Journal of wound care最新文献

{"title":"Relaxation intervention to improve diabetic foot ulcer healing: protocol for a pilot study with a nested qualitative study.","authors":"Gabriela Ferreira, André Carvalho, M Graça Pereira","doi":"10.12968/jowc.2022.0175","DOIUrl":"10.12968/jowc.2022.0175","url":null,"abstract":"<p><strong>Objective: </strong>A mixed-methods approach nested in a pilot three-arm randomised controlled trial (RCT) was conducted to evaluate the feasibility and acceptability of an intervention of progressive muscle relaxation with guided imagery (experimental group) compared to a neutral guided imagery placebo (active control group) and a group that did not receive any psychological intervention (passive control group). The purpose was to inform a future definitive RCT that will test its effectiveness. Qualitatively, this study examined patients and health professionals' perspectives regarding the relaxation intervention, in order to assess the acceptability and applicability of relaxation as an adjuvant therapy.</p><p><strong>Method: </strong>Participants must have had a diagnosis of diabetes and diabetic foot disease; one or two active hard-to-heal ulcers at the time of the assessment; and clinical levels of stress or anxiety or depression. Participants were randomised and assessed at three timepoints after the first hospital consultation for hard-to-heal diabetic foot ulcer (DFU).</p><p><strong>Results: </strong>Rates of eligibility, recruitment, refusal, adherence to study protocol, participation in follow-up and dropout, and patients' satisfaction with the relaxation intervention were assessed as primary outcomes. Secondary outcomes were DFU healing; patients' DFU-related quality of life; physical and mental quality of life; perceived stress; emotional distress; adherence to DFU care; perceptions of DFU; as well as arterial systolic/diastolic pressure and heart rate.</p><p><strong>Conclusion: </strong>The results of this pilot study contributed to clarification and better elucidation of the benefits of relaxation techniques regarding patients' HRQoL and DFU healing.</p><p><strong>Declaration of interest: </strong>Funding: This study was conducted at the Psychology Research Centre (CIPsi/UM) School of Psychology, University of Minho, Portugal and supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (UIDB/01662/2020) and by a PhD fellowship from FCT assigned to GF (SFRH/BD/131780/2017) and an FCT grant (PTDC/PSI-GER/28163/2017) assigned to MGP. The authors have no conflicts of interest to declare.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559015","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":"Where are the young wound clinicians?","authors":"John C Lantis","doi":"10.12968/jowc.2024.0193","DOIUrl":"10.12968/jowc.2024.0193","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555058","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 review of the proposed draft CAMPs LCDs compared to evidence-based medicine: a letter to the MACs for consideration","authors":"William Tettelbach, Martha R Kelso, David G Armstrong","doi":"10.12968/jowc.2024.0169","DOIUrl":"https://doi.org/10.12968/jowc.2024.0169","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141371680","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":"Dehydrated Amnion Chorion Membrane versus standard of care for diabetic foot ulcers: a randomised controlled trial","authors":"S. Cazzell, J. Caporusso, D. Vayser, R. D. Davis, Oscar M Alvarez, Michael L Sabolinski","doi":"10.12968/jowc.2024.0139","DOIUrl":"https://doi.org/10.12968/jowc.2024.0139","url":null,"abstract":"Diabetic foot ulcers (DFUs) continue to challenge wound care practitioners. This prospective, multicentre, randomised controlled trial (RCT) evaluated the effectiveness of a dehydrated Amnion Chorion Membrane (dACM) (Organogenesis Inc., US) versus standard of care (SoC) alone in complex DFUs in a challenging patient population. Subjects with a DFU extending into dermis, subcutaneous tissue, tendon, capsule, bone or joint were enrolled in a 12-week trial. They were allocated equally to two treatment groups: dACM (plus SoC); or SoC alone. The primary endpoint was frequency of wound closure determined by a Cox analysis that adjusted for duration and wound area. Kaplan–Meier analysis was used to determine median time to complete wound closure (CWC). The cohort comprised 218 patients, and these were split equally between the two treatment groups with 109 patients in each. A Cox analysis showed that the estimated frequency of wound closure for the dACM plus SoC group was statistically superior to the SoC alone group at week 4 (12% versus 8%), week 6 (22% versus 11%), week 8 (31% versus 21%), week 10 (42% versus 27%) and week 12 (50% versus 35%), respectively (p=0.04). The computed hazard ratio (1.48 (confidence interval: 0.95, 2.29) showed a 48% greater probability of wound closure in favour of the dACM group. Median time to wound closure for dACM-treated ulcers was 84 days compared to ‘not achieved’ in the SoC-treated group (i.e., ≥50% of SoC-treated DFUs failed to heal by week 12; p=0.04). In an adequately powered DFU RCT, dACM increased the frequency, decreased the median time, and improved the probability of CWC when compared with SoC alone. dACM demonstrated beneficial effects in DFUs in a complex patient population.","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141376556","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":"Patients' behaviour after referral to a wound care clinic for diabetic foot ulcer care: a grounded theory study.","authors":"Thomas Vedste Aagaard, Søren T Skou, Stig Brorson, Ulla Riis Madsen","doi":"10.12968/jowc.2022.0265","DOIUrl":"https://doi.org/10.12968/jowc.2022.0265","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to construct a grounded theory regarding patients' activity behaviour over time after referral to an outpatient clinic for diabetic foot ulcer (DFU) care.</p><p><strong>Method: </strong>A constructivist grounded theory approach was used. Data from observations of and interviews with participants were collected and analysed using the constant comparative method. Based on this, the grounded theory 'Just a bump in the road' was constructed.</p><p><strong>Results: </strong>The cohort included five participants who considered their ulcers as 'Just a bump in the road' in their lives, and four subcategories were embedded in this core category: 'Restricting my freedom'; 'Trusting or doubting the system'; 'Feeling no pain or illness'; and 'Receiving insufficient information'. Together, these categories describe the participants' behaviour and underlying concerns related to daily activities after referral to an outpatient clinic for the care of their DFU.</p><p><strong>Conclusion: </strong>The grounded theory 'Just a bump in the road' describes how participants with a DFU viewed their condition as merely a passing phase that would end with them regaining what they considered a normal life. Integrating these results into clinical practice could lead to improved care and a focus shift among health professionals from viewing patients as being defined by their wounds to seeing them as people who live with a wound.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284058","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":"Effect of oral multispecies probiotic on wound healing, periodontitis and quality of life on patients with diabetes.","authors":"Ewa Klara Stuermer, Corinna Bang, Anna Giessler, Ralf Smeets, Toni Maria Janke, Filip David Seki, Eike Sebastian Debus, Andre Franke, Matthias Augustin","doi":"10.12968/jowc.2023.0302","DOIUrl":"https://doi.org/10.12968/jowc.2023.0302","url":null,"abstract":"<p><strong>Objective: </strong>Hard-to-heal (chronic) wounds are common in patients with diabetes and are associated with a decrease in quality of life (QoL). Pathogenic bacteria often colonise hard-to-heal wounds and hinder the healing process which poses a high risk for (systemic) infections. In this study, we aim to prove that probiotics are capable of displacing human pathogenic bacteria, ameliorating inflammation and positively influencing the microenvironment/microbiome of skin and mucosa.</p><p><strong>Method: </strong>In this pilot study, patients with diabetes and hard-to-heal wounds with a duration of 2-120 months received an oral multispecies probiotic daily for six months. Changes in oral, stool and wound microbiome were investigated, and the effects of the probiotic intervention on wound healing, periodontitis and wound-specific quality of life (Wound-QOL-17) were analysed throughout the course of this clinical study.</p><p><strong>Results: </strong>In total, seven of the 20 patients included were unable to complete the study. After six months of oral probiotic intake supplementation in five out of the remaining 13 patients, the wounds had healed completely. Most patients reported an improvement in wound-specific QoL, with particular positive effects on pain and mobility. Microbiome analysis revealed a reduction in <i>Staphylococcus aureus</i> and <i>Pseudomonas aeruginosa</i>, and <i>Staphylococcus epidermis</i> in healed wounds.</p><p><strong>Conclusion: </strong>This findings of this study provide evidence for the beneficial effects of the oral application of a multispecies probiotic over six months in patients with diabetes and hard-to-heal wounds on wound closure, wound microbial pattern, QoL, and on dental health. A randomised, placebo-controlled, double-blinded clinical trial is required to verify the results.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284054","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":"Pressure ulcer development in patients treated for acute ischaemic stroke.","authors":"Esin Derin Cicek, Ayper Önal Alkan, Nihan Parasiz Yukselen, Yılmaz Onal, Hakki Muammer Karakas, Ahmet Vural","doi":"10.12968/jowc.2020.0331","DOIUrl":"https://doi.org/10.12968/jowc.2020.0331","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the incidence of pressure ulcers (PUs) in patients treated for acute ischaemic stroke (AIS) and to evaluate comorbid/confounding factors.</p><p><strong>Method: </strong>The study included patients treated for AIS who were divided into three treatment groups: those receiving intravenous tissue plasminogen activator therapy (tPA); patients receiving mechanical thrombectomy (MT); and those receiving both tPA and MT. PUs were classified according to the international classification system and factors that may influence their development were investigated.</p><p><strong>Results: </strong>A total of 242 patients were included in this study. The incidence of PUs in patients treated for AIS was 7.4%. Most PUs were located on the sacrum (3.7%), followed by the gluteus (3.3%) and trochanter (2.9%). With regards to PU classification: 29% were stage I; 34% were stage II; and the remainder were stage III. Age was not a significant factor in the development of PUs (p=0.172). Patients in the tPA group had a lower PU incidence (2.3%) than patients in the tPA+MT group (15.7%) and MT group (12.1%) (p=0.001). Patients with PUs had a longer period of hospitalisation (18.5±11.92 days) than patients without a PU (8.0±8.52 days) (p=0.000). National Institute of Health Stroke Scale (NIHSS) scores at admission were higher in patients with PUs than in patients without a PU (14.33±4.38 versus 11.08±5.68, respectively; p=0.010). The difference in presence of comorbidities between patients with and without PUs (p=0.922) and between treatment groups (p=0.677) were not statistically significant. The incidence of PUs was higher in patients requiring intensive care, but this difference was not statistically significant (p=0.089).</p><p><strong>Conclusion: </strong>In this study, patients treated for AIS with high NIHSS scores at admission and/or receiving MT were at higher risk for PUs, and so particular attention should be given to these patients in order to prevent PU development.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284059","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":"Effects of neuromuscular taping form I on wound temperature and erythema in diabetic foot ulcer: a preliminary study.","authors":"Heri Kristianto, Ahsan Ahsan, Lailatul Mukaroma, Fenida Akhsinnadya, Melati Cahyani Indri, Nina Damayanti, Inne Kusbandiyah, Ridha Tri Rohyani, David Blow, Yohanes Andy Rias, Ahmad Hasyim Wibisono, Linda Wieke Noviyanti, Tina Handayani Nasution","doi":"10.12968/jowc.2020.0291","DOIUrl":"https://doi.org/10.12968/jowc.2020.0291","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to measure the effectiveness of neuromuscular taping (NMT) form I (a polyacrylate tape 0.6cm wide and 30cm long) on wound temperature and erythema in diabetic foot ulcers (DFUs) as an initial study in NMT intervention trials.</p><p><strong>Method: </strong>The study employed a quasi-experimental pretest and post-test design with a seven-day observation. The research sample was 38 patients with DFU grades 2 and 3. The sample was divided into two groups: the control group (n=19) and the intervention group (n=19). In wound care, the modern dressing was applied to both groups while NMT was applied to the intervention group in form I with 30cm long and 6mm wide strips, and on the proximal, distal and lateral sides. The wound bed temperature was measured with a non-contact infrared thermometer, and erythema was measured with Corel Photo-Paint X5 software (Corel Corp, Canada). Statistical analysis between the two groups was carried out using the Mann-Whitney test, independent t-test and Chi-squared test with p< 0.05 representing statistical significance.</p><p><strong>Results: </strong>The preliminary results revealed that no statistically significant differences (p>0.05) were noted between the groups in sociodemographic or clinical characteristics, including age, body mass index, blood sugar, duration of diabetes, sex, smoking history, wound temperature and degree of erythema. Finally, it was also observed that, after seven days of application, NMT form I increased wound bed temperature, and reduced the level of erythema (p<0.05).</p><p><strong>Conclusion: </strong>In this study, NMT form I has been shown to increase the wound bed temperature and reduce the degree of erythema in DFUs.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284055","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":"In memory of Gregory Schultz.","authors":"Vincent Falanga","doi":"10.12968/jowc.2024.0153","DOIUrl":"https://doi.org/10.12968/jowc.2024.0153","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284057","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":"Clinical performance and safety of a debridement pad with abrasive and non-abrasive fibres.","authors":"Ewa Stürmer, Eike Sebastian Debus, Leanne Atkin","doi":"10.12968/jowc.2024.0162","DOIUrl":"10.12968/jowc.2024.0162","url":null,"abstract":"<p><strong>Background: </strong>Debridement is key to removing devitalised tissue, debris and biofilm as part of wound-bed preparation. Unlike many other methods of debridement, mechanical debridement with a pad is effective enough to be used independently without an adjunctive method of debridement, while being more accessible than other standalone options.</p><p><strong>Objective: </strong>To explore the clinical performance and safety of a debridement pad with both abrasive and non-abrasive surfaces in daily clinical practice.</p><p><strong>Methods: </strong>This was a prospective, non-controlled, non-randomised, single-arm, open-label, multicentred observational evaluation. Inclusion criteria were wounds >4 cm² covered with at least 30% debris, necrotic tissue or slough in patients aged ≥18 years. The treatment protocol comprised a single application of the debridement pad. The primary outcome measure was the amount of necrotic tissue, slough or debris in the wound bed. Secondary outcomes included the appearance of the wound bed, edges and periwound skin; self-reported pain scores; foreseeable negative impacts; and clinician satisfaction.</p><p><strong>Results: </strong>A total of 62 participants with a variety of wound types were included in the analysis. Most wounds (87%) had been present for over 3 months and had high or moderate exudate levels (90%). A significant reduction was observed in all three parameters: necrotic tissue (p=0.043), slough (p<0.001) and debris (p<0.001). Necrotic tissue, slough and debris showed mean relative reductions of 40%, 72% and 40%, respectively. Of participants, 84% did not experience an increase in pain during the debridement procedure.</p><p><strong>Conclusion: </strong>This clinical real-world data shows the debridement pad to be an effective and well-tolerated device for debridement and wound bed preparation.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284053","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}