Advances in wound care最新文献

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An Improved Clinical and Genetics-Based Prediction Model for Diabetic Foot Ulcer Healing. 基于临床和遗传学的糖尿病足溃疡愈合改进预测模型。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-06-01 Epub Date: 2024-03-05 DOI: 10.1089/wound.2023.0194
Gary Hettinger, Nandita Mitra, Stephen R Thom, David J Margolis
{"title":"An Improved Clinical and Genetics-Based Prediction Model for Diabetic Foot Ulcer Healing.","authors":"Gary Hettinger, Nandita Mitra, Stephen R Thom, David J Margolis","doi":"10.1089/wound.2023.0194","DOIUrl":"10.1089/wound.2023.0194","url":null,"abstract":"<p><p><b>Objective:</b> The goal of this investigation was to use comprehensive prediction modeling tools and available genetic information to try to improve upon the performance of simple clinical models in predicting whether a diabetic foot ulcer (DFU) will heal. <b>Approach:</b> We utilized a cohort study (<i>n</i> = 206) that included clinical factors, measurements of circulating endothelial precursor cells (CEPCs), and fine sequencing of the <i>NOS1AP</i> gene. We derived and selected relevant predictive features from this patient-level information using statistical and machine learning techniques. We then developed prognostic models using machine learning approaches and assessed predictive performance. The presentation is consistent with TRIPOD requirements. <b>Results:</b> Models using baseline clinical and CEPC data had an area under the receiver operating characteristic curve (AUC) of 0.73 (0.66-0.80). Models using only single nucleotide polymorphisms (SNPs) of the <i>NOS1AP</i> gene had an AUC of 0.67 (95% confidence interval, CI: [0.59-0.75]). However, models incorporating baseline and SNP information resulted in improved AUC (0.80, 95% CI [0.73-0.87]). <b>Innovation:</b> We provide a rigorous analysis demonstrating the predictive potential of genetic information in DFU healing. In this process, we present a framework for using advanced statistical and bioinformatics techniques for creating superior prognostic models and identify potentially predictive SNPs for future research. <b>Conclusion:</b> We have developed a new benchmark for which future predictive models can be compared against. Such models will enable wound care experts to more accurately predict whether a patient will heal and aid clinical trialists in designing studies to evaluate therapies for subjects likely or unlikely to heal.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"281-290"},"PeriodicalIF":5.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stem Cell Therapy for Diabetic Foot: An Umbrella Review of Systematic Reviews and Meta-Analyses. 干细胞疗法治疗糖尿病足:系统综述和荟萃分析总览。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-05-01 Epub Date: 2024-01-29 DOI: 10.1089/wound.2023.0136
Hongshuo Shi, Xin Yuan, Weijing Fan, Xiao Yang, Guobin Liu
{"title":"Stem Cell Therapy for Diabetic Foot: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Hongshuo Shi, Xin Yuan, Weijing Fan, Xiao Yang, Guobin Liu","doi":"10.1089/wound.2023.0136","DOIUrl":"10.1089/wound.2023.0136","url":null,"abstract":"<p><p><b>Objective:</b> This umbrella review aims to summarize and evaluate the evidence from current systematic reviews/meta-analyses (SRs/MAs) on the effectiveness of stem cell therapy for diabetic foot (DF). <b>Approach:</b> We conducted a comprehensive search in four databases for SRs/MAs that included randomized controlled trials (RCTs) on stem cell therapy for DF. Two separate researchers independently evaluated the methodological quality and evidence quality of the SRs/MAs that were included in the study. We conducted a quantitative synthesis of all RCTs included in the SRs/MAs to obtain objective and updated conclusions. Egger's test and sensitivity analysis are used to examine the reliability of the results. <b>Results:</b> This umbrella review includes eight SRs/MAs, and their methodological quality and evidence quality were all deemed unsatisfactory. Out of the 8 SRs/MAs, 26 RCTs were included, with a total corrected covered area of 21.4%, indicating a high degree of overlap. The test of super-significance did not yield any significant results. Our updated meta-analysis suggests that DF patients can benefit from stem cell therapy, as indicated by effectiveness in measures, including healing rate, amputation rate, ankle-brachial index, transcutaneous oxygen pressure, ulcer size reduction, complete healing time, pain-free walking distance, rest pain score, and new angiogenesis rate. <b>Innovation:</b> This study conducted a comprehensive evaluation and reanalysis of the current evidence regarding the effectiveness and safety of stem cell therapy for DF, which is the first of its kind. <b>Conclusion:</b> Based on the existing evidence, stem cell therapy is effective and safe for patients with DF.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"201-216"},"PeriodicalIF":5.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139039364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modalities to Deliver Cell Therapy for Treatment of Chronic Limb Threatening Ischemia. 细胞疗法用于治疗慢性肢体缺血的模式。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-05-01 Epub Date: 2023-05-08 DOI: 10.1089/wound.2022.0114
Ocean Setia, Shin-Rong Lee, Alan Dardik
{"title":"Modalities to Deliver Cell Therapy for Treatment of Chronic Limb Threatening Ischemia.","authors":"Ocean Setia, Shin-Rong Lee, Alan Dardik","doi":"10.1089/wound.2022.0114","DOIUrl":"10.1089/wound.2022.0114","url":null,"abstract":"<p><p><b>Significance:</b> Chronic limb threatening ischemia (CLTI) is a severe form of peripheral arterial disease (PAD) that is associated with high rates of morbidity and mortality, and especially limb loss. In patients with no options for revascularization, stem cell therapy is a promising treatment option. <b>Recent Advances:</b> Cell therapy directly delivered to the affected ischemic limb has been shown to be a safe, effective, and feasible therapeutic alternative for patients with severe PAD. Multiple methods for cell delivery, including local, regional, and combination approaches, have been examined in both pre-clinical studies and clinical trials. This review focuses on delivery modalities used in clinical trials that deliver cell therapy to patients with severe PAD. <b>Critical Issues:</b> Patients with CLTI are at high risk for complications of the disease, such as amputations, leading to a poor quality of life. Many of these patients do not have viable options for revascularization using traditional interventional or surgical methods. Clinical trials have shown therapeutic benefit for cell therapy in these patients, but methods of cell treatment are not standardized, including the method of cell delivery to the ischemic limb. <b>Future Directions:</b> The ideal delivery approach for stem cell therapy in PAD patients remains unclear. Further studies are needed to determine the best modality of cell delivery to maximize clinical benefits.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"253-279"},"PeriodicalIF":5.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9411692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adipose-Derived Stromal Cell-Based Therapies for Radiation-Induced Fibrosis. 以脂肪基质细胞为基础的辐射诱导纤维化疗法。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-05-01 Epub Date: 2022-12-09 DOI: 10.1089/wound.2022.0103
Charlotte E Berry, Darren B Abbas, Hendrik A Lintel, Andrew A Churukian, Michelle Griffin, Jason L Guo, Asha C Cotterell, Jennifer B Laufey Parker, Mauricio A Downer, Michael T Longaker, Derrick C Wan
{"title":"Adipose-Derived Stromal Cell-Based Therapies for Radiation-Induced Fibrosis.","authors":"Charlotte E Berry, Darren B Abbas, Hendrik A Lintel, Andrew A Churukian, Michelle Griffin, Jason L Guo, Asha C Cotterell, Jennifer B Laufey Parker, Mauricio A Downer, Michael T Longaker, Derrick C Wan","doi":"10.1089/wound.2022.0103","DOIUrl":"10.1089/wound.2022.0103","url":null,"abstract":"<p><p><b>Significance:</b> Half of all cancer patients receive radiation therapy as a component of their treatment regimen, and the most common resulting complication is radiation-induced fibrosis (RIF) of the skin and soft tissue. This thickening of the dermis paired with decreased vascularity results in functional limitations and esthetic concerns and poses unique challenges when considering surgical exploration or reconstruction. Existing therapeutic options for RIF of the skin are limited both in scope and efficacy. Cell-based therapies have emerged as a promising means of utilizing regenerative cell populations to improve both functional and esthetic outcomes, and even as prophylaxis for RIF. <b>Recent Advances:</b> As one of the leading areas of cell-based therapy research, adipose-derived stromal cells (ADSCs) demonstrate significant therapeutic potential in the treatment of RIF. The introduction of the ADSC-augmented fat graft has shown clinical utility. Recent research dedicated to characterizing specific ADSC subpopulations points toward further granularity in understanding of the mechanisms driving the well-established clinical outcomes seen with fat grafting therapy. <b>Critical Issues:</b> Various animal models of RIF demonstrated improved clinical outcomes following treatment with cell-based therapies, but the cellular and molecular basis underlying these effects remains poorly understood. <b>Future Directions:</b> Recent literature has focused on improving the efficacy of cell-based therapies, most notably through (1) augmentation of fat grafts with platelet-rich plasma and (2) the modification of expressed RNA through epitranscriptomics. For the latter, new and promising gene targets continue to be identified which have the potential to reverse the effects of fibrosis by increasing angiogenesis, decreasing inflammation, and promoting adipogenesis.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"235-252"},"PeriodicalIF":5.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10362870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chemotherapy-Mediated Complications of Wound Healing: An Understudied Side Effect. 化疗介导的伤口愈合并发症。这是未被充分研究的副作用。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI: 10.1089/wound.2023.0097
Paulina Słonimska, Paweł Sachadyn, Jacek Zieliński, Marcin Skrzypski, Michał Pikuła
{"title":"Chemotherapy-Mediated Complications of Wound Healing: An Understudied Side Effect.","authors":"Paulina Słonimska, Paweł Sachadyn, Jacek Zieliński, Marcin Skrzypski, Michał Pikuła","doi":"10.1089/wound.2023.0097","DOIUrl":"10.1089/wound.2023.0097","url":null,"abstract":"<p><p><b>Significance:</b> Chemotherapy is a primary method to treat cancer. While chemotherapeutic drugs are designed to target rapidly dividing cancer cells, they can also affect other cell types. In the case of dermal cells and macrophages involved in wound healing, cytotoxicity often leads to the development of chronic wounds. The situation becomes even more severe when chemotherapy is combined with surgical tumor excision. <b>Recent Advances:</b> Despite its significant impact on patients' recovery from surgery, the issue of delayed wound healing in individuals undergoing chemotherapy remains inadequately explored. <b>Critical Issues:</b> This review aims to analyze the harmful impact of chemotherapy on wound healing. The analysis showed that chemotherapy drugs could inhibit cellular metabolism, cell division, and angiogenesis and lead to nerve damage. They impede the migration of cells into the wound and reduce the production of extracellular matrix. At the molecular level, they interfere with replication, transcription, translation, and cell signaling. This work reviews skin problems that patients may experience during and after chemotherapy and demonstrates insights into the cellular and molecular mechanisms of these pathologies. <b>Future Directions:</b> In the future, the problem of impaired wound healing in patients treated with chemotherapy may be addressed by cell therapies like autologous keratinocyte transplantation, which has already proved effective in this case. Epigenetic intervention to mitigate the side effects of chemotherapy is also worth considering, but epigenetic consequences of chemotherapy on skin cells are largely unknown and should be investigated.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"187-199"},"PeriodicalIF":5.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139110664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Avenanthramide and β-Glucan Therapeutics Accelerate Wound Healing Via Distinct and Nonoverlapping Mechanisms. 金刚烷胺和β-葡聚糖疗法通过不同且不重叠的机制加速伤口愈合
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-04-01 Epub Date: 2024-02-26 DOI: 10.1089/wound.2023.0050
Hudson C Kussie, William Hahn, Dharshan Sivaraj, Filiberto Quintero, Amelia Knochel, Abdelrahman M Alfsharif, Jonathan P Yasmeh, Katharina Fischer, Sultana Mojadidi, Andrew Hostler, Maia Granoski, Eamonn McKenna, Dominic Henn, Ben Litmanovich, Abigail A Miller, Delaney K Schurr, Vincent W Li, William W Li, Geoffrey C Gurtner, Kellen Chen
{"title":"Avenanthramide and β-Glucan Therapeutics Accelerate Wound Healing Via Distinct and Nonoverlapping Mechanisms.","authors":"Hudson C Kussie, William Hahn, Dharshan Sivaraj, Filiberto Quintero, Amelia Knochel, Abdelrahman M Alfsharif, Jonathan P Yasmeh, Katharina Fischer, Sultana Mojadidi, Andrew Hostler, Maia Granoski, Eamonn McKenna, Dominic Henn, Ben Litmanovich, Abigail A Miller, Delaney K Schurr, Vincent W Li, William W Li, Geoffrey C Gurtner, Kellen Chen","doi":"10.1089/wound.2023.0050","DOIUrl":"10.1089/wound.2023.0050","url":null,"abstract":"<p><p><b>Objective:</b> Given the significant economic, health care, and personal burden of acute and chronic wounds, we investigated the dose dependent wound healing mechanisms of two <i>Avena sativa</i> derived compounds: avenanthramide (AVN) and β-Glucan. <b>Approach:</b> We utilized a splinted excisional wound model that mimics human-like wound healing and performed subcutaneous AVN and β-Glucan injections in 15-week-old C57BL/6 mice. Histologic and immunohistochemical analysis was performed on the explanted scar tissue to assess changes in collagen architecture and cellular responses. <b>Results:</b> AVN and β-Glucan treatment provided therapeutic benefits at a 1% dose by weight in a phosphate-buffered saline vehicle, including accelerated healing time, beneficial cellular recruitment, and improved tissue architecture of healed scars. One percent AVN treatment promoted an extracellular matrix (ECM) architecture similar to unwounded skin, with shorter, more randomly aligned collagen fibers and reduced inflammatory cell presence in the healed tissue. One percent β-Glucan treatment promoted a tissue architecture characterized by long, thick bundles of collagen with increased blood vessel density. <b>Innovation:</b> AVN and β-Glucan have previously shown promise in promoting wound healing, although the therapeutic efficacies and mechanisms of these bioactive compounds remain incompletely understood. Furthermore, the healed ECM architecture of these wounds has not been characterized. <b>Conclusions:</b> AVN and β-Glucan accelerated wound closure compared to controls through distinct mechanisms. AVN-treated scars displayed a more regenerative tissue architecture with reduced inflammatory cell recruitment, while β-Glucan demonstrated increased angiogenesis with more highly aligned tissue architecture more indicative of fibrosis. A deeper understanding of the mechanisms driving healing in these two naturally derived therapeutics will be important for translation to human use.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"155-166"},"PeriodicalIF":5.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic Performance of Ultrasonography for Diabetic Foot Osteomyelitis. 超声对糖尿病足骨髓炎的诊断价值。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-04-01 Epub Date: 2023-12-20 DOI: 10.1089/wound.2023.0135
Mateo López-Moral, Marta García-Madrid, Raúl J Molines-Barroso, Yolanda García-Álvarez, Francisco J Álvaro-Afonso, José Luis Lázaro-Martínez
{"title":"Diagnostic Performance of Ultrasonography for Diabetic Foot Osteomyelitis.","authors":"Mateo López-Moral, Marta García-Madrid, Raúl J Molines-Barroso, Yolanda García-Álvarez, Francisco J Álvaro-Afonso, José Luis Lázaro-Martínez","doi":"10.1089/wound.2023.0135","DOIUrl":"10.1089/wound.2023.0135","url":null,"abstract":"<p><p><b>Objective:</b> This study aims to analyze the potential diagnostic capability of ultrasonography (US) in detecting diabetic foot osteomyelitis (DFO) in patients with diabetic foot ulcers (DFUs). <b>Approach:</b> A 1-year prospective study was conducted on 47 consecutive patients with active DFUs and suspicion of DFO at a specialized diabetic foot unit. The following ultrasonographic features were evaluated at baseline: (1) periosteal reaction; (2) periosteal elevation; (3) cortical disruption; (4) sequestrum; and (5) positive power Doppler. The primary outcome measure aimed to establish the effectiveness of ultrasonographic features compared with aseptic bone culture for diagnosing DFO. Receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic performance of ultrasonographic features. Sample size could not be determined as it is the first study to assess ultrasonographic features for the diagnosis of DFO. The research adhered to the guidelines for diagnostic accuracy studies (Standards for Reporting of Diagnostic Accuracy Studies [STARD] 2015). <b>Results:</b> All patients (<i>n</i> = 24) diagnosed with DFO exhibited positive power Doppler, resulting in a sensitivity (S) and specificity (SP) of 1 and an area under the curve (AUC) of 1 (<i>p</i> < 0.001 [1-1]). Cortical disruption was present in 23 patients (95.8%) with DFO, yielding an S of 0.93, SP of 1, and AUC of 0.96 (<i>p</i> < 0.001 [0.88-1]). <b>Innovation:</b> It validates the diagnostic value of US for DFO as it is the first and largest study of its kind to establish a clear reference standard to guide clinician decision-making. <b>Conclusion:</b> This study demonstrates the effectiveness of cortical disruption and positive power Doppler in assessing DFO through US.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"167-175"},"PeriodicalIF":5.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89716621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Split-Thickness Skin and Dermal Pixel Grafts Can Be Expanded up to 500 Times to Re-Epithelialize a Full-Thickness Burn Wound. 分层皮肤和真皮像素移植物可以扩展到500倍,以使全层烧伤伤口重新上皮化。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-04-01 Epub Date: 2023-12-11 DOI: 10.1089/wound.2023.0020
Kristo Nuutila, Riyam Mistry, Michael Broomhead, Elof Eriksson
{"title":"Split-Thickness Skin and Dermal Pixel Grafts Can Be Expanded up to 500 Times to Re-Epithelialize a Full-Thickness Burn Wound.","authors":"Kristo Nuutila, Riyam Mistry, Michael Broomhead, Elof Eriksson","doi":"10.1089/wound.2023.0020","DOIUrl":"10.1089/wound.2023.0020","url":null,"abstract":"<p><p><b>Objective:</b> Autologous skin transplantation is limited by donor site availability for patients with extensive burns. The objective of this study was to demonstrate the feasibility and efficacy of split-thickness skin (STS) and dermal pixel grafts (PG) in the treatment of burns. <b>Approach:</b> The study was divided into three arms of validation, expansion, and combination that all followed the same study design. Sixteen deep partial-thickness burns were created on the dorsum of anesthetized pigs. Three days postinjury the burns were debrided and grafted with STS and dermal PGs. The PGs were prepared by harvesting two skin grafts (split-thickness skin graft [STSG] and dermal graft) from the same donor site going down in depth. The grafts were minced to 0.3 × 0.3 × 0.3 mm PGs and suspended in a small volume of hydrogel. Healing was monitored for 6, 10, 14, or 28 days. In the validation study the PGs at 1:2 expansion ratio were transplanted and compared with STSG and untreated controls. The expansion study investigated the maximum expansion potential of the PGs and the combination of the benefits of transplanting STS and dermal PGs together. <b>Results:</b> The validation study showed that when STS and dermal PGs were transplanted in a 1:2 ratio they fully re-epithelialized the wounds in 14 days. The expansion study demonstrated that using expansion ratios up to 1:500 the wounds were re-epithelialized by day 28. The combination study showed that there was no additional benefit to use STS and dermal PGs together. <b>Innovation:</b> Pixel grafting provides expansion ratios greater than conventional STSG. The possibility to harvest both STS and dermal PGs from the same donor area further reduces the need for healthy skin. <b>Conclusion:</b> STSG and dermal grafts can be minced to PGs with preserved viability and expanded up to 500 times to re-epithelialize a wound.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"176-186"},"PeriodicalIF":5.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71410165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphine (10, 20 mg) in a Postoperative Dressing Used with Patients After Surgical Debridement of Burn Wounds: A Prospective, Double-Blinded, Randomized Controlled Trial. 烧伤创面清创术后患者使用的术后敷料中的吗啡(1020mg):一项前瞻性、双盲、随机、对照试验。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-03-01 Epub Date: 2023-10-18 DOI: 10.1089/wound.2023.0037
Grzegorz Kowalski, Małgorzata Domagalska, Krzysztof Słowiński, Monika Grochowicka, Marcin Zawadzki, Sylwia Kropińska, Wojciech Leppert, Katarzyna Wieczorowska-Tobis
{"title":"Morphine (10, 20 mg) in a Postoperative Dressing Used with Patients After Surgical Debridement of Burn Wounds: A Prospective, Double-Blinded, Randomized Controlled Trial.","authors":"Grzegorz Kowalski, Małgorzata Domagalska, Krzysztof Słowiński, Monika Grochowicka, Marcin Zawadzki, Sylwia Kropińska, Wojciech Leppert, Katarzyna Wieczorowska-Tobis","doi":"10.1089/wound.2023.0037","DOIUrl":"10.1089/wound.2023.0037","url":null,"abstract":"<p><p><b>Objective:</b> This is the first clinical trial to evaluate the analgesic effect of 10 and 20 mg of morphine used in a postoperative dressing with patients after surgical debridement of burn wounds. <b>Approach:</b> In this randomized controlled trial, 20 adult patients with third-degree flame burns, who had undergone surgical debridement under general anesthesia, were randomly assigned to either group A, whose members were treated with a burn dressing that contained 10 mg of morphine, or group B, whose members were treated with a burn dressing that contained 20 mg of morphine; the dressing was also soaked with octenidine and phenoxyethanol in the case of both groups. The plasma morphine concentrations were measured 1, 2, 3, and 6 h after surgery, while the level of pain intensity was determined on the Numeric Pain Rating Scale (NRS), and the occurrence of side effects was observed. <b>Results:</b> The serum morphine concentration levels were very low, but statistically different between the two groups at all time points. The NRS value was similar in both groups at all time points (<i>p</i> > 0.05). Despite this, in group B, the NRS value was 0 in all patients in postoperative hours 1, 2, and 3. No adverse effect of morphine sulfate was observed in any patient. <b>Innovation:</b> This project is the first clinical study to have demonstrated that morphine administered in dressings in concentrations of 0.02-0.08 mg/mL significantly reduces the occurrence of pain. <b>Conclusion:</b> The use of morphine in dressings after surgical treatment of burn wounds is very effective when it comes to pain management and is safe for the patient.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"115-122"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Switching from Galenic to Advanced Dressings or Vacuum Assisted Closure Therapy Can Improve Quality of Life of Patients with Chronic Non-Responsive Pressure Skin Ulcers: Preliminary Data with Italian Translation of WOUND-Q. 从加利尼换成高级敷料或真空辅助闭合疗法可改善慢性非反应性压力性皮肤溃疡患者的生活质量:WOUND-Q 意大利语翻译的初步数据。
IF 5.8 3区 医学
Advances in wound care Pub Date : 2024-03-01 Epub Date: 2023-09-04 DOI: 10.1089/wound.2022.0150
Giovanni Francesco Marangi, Carlo Mirra, Marco Gratteri, Annalisa Cogliandro, Rosa Salzillo, Francesco Segreto, Gaetano Federico, Fara Desiree Romano, Caterina Rossi, Paolo Persichetti
{"title":"Switching from Galenic to Advanced Dressings or Vacuum Assisted Closure Therapy Can Improve Quality of Life of Patients with Chronic Non-Responsive Pressure Skin Ulcers: Preliminary Data with Italian Translation of WOUND-Q.","authors":"Giovanni Francesco Marangi, Carlo Mirra, Marco Gratteri, Annalisa Cogliandro, Rosa Salzillo, Francesco Segreto, Gaetano Federico, Fara Desiree Romano, Caterina Rossi, Paolo Persichetti","doi":"10.1089/wound.2022.0150","DOIUrl":"10.1089/wound.2022.0150","url":null,"abstract":"<p><p><b>Objective:</b> A few studies have focused on the quality of life (QoL) of patients with chronic non-responsive pressure skin ulcers. The aim of this study was to assess how correct treatment (advanced wound care [AWC] dressings alone or vacuum assisted closure [VAC] therapy alone) changes the QoL of these patients. <b>Approach:</b> One hundred six patients with chronic non-responsive pressure skin ulcers, who had previously used galenic dressings, applied without proper therapeutic indication, were included in this study. We administered the WOUND-Q, at time 0 and after 1 month of appropriate therapy, to assess patient-reported outcome measures. Group 1 consisted of 30 patients treated with advanced dressings, Group 2: 22 patients treated with VAC therapy, and Group 3: 30 patients continuing conventional galenic dressings (Control group). Statistical analysis allowed us to analyze QoL changes over time and to compare WOUND-Q Group 1 and 2 deltas with those of Group 3. The study followed the STROBE statement. <b>Results and Innovation:</b> In all the scales evaluated (Assessment, Drainage, Smell, Life impact, Psychological, Social, Sleep and Dressing), there were significant improvements in mean values for Groups 1 and 2. Kruskal-Wallis tests with Dunn's multiple-comparisons tests and Brown-Forsythe and Welch Analysis of Variance tests demonstrated significant differences between deltas of Group 1 and Group 2 compared with those of Group 3 for most scales analyzed. <b>Conclusions:</b> Administration of the WOUND-Q demonstrated that the application of advanced dressings alone or VAC therapy alone positively affects the QoL of patients with chronic nonresponsive pressure wounds, in comparison with galenic dressings alone. The WOUND-Q has been shown to be a valid tool in studying changes in QoL of these patients.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"131-139"},"PeriodicalIF":5.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10147249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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