    Objective To investigate the influence of negative pressure wound therapy ( NPWT ) on vascular endothelial cells, proliferating cells and interleukin-6 variation in chronic wound. Methods Forty patients with chronic wound were divided into negative pressure wound therapy treatment group and conventional treatment group randomly. The granulation tissue formation was observed, and specimens were obtained from wound bed at 1, 4, 7, 14 days after treatment. The specimens were pathologically studied with hematoxylin-eosin staining to assess the wound healing process of the two groups. Furthermore, immunohistochemistry was done to estimate the number of vascular endothelial cells ( factor vm related antigen being used as marker ) and proliferating cells ( mouse anti-Ki-67 nuclear antigen being used as marker). Exudates of chronic wound were collected at 1, 4, 7, 14 days after negative pressure wound therapy treatment, interleukin-6 contents were determined and comparisons were made between them based on enzyme linked Immunosorbnent assay.Results The wounds of patients in negative pressure wound therapy treatment group were cured rapidly. The granulation tissue formation was promoted in negative pressure wound therapy treatment group. The number of vascular endothelial cells and proliferating cells in negative pressure wound therapy treatment group was larger than that of conventional treatment group ( P <0. 05 ). Interleukin-6 contents were decreased with time going after negative pressure wound therapy with significant variations between 1 ,4, 7 days ( P <0. 05 ), and levels of interleukin-6 were got close to normal at 7, 14days. Conclusion Compared with conventional treatment, negative pressure wound therapy could initiate granulation tissue formation more promptly, accelerate endothelial cell cytopoiesis, stimulate cell proliferation and decrease interleukin-6 contents.%目的 研究负压创面疗法对慢性创面血管内皮细胞、增

  5. 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...

  6. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    Directory of Open Access Journals (Sweden)

    Burçin Abud

    2014-12-01

    Full Text Available Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the present study, we retrospectively evaluated the results of topical application of amelogenin extracellular matrix protein in resistant venous ulcers. Materials and Methods: We analyzed the records of patients with treatment-resistant venous ulceration who were treated with amelogenin extracellular matrix protein between June 2011 and December 2012.. Results: 26 patients (21 male and 5 female with a total number of 28 ulcers (24 patients with 1 ulcer, 2 patients with two ulcers were evaluated. The patients were treated with topically applied amelogenin extracellular matrix protein and regional four bandage compression. Bandages were changed weekly. Each cure continued for six weeks. In fourteen patients (15 ulcers, we observed a complete healing by the end of the first cure. In another twelve cases (13 ulcers, the same period resulted with a reduction in wound diameter. We continued to the second cure for these patients. By the end of the second cure, complete healing was achieved in five cases (6 ulcers. Conclusion: Topical application of amelogenin extracellular matrix protein may be considered as an effective therapeutic choice for refractory venous ulcers.

  7. 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.

  8. Clinical analysis of vacuum sealing drainage combined with artificial dermis in repairing chronic wounds%封闭负压引流技术联合人工真皮修复慢性创面的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈柏秋; 彭文要; 邱加崇; 余继超; 刘冰峰; 招伟峰

    2014-01-01

    目的 观察封闭负压引流技术(VSD)联合人工真皮修复慢性创面的临床疗效.方法 66例慢性创面患者随机分成两组.对照组33例:予抗感染,改善微循环,聚维酮纱外敷,经换药治疗创面未愈者行植皮或皮瓣修复术.观察组33例:予抗感染,改善微循环,早期应用VSD处理创面,创面有新鲜肉芽组织后植入人工真皮(皮耐克),待其肉芽生长满意后行植皮术.结果 对照组平均住院天数(55.3±1.2)天,其中植皮或皮瓣修复术修复30例,创面换药愈合者3例,创面愈合后疤痕增生明显.观察组平均住院天数(31.6±1.2)天,其中20例患者创面较大,经外敷人工真皮,肉芽生长满意后予植皮手术,其余患者经植入人工真皮换药,创面治愈后外观满意,疤痕增生轻或不明显.结论 VSD联合人工真皮修复慢性创面可以有效的促进慢性创面愈合,减少疤痕增生,缩短住院时间.%Objective To observe the clinical efficacy of vacuum sealing drainage (VSD) combined with artificial dermis in repairing chronic wounds.Methods 66 cases of chronic wounds were randomly divided into control group and observation group,33 cases in each group.Control group was treated by antiinfection,microcirculation improvement,and wounds were covered by gauze soaked with povidone iodine cream with regular dressing change.Observation group was treated by anti-infection,microcirculation improvement and early vacuum sealing drainage (VSD),wounds were covered by artificial dermis (PELNAC) to induce dermal reconstruction after granulation tissue grew.Some bigger wounds were treated by skin grafting on base of satisfying growth of granulation tissue.Results In control group,the average hospital stay was (55.3 ± 1.2) days,30 cases received skin grafting or skin flap transplantation,wounds in 3 cases healed by wound dressing with remarkable scar formation.In observation group,the average hospital stay was (31.6 ± 1.2) days,bigger wounds in 20 cases

  9. 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.

  10. Improvement of wound healing by water-filtered infrared-A (wIRA in patients with chronic venous stasis ulcers of the lower legs including evaluation using infrared thermography

    Directory of Open Access Journals (Sweden)

    Hoffmann, Gerd

    2008-10-01

    Full Text Available Background: Water-filtered infrared-A (wIRA is a special form of heat radiation with a high tissue-penetration and with a low thermal burden to the surface of the skin. wIRA is able to improve essential and energetically meaningful factors of wound healing by thermal and non-thermal effects. Aim of the study: prospective study (primarily planned randomised, controlled, blinded, de facto with one exception only one cohort possible using wIRA in the treatment of patients with recalcitrant chronic venous stasis ulcers of the lower legs with thermographic follow-up. Methods: 10 patients (5 males, 5 females, median age 62 years with 11 recalcitrant chronic venous stasis ulcers of the lower legs were treated with water-filtered infrared-A and visible light irradiation (wIRA(+VIS, Hydrosun® radiator type 501, 10 mm water cuvette, water-filtered spectrum 550–1400 nm or visible light irradiation (VIS; only possible in one patient. The uncovered wounds of the patients were irradiated two to five times per week for 30 minutes at a standard distance of 25 cm (approximately 140 mW/cm2 wIRA and approximately 45 mW/cm2 VIS. Treatment continued for a period of up to 2 months (typically until closure or nearly closure of the ulcer. The main variable of interest was “percent change of ulcer size over time” including complete wound closure. Additional variables of interest were thermographic image analysis, patient’s feeling of pain in the wound, amount of pain medication, assessment of the effect of the irradiation (by patient and by clinical investigator, assessment of feeling of the wound area (by patient, assessment of wound healing (by clinical investigator and assessment of the cosmetic state (by patient and by clinical investigator. For these assessments visual analogue scales (VAS were used. Results: The study showed a complete or nearly complete healing of lower leg ulcers in 7 patients and a clear reduction of ulcer size in another 2 of 10

  11. 碱性成纤维细胞生长因子加速慢性难愈合创面愈合%Healing of chronic cutaneous wounds by topical treatment with basic fibroblast growth factor

    Institute of Scientific and Technical Information of China (English)

    付小兵; 沈祖尧; 郭振荣; 张明良; 盛志勇

    2002-01-01

    Objective To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. Methods Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150?AU/cm2. Healing time and the quality of wounds were used to evaluate the efficacy of the treatment.Results Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed.Conclusions Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.%目的 观察重组中碱性成纤维细胞生长因子(rbFGF)对慢性难愈合创面(溃疡)的促修复作用并探讨其促修复机制。方法 本组28例共33个慢性难愈合创面,其中创伤性溃疡12例(13个创面)、压迫性溃疡9例(13个创面),糖尿病溃疡4例,放射性溃疡3例。所有创面经清创后用rbFGF治疗(150?AU/cm2创面,每天1次)。结果 所有经rbFGF治疗的创面都产生了明显的愈合,其中2周内愈合为18例,2-3周内愈合为4

  12. A novel strategy for the treatment of chronic wounds based on the topical administration of rhEGF-loaded lipid nanoparticles: In vitro bioactivity and in vivo effectiveness in healing-impaired db/db mice.

    Science.gov (United States)

    Gainza, Garazi; Pastor, Marta; Aguirre, José Javier; Villullas, Silvia; Pedraz, José Luis; Hernandez, Rosa Maria; Igartua, Manoli

    2014-07-10

    Lipid nanoparticles are currently receiving increasing interest because they permit the topical administration of proteins, such as recombinant human epidermal growth factor (rhEGF), in a sustained and effective manner. Because chronic wounds have become a major healthcare burden, the topical administration of rhEGF-loaded lipid nanoparticles, namely solid lipid nanoparticles (SLN) and nanostructured lipid carries (NLC), appears to be an interesting and suitable strategy for the treatment of chronic wounds. Both rhEGF-loaded lipid nanoparticles were prepared through the emulsification-ultrasonication method; however, the NLC-rhEGF preparation did not require the use of any organic solvents. The characterisation of the nanoparticles (NP) revealed that the encapsulation efficiency (EE) of NLC-rhEGF was significantly greater than obtained with SLN-rhEGF. The in vitro experiments demonstrated that gamma sterilisation is a suitable process for the final sterilisation because no loss in activity was observed after the sterilisation process. In addition, the proliferation assays revealed that the bioactivity of the nanoformulations was even higher than that of free rhEGF. Finally, the effectiveness of the rhEGF-loaded lipid nanoparticles was assayed in a full-thickness wound model in db/db mice. The data demonstrated that four topical administrations of SLN-rhEGF and NLC-rhEGF significantly improved healing in terms of wound closure, restoration of the inflammatory process, and re-epithelisation grade. In addition, the data did not reveal any differences in the in vivo effectiveness between the different rhEGF-loaded lipid nanoparticles. Overall, these findings demonstrate the promising potential of rhEGF-loaded lipid nanoparticles, particularly NLC-rhEGF, for the promotion of faster and more effective healing and suggest their future application for the treatment of chronic wounds.

  13. 封闭式负压引流治疗急慢性创面修复56例临床分析%Clinical Analysis of 56 Cases Closed Suction Drainage Treatment of Acute and Chronic Wound Repair

    Institute of Scientific and Technical Information of China (English)

    王胜宝; 班开洪; 肖巍; 刘微波; 王庆华

    2014-01-01

    Objective To investigate Vacuum-sealing drainage, VSD treatment of acute and chronic wound healing clinical ef icacy. Methods A retrospective analysis the 56 patients from March 2012 to December 2013 in Second surgery of the hospital, 36 cases of acute trauma patients, chronic merger bedsores, pressure sores 20 patients were observed Vacuum-sealing drainage applications in the treatment of acute and chronic wound healing process of clinical ef icacy. Result The group of 56 patients wound healed wel , the average healing time was 7 ~ 26 d, time from surgery, granulation tissue growth time, oozing wound tissue and the incidence of infection, total hospitalization time analyzes, clinical results were satisfactory. Conclusion VSD in acute and chronic wound healing applications, with a strong resistance to infection, shorter healing time performance, improved clinical cure rate of acute and chronic wounds.%目的:探讨封闭式负压引流术(Vacuum-sealing drainage,VSD)治疗急慢性创面修复的临床疗效。方法回顾性分析自2012年3月~2013年12月在我院外二科住院的56例患者,其中急性外伤患者36例,慢性病合并褥疮、压疮患者20例,观察其应用封闭式负压引流术在急慢性创面修复治疗过程中的临床疗效。结果本组56例患者创面愈合良好,平均愈合时间为7~26 d,从手术时间、肉芽组织生长时间、创面组织渗出及感染发生率、总住院时间方面分析,临床效果满意。结论VSD在急慢性创面修复的应用中,具有抗感染能力强、愈合时间短的性能,提高了急慢性创面的临床治愈率。

  14. Adjuvant combined ozone therapy for extensive wound over tibia

    Directory of Open Access Journals (Sweden)

    Prasham Shah

    2011-01-01

    Full Text Available Disinfectant and antibacterial properties of ozone are utilized in the treatment of nonhealing or ischemic wounds. We present here a case of 59 years old woman with compartment syndrome following surgical treatment of stress fracture of proximal tibia with extensively infected wound and exposed tibia to about 4/5 of its extent. The knee joint was also infected with active pus draining from a medial wound. At presentation the patient had already taken treatment for 15 days in the form of repeated wound debridements and parenteral antibiotics, which failed to heal the wound and she was advised amputation. Topical ozone therapy twice daily and ozone autohemotherapy once daily were given to the patient along with daily dressings and parenteral antibiotics. Within 5 days, the wound was healthy enough for spilt thickness skin graft to provide biological dressing to the exposed tibia bone. Topical ozone therapy was continued for further 5 days till the knee wound healed. On the 15th day, implant removal, intramedullary nailing, and latissimus dorsi pedicle flap were performed. Both the bone and the soft tissue healed without further complications and at 20 months follow-up, the patient was walking independently with minimal disability.

  15. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Raffaele Marfella

    2012-01-01

    Full Text Available The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  16. Dipeptidyl peptidase 4 inhibition may facilitate healing of chronic foot ulcers in patients with type 2 diabetes.

    Science.gov (United States)

    Marfella, Raffaele; Sasso, Ferdinando Carlo; Rizzo, Maria Rosaria; Paolisso, Pasquale; Barbieri, Michelangela; Padovano, Vincenzo; Carbonara, Ornella; Gualdiero, Pasquale; Petronella, Pasquale; Ferraraccio, Franca; Petrella, Antonello; Canonico, Raffaele; Campitiello, Ferdinando; Della Corte, Angela; Paolisso, Giuseppe; Canonico, Silvestro

    2012-01-01

    The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19-35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  17. WOUND IMAGE ANALYSIS CLASSIFIER FOR EFFICIENT TRACKING OF WOUND HEALING STATUS

    Directory of Open Access Journals (Sweden)

    K. Sundeep Kumar

    2014-04-01

    Full Text Available Wounds are evolved by increase in number of damage tissues. The traditional way of assessing the wound healing status is to periodic measure of the area covered by the wound. This technique is tedious to measure and periodic assessment is cumbersome. Basically healing status of the wound can be classified as contact methods and non contact methods. The purpose of this research work is to accurately assess the healing status of the wound .To accurately assess the wound, capturing of the wound images are the first task to be performed. There are various tools like the photographic wound assessment tool (PWAT to acquire efficient wound images. Since the characteristics of different types of wounds (venous, pressure, diabetic, and arterial ulcers vary markedly, determining the reliability and validity of using the PWAT to assess wound appearance for both chronic pressure ulcers and leg ulcers due to vascular insufficiency is important. Segmenting the area of the wound from the wound image using efficient segmentation techniques and preprocessing the segmented wound to reduce the noise using efficient filters and efficient denoising techniques. Efficient classifiers are needed to classify the wound images. One among the classifiers are the Wound Image Analysis Classifier (WIAC. Experimental evaluation has been made on comparing various classifiers like SVM, KNN, WIAC.

  18. Wound Image Analysis Classifier for Efficient Tracking of Wound Healing Status

    Directory of Open Access Journals (Sweden)

    K. Sundeep Kumar

    2014-04-01

    Full Text Available Wounds are evolved by increase in number of damage tissues. The traditional way of assessing the wound healing status is to periodic measure of the area covered by the wound. This technique is tedious to measure and periodic assessment is cumbersome. Basically healing status of the wound can be classified as contact methods and non contact methods. The purpose of this research work is to accurately assess the healing status of the wound .To accurately assess the wound, capturing of the wound images are the first task to be performed. There are various tools like the photographic wound assessment tool (PWAT to acquire efficient wound images. Since the characteristics of different types of wounds (venous, pressure, diabetic, and arterial ulcers vary markedly, determining the reliability and validity of using the PWAT to assess wound appearance for both chronic pressure ulcers and leg ulcers due to vascular insufficiency is important. Segmenting the area of the wound from the wound image using efficient segmentation techniques and preprocessing the segmented wound to reduce the noise using efficient filters and efficient denoising techniques. Efficient classifiers are needed to classify the wound images. One among the classifiers are the Wound Image Analysis Classifier (WIAC. Experimental evaluation has been made on comparing various classifiers like SVM, KNN, WIAC.

  19. 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

  20. Regenerative Medicine: Charting a New Course in Wound Healing

    OpenAIRE

    Geoffrey C Gurtner; Chapman, Mary Ann

    2016-01-01

    Significance: Chronic wounds are a prevalent and costly problem in the United States. Improved treatments are needed to heal these wounds and prevent serious complications such as infection and amputation.

  1. Protein Degradation and Protection Observed in the Presence of Novel Wound Dressing Components

    OpenAIRE

    Parnell, Laura K.S.

    2011-01-01

    Chronic wounds typically have excessive levels of matrix metalloproteinases (MMPs) and proinflammatory cytokines that impair healing. Reducing these detrimental proteins may be key to healing chronic wounds. Proprietary protease blends were formulated specifically to degrade excessive amounts of proinflammatory factors that could prevent wound healing. Applications of protease-containing wound dressings to acute and chronic wounds have been observed clinically to resolve inflammation and appe...

  2. 负压治疗技术在急、慢性骨感染中的应用%Treatment of acute and chronic osteomyelitis with negative pressure wound therapy

    Institute of Scientific and Technical Information of China (English)

    谭延斌; 李杭; 潘志军; 郑强; 李建兵; 冯钢

    2008-01-01

    Objective To investigate the treatment of acute and chronic osteomyelitis with negative pressure wound therapy.Method Thirty cases of acute and chronic osteomyelitis were treated with negative presage wound therapy,assisted with debridement,autodermoplasty and myo-cutaneous flap surgery.Results No evidence of relapse was found in all cases treated with negative pressure wound thempy.All the patients were followed up,range from 6 to 23 months,the average was 13.6 months.Condusion The negative pressure wound thempy maybe a simple,effective and inexpensive method,and could be one of the favorable therapy in the treatment of acute and chronic osteomyelitis.%目的 探讨负压治疗技术在治疗急、慢性骨感染中的价值.方法 采用负压治疗技术.即在一段时间内将伤口置于密闭强力负压状态,治疗急、慢性骨感染患者30例(33个部位),辅助清创手术,应用敏感抗生素,应用植皮、肌皮瓣转移等方法闭合创面.结果 29个部位通过1次负压治疗就可达到创面闭合条件.所有患者均获随访,随访时间6~23个月,平均13.6个月,感染无复发.结论 负压治疗技术能有效控制急、慢性骨感染,缩短治疗时间,在骨感染治疗中有较好的应用前景.

  3. Telemedicine in wound care.

    Science.gov (United States)

    Chanussot-Deprez, Caroline; Contreras-Ruiz, José

    2008-12-01

    Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation. PMID:18808429

  4. 蜂蜜敷料在糖尿病慢性伤口创面床准备中的应用%Application of Honey Dressings in Diabetes Chronic Wound Bed Preparation

    Institute of Scientific and Technical Information of China (English)

    郭春兰; 付俊芳

    2012-01-01

    To observe the effects of honey dressings on diabetes chronic wound bed preparation. Methods A total of 55 cases with diabetes chronic wound were divided into control group, in which patients were coped with vaseline gauze and experiment group, in which patients were provided with honey dressings and integrated intervention was applied as well until wound healed or met surgery repairing indication. Healing and treatment time of two groups were recorded and the results were compared. Results Evolution period of experiment group was obviously faster than that of control group, which was similar to the healing process of acute wound. Meanwhile, time of wound red period evolution and treatment of experiment group were much faster than those of control group (P<0.01). Conclusion Honey dressings is an effective way for diabetes chronic wound bed preparation and is worthy of clinical application and further research.%目的 观察蜂蜜敷料在糖尿病慢性伤口创面床准备中的应用效果.方法 按入选标准选择55例糖尿病慢性伤口患者,分为两组,对照组采用传统的创面处理方法即凡士林敷料换药,观察组在创面床处理中采用蜂蜜敷料换药,并结合整体干预至伤口愈合或创面达到手术修复适应证时.记录比较两组伤口红期演进时间和治疗时间.结果 观察组各期间的演进速度明显快于对照组,表现出类似于急性伤口愈合过程;观察组红期的演进速度和治疗时间明显快于对照组,差异均有统计学意义(P<0.01).结论 在糖尿病慢性伤口创面床准备中采用蜂蜜敷料换药是有效的方法,符合慢性伤口"创面床准备"方案,值得临床推广应用和进一步研究.

  5. 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

  6. 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

  7. ROS constitute a convergence nexus in the development of IGF1 resistance and impaired wound healing in a rat model of type 2 diabetes

    OpenAIRE

    Bitar, Milad S.; Fahd Al-Mulla

    2012-01-01

    SUMMARY An indolent non-healing wound and insulin and/or insulin-like growth factor (IGF1) resistance are cardinal features of diabetes, inflammation and hypercortisolemia. Little is known about why these phenomena occur in so many contexts. Do the various triggers that induce insulin and/or IGF1 resistance and retard wound healing act through a common mechanism? Cultured dermal fibroblasts from rats and full-thickness excisional wounds were used as models to test the premise that reactive ox...

  8. 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

  9. Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia

    International Nuclear Information System (INIS)

    Objective: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. Design: Retrospective study of angiographic and clinical files in selected group. Materials and methods: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. Results: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). Conclusions: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group

  10. Complex wounds Feridas complexas

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    2006-01-01

    Full Text Available 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 treatment is unavoidable, because the extent of skin and subcutaneous tissue loss requires reconstruction with grafts and flaps. New technologies, such as the negative pressure device, should be introduced. A brief review is provided of the major groups of complex wounds-diabetic wounds, pressure sores, chronic venous ulcers, post-infection soft-tissue gangrenes, and ulcers resulting from vasculitis.Ferida complexa é uma nova definição para identificar aquelas feridas crônicas e algumas agudas já bem conhecidas e que desafiam equipes médicas e de enfermagem. São difíceis de serem resolvidas usando tratamentos convencionais e simples curativos. Têm atualmente grande impacto sócio-econômico. Esta revisão procura atrair atenção da comunidade de profissionais de saúde para estas feridas, sugerindo que devam ser tratadas por equipe multidisciplinar em centro hospitalar especializado. Na maioria dos casos o tratamento cirúrgico deve ser indicado, uma vez que a perda de pele e tecido subcutâneo é extensa, necessitando de reconstrução com enxertos e retalhos. Nova tecnologia, como uso da terapia por pressão negativa foi introduzido. Breves comentários sobre os principais grupos de feridas complexas: pé diabético, úlceras por pressão, úlceras venosas, síndrome de Fournier e vasculites.

  11. Biofilms and Wounds: An Overview of the Evidence

    OpenAIRE

    Percival, Steven L.; McCarty, Sara M.; Lipsky, Benjamin

    2015-01-01

    Significance: Microorganisms can exist both in the planktonic and biofilm state. Each phenotypic state has a role to play in delaying healing and causing infections of both acute and chronic wounds. However, the virulent biofilm state is the fundamental reason that chronic wounds do not heal in a timely manner. We hypothesize that because microorganisms attach to any surface, biofilms can be found in all chronic wounds. However, it is not the biofilm per se that represents the greatest obstac...

  12. EFFICACY OF HONEY BEE AND FAGOPYRUM ESCULENTUM MOENCH OINTMENT IN THE TREATMENT OF SUB CHRONIC WOUND IN RABBITS: A CASE CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    Djerrou Zouhir

    2014-01-01

    Full Text Available The present study was undertaken to evaluate the efficacy of an ointment of honey bee and Fagopyrum esculentum Moench in the management of large dermal wound in a male rabbit wounded accidently. The wound was covered entirely by honey and then the fine powder of buckwheat grains was added. The treatment was applied once a day until complete epithelization has taken place. The results showed a complete resorption of inflammatory exsudate of wound at 4th day. The percentage of wound contraction has shown a rate of 5.55% at the 4th, it has risen to 32.22 and 71.48% at days 7 and 11 respectively to register 99.53% at the 26th days. The epithelization period was 27 days with a mean healing rate of 200 mm2 day-1. The study concludes that the ointment of honey and buckwheat stimulate the healing process in dermal wounds particularly in term of wound contraction. Other studies are underway to understand the possible implication of some amino acids as lysine, proline and glycine presented in buckwheat in the collagen synthesis process.

  13. Treatment of a non-healing diabetic foot ulcer with platelet-rich plasma.

    Science.gov (United States)

    Suresh, Deepak H; Suryanarayan, Shwetha; Sarvajnamurthy, Sacchidanand; Puvvadi, Srikanth

    2014-01-01

    Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Among diabetes mellitus-related complications, foot ulceration is the most common, affecting approximately 15% of diabetic patients during their lifetime. The pathogenesis of diabetic ulcer is peripheral sensory neuropathy, calluses, oedema and peripheral vascular disease. Diabetic ulcer is managed by adequate control of infections and blood sugar levels, surgical debridement with various dressings and off loading of the foot from pressure. In spite of these standard measures, some recalcitrant non-healing ulcers need additional growth factors for healing. Autologous platelet-rich plasma is easy and cost-effective method in treating diabetic ulcers as it provides necessary growth factors which enhance healing.

  14. Treatment of a non-healing diabetic foot ulcer with platelet-rich plasma

    Directory of Open Access Journals (Sweden)

    Deepak H Suresh

    2014-01-01

    Full Text Available Lower extremity ulcers and amputations are an increasing problem among individuals with diabetes. Among diabetes mellitus-related complications, foot ulceration is the most common, affecting approximately 15% of diabetic patients during their lifetime. The pathogenesis of diabetic ulcer is peripheral sensory neuropathy, calluses, oedema and peripheral vascular disease. Diabetic ulcer is managed by adequate control of infections and blood sugar levels, surgical debridement with various dressings and off loading of the foot from pressure. In spite of these standard measures, some recalcitrant non-healing ulcers need additional growth factors for healing. Autologous platelet-rich plasma is easy and cost-effective method in treating diabetic ulcers as it provides necessary growth factors which enhance healing.

  15. Stem Cells for Cutaneous Wound Healing

    OpenAIRE

    Giles T. S. Kirby; Stuart J. Mills; Cowin, Allison J.; Smith, Louise E.

    2015-01-01

    Optimum healing of a cutaneous wound involves a well-orchestrated cascade of biological and molecular processes involving cell migration, proliferation, extracellular matrix deposition, and remodelling. When the normal biological process fails for any reason, this healing process can stall resulting in chronic wounds. Wounds are a growing clinical burden on healthcare systems and with an aging population as well as increasing incidences of obesity and diabetes, this problem is set to increase...

  16. Autologous Platelet Concentrate and Vacuum-Assisted Closure Device Use in a Nonhealing Total Knee Replacement

    OpenAIRE

    Klayman, Myra H.; Trowbridge, Cody C.; Stammers, Alfred H.; Wolfgang, Gary L.; Zijerdi, David A.; Bitterly, Thomas J.

    2006-01-01

    Following a total knee replacement surgery, a 51-year-old insulin-dependent patient presented with complications of impaired healing and postoperative trauma to the wound site. The inability of this leg wound to heal placed this patient at risk of amputation. Vacuum-assisted closure therapy was initiated at postoperative day 53; after 100 days of protracted wound history a series of treatments with topical platelet concentrates were added to the vacuum assisted closure therapy and conventiona...

  17. 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.

  18. Observation on the effect of Urgotul in the dressing change of acute and chronic wounds%优拓SSD用于急慢性伤口换药效果观察

    Institute of Scientific and Technical Information of China (English)

    来玉民; 高景芳; 戚海英

    2011-01-01

    目的:探讨优拓SSD用于急慢性伤口换药的效果.方法:将200例门诊换药患者采用随机分组法按双日单日分为观察组与对照组各100例.双日为观察组,用优拓SSD敷料覆盖创面;单日为对照组,用凡士林油纱覆盖创面.观察并记录两组患者第1次与第2次换药更换敷料时伤口出血、疼痛、粘连情况.结果:两组第1次、第2次换药更换敷料时伤口粘连、出血、疼痛程度比较差异有统计学意义(P<0.01).结论:优拓SSD用于急慢性伤口换药疗效优于凡士林油纱,具有促进伤口愈合、患者痛苦小等特点,是一种较为理想的换药敷料,值得临床推广应用.%Objective: To investigate the effect of Urgotul in the dressing change of acute and chronic wounds. Methods: 200 patients with dressing change in the outpatient department were randomly divided into observation group and control group ( 100 cases for each group ) according to the odd - numbered and even - numbered days. Urgotul was used to cover wound of the patients in the observation group and Vaseline gauze was used in the control group. The bleeding of the wound, pain and adhesion were observed and recorded in the two groups when the patients had dressing change for the 1 st and 2nd time. Results: There were statistically significant differences in the comparison of bleeding of the wound, pain and adhesion between the two groups ( P < 0.01 ). Conclusion: Urgotul used for the dressing change of acute and chronic wounds is more effective than Vaseline gauze, with the characteristics of promoting wound healing and little pain. It is one of ideal medical dressing and is worthy of being applied clinically.

  19. 局部高渗环境对慢性创伤性窦道的治疗效果分析%Analysis of curative effect on local hypertonic environment improves healing of chronic traumatic wounds

    Institute of Scientific and Technical Information of China (English)

    朱颉; 罗自通; 曹亿; 于萌蕾; 曾兵; 彭吉才; 黄都平

    2014-01-01

    Objective To compare the effects of hypertonic saline and isotonic saline solutions on the healing of chronic traumatic wounds. Methods Between March 2011 and March 2014, sixty-two patients with chronic traumatic wounds were randomized to 2 groups. Thirty-one cases were treated with 28%sodium chloride medical fiber/polyester non-woven dressing (group A) and the other 31 cases , with 0.9% sodium chloride medical gauze (group B). Series of wound cultures were performed, wound conditions were assessed, and the timing of wound healing and adverse reactions were recorded. Results The average healing time in group A was 18.6 days. The average healing time for group B patients was 22.5 days (P<0.05). No obvious adverse effects were observed in either group. Wound cultures showed that 80% of the patients with positive pre-treatment cultures became negative after 3 days of hypertonic saline treatment whereas only 10% turned negative in group B. Conclusion Local hypertonic environment may significantly reduce bacteria load in chronic wounds and improve wound healing.%目的:局部高渗引流及普通引流方法的比较,分析高渗环境下引流对慢性窦道的治疗效果。方法慢性创伤性窦道病例62例进行随机分成2组,其中31例伤口窦道内使用28%高渗氯化钠纤维/聚酯无纺布敷料进行引流,31例使用0.9%氯化钠纱条进行引流观察治疗效果及不良反应。结果28%高渗氯化钠纤维/聚酯无纺布敷料治疗组(高渗引流组)平均痊愈时间18.6天,0.9%氯化钠纱条组(等渗引流组)平均痊愈时间22.5天,两组慢性创面窦道痊愈时间差异有显著统计学意义(P<0.05);高渗引流组患者创面细菌培养阳性例数也明显低于等渗引流组。结论局部高渗压环境引流可显著抑制慢性创伤性窦道细菌微生物被膜的形成,对慢性窦道的愈合有显著的效果。

  20. 创面修复长路漫漫%It's a long way to go to apprehend wound repair

    Institute of Scientific and Technical Information of China (English)

    王一兵

    2014-01-01

    Wound healing is a complicated process,involving the activity of multiple cells and various cytokines.Chronic wound or intractable wound has already become a big challenge for clinicians.There are imbalances in the healing process of chronic wound,such as inflammatory response,cell proliferation,and remodeling of extracellular matrix.Combination of tissue transplantation and vacuum sealing drainage may be the optimum selection for wound repair.Besides the chronic wound,more attention should be paid to experimental and clinical studies on early-stage of healing of fresh wound and granulation wound in middle and late stages.

  1. Allogeneic Transplantation of an Adipose-Derived Stem Cell Sheet Combined With Artificial Skin Accelerates Wound Healing in a Rat Wound Model of Type 2 Diabetes and Obesity.

    Science.gov (United States)

    Kato, Yuka; Iwata, Takanori; Morikawa, Shunichi; Yamato, Masayuki; Okano, Teruo; Uchigata, Yasuko

    2015-08-01

    One of the most common complications of diabetes is diabetic foot ulcer. Diabetic ulcers do not heal easily due to diabetic neuropathy and reduced blood flow, and nonhealing ulcers may progress to gangrene, which necessitates amputation of the patient's foot. This study attempted to develop a new cell-based therapy for nonhealing diabetic ulcers using a full-thickness skin defect in a rat model of type 2 diabetes and obesity. Allogeneic adipose-derived stem cells (ASCs) were harvested from the inguinal fat of normal rats, and ASC sheets were created using cell sheet technology and transplanted into full-thickness skin defects in Zucker diabetic fatty rats. The results indicate that the transplantation of ASC sheets combined with artificial skin accelerated wound healing and vascularization, with significant differences observed 2 weeks after treatment. The ASC sheets secreted large amounts of several angiogenic growth factors in vitro, and transplanted ASCs were observed in perivascular regions and incorporated into the newly constructed vessel structures in vivo. These results suggest that ASC sheets accelerate wound healing both directly and indirectly in this diabetic wound-healing model. In conclusion, allogeneic ASC sheets exhibit potential as a new therapeutic strategy for the treatment of diabetic ulcers.

  2. Dermal Wound Fibroblasts and Matrix Metaloproteinases (MMPs: Their Possible Role in Allergic Contact Dermatitis

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khorramizadeh

    2004-03-01

    Full Text Available This study was conducted to examine if allergic contact dermatitis (ACD alters the expression of MMPs in human dermal fibroblasts. Fibroblasts are the primary source for MMP and matrix production in skin. MMPs are known to involve in a number of physiological and pathological processes. Some published data indicated a gelatinase-like activity in acute and chronic phases of allergic contact dermatitis. However, no exact source of gelatinase activity was demonstrated. Moreover, little is known about the role of MMPs in immune responses.To study and predict the pathophysiological effects of (MMP-2 in allergic contact dermatitic (ACD patients, we established an in vitro tissue culture survey based on fibroblast explanted from ACD wounds and normal tissues respectively. We also employed a precise proliferation assay [i.e. MTT; 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide] to analyze and compare three ACD vs. three normal cell strains. Parallel to MTT assay, we assessed the activity as well as the kinetics of gelatinase (MMP-2 in conditioned media using a zymogeraphy analysis. There was a significant difference in proliferation capacity between mean ACD fibroblast strains vs. mean normal cells, particularly in days 6 to 8 post explantation, 492.5±6.6 vs. 361.75±8.25 respectively. Zymoanalyses indicated significant differences between ACD cells and normal fibroblasts both in time-course and MMP-2 activity per cell fashions, 163.7±16.21 for mean ACD fibroblasts vs. 130±9.09 for normal cells respectively. These data suggest that fibroblasts overproliferated in the process of ACD.  Moreover, simultaneous overexpression of MMPs observed in ACD fibroblasts vs. normal strains, is indicative of altered fibroblast functionality in the process of allergic contactdermatitis. The activity per cell analysis showed that MMP-2 expression in ACD fibroblasts is independent of cell number, suggesting that either intra- or inter-cellular control

  3. 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 ...

  4. Teaching wound care to family medicine residents on a wound care service

    Directory of Open Access Journals (Sweden)

    Little SH

    2013-08-01

    Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

  5. 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.

  6. 慢性伤口癌变筛查结果分析及干预方法的初步探讨%Malignant changes of chronic wounds:Screening and intervention

    Institute of Scientific and Technical Information of China (English)

    蒋琪霞; 王建东; 周济宏; 彭青; 黄秀玲; 周昕; 王海; 李晓华; 李洋

    2015-01-01

    目的 慢性伤口长期反复感染增加处理难度和癌变风险.文中旨在探讨慢性伤口癌变筛查方法、临床特征及干预方法,为临床及早发现和有效干预提供依据. 方法 入选2010 年1 月至2014 年8 月在南京军区南京总医院初诊为慢性伤口患者共358 例,分为手术治疗组(n =78)和非手术治疗组(n =280),2 组均包扎伤口使用银敷料抗感染,全身采用口入营养食谱、心理调适等整体干预方案,前者实施病灶切除和转皮瓣手术,2 组干预观察期均为从伤口处理开始至第9 周.观察指标包括癌变检出率、致病菌阳性率、癌变伤口愈合率等. 结果 358 例患者癌变检出率为6.70%,癌变伤口患者的持续时间中位数为352.50d,癌变伤口类型构成比分别为不典型伤口(58.33%)、切口难愈(25%)、压疮(8.33%)、静脉性溃疡(4.17%)、外伤溃疡(4.17%).致病菌阳性率67.32%,2 组患者干预期内无死亡,伤口总愈合率差异无统计学意义(P =0.187),但手术治疗组癌变伤口愈合率高于非手术治疗组(75.00% vs 37.50%, P =0.040). 结论 长期感染是诱发慢性伤口癌变的可能原因,手术治疗是癌变伤口和引流不畅深部伤口的有效干预手段,非手术治疗是癌变伤口姑息治疗的可选方法和大部分未癌变伤口的有效干预方法.%Objective Long-term repeated infection of chronic wounds adds to the difficulty of management and risk of can -cerization.This article aimed to investigate the malignancy screening , clinical characteristics , and intervention strategies of chronic wounds in order to provide some evidence for the early detection and effective intervention of cancerization . Methods We allocated 358 patients with chronic wounds to a surgical (n=78) a non-surgical treatment group (n=280), both treated by application of silver dressing, oral nutrition and psychological adjustment , the former by lesion resection and skin flap transplantation in addition

  7. Experimental study on influence of chronic stress on skin wound healing and skin graft survival time in mice%慢性应激对小鼠创面愈合及移植皮片存活时间影响的初步研究

    Institute of Scientific and Technical Information of China (English)

    杨震; 亓发芝; 曹小曼; 潘思璇

    2009-01-01

    Objective To investigate the influence of chronic stress on skin wound healing and skin graft survival time in mice. Methods In the study on skin wound healing,a full-thickness dermal wound on the hack of the female C57 BL/6J mice was made, then the mice were randomly divided into simple wound group and wound plus chronic stress group. The chronic stress was given in the latter group. The wound healing conditions of two groups were observed. Meanwhile, the female C57BL/6J mice were grafted with skin donated from the female BALB/C mice,and randomly divided into,the simple skin graft group and the skin graft plus chronic stress group. The chronic stress was given in the latter group. The skin graft survival time of two groups were observed. Re-sults Compared with simple wound group, the healing speed of the wound plus chronic stress group was notably lower, and the difference was significant (P0.05). Conclusion Chronic stress may delay wound healing. But there is no certain conclusion that whether chronic stress impact on skin graft survival time. We need further investigation.%目的 探讨慢性应激对小鼠创面愈合及移植皮片存活时间的影响.方法 在C57BL/6J小鼠背部形成创面,术后将小鼠随机分到单纯创面组和慢性应激创面组,慢性应激创面组给予慢性刺激,观察两组创面愈合伤口情况;同时取BALB/C小鼠背部皮肤移植于C57BL/6J小鼠创面,术后将小鼠随机分到单纯移植组和慢性应激植皮组2个组,观察移植皮片存活情况.结果 与单纯创面组相比,慢性应激创面组创面残余面积较大[第10天时分别为(20.33±0.38)%,(33.55±7.02)%],差异有显著性(P0.05).结论 慢性应激能够延缓创面愈合,而慢性应激对皮片移植影响则不明确,需要进一步研究.

  8. Clinical application of negative pressure wound therapy with hypertonic saline dressing in the treatment of cancer patients chronic wounds%高渗盐敷料结合负压创面治疗技术治疗肿瘤患者慢性伤口的临床研究

    Institute of Scientific and Technical Information of China (English)

    张玲玲; 袁艺

    2012-01-01

    Objective Observe and study the application and the therapeutic effect of negative pressure wound therapy (NPWT) using hypertonic saline dressing in cancer patients'chronically moderate-sized superficial wounds. Method Sixty cancer patients who had chronically superficial wounds of moderate size were randomly divided into an experimental group (negative pressure treatment group) and a control group (conventional dressing group). The former was treated with a modified NPWT, which is using hypertonic saline dressing as filling material and disposable silicone gastric tube as the drainage tube to cooperate with clinical negative pressure suction device. The latter was strictly applied conventional dressing method. Noticeable-findings were observed and compared in terms of the wounds'healing time, frequency and costs of dressing changes. Result The healing period(P<0. 05), the frequency and the costs of dressing changes in the experimental group were significantly reduced comparing to the control group(P<0. 05). Conclusion The modified negative pressure wound therapy is likely to improve the wound closure rate of cancer patients with certain chronic wounds, reduce costs and shorten hospitalization for the patients; and lower related workload of nurses'.%目的 探讨高渗盐敷料结合负压创面治疗技术在肿瘤患者慢性、中小型、表浅伤口的运用和疗效.方法 将60例有慢性、中小型、表浅伤口的肿瘤患者随机分为实验组(负压治疗组)和对照组(常规换药组).实验组采用高渗盐敷料为伤口填充材料,以一次性使用胃导管为引流管,利用病房的负压吸引系统为患者进行负压创面引流治疗;对照组采用湿性愈合原理常规换药.观察比较两组患者伤口愈合时间、换药次数、换药费用.结果 实验组的伤口愈合时间、换药次数、换药费用都较对照组明显减少,P<0.05,差异具有显著意义.结论 高渗盐敷料结合负压创面治疗技术,

  9. 大枣牛肉粥治疗眼部慢性难愈合创面1例%1 case of ocular chronic wounds treated with jujube minced beef congee

    Institute of Scientific and Technical Information of China (English)

    闫平

    2015-01-01

    由于组织结构的特殊性,眼部慢性难愈合创面的治疗十分困难。本文就1例右眼慢性泪囊炎患者采用泪囊摘除术后,配合服用大枣牛肉粥治疗的临床经验作一简单介绍,旨在为今后的临床治疗提供经验。%Because of the special nature of the organizational structure,the treatment of eye chronic wounds is very difficult.In this paper,we introduced therapy experience on 1 cases of chronic dacryocystitis who were treated with eye dacryocystectomy, combined with taking jujube beef porridge briefly,in order to provide experience for clinical treatment in the future.

  10. Review of animal models used to study effects of bee products on wound healing: findings and applications

    Directory of Open Access Journals (Sweden)

    Hananeh Wael M.

    2015-09-01

    Full Text Available Non-healing wounds are associated with high morbidity and might greatly impact a patient’s well-being and economic status. For many years, scientific research has focused on developing and testing several natural and synthetic materials that enhance the rate of wound healing or eliminate healing complications. Honey has been used for thousands of years as a traditional remedy for many ailments. Recently, honey has reemerged as a promising wound care product especially for infected wounds and for wounds in diabetic patients. In addition to its proposed potent broad-spectrum antibacterial properties, honey has been claimed to promote wound healing by reducing wound hyperaemia, oedema, and exudate, and by stimulating angiogenesis, granulation tissue formation and epithelialisation. Several animal models, including large animals, dogs and cats, and different species of laboratory animals have been used to investigate the efficacy and safety of various natural and synthetic agents for wound healing enhancement. Interpreting the results obtained by these studies is, however, rather difficult and usually hampered by many limiting factors including great variation in types and origins of honey, the type of animal species used as models, the type of wounds, the number of animals, the number and type of controls, and variation in treatment protocols. In this article, we provide a comprehensive review of the most recent findings and applications of published experimental and clinical trials using honey as an agent for wound healing enhancement in different animal models.

  11. A non-healing corneal ulcer as the presenting feature of type 1 diabetes mellitus: a case report

    OpenAIRE

    Ioannidis Alexander S; Zagora Sofia L; Wechsler Alfred W

    2011-01-01

    Abstract Introduction Diabetic keratopathy is a rare complication of diabetes mellitus. This case illustrates the importance of checking blood sugar levels of patients with non-healing corneal ulcers to rule out the possibility of undiagnosed diabetes mellitus. Case presentation We report the unusual case of a 24-year-old southeast Asian woman who presented with a sterile corneal ulcer to our hospital and later was found to be diabetic after a prolonged hospital stay. Despite all efforts, the...

  12. The Micrograft Concept for Wound Healing: Strategies and Applications

    OpenAIRE

    Biswas, Atanu; Bharara, Manish; Hurst, Craig; David G. Armstrong; Rilo, Horacio

    2010-01-01

    The standard of care for wound coverage is to use an autologous skin graft. However, large or chronic wounds become an exceptionally challenging problem especially when donor sites are limited. It is important that the clinician be aware of various treatment modalities for wound care and incorporate those methods appropriately in the proper clinical context. This report reviews an alternative to traditional meshed skin grafting for wound coverage: micrografting. The physiological concept of m...

  13. Wound Healing in Patients With Impaired Kidney Function

    OpenAIRE

    Maroz, Natallia; Simman, Richard

    2014-01-01

    Renal impairment has long been known to affect wound healing. However, information on differences in the spectrum of wound healing depending on the type of renal insufficiency is limited. Acute kidney injury (AKI) may be observed with different wound types. On one hand, it follows acute traumatic conditions such as crush injury, burns, and post-surgical wounds, and on the other hand, it arises as simultaneous targeting of skin and kidneys by autoimmune-mediated vasculitis. Chronic kidney dise...

  14. Investigating the role of acellular skin substitutes in wound healing

    OpenAIRE

    Greaves, Nicholas Stuart

    2015-01-01

    After cutaneous injury, wound healing is an essential process that restores barrier and homeostatic function to the skin. Tissue restoration is classically grouped into four phases, involving the dynamic, regulated and sequential interaction of multiple cells types, effector molecules and extracellular matrix components. While most wounds heal in a timely fashion, local and systemic factors can prevent wound resolution resulting in chronic wound formation. Examples include diabetic and venous...

  15. 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,...

  16. Hypochlorous Acid as a Potential Wound Care Agent

    OpenAIRE

    Wang, L.; Bassiri, M; R. Najafi; Najafi, K.; Yang, J.; Khosrovi, B; Hwong, W; Barati, E; Belisle, B; Celeri, C; Robson, MC

    2007-01-01

    Background: A topical antimicrobial that can decrease the bacterial bioburden of chronic wounds without impairing the wound's ability to heal is a therapeutic imperative. A stabilized form of hypochlorous acid (NVC-101) has been demonstrated in vitro and in standard toxicity testing to possess properties that could fulfill these criteria. Materials and Methods: Using a standard rodent model of a chronically infected granulating wound, various preparations of NVC-101 and multiple treatment reg...

  17. Wound Care in Burn Patients

    Directory of Open Access Journals (Sweden)

    Orhan Çizmeci

    2011-07-01

    Full Text Available Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are genereally adequate for first-degree burns. However, topical antibacterial agents are usually required for second to third-degree wounds. Standart treatment for the open wound without epithelization is autologous skin grafting. In cases where more than 50% of the skin surface in affected, autologus donor skin may not be enough. For these cases, epidermal cell culture in vitro may be used. Mesenchymal stem cell applications which have immunosupressive effects should be utilized in cases where cells need to be prepared as allografts. (Journal of the Turkish Society intensive Care 2011; 9 Suppl: 51-4

  18. 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.

  19. 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.

  20. Potential of oncostatin M to accelerate diabetic wound healing.

    Science.gov (United States)

    Shin, Soo Hye; Han, Seung-Kyu; Jeong, Seong-Ho; Kim, Woo-Kyung

    2014-08-01

    Oncostatin M (OSM) is a multifunctional cytokine found in a variety of pathologic conditions, which leads to excessive collagen deposition. Current studies demonstrate that OSM is also a mitogen for fibroblasts and has an anti-inflammatory action. It was therefore hypothesised that OSM may play an important role in healing of chronic wounds that usually involve decreased fibroblast function and persist in the inflammatory stage for a long time. In a previous in vitro study, the authors showed that OSM increased wound healing activities of diabetic dermal fibroblasts. However, wound healing in vivo is a complex process involving multiple factors. Thus, the purpose of this study was to evaluate the effect of OSM on diabetic wound healing in vivo. Five diabetic mice were used in this study. Four full-thickness round wounds were created on the back of each mouse (total 20 wounds). OSM was applied on the two left-side wounds (n = 10) and phosphate-buffered saline was applied on the two right-side wounds (n = 10). After 10 days, unhealed wound areas of the OSM and control groups were compared using the stereoimage optical topometer system. Also, epithelialisation, wound contraction and reduction in wound volume in each group were compared. The OSM-treated group showed superior results in all of the tested parameters. In particular, the unhealed wound area and the reduction in wound volume demonstrated statistically significant differences (P healing of diabetic wounds.

  1. 不同银敷料在慢性伤口治疗中应用效果的对比研究%A comparative study on application effect of different silver dressings in treatment of patients with chronic wounds

    Institute of Scientific and Technical Information of China (English)

    郭春兰; 邓红艳; 屈红玲

    2015-01-01

    [目的]观察比较进口和国产银敷料用于慢性伤口治疗的效果,以指导银敷料在伤口治疗中的合理使用。[方法]对入选的外伤、烧伤、手术等延迟愈合伤口和Ⅱ级~Ⅲ级压疮、糖尿病足溃疡90例病人随机分为两组,A组使用进口的银离子藻酸盐敷料处理, B组使用国产的纳米银敷料处理,两组病人均给予基础治疗,并接受30 d的治疗方案,研究结束时伤口未愈者选择外科手术或湿性愈合技术处理至愈合。治疗第7天、第14天、第21天观察伤口的细菌清除率;治疗第10天、第20天、第30天观察伤口面积愈合率及观察期内伤口的愈合情况,并于每次处理伤口时观察评价伤口表现(渗液清除时间、肉芽分级和周围皮肤状况)和敷料参数(病人疼痛感和敷料二次创伤)。[结果]入选病人均完成了30 d的疗程观察,A组完全愈合35例、基本愈合7例、有效3例,B组完全愈合21例、基本愈合10例、有效14例,两组差异有统计学意义( P<0.05);两组伤口细菌清除率随着时间的延长而增加,治疗第30天时细菌清除率均达100%,差异无统计学意义( P>0.05);随着治疗时间延长,两组伤口面积愈合率明显增加、伤口表现也显著改善,疼痛感明显减轻,A组的效果要明显优于B组,敷料二次损伤较B组轻,差异均有统计学意义(P<0.05)。[结论]两种银敷料均可清除伤口感染和组织的炎症反应,减轻疼痛,促进伤口愈合,可用于慢性伤口的治疗,但银离子藻酸盐敷料的有效性和安全性更优越。%Objective:To observe and compare the treatment effect of domestic and imported silver dressings for patients with chronic wounds ,so as to guide the rational use of silver dressings in wound therapy .Methods:A total of 90 patients including trauma ,injury ,delayed wound healing(operation) ,grade Ⅱ Ⅲ pressure sorse

  2. 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

  3. 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.

  4. What Is New in the Understanding of Non Healing Wounds Epidemiology, Pathophysiology, and Therapies

    OpenAIRE

    H. Trøstrup; T. Bjarnsholt; Kirketerp-Møller, K.; Høiby, N; Moser, C.

    2013-01-01

    Chronic wounds are a growing socioeconomic problem in the western world. Knowledge on recalcitrant wounds relies on in vitro studies or clinical observations, and there is emerging evidence on the clinical impact of bacterial biofilm on skin healing. Chronic wounds are locked in the inflammatory state of wound healing, and there are multiple explanations for this arrest with the theory of exaggerated proteolysis as the most commonly accepted. Previously, there has not been enough focus on the...

  5. Mesenchymal stem cells: paracrine signaling and differentiation during cutaneous wound repair

    OpenAIRE

    Hocking, Anne M.; Gibran, Nicole S.

    2010-01-01

    Cutaneous wounds persist as a health care crisis in spite of increased understanding of the cellular and molecular responses to injury. Contributing significantly to this crisis is the lack of reliable therapies for treatment of wounds that are slow to heal including chronic wounds and deep dermal wounds that develop hypertrophic scars. This article will review the growing evidence demonstrating the promise of multipotent mesenchymal stem/stromal (MSCs) for the treatment of impaired wound hea...

  6. Estrogen modulates cutaneous wound healing by downregulating macrophage migration inhibitory factor

    OpenAIRE

    Ashcroft, Gillian S.; Stuart J. Mills; Lei, Kejian; Gibbons, Linda; Jeong, Moon-Jin; Taniguchi, Marisu; Burow, Matthew; Horan, Michael A.; Wahl, Sharon M.; Nakayama, Toshinori

    2003-01-01

    Characteristic of both chronic wounds and acute wounds that fail to heal are excessive leukocytosis and reduced matrix deposition. Estrogen is a major regulator of wound repair that can reverse age-related impaired wound healing in human and animal models, characterized by a dampened inflammatory response and increased matrix deposited at the wound site. Macrophage migration inhibitory factor (MIF) is a candidate proinflammatory cytokine involved in the hormonal regulation of inflammation. We...

  7. Use of a Dehydrated Amniotic Membrane Allograft on Lower Extremity Ulcers in Patients with Challenging Wounds: A Retrospective Case Series.

    Science.gov (United States)

    Lintzeris, Dimitrios; Yarrow, Kari; Johnson, Laura; White, Amber; Hampton, Amanda; Strickland, Andy; Albert, Kristy; Cook, Arlene

    2015-10-01

    Lower extremity ulcers in patients with diabetes mellitus may take a long time to heal despite the use of advanced topical therapies. A retrospective review of cases was conducted to assess the use of a dehydrated amniotic membrane allograft (DAMA) in a convenience sample of 9 wounds in 8 patients (5 men, 3 women, average age 62 years [range 31-81 years]) with diabetes mellitus and/or vascular disease. Wound data and patient characteristics were abstracted from medical records. Descriptive statistics were used to summarize the data. In 5 of 9 wounds, DAMA was applied after a failure to demonstrate a 50% reduction in area after 4 weeks of treatment with advanced wound care, offloading, and compression as indicated. In 4 wounds, DAMA was applied 2-4 weeks after presentation because of concerns about existing patient risk factors for nonhealing. Wounds were present for an average of 11 weeks (range 1-35 weeks) before application of DAMA. Mean baseline wound area and volume were 3.11 cm2 (± 3.73) and 0.55 cm3 (± 0.58), respectively. All wounds healed in an average of 5.7 (± 2.9) weeks (range: 1-9 weeks) after a mean of 2.7 applications (± 1.7) (range 1-5 applications). No adverse events occurred. These observations suggest prospective, randomized, controlled clinical studies to compare the use of DAMA to other topical treatment modalities are warranted. PMID:26479124

  8. Wound Pruritus: Prevalence, Aetiology and Treatment.

    OpenAIRE

    Upton D, Richardson C, Van Acker K, Andrews A and Springett K

    2013-01-01

    l O bjective: To review the literature into itching or pruritus, in relation to burns or other types of wound, with a focus on the physiological mechanisms underlying itching and the issues associated with itching in people with wounds. l Method: A literature search was conducted using PubMed, MEDLINE and Google Scholar, including English-language papers published up to 2012. The search terms used were: [‘pruritus’ OR ‘itching’] OR [‘chronic’] AND [‘wounds’ OR â...

  9. 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.

  10. 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.

  11. General concept of wound healing, revisited

    Directory of Open Access Journals (Sweden)

    Theddeus O.H. Prasetyono

    2009-09-01

    Full Text Available Wound healing is a transition of processes which is also recognized as one of the most complex processes in human physiology. Complex series of reactions and interactions among cells and mediators take place in the healing process of wound involving cellular and molecular events. The inflammatory phase is naturally intended to remove devitalized tissue and prevent invasive infection. The proliferative phase is characterized by the formation of granulation tissue within the wound bed, composed of new capillary network, fibroblast, and macrophages in a loose arrangement of supporting structure. This second phase lasts from day 8 to 21 after the injury is also the phase for epithelialisation. The natural period of proliferative phase is a reflection for us in treating wound to reach the goal which ultimately defines as closed wound. The final maturation phase is also characterized by the balancing between deposition of collagen and its degradation. There are at least three prerequisites which are ideal local conditions for the nature of wound to go on a normal process of healing i.e. 1 all tissue involved in the wound and surrounding should be vital, 2 no foreign bodies in the wound, and 3 free from excessive contamination/infection. The author formulated a step ladder of thinking in regards of healing intentions covering all acute and chronic wounds. Regarding the “hierarchy” of healing intention, the fi rst and ideal choice to heal wounds is by primary intention followed by tertiary intention and lastly the secondary intention. (Med J Indones 2009;18:206-14Key words: inflammatory mediator, epithelialisation, growth factor, wound healing

  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. Wound cleansing: a key player in the implementation of the TIME paradigm.

    Science.gov (United States)

    Pilcher, Matthew

    2016-03-01

    The concept of wound bed preparation can be implemented using the TIME paradigm. Chronic wounds are mostly characterised by prolonged inflammation and increased bioburden. Removal of wound biofilm and devitalised tissue, which is an ideal environment for bacterial growth, can help address the I in TIME. Wound cleansing aims to remove contaminants, debris, dressing remnants and superficial slough from the wound. Some wound cleansers contain surfactants, which reduce the surface tension of a liquid, enabling it to spread further over a surface. This article describes how these solutions can be used to debride the wound surface without damaging healthy cells. PMID:26949864

  14. Intermittent suction wound closure therapy for the restoration of acute and chronic wounded areas%间歇封闭负压创面治疗技术在急慢性创面修复中的应用

    Institute of Scientific and Technical Information of China (English)

    陈金武; 白祥军; 蔡玲娟; 郝杰; 郑凯夫

    2009-01-01

    目的 探讨间歇封闭负压创面治疗(suction wound closure therapy,SWCT)技术在创面修复中的应用,比较其与传统换药治疗的优缺点.方法 将不同深度及大小的急、慢性创面220例随机分为两组,对比采用间歇封闭负压创面治疗(治疗组)和传统换药治疗(对照组)两种方法的应用.其中治疗组彻底清创后使用无菌生物半透膜覆盖创面,使用间歇负压泵调节负压(80~100 mm Hg),治疗时间(治疗5 min,间歇2-3min)、持续时间依创面情况而定,3-7d换药一次.对照组使用无菌敷料覆盖创面,根据渗出量每天换药1-2次.比较两种治疗方法的效果、操作难易程度、患者耐受性、住院时间、住院费用等.结果 急性创面愈合时间:治疗组1~2周(平均1.5周),对照组2~12周;慢性创面愈合时间:治疗组2-4周(平均3周),对照组2-32周.平均换药治疗费用:治疗组约1 200元左右,对照组约2000元左右.治疗组创面愈合快、操作简单、患者易耐受、住院时间短、住院费用低.也有极少数患者出现贴膜过敏现象.结论 间歇封闭负压创面治疗技术具有操作简单、无需特殊用药、创面愈合速度加快、减少医务人员工作量、减少交叉感染、降低医疗费、减少患者痛苦、患者易耐受等优点.

  15. Human skin wounds: A major and snowballing threat to public health and the economy

    DEFF Research Database (Denmark)

    Sen, C.K.; Gordillo, G.M.; Roy, S.;

    2009-01-01

    In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes...... and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from "highly branded" diseases such as diabetes and obesity. This seems to have....... Forty million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also...

  16. 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

  17. 慢性伤口感染病原菌分布与银离子抗菌敷料应用的研究%Distribution of pathogenic bacteria in chronic wound infections and application of silver ion antimicrobial dressing

    Institute of Scientific and Technical Information of China (English)

    陈小芬; 林白浪; 符小玲; 李燕霞; 符小玉

    2016-01-01

    目的 研究慢性伤口感染常见病原菌分布,并观察银离子抗菌敷料的治疗效果,为临床诊疗提供参考依据.方法 选择2013年4月-2015年8月就诊的2890例慢性伤口感染患者为研究对象,伤口包括:手术切口、外伤、糖尿病足溃疡、静脉性溃疡、压疮等常见伤口;运用BACTEC MGI 960系统进行菌种鉴定,分析病原菌种类及其耐药率,观察银离子抗菌敷料3周内的治疗效果.结果 从2890份标本中分离出病原菌1846株,检出阳性率为63.88%,革兰阴性杆菌943株占51.08%,革兰阳性球菌835株占45.23%,真菌68株占3.69%;在治疗3周后,慢性伤口愈合1480例愈合率为80.17%,随访期8周,慢性伤口愈合1611例愈合率87.27%,愈合时间(6.1±2.5)周;与治疗前对比,治疗后的伤口面积、疼痛评分均明显降低(P<0.05),且随着治疗时间的延长,两者均显著改善(P<0.05).结论 慢性伤口感染率较高,以大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌感染为主,经银离子抗菌敷料治疗后疗效明显.%OBJECTIVE To study the distribution of common pathogenic bacteria in chronic wound infections and observe the intervention effect of silver ion antimicrobial dressing on the infections ,so as to provide reference for clinical diagnosis and treatment .METHODS A total of 2890 patients with chronic wound infections from Apr . 2013 to Aug .2015 were selected as the research subjects .The infection involved wounds such as surgical incision , trauma ,diabetic foot ulcer ,venous ulcer and pressure sores .The BACTEC MGI 960 system was used to identify the strains and analyze the species of pathogenic bacteria and drug resistance ,and the intervention effect of silver ion antimicrobial dressings for 3 weeks was observed .RESULTS Totally 1846 (63 .88% ) strains of common path-ogenic bacteria were isolated from 2890 samples .In the 1846 strains of common pathogenic bacteria ,there were 943 (51 .08% ) strains of gram negative bacilli

  18. Hyperspectral imaging of ischemic wounds

    Science.gov (United States)

    Gnyawali, Surya C.; Elgharably, Haytham; Melvin, James; Huang, Kun; Bergdall, Valerie; Allen, David W.; Hwang, Jeeseong; Litorja, Maritoni; Shirley, Eric; Sen, Chandan K.; Xu, Ronald

    2012-03-01

    Optical imaging has the potential to achieve high spatial resolution and high functional sensitivity in wound assessment. However, clinical acceptance of many optical imaging devices is hampered by poor reproducibility, low accuracy, and lack of biological interpretation. We developed an in vivo model of ischemic flap for non-contact assessment of wound tissue functional parameters and spectral characteristics. The model was created by elevating the bipedicle skin flaps of a domestic pig from the underlying vascular bed and inhibiting graft bed reperfusion by a silastic sheet. Hyperspectral imaging was carried out on the ischemic flap model and compared with transcutaneous oxygen tension and perfusion measurements at different positions of the wound. Hyperspectral images have also been captured continuously during a post-occlusive reactive hyperemia (PORH) procedure. Tissue spectral characteristics obtained by hyperspectral imaging correlated well with cutaneous tissue oxygen tension, blood perfusion, and microscopic changes of tissue morphology. Our experiments not only demonstrated the technical feasibility for quantitative assessment of chronic wound but also provided a potential digital phantom platform for quantitative characterization and calibration of medical optical devices.

  19. 慢性伤口门诊处理中的风险管理及个体化护理%Risk management and individualized nursing care for chronic wounds in outpatient department

    Institute of Scientific and Technical Information of China (English)

    戴雪群

    2014-01-01

    Objective To explore the risk management and individualized nursing care for chronic wounds in outpatient department. Methods Clinical data of 82 patients with chronic wounds who were admitted to our outpatient department from May 2010 to August 2013 were retrospectively analyzed. They were randomly allocated to two groups, with 41 in each group(approved by the Ethics Committee in our hospital and known to patients' family). The control group received regular nursing intervention, while the observation group received individualized nursing intervention. Satisfaction rates towards the nursing care in the two groups were compared. Results 35 patients were satisfactory to the nursing care in the observation group, and 5 patients were fairly satisfactory. The total satisfaction rate was 97.6%; 28 patients were satisfactory to the nursing care in the control group, and 6 patients were fairly satisfactory. The total satisfaction rate was 82.9%. Satisfaction rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05). Conclusion In the nursing care for patients with chronic wounds, risk management should be firstly carried out and individualized nursing care should be done, which is beneficial to improve patients' satisfaction rate and avoid adverse events.%目的:研究慢性伤口门诊处理中的风险管理与个体化护理方法。方法回顾性分析本门诊在2010年5月~2013年8月间收治的82例慢性伤口患者的临床资料,随机将患者分为两组,每组各41例病例,对照组实施常规护理干预,观察组实施个体化护理干预,比较两组患者的护理满意度。结果观察组中有35例患者护理满意,5例患者护理较满意,总满意度为97.6%;对照组中有28例患者护理满意,6例患者护理较满意,总满意度为82.9%。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。结论在慢性伤口患

  20. Allergic contact dermatitis to Plectranthus amboinicus masquerading as chronic leg ulcer.

    Science.gov (United States)

    Chang, Shyue-Luen; Chang, Ya-Ching; Yang, Chin-Hsun; Hong, Hong-Shang

    2005-12-01

    This report discusses a case of a 69-year-old woman who developed chronic non-healing leg ulcers after long-term topical use of Plectranthus amboinicus. The ulcer was proven to be allergic contact dermatitis to P. amboinicus by a patch test. The ulcer healed after discontinuation of P. amboinicus. To the best of our knowledge, this is the first reported case of allergic contact dermatitis to P. amboinicus masquerading as chronic leg ulcer. PMID:16364130

  1. Comparison of the immune profile of nonhealing cutaneous Leishmaniasis patients with those with active lesions and those who have recovered from infection

    DEFF Research Database (Denmark)

    Ajdary, S; Alimohammadian, M H; Eslami, M B;

    2000-01-01

    Th1-type cellular immune responses play a critical role in protection against infection with Leishmania parasites, whereas activation of Th2-type cells results in progressive disease. Cutaneous leishmaniasis caused by Leishmania major is often a self-healing disease; however, persistent nonhealing...

  2. 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.

  3. Application of lavation and drainage with continuous negative pressure in repairing chronic infectious wounds on axial-pattern flap%持续负压灌洗引流技术在轴型皮瓣修复慢性感染创面中的应用

    Institute of Scientific and Technical Information of China (English)

    郭志谦; 江碧川; 张新合; 杨新蕾; 雷磊; 孟红阳; 米增法

    2012-01-01

    Objective To evaluate the repair of chronic infectious wounds on axial-pattern flap by using lavation and drainage under continuous negative pressure. Metheods Twenty-five patiens suffering chronic infectious wound were involved.After the axial-pattern flap overcastted.wounds of pations were lavaged and drained for 7-14 days under continuous negative pressure through a detained tube.Suction under negative pressure continued for 3~5days after lavation,and then grainage tube was removed.The conditions of the wounds were observed. Results All flaps survived with infection controlled and wounds cicatrized. Conclution Lavation and drainage under continuous negative pressure can help control infection,increase flaps survival and wound plerosis.%目的:总结持续负压灌洗引流技术应用于轴型皮瓣修复慢性感染创面中的临床经验.方法:慢性感染创面共25例,实施轴型皮瓣修复,皮瓣下留置负压引流管进行持续负压灌洗引流7~14天,停止灌洗后维持负压吸引3~5天,拔除引流管,观察创面愈合情况.结果:所有皮瓣均存活,感染控制,创面及时修复.结论:持续负压灌洗引流有利于控制感染,促进皮瓣存活及创面修复.

  4. "Healing Effect of Topical Nifedipine on Skin Wounds of Diabetic Rats "

    Directory of Open Access Journals (Sweden)

    Abbas Ebadi

    2003-07-01

    Full Text Available Non-healing foot ulcers in patients with diabetes are the leading causes of complications such as infection and amputation. Ulceration is the most common single precursor to amputation and has been identified as a causative factor in 85% of lower extremity amputations. It seems that poor outcomes are generally associated with infection, peripheral vascular disease and wounds of increasing depth. Nifedipine, a calcium channel blocker that is mainly used for the treatment of cardiovascular disorders has recently been used to treat wounds caused by peripheral vascular disorders. In present study topical Nifedipine 3% has been used to treat skin wounds in normal and diabetic rats. Effects of Nifedipine were evaluated in three different phases of wound healing process. In both experiments (normal and diabetic rats topical Nifedipine significantly improved inflammatory phase. However, maturation phase was only significantly improved in diabetic rats. Nifedipine did not affect proliferation phase in either group significantly. Overall results of this study showed topical Nifedipine improved skin wound healing process in normal and diabetic rats.

  5. Transforming Growth Factor-β1 Fails to Stimulate Wound Healing and Impairs Its Signal Transduction in an Aged Ischemic Ulcer Model : Importance of Oxygen and Age

    OpenAIRE

    Wu, Liancun; Xia, Yu-Ping; Roth, Sanford I.; Gruskin, Elliott; Mustoe, Thomas A.

    1999-01-01

    Clinical trials of exogenous growth factors in treating chronic wounds have been less successful than expected. One possible explanation is that most studies used animal models of acute wounds in young animals, whereas most chronic wounds occur in elderly patients with tissue ischemia. We described an animal model of age- and ischemia-impaired wound healing and analyzed the wound-healing response as well as the transforming growth factor (TGF)-β1 effect in this model. Rabbits of increasing ag...

  6. 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

  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. Wound care in the geriatric client

    OpenAIRE

    Steve Gist; Iris Tio-Matos; Sharon Falzgraf; Shirley Cameron; Michael Beebe

    2009-01-01

    Steve Gist, Iris Tio-Matos, Sharon Falzgraf, Shirley Cameron, Michael BeebeGeriatrics and Extended Care, Programs, VA Puget Sound Health Care Systems, American Lake Division, Tacoma, WA, USAAbstract: With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these disease...

  9. Cellular and genetic analysis of wound healing in Drosophila larvae.

    Directory of Open Access Journals (Sweden)

    Michael J Galko

    2004-08-01

    Full Text Available To establish a genetic system to study postembryonic wound healing, we characterized epidermal wound healing in Drosophila larvae. Following puncture wounding, larvae begin to bleed but within an hour a plug forms in the wound gap. Over the next couple of hours the outer part of the plug melanizes to form a scab, and epidermal cells surrounding the plug orient toward it and then fuse to form a syncytium. Subsequently, more-peripheral cells orient toward and fuse with the central syncytium. During this time, the Jun N-terminal kinase (JNK pathway is activated in a gradient emanating out from the wound, and the epidermal cells spread along or through the wound plug to reestablish a continuous epithelium and its basal lamina and apical cuticle lining. Inactivation of the JNK pathway inhibits epidermal spreading and reepithelialization but does not affect scab formation or other wound healing responses. Conversely, mutations that block scab formation, and a scabless wounding procedure, provide evidence that the scab stabilizes the wound site but is not required to initiate other wound responses. However, in the absence of a scab, the JNK pathway is hyperinduced, reepithelialization initiates but is not always completed, and a chronic wound ensues. The results demonstrate that the cellular responses of wound healing are under separate genetic control, and that the responses are coordinated by multiple signals emanating from the wound site, including a negative feedback signal between scab formation and the JNK pathway. Cell biological and molecular parallels to vertebrate wound healing lead us to speculate that wound healing is an ancient response that has diversified during evolution.

  10. Topical iodophor use in chronic wounds: a literature review Uso de yodo tópico y/o compuestos en heridas crónicas: revisión de la literatura Uso de iodóforo tópico em feridas crônicas: revisão da literatura

    OpenAIRE

    Alcicléa dos Santos Oliveira; Vera Lúcia Conceição de Gouveia Santos

    2007-01-01

    This study aimed to do a review of the literature regarding the use of topic iodine and/or compounds in the treatment of chronic wounds. The clinical trials were searched in the Cochrane database. Fourteen (58.3%) among 24 studies fulfilled the inclusion criteria. The articles were analyzed regarding journal and study characteristics and classified into three groups: Iodine versus other topic agents (7/ 50%); Iodine versus different dressings (6/ 42.9%); Iodine versus without Iodine (1/ 7.1%)...

  11. 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

  12. Survey of Wound-Healing Centers and Wound Care Units in China.

    Science.gov (United States)

    Jiang, Yufeng; Xia, Lei; Jia, Lijing; Fu, Xiaobing

    2016-09-01

    The purpose of this study is to report the Chinese experience of establishing hospital-based wound care centers over 15 years. A total of 69 wound-healing centers (WHCs) and wound care units (WCUs) were involved. Questionnaires were diverged to the principal directors of these sites; data extracted for this study included origin, year of establishment, medical staff, degree of hospitals, wound etiology, wound-healing rate, hospital stay, and outcomes data. The period of data extraction was defined as before and after 1 year of the establishment of WHCs and WCUs. The earliest WHC was established in 1999, and from 2010 the speeds of establishing WHCs and WCUs rapidly increased. The majority of WHCs were divisions of burn departments, and all WHCs came from departments of outpatient dressing rooms. Full-time multidisciplinary employees of WHCs differed greatly to WCUs. Types of wound and outcomes vary with those of centers reported from Western countries and the United States. Improvement in wound healing caused by the establishment of WHCs and WCUs in China occurred without doubt. Some advices include the following: rearrange and reorganize the distribution of WHCs and WCUs; enact and generalize Chinese guidelines for chronic wounds; utilize medical resources reasonably; improve multidisciplinary medical staff team; draw up and change some medical and public policies and regulations.

  13. An application of embryonic skin cells to repair diabetic skin wound: a wound reparation trail.

    Science.gov (United States)

    Qian, De Jian; Guo, Xiang Kai; Duan, Hui Chuan; Han, Zhi Hua; Meng, Fei; Liu, Ju; Wang, Yan

    2014-12-01

    Cell therapy has shown its power to promote diabetic chronic wound healing. However, problems of scar formation and loss of appendages have not yet been solved. Our study aims to explore the potential of using embryonic skin cells (ESkCs) to repair diabetic wounds. Circular wound was created on the back of the diabetic mice, and ESkCs stained with CM-DIL were transplanted into the wound. Wound area was recorded at the day 4, 7, 11, and 14 after transplantation. The tissue samples were obtained at week 1, 2, and 3, and the tissue sections were stained by transforming growth factor β1 (TGF-β1), TGF-β3, vascular endothelial growth factor (VEGF), and CD31. The new skin formed on the wound of the diabetic mice with ESkC treatment at week 1 but not on the wounds of the non-treatment group. The histological scores of diabetic group with ESkC treatment were significantly better than the non-treatment group (P hair follicles formation, and angiogenesis. The expression of TGF-β1 and VEGF in ESkC-treated groups was noticeable in week 1 but disappeared in week 2. TGF-β3 was not expressed at week 1 but expressed markedly around hair follicles in week 2 in ESkC-treated groups. Our study demonstrated that ESkCs are capable of developing new skin with appendage restoration to repair the diabetic wounds. PMID:25030484

  14. 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....

  15. Tumour endothelial marker-8 in wound healing and its impact on the proliferation and migration of keratinocytes

    OpenAIRE

    Wang, Sheila C.; Lin YE; Sanders, Andrew J.; Ruge, Fiona; HARDING, KEITH G.; Jiang, Wen G

    2015-01-01

    Chronic wound management represents a significant burden on healthcare systems and negatively impacts on the quality of patient life. New strategies to understand and identify wounds that will not heal in a normal manner are required. Tumour endothelial marker-8 (TEM-8) has been implicated in the wound healing and angiogenesis processes. TEM-8 expression was examined at the transcript level in a cohort of acute (n=10) and chronic (n=14) wounds and in normal skin (n=10). Protein analysis of TE...

  16. Connexins in wound healing; perspectives in diabetic patients.

    OpenAIRE

    Becker, D. L.; Thrasivoulou, C.; Phillips, A. R.

    2012-01-01

    Skin lesions are common events and we have evolved to rapidly heal them in order to maintain homeostasis and prevent infection and sepsis. Most acute wounds heal without issue, but as we get older our bodies become compromised by poor blood circulation and conditions such as diabetes, leading to slower healing. This can result in stalled or hard-to-heal chronic wounds. Currently about 2% of the Western population develop a chronic wound and this figure will rise as the population ages and dia...

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

    OpenAIRE

    Medicherla, Satyanarayana; Wadsworth, Scott; Cullen, Breda; Silcock, Derek; Ma, Jing Y; Mangadu, Ruban; Kerr, Irene; Chakravarty, Sarvajit; Luedtke, Gregory L; Dugar, Sundeep; Protter, Andrew A.; Higgins, Linda S

    2009-01-01

    In healthy tissue, a wound initiates an inflammatory response characterized by the presence of a hematoma, infiltration of inflammatory cells into the wound and, eventually, wound healing. In pathological conditions like diabetes mellitus, wound healing is impaired by the presence of chronic nonresolving inflammation. p38 mitogen-activated protein kinase (MAPK) inhibitors have demonstrated anti-inflammatory effects, primarily by inhibiting the expression of inflammatory cytokines and regulati...

  18. 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...

  19. 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:...

  20. 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...

  1. Negative Pressure Wound Therapy – A Review of its Uses in Orthopaedic Trauma

    OpenAIRE

    Putnis, Sven; Khan, Wasim S; Wong, James M.-L

    2014-01-01

    The use of Negative Pressure Wound Therapy (NPWT) for complex and large wounds has increased in popularity over the past decade. Modern NPWT systems consisting of an open pore foam sponge, adhesive dressing and a vacuum pump producing negative pressure have been used as an adjunct to surgical debridement to treat tissue defects around open fractures and chronic, contaminated wounds. Other uses include supporting skin grafts and protecting wounds at risk of breaking down. This review outlines ...

  2. Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy

    OpenAIRE

    Sen, Chandan K.; Gordillo, Gayle M.; Roy, Sashwati; Kirsner, Robert; Lambert, Lynn; Hunt, Thomas K.; Gottrup, Finn; Gurtner, Geoffrey C.; Longaker, Michael T.

    2009-01-01

    In the United States, chronic wounds affect around 6.5 million patients. It is claimed that an excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is growing rapidly due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chro...

  3. The use of silver-based dressings in wound care.

    Science.gov (United States)

    Dowsett, Caroline

    Chronic wounds such as leg ulcers and pressure ulcers are often slow to heal. One of the causes of delayed wound healing is the presence of micro-organisms in the wound. A strategy for the prevention and treatment of wound colonisation or infection, which is receiving renewed attention, is the use of silver-based dressings. Silver has been used as an antimicrobial agent for centuries. It is effective against a broad range of bacteria (including methicillin and vancomycin-resistant strains), yeast, fungi and viruses. A number of new silver-based dressings, some of which act by the sustained release of silver ions to the wound bed, have recently become available, but there are wide variations in the amount of data supporting the use of individual products. This article reviews the evidence base for silver-containing dressings to help practitioners select the most appropriate product for the type of wound being treated. PMID:15551918

  4. Methods to assess area and volume of wounds

    DEFF Research Database (Denmark)

    Jørgensen, Line Bisgaard; Sørensen, Jens A; Jemec, Gregor Be;

    2016-01-01

    Wound measurement is important in monitoring the healing process of chronic wounds and in evaluating the effect of treatment. The objective of this systematic review was to evaluate evidence from the literature on accuracy, agreement, reliability and feasibility of wound measurement techniques...... described since 1994. Studies were identified by searching the electronic databases PubMed, Embase and Cochrane Library. Of the 12 013 studies identified, 43 were included in the review. A total of 30 papers evaluated techniques for measuring wound area and 13 evaluated techniques for measuring wound volume....... The six approaches for measuring wound area were simple ruler method (10 papers), mathematical models (5 papers), manual planimetry (10 papers), digital planimetry (16 papers), stereophotogrammetry (2 papers) and digital imaging method (20 papers). Of these studies, 10 evaluated accuracy, 15 agreement, 17...

  5. The use of desiccation to treat Staphylococcus aureus biofilm-infected wounds.

    Science.gov (United States)

    Park, Eugene; Long, Sarah A; Seth, Akhil K; Geringer, Matthew; Xu, Wei; Chavez-Munoz, Claudia; Leung, Kai; Hong, Seok Jong; Galiano, Robert D; Mustoe, Thomas A

    2016-03-01

    Chronic wounds colonized with biofilm present a major burden to our healthcare system. While the current paradigm for wound healing is to maintain a moist environment, we sought to evaluate the effects of desiccation, and the ability of honey to desiccate wounds, on wound healing characteristics in Staphylococcus aureus biofilm wounds. In vivo biofilm wound healing after exposure to open-air desiccation, honey, molasses, and saline was analyzed using a rabbit ear model of S. aureus biofilm wounds previously developed by our group. Wound morphology was examined using scanning electron microscopy and granulation tissue deposition was measured using light microscopy with hematoxylin and eosin staining. Viable bacterial counts in rabbit ear biofilm wounds and scabs were measured using a drop dilution method. In vitro S. aureus growth curves were established using tryptic soy broth containing honey and glycerol. Gene expression analysis of rabbit ear wounds was performed using reverse transcription quantitative PCR. Rabbit ear S. aureus biofilm wounds exposed to open-air desiccation, honey, and molasses developed a dry scab, which displaced the majority of biofilm bacteria off of the wound bed. Wounds treated with open-air desiccation, honey, and molasses expressed lower levels of the inflammatory markers tumor necrosis factor-α and interleukin-1β at postoperative day 12 compared with wounds treated with saline, and had increased levels of granulation tissue formation. In vitro growth of S. aureus in tryptic soy broth was inhibited by the presence of honey to a greater extent than by the presence of osmolality-matched glycerol. Desiccation of chronic wounds colonized with biofilm via exposure to open air or honey leads to improved wound healing by decreasing bacterial burden and inflammation, and increasing granulation tissue formation. The ability of honey to help heal chronic wounds is at least in part due to its ability to desiccate bacterial biofilm, but other

  6. What Is New in the Understanding of Non Healing Wounds Epidemiology, Pathophysiology, and Therapies

    Directory of Open Access Journals (Sweden)

    H. Trøstrup

    2013-01-01

    Full Text Available Chronic wounds are a growing socioeconomic problem in the western world. Knowledge on recalcitrant wounds relies on in vitro studies or clinical observations, and there is emerging evidence on the clinical impact of bacterial biofilm on skin healing. Chronic wounds are locked in the inflammatory state of wound healing, and there are multiple explanations for this arrest with the theory of exaggerated proteolysis as the most commonly accepted. Previously, there has not been enough focus on the different etiologies of chronic wounds compared to acute, healing wounds. There is an urgent need to group chronic wounds by its cause when searching for possible diagnostic or therapeutic targets. Good wound management should therefore consist of recognition of basic wound etiology, irrigation, and debridement in order to reduce microbial and necrotic load, frequently changed dressings, and appropriate antimicrobial and antibiofilm strategies based on precise diagnosis. Representative sampling is required for diagnosis and antimicrobial treatment of wounds. The present review aims at describing the impact of biofilm infections on wounds in relation to diagnosing, treatment strategies, including experimentally adjuvant approaches and animal models.

  7. Wound Healing and Indigenous Drugs: Role as Antioxidants: A Review

    Directory of Open Access Journals (Sweden)

    B Somashekar Shetty

    2013-06-01

    Full Text Available Traditional medicine, especially herbal medicine has recently been receiving heightened interest all over the world. Man from the very beginning has been aware of the health problems and has been taking care of health through diet and drugs for which plants were used extensively. Molecular oxygen plays a central role in the pathogenesis and therapy of chronic wounds. When reactive oxygen species are overproduced, oxidative stress results in detrimental cytotoxic effects causing delayed wound healing. Therefore, elimination of reactive oxygen species (ROS could be an important strategy to improve healing of chronic wounds. Currently therapeutic strategies targeting reactive oxygen species (ROS by antioxidants are being introduced into the treatment of chronic wounds. Natural compounds from medicinal plants having antioxidant and immunomodulatory activities are used as therapeutic agents. Indian medicinal plants with these activities have been identified and their antioxidant and immunomodulatory effects have been reviewed.

  8. The Evidence-Based Principles of Negative Pressure Wound Therapy in Trauma & Orthopedics

    OpenAIRE

    A, Novak; Wasim S. Khan; J, Palmer

    2014-01-01

    Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describe...

  9. 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.

  10. 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.

  11. Stem Cells for Cutaneous Wound Healing

    Directory of Open Access Journals (Sweden)

    Giles T. S. Kirby

    2015-01-01

    Full Text Available Optimum healing of a cutaneous wound involves a well-orchestrated cascade of biological and molecular processes involving cell migration, proliferation, extracellular matrix deposition, and remodelling. When the normal biological process fails for any reason, this healing process can stall resulting in chronic wounds. Wounds are a growing clinical burden on healthcare systems and with an aging population as well as increasing incidences of obesity and diabetes, this problem is set to increase. Cell therapies may be the solution. A range of cell based approaches have begun to cross the rift from bench to bedside and the supporting data suggests that the appropriate administration of stem cells can accelerate wound healing. This review examines the main cell types explored for cutaneous wound healing with a focus on clinical use. The literature overwhelmingly suggests that cell therapies can help to heal cutaneous wounds when used appropriately but we are at risk of clinical use outpacing the evidence. There is a need, now more than ever, for standardised methods of cell characterisation and delivery, as well as randomised clinical trials.

  12. Grand challenge in Biomaterials-wound healing.

    Science.gov (United States)

    Salamone, Joseph C; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E

    2016-06-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  13. Grand challenge in Biomaterials-wound healing

    Science.gov (United States)

    Salamone, Joseph C.; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E.

    2016-01-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  14. Self-assembling peptide nanofiber scaffolds accelerate wound healing.

    Directory of Open Access Journals (Sweden)

    Aurore Schneider

    Full Text Available Cutaneous wound repair regenerates skin integrity, but a chronic failure to heal results in compromised tissue function and increased morbidity. To address this, we have used an integrated approach, using nanobiotechnology to augment the rate of wound reepithelialization by combining self-assembling peptide (SAP nanofiber scaffold and Epidermal Growth Factor (EGF. This SAP bioscaffold was tested in a bioengineered Human Skin Equivalent (HSE tissue model that enabled wound reepithelialization to be monitored in a tissue that recapitulates molecular and cellular mechanisms of repair known to occur in human skin. We found that SAP underwent molecular self-assembly to form unique 3D structures that stably covered the surface of the wound, suggesting that this scaffold may serve as a viable wound dressing. We measured the rates of release of EGF from the SAP scaffold and determined that EGF was only released when the scaffold was in direct contact with the HSE. By measuring the length of the epithelial tongue during wound reepithelialization, we found that SAP scaffolds containing EGF accelerated the rate of wound coverage by 5 fold when compared to controls without scaffolds and by 3.5 fold when compared to the scaffold without EGF. In conclusion, our experiments demonstrated that biomaterials composed of a biofunctionalized peptidic scaffold have many properties that are well-suited for the treatment of cutaneous wounds including wound coverage, functionalization with bioactive molecules, localized growth factor release and activation of wound repair.

  15. Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy

    Directory of Open Access Journals (Sweden)

    Helena Čičková

    2013-01-01

    Full Text Available Maggot debridement therapy (MDT is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n=52, which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9–19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09–9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.

  16. Growth and Survival of Bagged Lucilia sericata Maggots in Wounds of Patients Undergoing Maggot Debridement Therapy.

    Science.gov (United States)

    Cičková, Helena; Cambal, Marek; Kozánek, Milan; Takáč, Peter

    2013-01-01

    Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n = 52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9-19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09-9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.

  17. Platelet rich plasma for treatment of nonhealing diabetic foot ulcers: a case report.

    Science.gov (United States)

    Mehrannia, Masoud; Vaezi, Mitra; Yousefshahi, Fardin; Rouhipour, Nahid

    2014-02-01

    Diabetic foot ulcers are one of the most important causes of lower limb amputations worldwide. The conventional treatments of diabetic foot ulcers are costly and often require patients to be hospitalized for long periods of time, thus representing a huge burden on any health care system. The use of autologous platelet-rich plasma (PRP), which is rich in multiple growth factors, may bear some similarities to the natural wound healing process. Nonetheless, few studies on human subjects have so far addressed the efficacy of PRP as a novel and minimally invasive treatment. Today, there is only 1 approved and available system to separate PRP from a patient's own blood in order to be used in diabetic ulcers. This system incorporates bovine thrombin for activation of PRP gel and may be applied by many healthcare providers without the need for extensive special training. In this report, a patient with extensive diabetic foot ulcers, non-responsive to other treatment modalities, was successfully treated by PRP.

  18. Wound care in the geriatric client

    Directory of Open Access Journals (Sweden)

    Steve Gist

    2009-06-01

    Full Text Available Steve Gist, Iris Tio-Matos, Sharon Falzgraf, Shirley Cameron, Michael BeebeGeriatrics and Extended Care, Programs, VA Puget Sound Health Care Systems, American Lake Division, Tacoma, WA, USAAbstract: With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension, and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydro-fibers, composite and alginate dressings.Keywords: wound care, pressure ulcers, vascular ulcers, diabetic ulcers, debridement, elderly

  19. 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.

  20. 新型敷料配合湿润烧伤膏在慢性伤口护理中的应用研究%Application and effect evaluation of moist exposed burn ointment combined with new type dressing in chronic wound care

    Institute of Scientific and Technical Information of China (English)

    叶小平; 陈捷清; 黎燕红; 陈晓莹; 蓝凤群; 梁伟平

    2014-01-01

    目的 探讨湿润烧伤膏与新型敷料联合应用促进慢性伤口康复的方法及效果.方法 按随机分组抽签法将60例慢性伤口患者随机分对照组和实验组各30例,对照组换药用生理盐水清洗,让伤口自然愈合、变干,每天换药1次等常规治疗及护理,实验组在常规治疗护理的基础上采用湿润烧伤膏与新型敷料联合应用,措施包括:正确评估伤口,根据伤口愈合不同阶段选择新型敷料及应用湿润烧伤膏,加强基础护理,增加营养,提高免疫力,落实严密的慢性伤口护理监控措施.结果 实验组有效率为93.3%,对照组为70%,实验组明显高于对照组,两组比较差异统计学意义(P<0.05);经治疗2、3、5w后伤口愈合例数实验组明显多于对照组,两组比较差异统计学意义(P<0.05).结论 湿润烧伤膏与新型敷料联合应用于慢性伤口的治疗及护理,可有效地缩短伤口的愈合时间,提高治疗效果.%Objective To discuss application and effect evaluation of moist exposed burn ointment combined with new type dressing in chronic wound care.Methods According to the random draw method 60 cases of chronic wound were randomly divided into control group and experimental group with 30 cases in each group,the control group was given conventional treatment and care such as medicinal saline wash,letting the wound heal,dry and daily dressing,the experimental group based on conventional treatment used moist exposed burn ointment combined with new type dressing,with measures as follows:correcting assessment of the wound,the wound healing in different stages of selection model and application of MEBO dressing,strengthening basic nursing,increasing nutrition,improving immunity,implementing strict control measures for chronic wound care.Results The curative effect of experimental group was significantly higher than that of the control group,the experimental group was 93.3%,while control group 70%,P < 0.05; two

  1. 远程伤口治疗平台在偏远地区下肢慢性溃疡患者中的应用%Application of tele-wound treatment platform to patients with chronic lower limb ulcers in remote areas

    Institute of Scientific and Technical Information of China (English)

    楚婷; 陈正英; 吴冬琼; 刘细寒

    2012-01-01

    目的 探讨以手机彩信为平台的远程伤口治疗模式对偏远地区下肢慢性溃疡的治疗作用.方法 采取整群抽样方法收集湘西地区综合性医院就诊的37例农村下肢慢性溃疡患者,随机分为干预组25例和对照组12例,干预组进行彩信平台的远程伤口治疗,对照组按常规处理伤口,6个月后通过自制问卷调查评估.结果 干预6个月后,干预组伤口治疗评分、疼痛及症状管理评分显著高于对照组(均P<0.05).结论 基于彩信平台的远程伤口治疗有助于改善偏远地区下肢慢性溃疡患者的伤口治疗效果.%Objective To investigate the effect of a multimedia-message-based tele-wound treatment platform on chronic lower limb ulcers for patients living in remote areas. Methods Thirty seven cases with chronic lower limb ulcers from backwoods of west Hunan Province, and seeking medical service in a comprehensive hospital, were collected by cluster sampling. They were randomly divided into 2 groups: the intervention group (n = 25) were managed with a remote wound treatment platform via which medical staff sent multimedia messages to inctruct patients to care for the wounds, while the control group (n=12) were given routine intervention. Six months later, a self-designed questionaire was used to assess the effect of the interventions. Results Six months later, the wound treatment score, pain management score, symptom management score of the intervention group were significantly higher than those of the controls (P<0. 05 for all). Conclusion The multimedia-message-based tele-wound treatment platform helps improve therapeutic effect of wound care of backwoods residents with chronic lower limb ulcers.

  2. Mystery behind Non-Healing Wound at Chin Region - Myiasis due to Neglected Trauma – A Case Report with Review of Literature

    Science.gov (United States)

    Hajira, Neha

    2016-01-01

    Myiasis is the infestation of human beings with fly larvae which feed on host’s living or dead tissue. Diagnosis of this condition is made by the presence of larvae in affected body parts. The standard treatment is the mechanical removal of the maggots from the lesion and management of the general systemic condition. This paper report a case of myiasis at the chin region in a 45-year-old male managed by manual removal of larvae after topical application of turpentine oil, surgical debridement of necrotic tissues and antimicrobial therapy. PMID:27504426

  3. Laryngeal tuberculosis: A case of a non-healing laryngeal lesion

    Directory of Open Access Journals (Sweden)

    HK Chen and P Thornley

    2012-03-01

    Full Text Available We report a case of laryngeal tuberculosis in a 47-year-old Korean man. Laryngeal tuberculosis is rare and currently accounts for less than 1% of all cases of tuberculosis. Clinical features of laryngeal tuberculosis include hoarseness, odynophagia and dyspnoea. Macroscopically, laryngeal tuberculosis may mimic laryngeal carcinoma, chronic laryngitis or laryngeal candidiasis. The diagnosis is often delayed due to a low index of clinical suspicion and hence may pose a significant public health risk. Laryngeal tuberculosis should be considered in the differential diagnosis of patients who present with any form of laryngeal lesion.

  4. 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...

  5. 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.

  6. Biofilms in wounds: a review of present knowledge.

    Science.gov (United States)

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

    2014-11-01

    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 century by Louis Pasteur and Robert Koch. Although this approach still provides valuable information with which to help diagnose acute infections and to select appropriate antibiotic therapies, it is evident that those organisms isolated from clinical specimens with the conditions normally used in diagnostic laboratories are mainly in a planktonic form that is unrepresentative of the way in which most microbial species exist naturally. Usually microbial species adhere to each other, as well as to living and non-living surfaces, where they form complex communities surrounded by collectively secreted 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 of biofilms, with a view to explaining their impact on wounds. PMID:25375405

  7. [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.

  8. A Novel Three-Dimensional Wound Healing Model

    Directory of Open Access Journals (Sweden)

    Zhuo J. Chen

    2014-12-01

    Full Text Available Wound healing is a well-orchestrated process, with various cells and growth factors coming into the wound bed at a specific time to influence the healing. Understanding the wound healing process is essential to generating wound healing products that help with hard-to-heal acute wounds and chronic wounds. The 2D scratch assay whereby a wound is created by scratching a confluent layer of cells on a 2D substrate is well established and used extensively but it has a major limitation—it lacks the complexity of the 3D wound healing environment. Established 3D wound healing models also have many limitations. In this paper, we present a novel 3D wound healing model that closely mimics the skin wound environment to study the cell migration of fibroblasts and keratinocytes. Three major components that exist in the wound environment are introduced in this new model: collagen, fibrin, and human foreskin fibroblasts. The novel 3D model consists of a defect, representing the actual wound, created by using a biopsy punch in a 3D collagen construct. The defect is then filled with collagen or with various solutions of fibrinogen and thrombin that polymerize into a 3D fibrin clot. Fibroblasts are then added on top of the collagen and their migration into the fibrin—or collagen—filled defect is followed for nine days. Our data clearly shows that fibroblasts migrate on both collagen and fibrin defects, though slightly faster on collagen defects than on fibrin defects. This paper shows the visibility of the model by introducing a defect filled with fibrin in a 3D collagen construct, thus mimicking a wound. Ongoing work examines keratinocyte migration on the defects of a 3D construct, which consists of collagen-containing fibroblasts. The model is also used to determine the effects of various growth factors, delivered in the wound defects, on fibroblasts’ and keratinocytes’ migration into the defects. Thus this novel 3D wound healing model provides a more

  9. Total Particulate Matter and Wound Healing: An in vivo Study with Histological Insights

    Institute of Scientific and Technical Information of China (English)

    SOHAIL EJAZ; MUHAMMAD ASHRAF; MUHAMMAD NAWAZ; CHAE WOONG LIM

    2009-01-01

    Objectives Wound healing in the skin is a multifarious orchestration of cellular processes and cigarette smoking may be a cause for delayed wound healing. The aim of this study was to investigate the plausible association between exposures of cigarette total particulate matter (TPM) and wound healing. Methods An in vivo wound healing model of mice was established for determination of assorted events of wound healing, dermal matrix regeneration, re-epithelialization, and neovascularization. A total of 72 adult mice, separated in eight groups, were exposed to TPM for 12 days. Results A highly considerable diminution in wound closure (P<0.001) was pragmatic among all TPM-treated mice from day 6 to day 8 post-wounding. Histological investigations unveiled a noteworthy impede in the outcome of re-epithelialization, dermal matrix regeneration and maturation of collagen bundles among all TPM-exposed wounds. Delayed commencement of neovascularization was pragmatic among all TPM-treated mice, on day 12 post wounding. Abbot curve, angular spectrum, and other different parameters of 3D surface behavior of wounds revealed a very highly significant reduction (P<0.001) in angiogenesis on days 6 and 8 post-wounding, which points that application of TPM instigates extensive delay in trigging the progression of angiogenesis, resulting in delayed onset of wound healing. Conclusion Our annotations validate the damaging effects of TPM on wound healing and excessive use of TPM may lead to the production of chronic wounds and oral ulcers.

  10. 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 ...

  11. 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 ...

  12. Rapid enzyme analysis as a diagnostic tool for wound infection: Comparison between clinical judgment, microbiological analysis, and enzyme analysis

    NARCIS (Netherlands)

    Blokhuis-Arkes, Miriam H.E.; Haalboom, Marieke; Palen, van der Job; Heinzle, Andrea; Sigi, Eva; Guebitz, Georg; Beuk, Roland

    2015-01-01

    In clinical practice, diagnosis of wound infection is based on the classical clinical signs of infection. When infection is suspected, wounds are often swabbed for microbiological culturing. These methods are not accurate (clinical judgment in chronic wounds) or provide results after several days (w

  13. Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis

    NARCIS (Netherlands)

    A.M. Eskes; L.A.A. Gerbens; C.M.A.M. van der Horst; H. Vermeulen; D.T. Ubbink

    2011-01-01

    The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW). Twenty-three digital photographs of DSWs in various s

  14. 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.

  15. 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...

  16. Analysis of a Mathematical Model of Ischemic Cutaneous wounds

    CERN Document Server

    Friedman, Avner; Xue, Chuan

    2009-01-01

    Chronic wounds represent a major public health problem affecting 6.5 million people in the United States. Ischemia represents a serious complicating factor in wound healing. In this paper we analyze a recently developed mathematical model of ischemic dermal wounds. The model consists of a coupled system of partial differential equations in the partially healed region, with the wound boundary as a free boundary. The extracellular matrix (ECM) is assumed to be viscoelastic, and the free boundary moves with the velocity of the ECM at the boundary of the open wound. The model equations involve the concentrations of oxygen, cytokines, and the densities of several types of cells. The ischemic level is represented by a parameter which appears in the boundary conditions, 0 <= gamma < 1; gamma near 1 corresponds to extreme ischemia and gamma = 0 corresponds to normal non-ischemic conditions. We establish global existence and uniqueness of the free boundary problem and study the dependence of the free boundary on...

  17. Biosurgery in wound healing--the renaissance of maggot therapy.

    Science.gov (United States)

    Wollina, U; Karte, K; Herold, C; Looks, A

    2000-07-01

    Chronic wounds are a challenge for modern health care. A basic principle of treatment is the removal of sloughy, necrotic, devitalized tissue to prevent wound infection and delayed healing. Biosurgery (syn. maggot or larval therapy) is a promising adjunct to the whole spectrum of topical treatment methods, in particular for debridement. The term 'biosurgery' describes the use of living maggots on wounds to remove devitalized tissue, decrease the risk of infection and improve wound healing. The present paper gives a brief review of history, entomology, biochemistry and medical indications of biosurgery and the practical handling of maggots. We also provide some clinical data from the literature and our own experience in a wound care unit. Biosurgery is an effective and safe treatment option for debridement and disinfection. PMID:11204517

  18. [Treatment path of wound patient in the HUC medical care district].

    Science.gov (United States)

    Lepäntalo, Mauri; Ahokas, Terttuliisa; Heinänen, Tuula; Heiskanen-Kuisma, Kaija; Hietanen, Helvi; Juutilainen, Vesa; Iivanainen, Antti; Iso-Aho, Merja; Tukiainen, Erkki; Sane, Timo; Valtonen, Ville

    2009-01-01

    Unorganized care on chronic wounds is expensive. Resources are focused on the care of complicated wounds, although a significant proportion of the wounds could be prevented or treated at an early stage. Good care is cost-effective, a delayed care and inoperative treatment chain will waste money and resources. Specialization of medical and nursing staff in wound care will improve treatment outcome. Prerequisites for the necessary care must be guaranteed by creating a complete treatment path for problematic wounds in the capital region.

  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. Adenosine receptor agonists for promotion of dermal wound healing

    OpenAIRE

    Valls, María D.; Cronstein, Bruce N.; Montesinos, M. Carmen

    2009-01-01

    Wound healing is a dynamic and complex process that involves a well coordinated, highly regulated series of events including inflammation, tissue formation, revascularization and tissue remodeling. However, this orderly sequence is impaired in certain pathophysiological conditions such as diabetes mellitus, venous insufficiency, chronic glucocorticoid use, aging and malnutrition. Together with proper wound care, promotion of the healing process is the primary objective in the management of ch...

  1. Development of a new antimicrobial material for wound dressing

    OpenAIRE

    Pinho, Eva Patrícia Paiva Santos

    2014-01-01

    Tese de doutoramento em Engenharia Biomédica Nowadays, wound dressings are complex materials that, behind the mechanical protection, are also capable of interacting with the injury tissue. These complex products improve the healing process by maintaining suitable conditions, allowing skin to establish integrity with appropriate cosmetic results. The incidence of chronic wounds related with diseases, population ageing, and tissue infection caused by multi-resistant strains of ba...

  2. Wound Healing and Indigenous Drugs: Role as Antioxidants: A Review

    OpenAIRE

    B Somashekar Shetty

    2013-01-01

    Traditional medicine, especially herbal medicine has recently been receiving heightened interest all over the world. Man from the very beginning has been aware of the health problems and has been taking care of health through diet and drugs for which plants were used extensively. Molecular oxygen plays a central role in the pathogenesis and therapy of chronic wounds. When reactive oxygen species are overproduced, oxidative stress results in detrimental cytotoxic effects causing delayed wound ...

  3. Compromised Wound Healing in Ischemic Type 2 Diabetic Rats.

    Directory of Open Access Journals (Sweden)

    Peilang Yang

    Full Text Available Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD feeding regimen followed by multiple injections of streptozotocin (STZ at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds.

  4. Compromised Wound Healing in Ischemic Type 2 Diabetic Rats.

    Science.gov (United States)

    Yang, Peilang; Pei, Qing; Yu, Tianyi; Chang, Qingxuan; Wang, Di; Gao, Min; Zhang, Xiong; Liu, Yan

    2016-01-01

    Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8 weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds. PMID:27028201

  5. Wound biofilms: lessons learned from oral biofilms

    OpenAIRE

    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 relati...

  6. 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.

  7. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny;

    2006-01-01

    species present were identified. More than one bacterial species were detected in all the ulcers. The most common bacteria found were Staphylococcus aureus (found in 93.5% of the ulcers), Enterococcus faecalis (71.7%), Pseudomonas aeruginosa (52.2%), coagulase-negative staphylococci (45.7%), Proteus...

  8. Quality of life related with chronic wounds

    OpenAIRE

    Renata Virginia González-Consuegra; José Verdú

    2010-01-01

    El presente artículo hace una revisión bibliográfica que se inicia con un recorrido de la evolución del concepto de calidad de vida (CV) y su aplicación en salud, el cual debe su importancia a la forma más amplia en que es concebido el estado de salud personal, al contener implícito el bienestar social, lo que ha generado el desarrollo de medidas que permiten captar la salud en sus dimensiones múltiples y también positivas, como las de salud percibida o de calidad de vida relacionada con la s...

  9. Protein Degradation and Protection Observed in the Presence of Novel Wound Dressing Components

    Directory of Open Access Journals (Sweden)

    Laura K.S. Parnell

    2011-12-01

    Full Text Available Chronic wounds typically have excessive levels of matrix metalloproteinases (MMPs and proinflammatory cytokines that impair healing. Reducing these detrimental proteins may be key to healing chronic wounds. Proprietary protease blends were formulated specifically to degrade excessive amounts of proinflammatory factors that could prevent wound healing. Applications of protease-containing wound dressings to acute and chronic wounds have been observed clinically to resolve inflammation and appear to aid healing. The purpose of this study was to test in vitro a deliberate blend of proteases for the ability to deactivate or activate known proteins associated with inflammation or healing. Purified human target proteins were incubated with test and control solutions and samples removed at various time points. Blinded samples were tested using a novel infrared protein multiplex sandwich-ELISA-type array technique. Many proinflammatory proteins such as MMPs, cytokines and chemokines were susceptible to degradation. Many proteins such as growth factors, cytokines and TIMP1 were resistant to degradation. Not all proinflammatory proteins were deactivated. Family protein structure did not appear to affect susceptibility to degradation or deactivation. These results suggest that specific protease containing wound dressings appear to reduce multiple detrimental components which may disrupt their deleterious effects on the wound bed and microenvironment. By improving the wound microenvironment through the use of definitive proteases, these novel wound dressings may help transition wounds into the subsequent phase of healing.

  10. 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...

  11. The effect of OTR4120, a heparan sulfate glycosaminoglycan memetic on improving acute and impaired wound healing in rats

    OpenAIRE

    Tong, Miao

    2012-01-01

    markdownabstract__Abstract__ Dating back to the prehistoric times, wounds have been common with mankind. The treatment of wounds is an art as old as humanity. Today, wounds are of increasing concern in our society in terms of their prevalence and costs. In the developed countries, patients suffering from chronic wounds, such as venous, diabetic, and pressure ulcers, comprise approximately 1% to 2% of the population. The incidence of pressure ulcers is as high as 11% in hospitalized patients a...

  12. 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.

  13. Expression of natural antimicrobial peptide β-defensin-2 and Langerhans cell accumulation in epidermis from human non-healing leg ulcers

    Directory of Open Access Journals (Sweden)

    Urszula Wojewodzka

    2011-08-01

    Full Text Available Chronic wounds like venous calf and diabetic foot ulcers are frequently contaminated and colonized by bacteria and it remains unclear whether there is sufficient expression of defensins and recruitment of epidermal Langerhans cells in the margin of ulcer compared to normal skin. The aim of this study was to examine immunohistochemically the expression of β-defensin-2 (hBD2, GM-CSF, VEGF growth factors and accumulation of CD1a+ Langerhans cells (LC in epidermis from chronic skin ulcers and to compare it to normal skin from the corresponding areas. Studies were carried out in 10 patients with diabetic foot, 10 patients with varicous ulcers of the calf and 10 patients undergoing orthopedic surgery (normal skin for control. Biopsy specimens were immunostained using specific primary antibodies, LSAB+ kit based on biotin-avidinperoxidase complex technique and DAB chromogen. Results were expressed as a mean staining intensity. Statistical analysis of staining showed significantly higher staining of hBD2 in both normal and ulcerated epidermis from foot sole skin compared to calf skin (normal and ulcerated, p<0.05. Chronic ulcers showed the same expression of hBD2 as normal skin. There was significantly lower accumulation of CD1a+ LC in normal epidermis from foot sole skin compared to normal calf skin (p<0.05. Accumulation of CD1a+ LC and GM-CSF upregulation at the border area of diabetic foot ulcer and reduction of LC concentration at the margin of venous calf ulcer compared to normal skin were observed. It seems that normal calf and sole epidermis is, unlike in the mechanisms of innate immunity, influenced by the different keratinocyte turnover and bacterial flora colonizing these regions. Insufficient upregulation of hBD2 in both diabetic foot and venous calf ulcers may suggest the pathological role of this protein in the chronicity of ulcers.

  14. Applicability of confocal laser scanning microscopy for evaluation and monitoring of cutaneous wound healing

    Science.gov (United States)

    Lange-Asschenfeldt, Susanne; Bob, Adrienne; Terhorst, Dorothea; Ulrich, Martina; Fluhr, Joachim; Mendez, Gil; Roewert-Huber, Hans-Joachim; Stockfleth, Eggert; Lange-Asschenfeldt, Bernhard

    2012-07-01

    There is a high demand for noninvasive imaging techniques for wound assessment. In vivo reflectance confocal laser scanning microscopy (CLSM) represents an innovative optical technique for noninvasive evaluation of normal and diseased skin in vivo at near cellular resolution. This study was designed to test the feasibility of CLSM for noninvasive analysis of cutaneous wound healing in 15 patients (7 male/8 female), including acute and chronic, superficial and deep dermal skin wounds. A commercially available CLSM system was used for the assessment of wound bed and wound margins in order to obtain descriptive cellular and morphological parameters of cutaneous wound repair noninvasively and over time. CLSM was able to visualize features of cutaneous wound repair in epidermal and superficial dermal wounds, including aspects of inflammation, neovascularisation, and tissue remodelling in vivo. Limitations include the lack of mechanic fixation of the optical system on moist surfaces restricting the analysis of chronic skin wounds to the wound margins, as well as a limited optical resolution in areas of significant slough formation. By describing CLSM features of cutaneous inflammation, vascularisation, and epithelialisation, the findings of this study support the role of CLSM in modern wound research and management.

  15. 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.

  16. 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

  17. 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

  18. Practice-oriented expert recommendation for the treatment of critical colonised and local infected wounds using polihexanide

    OpenAIRE

    Vasel-Biergans, Anette; Strohal, Robert; Riepe, Gunnar; Kramer, Axel; Gerber, Veronika; Dissemond, Joachim; Eberlein, Thomas

    2009-01-01

    Wound infections are special and challenging situations in the therapy of acute and chronic wounds. Typical complications are riskful not only for the therapeutic process but also for amputation and viability of patients. Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and tiss...

  19. Practice-oriented expert recommendation for the treatment of critical colonised and local infected wounds using polihexanide

    OpenAIRE

    Dissemond, J; Gerber, V.; Kramer, A.; Riepe, G.; Strohal, R; Vasel-Biergans, A; Eberlein, T.

    2009-01-01

    Wound infections are special and challenging situations in the therapy of acute and chronic wounds. Typical complications are riskful not only for the therapeutic process but also for amputation and viability of patients. Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and...

  20. Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

    OpenAIRE

    Seo, Sang Gyo; Yeo, Ji Hyun; Kim, Ji Hye; Kim, Ji-Beom; Cho, Tae-Joon; Lee, Dong Yeon

    2013-01-01

    Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) ...

  1. Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review

    OpenAIRE

    John J. Anderson; Wallin, Kelly J.; Spencer, Loren

    2012-01-01

    We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean he...

  2. The Use of Hyperbaric Oxygen Therapy in the Treatment of Non-healing Ulcers Secondary to Graft-versus-host Disease

    OpenAIRE

    Heyboer, Marvin; Taylor, Justin; Morgan, Monica; Mariani, Peter; Jennings, Shane

    2014-01-01

    We present the case of a 69 year-old gentleman with non-healing ulcers of the bilateral medial malleoli as a result of graft-versus-host disease (GvHD). The patient discussed was diagnosed with stage IV mantle cell lymphoma. Over the course of 4 years the patient was treated with autologous stem cell transplant, later reduced-intensity allogeneic stem cell transplant, and finally donor lymphocyte infusion due to recurrence. Following these therapies, the patient developed extensive GvHD that ...

  3. 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...

  4. 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

  5. A Rat Model of Diabetic Wound Infection for the Evaluation of Topical Antimicrobial Therapies

    OpenAIRE

    Mendes, JJ; Leandro, C; Bonaparte, D; Pinto, A.

    2012-01-01

    Diabetes mellitus is an epidemic multisystemic chronic disease that frequently is complicated by complex wound infections. Innovative topical antimicrobial therapy agents are potentially useful for multimodal treatment of these infections. However, an appropriately standardized in vivo model is currently not available to facilitate the screening of these emerging products and their effect on wound healing. To develop such a model, we analyzed, tested, and modified published models of wound he...

  6. Cutaneous Wound Healing After Treatment with Plant-Derived Human Recombinant Collagen Flowable Gel

    OpenAIRE

    Shilo, Shani; Roth, Sigal; Amzel, Tal; Harel-Adar, Tamar; Tamir, Eran; Grynspan, Frida; Shoseyov, Oded

    2013-01-01

    Chronic wounds, particularly diabetic ulcers, represent a main public health concern with significant costs. Ulcers often harbor an additional obstacle in the form of tunneled or undermined wounds, requiring treatments that can reach the entire wound tunnel, because bioengineered grafts are typically available only in a sheet form. While collagen is considered a suitable biodegradable scaffold material, it is usually extracted from animal and human cadaveric sources, and accompanied by potent...

  7. Timer switch to convert suction apparatus for negative pressure wound therapy application

    OpenAIRE

    Surath Amarnath; Mettu Rami Reddy; Chayam Hanumantha Rao; Harsha Vardan Surath

    2014-01-01

    Background: Negative pressure wound therapy (NPWT) is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatu...

  8. Human skin wounds: a major and snowballing threat to public health and the economy.

    Science.gov (United States)

    Sen, Chandan K; Gordillo, Gayle M; Roy, Sashwati; Kirsner, Robert; Lambert, Lynn; Hunt, Thomas K; Gottrup, Finn; Gurtner, Geoffrey C; Longaker, Michael T

    2009-01-01

    ABSTRACT In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from "highly branded" diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH's Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions does list several rare diseases but does not list wounds. Forty million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications. PMID:19903300

  9. Macrophage dysfunction impairs resolution of inflammation in the wounds of diabetic mice.

    Directory of Open Access Journals (Sweden)

    Savita Khanna

    Full Text Available BACKGROUND: Chronic inflammation is a characteristic feature of diabetic cutaneous wounds. We sought to delineate novel mechanisms involved in the impairment of resolution of inflammation in diabetic cutaneous wounds. At the wound-site, efficient dead cell clearance (efferocytosis is a pre-requisite for the timely resolution of inflammation and successful healing. METHODOLOGY/PRINCIPAL FINDINGS: Macrophages isolated from wounds of diabetic mice showed significant impairment in efferocytosis. Impaired efferocytosis was associated with significantly higher burden of apoptotic cells in wound tissue as well as higher expression of pro-inflammatory and lower expression of anti-inflammatory cytokines. Observations related to apoptotic cell load at the wound site in mice were validated in the wound tissue of diabetic and non-diabetic patients. Forced Fas ligand driven elevation of apoptotic cell burden at the wound site augmented pro-inflammatory and attenuated anti-inflammatory cytokine response. Furthermore, successful efferocytosis switched wound macrophages from pro-inflammatory to an anti-inflammatory mode. CONCLUSIONS/SIGNIFICANCE: Taken together, this study presents first evidence demonstrating that diabetic wounds suffer from dysfunctional macrophage efferocytosis resulting in increased apoptotic cell burden at the wound site. This burden, in turn, prolongs the inflammatory phase and complicates wound healing.

  10. Evaluation of wound care options in patients with recessive dystrophic epidermolysis bullosa: a costly necessity.

    Science.gov (United States)

    Kirkorian, Anna Yasmine; Weitz, Nicole A; Tlougan, Brook; Morel, Kimberly D

    2014-01-01

    Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic disorder in which mutations in collagen VII, the main component of the anchoring fibril, lead to skin fragility and to the development of acute and chronic wounds. Wound care and dressing changes are an important part of the daily lives of individuals with RDEB. Ideal wound care should improve wound healing, minimize pain, and improve quality of life. The objective of the current study was to review wound care options that might be used in a patient with RDEB and calculate the cost of these various options based on publicly available pricing of wound care products. There is a wide range of costs for wound care options in patients with RDEB. For example, a 1-day supply of dressing for a neonate boy with RDEB ranges from $10.64 for the least expensive option to $127.54 for the most expensive option. Wound care in patients with severe, generalized RDEB has not only a significant economic effect, but also directly affects quality of life in this patient population. Although randomized controlled trials evaluating different wound care products in patients with RDEB are lacking, small studies and expert opinion support the use of specialized nonadherent dressings that minimize skin trauma and promote wound healing. Until there is a cure, prospective studies are needed to assess pain, quality of life, and wound healing associated with the use of specialized wound care products for this life-altering condition.

  11. 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.

  12. 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

  13. 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.

  14. Electrospun polyurethane-dextran nanofiber mats loaded with Estradiol for post-menopausal wound dressing.

    Science.gov (United States)

    Unnithan, Afeesh Rajan; Sasikala, Arathyram Ramachandra Kurup; Murugesan, Priya; Gurusamy, Malarvizhi; Wu, Dongmei; Park, Chan Hee; Kim, Cheol Sang

    2015-01-01

    Post-menopausal wound care management is a substantial burden on health services, since there are an increased number of elderly populations linked with age-related delayed wound healing. The controlled estrogen replacement can accelerate healing of acute cutaneous wounds, linked to its potent anti-inflammatory activity. The electrospinning technique can be used to introduce the desired therapeutic agents to the nanofiber matrix. So here we introduce a new material for wound tissue dressing, in which a polyurethane-dextran composite nanofibrous wound dressing material loaded with β-estradiol was obtained through electrospinning. Dextran can promote neovascularization and skin regeneration in chronic wounds. This study involves the characterization of these nanofibers and analysis of cell growth and proliferation to determine the efficiency of tissue regeneration on these biocomposite polymer nanofibrous scaffolds and to study the possibility of using it as a potential wound dressing material in the in vivo models. PMID:25748849

  15. 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

  16. Delayed cutaneous wound closure in HO-2 deficient mice despite normal HO-1 expression

    NARCIS (Netherlands)

    Lundvig, D.M.S.; Scharstuhl, A.; Cremers, N.A.J.; Pennings, S.W.C.; Paske, J. Te; Rheden, R. van; Breda, C. van Run-van; Regan, R.F.; Russel, F.G.M.; Carels, C.E.L.; Maltha, J.C.; Wagener, F.A.D.T.G.

    2014-01-01

    Impaired wound healing can lead to scarring, and aesthetical and functional problems. The cytoprotective haem oxygenase (HO) enzymes degrade haem into iron, biliverdin and carbon monoxide. HO-1 deficient mice suffer from chronic inflammatory stress and delayed cutaneous wound healing, while corneal

  17. [Enhance the connotation of establishment of wound healing department].

    Science.gov (United States)

    Lu, Shu-liang

    2012-02-01

    Following the development of social economy, the acceleration of aging problem, and the changes in disease spectrum, the incidence of various chronic wound diseases increased significantly, and it has become one of the most frequently encountered diseases that affect the people's health. The contradiction between the increase of medical need of wound diseases and the insufficiency of the medical service in our country is becoming increasingly conspicuous. Wound healing department, as a new cross subject that has emerged as the times require, needs to be perfected in its diagnostic and treatment strategies and methods. At present time, how to explore the new theory and pathologic mechanism of various chronic wounds, in order to establish the clinical guidelines in diagnosis and treatment that conform to national conditions of our country, and to establish efficient clinical pathway and medical-seeking model have become serious challenges to the establishment of wound healing department in our country. Thus, it is imperative for us to enhance the connotation of establishment of wound healing department. For this purpose, this article mainly elaborates on three aspects, including "enriching traditional diagnostic system with new theory and new technology", "improving treatment effect by ameliorating traditional methods and absorbing new technology from relating subspecialty", "establishing a new medical-seeking model by applying digital technology and vertically integrating medical resources". PMID:22490530

  18. A case report of a 19-week gravid patient with a dehisced abdominal wound and treated with V.A.C. ATS(®) Therapy System.

    Science.gov (United States)

    Asukai, Kei; Kashiwazaki, Masaki; Koizumi, Kaori; Nobunaga, Toshikatsu; Yano, Hiroshi

    2016-10-01

    Negative pressure wound therapy (NPWT) is an effective treatment for various non-healing wounds, and V.A.C.(®) Therapy was the first-approved NPWT device by the Japanese government in 2009. We report the case of a 19-week pregnant patient where V.A.C.(®) Therapy was applied to her dehisced laparotomy wound with satisfactory results. The patient was a 30-year-old female who was referred to our hospital from her previous doctor because of the presence of an ovarian cyst on the left ovary. The patient presented at 14 weeks into her pregnancy, and surgery was considered because of no reduction in the size of the cyst. An oophorocystectomy was performed, and then the surgical incision was re-opened at postoperative day (POD) 10 due to a surgical site infection. V.A.C.(®) Therapy was initiated on POD 26 (20 weeks of pregnancy) and continued for 28 days. After 28 days of V.A.C.(®) Therapy (POD 54), the wound was sutured for complete closure. The foetus did not experience any adverse affects from the surgery and, subsequently, normal vaginal delivery was achieved. This case is the first report of the use of V.A.C.(®) Therapy over a dehisced abdominal wound on a pregnant patient in our country.

  19. Exploiting potency of negative pressure in wound dressing using limited access dressing and suction-assisted dressing

    Directory of Open Access Journals (Sweden)

    Pramod Kumar

    2012-01-01

    Full Text Available Role of negative pressure dressing and moist wound healing are well established in the treatment of both acute and chronic wounds with certain advantages and disadvantages in both the techniques. Both these techniques prevents wound colonization, but the negative pressure dressing method has proved to have a greater potency to remove secretions, prevent wound invasion and eradication established infection. In both these techniques there is no accessibility to wound environment. Limited access dressing (LAD is a moist wound dressing with negative pressure. It provides limited access to the wound through two small ports for both dressers and pathogens. The LAD design has notable advantages like wound isolation that reduces chance of wound colonization and safe disposal of infected materials (important factor to reduce hospital-acquired infections, while avoiding some major disadvantages such as opacity of dressing materials, inaccessible offensive smelling wound environment, and relatively high treatment costs. In LAD a definite intermittent negative pressure regimen is followed. The intermittent negative pressure (cycle of 30 minutes suction and 3 1 / 2 hours rest is effective. Overall, the LAD is a safe and effective alternative to conventional dressing methods. LAD is an excellent research tool for wound healing as frequent/continuous record of wound healing is possible without disturbing the wound healing process. LAD is an effective dressing for limb salvage in cases of acute and chronic complex wounds. Leech effect prevents wound related systematic response syndrome and sepsis. Suction-assisted dressing (SAD is a combination of semiocclusive dressing with negative pressure. It works by removal of fluids by intermittent (like LAD negative pressure and preventing bacterial invasion. SAD is especially advantageous where soakage is less, there is no dead tissue covering the wound (e.g., following skin grafting, superficial skin wounds (e

  20. The Role of Iron in the Skin & Cutaneous Wound Healing

    Directory of Open Access Journals (Sweden)

    Josephine Anne Wright

    2014-07-01

    Full Text Available In this review article we discuss current knowledge about iron in the skin and the cutaneous wound healing process. Iron plays a key role in both oxidative stress and photo-induced skin damage. The main causes of oxidative stress in the skin include reactive oxygen species (ROS generated in the skin by ultraviolet (UVA 320-400 nm portion of the ultraviolet spectrum and biologically available iron. We also discuss the relationships between iron deficiency, anaemia and cutaneous wound healing. Studies looking at this fall into two distinct groups. Early studies investigated the effect of anaemia on wound healing using a variety of experimental methodology to establish anaemia or iron deficiency and focused on wound-strength rather than effect on macroscopic healing or re-epithelialisation. More recent animal studies have investigated novel treatments aimed at correcting the effects of systemic iron deficiency and localised iron overload. Iron overload is associated with local cutaneous iron deposition, which has numerous deleterious effects in chronic venous disease and hereditary haemochromatosis. Iron plays a key role in chronic ulceration and conditions such as Rheumatoid Arthritis (RA and Lupus Erythematosus are associated with both anaemia of chronic disease and dysregulation of local cutaneous iron haemostasis. Iron is a potential therapeutic target in the skin by application of topical iron chelators and novel pharmacological agents, and in delayed cutaneous wound healing by treatment of iron deficiency or underlying systemic inflammation.

  1. Heme Oxygenase-1 Promotes Delayed Wound Healing in Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Qing-Ying Chen

    2016-01-01

    Full Text Available Diabetic ulcers are one of the most serious and costly chronic complications for diabetic patients. Hyperglycemia-induced oxidative stress may play an important role in diabetes and its complications. The aim of the study was to explore the effect of heme oxygenase-1 on wound closure in diabetic rats. Diabetic wound model was prepared by making an incision with full thickness in STZ-induced diabetic rats. Wounds from diabetic rats were treated with 10% hemin ointment for 21 days. Increase of HO-1 protein expression enhanced anti-inflammation and antioxidant in diabetic rats. Furthermore, HO-1 increased the levels of VEGF and ICAM-1 and expressions of CBS and CSE protein. In summary, HO-1 promoted the wound closure by augmenting anti-inflammation, antioxidant, and angiogenesis in diabetic rats.

  2. 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

  3. Effects of the blended fibroin/aloe gel film on wound healing in streptozotocin-induced diabetic rats

    International Nuclear Information System (INIS)

    Delayed healing remains a major clinical problem and here we have sought to develop an improved dressing film comprising 1.95% w/v fibroin and 0.05% w/v aloe gel extract. The tensile strength of dry film was 21.1 ± 0.5 MPa and broke at 1.1 ± 0.2% elongation; corresponding values for wet film were 18.3 ± 1.3 MPa and 1.9 ± 0.1%. The film maintained its shape upon water immersion and the swelling ratio of the dry film was 0.8 ± 0.1 while the water uptake was 43.7 ± 2.6%. After 28 days of incubation in phosphate buffered saline (1 M, pH 7.4, 37 °C), the weight of film was reduced by 6.7 ± 1.1% and the tensile strength and elongation at breaking point (dry state) were 15.4 ± 0.6 MPa and 1.5 ± 0.2%, respectively. Compared to aloe-free fibroin film (2.0% fibroin extract only), the blended film enhanced the attachment and proliferation of skin fibroblasts. The bFGF immunofluorescence of fibroblasts cultured on the blended film appeared greater than those cultured on tissue culture plate or on aloe-free fibroin film while α-smooth muscle actin was maintained. In streptozotocin-induced diabetic rats, the wounds dressed with the blended film were smaller (p <0.05) by day 7 after wounding, compared to untreated diabetic wounds. Histology of repaired diabetic wounds showed the fibroblast distribution and collagen fiber organization to be similar to wounds in normal rats, and this was matched by enhanced hydroxyproline content. Thus, such accelerated wound healing by the blended fibroin/aloe gel films may find application in treatment of diabetic non-healing skin ulcers. (paper)

  4. 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.

  5. Intraperitoneal wound in abdominal surgery

    OpenAIRE

    Kahokehr, Arman Adam

    2013-01-01

    The intraperitoneal wound is often forgotten after transperitoneal surgery. This review is a on the peritoneum and the implications of peritoneal injury after surgery. This review will focus on the intraperitoneal wound response after surgical injury.

  6. Mesenchymal stem cell-laden anti-inflammatory hydrogel enhances diabetic wound healing

    OpenAIRE

    Shixuan Chen; Junbin Shi; Min Zhang; Yinghua Chen; Xueer Wang; Lei Zhang; Zhihui Tian; Yuan Yan; Qinglin Li; Wen Zhong; Malcolm Xing; Lu Zhang; Lin Zhang

    2015-01-01

    The purpose of this study was to permit bone marrow mesenchymal stem cells (BMSCs) to reach their full potential in the treatment of chronic wounds. A biocompatible multifunctional crosslinker based temperature sensitive hydrogel was developed to deliver BMSCs, which improve the chronic inflammation microenvironments of wounds. A detailed in vitro investigation found that the hydrogel is suitable for BMSC encapsulation and can promote BMSC secretion of TGF-β1 and bFGF. In vivo, full-thickness...

  7. Wound Care in Primary Health Care

    OpenAIRE

    Nail Ersoz; Ismail Hakki Ozerhan; Fatih Zor

    2008-01-01

    Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000): 71-74

  8. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull. 2008; 7(1: 71-74

  9. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000: 71-74

  10. The wound inflammatory response exacerbates growth of pre-neoplastic cells and progression to cancer

    DEFF Research Database (Denmark)

    Antonio, Nicole; Bønnelykke-Behrndtz, Marie Louise; Ward, Laura Chloe;

    2015-01-01

    zebrafish larval model of Ras(G12V)-driven neoplasia to image the interactions between inflammatory cells drawn to a wound, and to adjacent pre-neoplastic cells. We show that neutrophils are rapidly diverted from a wound to pre-neoplastic cells and these interactions lead to increased proliferation......There is a long-standing association between wound healing and cancer, with cancer often described as a "wound that does not heal". However, little is known about how wounding, such as following surgery, biopsy collection or ulceration, might impact on cancer progression. Here, we use a translucent...... of the pre-neoplastic cells. One of the wound-inflammation-induced trophic signals is prostaglandin E2 (PGE2). In an adult model of chronic wounding in zebrafish, we show that repeated wounding with subsequent inflammation leads to a greater incidence of local melanoma formation. Our zebrafish studies led us...

  11. Wound Drainage Culture (For Parents)

    Science.gov (United States)

    ... Melon Smoothie Pregnant? Your Baby's Growth Wound Drainage Culture KidsHealth > For Parents > Wound Drainage Culture Print A A A Text Size What's in ... de heridas What It Is A wound drainage culture is a test to detect germs such as ...

  12. Wound Healing Devices Brief Vignettes

    OpenAIRE

    Anderson, Caesar A.; Hare, Marc A.; Perdrizet, George A.

    2016-01-01

    Significance: The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications.

  13. Value networks in the life science industry. Case: Wound care product segment

    OpenAIRE

    Kiuru, Tony

    2015-01-01

    Chronic wounds have been steadily increasing in the developed countries, caused by the combination of aging population and obesity. In the EU-27 area there are around 4 million patients yearly requiring hospital care for wounds. The total costs of treatment for a wound are around €6650-€10000 per patient. The medical supplies and equipment market, where wound care products belong to, is estimated to grow 5.8% between 2013 and 2018. These growth and value creation opportunities have been notic...

  14. Effects of the topical application of the extract of Vernonia scorpioides on excisional wounds in mice

    OpenAIRE

    P. Dalazen; A. Molon; M.W. Biavatti; M.R.O. Kreuger

    2005-01-01

    Vernonia scorpioides is traditionally widely used in Brazil to treat skin problems, including healing of chronic wounds, such as ulcers of the lower limbs and diabetic wounds. This work investigated the healing process on excisional wounds in the skin of mice, treated daily with an ointment containing 20% of the ethanol extract of the leaves of Vernonia scorpioides, compared with the control. A skin wound area of about 4 mm was excised on anaesthetised mice, and after 3, 7 and 14 days of trea...

  15. 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.

  16. Visual effects of β-­glucans on wound healing in fish

    DEFF Research Database (Denmark)

    Schmidt, Jacob; Ljungqvist, Martin Georg; Ersbøll, Bjarne Kjær;

    2011-01-01

    Introduction B-glucans are diverse polysaccharides that occur naturally in plants, fungi and bacteria. B-glucans have been shown to have an immunostimulatory effect1. In addition, B-glucans have been found to increase wound tensile strength and collagen synthesis2. This is likely to affect...... the filet quality3. With multispectral imaging we investigate the effect of adding B-glucans to the water during healing of open wounds in fish. Multispectral imaging is used in human diagnostic medicine for evaluating fx proriasis and chronic diabetic wounds, but has not yet been applied to wounds in fish...

  17. Fungal Wound Infection

    Centers for Disease Control (CDC) Podcasts

    2016-01-28

    Dr. David Tribble, acting director of the infectious disease clinical research program at Uniformed Services University of the Health Sciences, discusses fungal wound infections after combat trauma.  Created: 1/28/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/28/2016.

  18. Healing Invisible Wounds

    Science.gov (United States)

    Adams, Erica J.

    2010-01-01

    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual abuse, war,…

  19. The Wounded Spirit.

    Science.gov (United States)

    Peretti, Frank

    2001-01-01

    This article offers a glimpse into the life of Frank Peretti, who as a child suffered abuse because of his physical disfigurement. He was bullied and physically assaulted by peers and sometimes adults. Now well known for his novels, Peretti suggests that people who cause others to suffer also suffer from a wounded spirit. (Author)

  20. Phytochemicals in Wound Healing

    OpenAIRE

    Thangapazham, Rajesh L.; Sharad, Shashwat; Radha K. Maheshwari

    2016-01-01

    Significance: Traditional therapies, including the use of dietary components for wound healing and skin regeneration, are very common in Asian countries such as China and India. The increasing evidence of health-protective benefits of phytochemicals, components derived from plants is generating a lot of interest, warranting further scientific evaluation and mechanistic studies.