Journal of wound care最新文献

{"title":"A new portable negative pressure wound therapy device: a prospective study investigating clinical outcomes.","authors":"Victoria Rose, Nadine Hachah Haram, Sarah Gallala","doi":"10.12968/jowc.2024.0033","DOIUrl":"10.12968/jowc.2024.0033","url":null,"abstract":"<p><strong>Objective: </strong>Closed surgical incision sites at high risk of complications, and with exudate or leakage, are increasingly being managed with closed incision negative pressure wound therapy (ciNPWT) to reduce tissue stress and increase the force necessary to disrupt the incision. This study was undertaken to investigate the performance and safety of a canister-based, single-use NPWT (suNPWT) system when used on closed surgical incision sites.</p><p><strong>Method: </strong>The investigation was designed as a prospective, open, non-comparative, multicentre study aimed at confirming the safety and performance attributes of the suNPWT system when applied to low-to-moderately exuding closed surgical incisions. The primary performance measure was the wound remaining closed from baseline to the last follow-up visit on day 14. Secondary performance measures included: wound and periwound condition; wear time of the system; product consumption; adherence to therapy; and patients' pain progress. Details of adverse events were also collected.</p><p><strong>Results: </strong>Some 35 patients were recruited. The closed surgical incisions responded well to treatment with the tested suNPWT system. All wounds remained closed throughout the investigation. Consistent with other studies of ciNPWT reporting low infection rates, the current study observed either no or low exudation in 90.4% of wounds at the final visit, together with absence of surgical site infection. Pain severity levels were low, both at dressing change and during delivery of negative pressure. No serious adverse device events were reported.</p><p><strong>Conclusion: </strong>In this study, the suNPWT system supported the healing of closed surgical incisions with no safety concerns relating to its use.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 11","pages":"833-840"},"PeriodicalIF":1.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic misinterpretations: dressing-packed surgical wounds and pressure ulcers.","authors":"Richard Simman","doi":"10.12968/jowc.2024.0264","DOIUrl":"10.12968/jowc.2024.0264","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 11","pages":"405"},"PeriodicalIF":1.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Cytoreg in the treatment of diabetic foot disease.","authors":"Darío Carrillo, Katiusca Villasana, Geizon Torres, Leonardo Dugarte, Lewis Pozo, William Bauta, William Jiménez","doi":"10.12968/jowc.2022.0024","DOIUrl":"10.12968/jowc.2022.0024","url":null,"abstract":"<p><strong>Objective: </strong>Complications from diabetic foot wounds, including bacterial infection, ulceration and gangrene, are major causes of hospitalisation and are responsible for 85% of amputations in patients with diabetes. Given that orally administered investigational therapeutic Cytoreg (Cytorex de Venezuela SA, Venezuela), a defined aqueous mixture of hydrofluoric, hydrochloric, sulfuric, phosphoric, citric and oxalic acids, has been shown to increase levels of arterial blood oxygen in a Wistar rat model, oral and oral+topical Cytoreg were tested on patients with diabetic foot ulcers (DFUs) under a humanitarian, compassionate-use protocol.</p><p><strong>Method: </strong>All patients received oral Cytoreg (5.0 ml concentrate in fruit juice) for 30 days; half also received weekly wound washing with Cytoreg concentrate in isotonic saline (1:50 volume/volume) (oral+topical group). In addition to standard clinical observations, wounds were monitored against the Saint Elian checklist system for the diabetic foot.</p><p><strong>Results: </strong>A total of 10 patients took part in the study. Complete wound closure was observed in 4/5 patients in the oral+topical group; in the remaining patient, necrotic and fibrin tissues on the wound edges were eliminated. Half (2/4) of the patients receiving oral-only Cytoreg experienced complete wound closure; one patient in this group was removed prematurely because of an unrelated illness and was not replaced. During the study, no significant differences were observed between groups in either the oxygen saturation of the affected tissues or in insulin and glycaemia levels (p<0.05). Significant increases in arterial haemoglobin and arterial oxygen partial pressure (p<0.05) were observed, and significant decreases were measured in the levels of glycosylated haemoglobin, aspartate aminotransferase, glutamic-pyruvic transaminase, creatine and urea (p<0.05).</p><p><strong>Conclusion: </strong>The results of this study justify an expanded clinical study for the treatment of DFUs with Cytoreg.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 11","pages":"806-812"},"PeriodicalIF":1.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a gelling-fibre dressing and a gelling-fibre dressing with silver nanoparticles at controlling exudate and infection: a 4-week multicentre clinical evaluation.","authors":"Choi Ching Fong, Anna Graham, Sandie Hamilton, Melissa Jelly, James Linsley, Hannah Perry, Hilary Weaver","doi":"10.12968/jowc.2024.33.Sup11a.S15","DOIUrl":"10.12968/jowc.2024.33.Sup11a.S15","url":null,"abstract":"<p><strong>Background: </strong>Suprasorb Liquacel Pro (standard test dressing) and Suprasorb Liquacel Ag (test dressing with silver nanoparticles) are absorptive gelling-fibre dressings designed to manage wound exudate levels and promote moist wound healing, with the latter having additional antimicrobial properties.</p><p><strong>Aims: </strong>To assess the impact of the test dressing on healing, exudate levels and signs of infection.</p><p><strong>Methods: </strong>Patients with moderately-to-highly exuding hard-to-heal wounds of any type were dressed with the standard test dressing or the test dressing with silver nanoparticles if they showed covert or overt signs of local infection. Comparative data were collected at baseline and 4-week conclusion. Adverse events and patient and professional opinions were also reported and collated.</p><p><strong>Findings: </strong>There were 19 patients with lower-limb wounds of various types present for a mean of 26 months. At baseline, most wounds were deteriorating or static (68%), while at conclusion most were improving or healed (84%), with additional indicators of improved healing. The number of patients with moderate-to-high exudate levels decreased from 84% to 53%. The 15 patients using the test dressing with silver nanoparticles saw reductions in covert signs of infection from 93% to 80%, overt signs of infection from 33% to 13% and antibiotic use from 13% to 7%.</p><p><strong>Conclusions: </strong>On average, the test dressings were effective in managing and reducing the barriers to healing, including high exudate, infection and biofilm, and in restarting stalled healing.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 Sup11a","pages":"S15-S20"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising wound healing: the role of gelling fibre technology and antimicrobial silver nanoparticles.","authors":"Luxmi Dhoonmoon","doi":"10.12968/jowc.2024.33.Sup11a.S4","DOIUrl":"10.12968/jowc.2024.33.Sup11a.S4","url":null,"abstract":"<p><p>Gelling-fibre dressings have been found to be a rapid and effective tool for exudate management. Suprasorb Liquacel Pro is a soft, conformable non-woven dressing made from sodium carboxymethyl cellulose and strengthening cellulose fibres. When it comes into contact with wound exudate or blood, the absorbent dressing forms a gel, creating a moist wound environment. Cell debris and bacteria in the exudate are retained inside the fibre dressing and removed during the dressing change. The high vertical absorption of exudate into the fibre dressing protects the wound environment and the wound edge, thus supporting the healing process. Suprasorb Liquacel Ag has additional antimicrobial abilities with the inclusion of nanosilver technology, shown to be effective in killing bacteria and managing bioburden.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 Sup11a","pages":"S4-S14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach for the treatment of diabetic foot ulcers using a multimodal wound matrix: a clinical study.","authors":"Richard Simman, Suzanne J Bakewell, Desmond Bell, Susan Shuman, Mary Cheney","doi":"10.12968/jowc.2024.0085","DOIUrl":"10.12968/jowc.2024.0085","url":null,"abstract":"<p><strong>Objective: </strong>Innovation in wound healing, particularly regarding diabetic foot ulcers (DFUs), is needed to reverse the number of diabetes-related amputations. This study evaluated a novel approach and performance of a multimodal wound matrix in converting stalled DFUs into a healing trajectory.</p><p><strong>Method: </strong>Patients with either type 1 or 2 diabetes and with foot ulcers (Wagner grade 1 and 2), were screened to determine eligibility for treatment. Ulcers improving >30% in area during a two-week screening phase were not eligible for the study treatment phase. The study was an open-label trial conducted in three phases: screening, treatment and healing confirmation. Patients enrolled in the study received a treatment protocol that included application of a wound matrix to the ulcer and offloading.</p><p><strong>Results: </strong>A total of 19 patients (15 males, four females) with a median age of 60 years, and a median ulcer duration of 36 weeks took part in the study. Patients showed an average four-week percentage area reduction (PAR) of 62%, a 12-week PAR of 94%, and a 12-week healing rate of 57% (8/14).</p><p><strong>Conclusion: </strong>Results of this study support the viability and potential of a novel approach to treating DFUs that includes use of a multimodal wound matrix.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 10","pages":"772-777"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the machines master simulations.","authors":"Amit Gefen","doi":"10.12968/jowc.2024.0304","DOIUrl":"10.12968/jowc.2024.0304","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 10","pages":"721-722"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of patients with hard-to-heal wounds: insights from a pilot survey.","authors":"Naz Wahab, R Allyn Forsyth","doi":"10.12968/jowc.2024.0109","DOIUrl":"https://doi.org/10.12968/jowc.2024.0109","url":null,"abstract":"<p><strong>Objective: </strong>To learn about the experiences of people who seek treatment for hard-to-heal wounds, we distributed a nationwide pilot survey, asking questions about the nature of their wound, how it shaped their daily lives, pathways to receiving care and experiences with treatment. The long-term objective is to quantify the journey of patients with hard-to-heal wounds to identify ideal intervention points that will lead to the best outcomes. This article summarises the findings, implications, limitations and suggestions for future research.</p><p><strong>Method: </strong>Qualitative data were self-reported from patients with hard-to-heal wounds (open for ≥4 weeks) in a pilot chatbot survey, (Wound Expert Survey (WES)) provided online in the US on Meta platforms (Facebook and Instagram) between 2021 and 2022.</p><p><strong>Results: </strong>The US national pilot survey attracted responses from 780 patients, 27 of whom provided a video testimonial. Some 57% of patients delayed treatment because they believed their wound would heal on its own, and only 4% saw a wound care specialist. Respondents reported the cost of care as the most frequent reason for not following all of a doctor's treatment recommendations. Queries regarding quality of life (QoL) revealed that more than half (65%) said they have negative thoughts associated with their wound at least every few days. Some 19% of respondents said their wound had an odour and, of them, 34% said odour had a major or severe negative impact on their self-confidence. Economically, nearly one-quarter of respondents said having a wound led to a drop in their total household income and 17% said their wound led to a change in their employment status.</p><p><strong>Conclusion: </strong>A national pilot survey of patients with hard-to-heal wounds revealed that many delay seeking professional assistance and only a small minority see a wound care specialist. Experiencing an ulcer, even for a few months, can have significant negative effects on a patient's QoL. Patients frequently had negative thoughts associated with their wound, and odour compounded these negative effects, leading to major or severe negative impacts on self-confidence. Households experienced a decline in income, due to both the direct reduction or loss of patient employment and the additional time spent by family members assisting in patient recovery. Thus, a variety of factors contribute to poor outcomes for patients with hard-to-heal wounds. To validate and extend these preliminary results, future surveys of patients with hard-to-heal wounds should focus on additional reasons patients do not seek professional help sooner. To improve health outcomes and QoL, assessment of patient socioeconomic variables should occur whenever wound closure stalls.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 10","pages":"788-794"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of combined hyperbaric oxygen therapy and topical haemoglobin spray in treating hard-to-heal sloughy wounds.","authors":"Levent Demir","doi":"10.12968/jowc.2024.0026","DOIUrl":"10.12968/jowc.2024.0026","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the effectiveness of a combination of hyperbaric oxygen therapy (HBOT) and topical haemoglobin spray in treating hard-to-heal, sloughy diabetic foot ulcers (DFUs).</p><p><strong>Method: </strong>Patients with hard-to-heal DFUs at least 25% sloughy or necrotic were included in the study. We compared the results of patients who received standard of care and HBOT with topical haemoglobin spray (oxygen group) to an equal number of patients who only received standard personalised wound care (control group). The initial values of haemoglobin A1C and C-reactive protein, wound culture results and SINBAD (site, ischaemia, neuropathy, bacterial infection, area, depth) scores were documented. Wounds were considered healed when completely closed within 16 weeks.</p><p><strong>Results: </strong>The oxygen group (n=21) had a mean SINBAD score of 5.00±0.89, while the control group (n=21) had a mean score of 4.62±0.80 (p=0.155). After 16 weeks, 85.7% of wounds in the oxygen group showed complete recovery, compared with 52.4% in the control group (p=0.02).</p><p><strong>Conclusion: </strong>In this study, a greater number of wounds in the oxygen group healed. Combining HBOT with topical haemoglobin spray provides oxygenation to the wound for longer, primarily because patients can receive 90 minutes of HBOT daily. This ensures that patients benefit from both systemic and local oxygen. This combination therapy may effectively address the problem of hypoxia and promote healing in hard-to-heal wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 10","pages":"796-802"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of maggot debridement therapy on the bacterial flora of hard-to-heal wounds.","authors":"Monika Gieroń, Małgorzata Słowik-Rylska, Monika Kucharczyk, Sylwia Cyran-Stemplewska, Bartłomiej Gieroń, Grzegorz Czerwonka, Dorota Kozieł, Beata Kręcisz","doi":"10.12968/jowc.2020.0168","DOIUrl":"https://doi.org/10.12968/jowc.2020.0168","url":null,"abstract":"<p><strong>Objective: </strong>Maggot debridement therapy (MDT) is increasingly being used in clinical practice as an alternative treatment for hard-to-heal (chronic) wounds. Among the many benefits of using MDT is its antimicrobial effect. Maggots secrete substances that are known to have antibacterial properties against both Gram-negative and Gram-positive bacteria. Clinically, this results in the effective eradication of pathogenic species and consequently, a faster healing process. The aim of this study was to evaluate the effect MDT has on the bacterial flora of hard-to-heal ulcers.</p><p><strong>Method: </strong>Patients with venous, mixed arteriovenous, decubitus, diabetic and neuropathic wounds were treated with larvae of <i>Lucilia sericata</i> enclosed in bags. Dressings were applied to the wounds for 72 hours. Before and after the therapy, a swab was taken from the wound, and bacterial diversity and bacterial growth scores were assessed. While 16 patients were treated only once, the treatment had to be repeated in four cases until the wounds were fully debrided.</p><p><strong>Results: </strong>Bacteria of the species <i>Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus</i> and <i>Enterococcus faecalis</i> were the most common strains observed. Of the 20 patients treated, the total number of bacterial strains decreased in eight wounds, but increased in five wounds, while no difference was observed in nine wounds. The average number of bacterial strains in wounds decreased after MDT. A lower incidence of alarm pathogens was also reported. In cases where multiple applications of larvae were administered, greater decreases in bacterial growth scores were observed than in cases with a single application of dressing (37.5% vs 18.1%, respectively). In 18 cases, after disinfection of the wound by larvae, it was reinfected by strains not detected before. Wounds healed completely after MDT in two patients.</p><p><strong>Conclusion: </strong>In this study, MDT changed the bacterial diversity of hard-to-heal wounds. The larvae reduced overall bacterial growth scores and acted on both Gram-positive and Gram-negative bacteria as well as on alarm pathogens. Cleaned wounds appeared to become vulnerable to infection by opportunistic bacteria. The bacterial burden decreased as the number of applications of biological dressings increased.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"33 10","pages":"778-787"},"PeriodicalIF":1.5,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}