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Advances in Wound Care

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https://www.readbyqxmd.com/read/29098115/comparison-of-intralesional-triamcinolone-acetonide-5-fluorouracil-and-their-combination-for-the-treatment-of-keloids
#1
Sunil Srivastava, Aditya Nanasaheb Patil, Chaitra Prakash, Hiranmayi Kumari
Objective: Despite the myriad options available, there is no universally accepted treatment for keloids. Our objective was to compare three regimens and establish superiority in terms of objective and subjective outcomes. Approach: In this randomized parallel group study, 60 patients were enrolled and randomly allocated to three groups. Patients received intralesional injections of triamcinolone acetonide (TAC) in Group TAC, 5-fluorouracil (5FU) in Group 5FU, and a combination in Group T + F every 3 weeks till 24 weeks or till the keloid resolved...
November 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29098114/high-frequency-ultrasound-obtaining-optimal-images-and-the-effect-of-image-artifacts-on-image-quality
#2
Ruth S Burk, Mary Jo Grap, Valentina Lucas, Cindy L Munro, Paul A Wetzel, Christine M Schubert
Objective: High-frequency ultrasound (HFUS) images are being researched for use in the prevention, detection, and monitoring of pressure injuries in patients at risk. This seminal longitudinal study in mechanically ventilated adults describes image quality, the incidence of image artifacts, and their effect on image quality in critically ill subjects. Approach: Mechanically ventilated subjects from three adult intensive care units were enrolled, and multiple sacral images from each subject were obtained daily...
November 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29098113/hyperbaric-oxygen-therapy-and-oxygen-compatibility-of-skin-and-wound-care-products
#3
Stéphanie F Bernatchez, Joseph Tucker, Gwenael Chiffoleau
Objective: Use test methods to assess the oxygen compatibility of various wound care products. Approach: There are currently no standard test methods specifically for evaluating the oxygen compatibility and safety of materials under hyperbaric oxygen (HBO) conditions. However, tests such as the oxygen index (OI), oxygen exposure (OE), and autogenous ignition temperature (AIT) can provide useful information. Results: The OI test measures the minimum oxygen concentration that will support candle-like burning, and it was used to test 44 materials...
November 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29062592/toll-like-receptor-4-signaling-drives-persistent-fibroblast-activation-and-prevents-fibrosis-resolution-in-scleroderma
#4
REVIEW
Swati Bhattacharyya, Kim S Midwood, Hang Yin, John Varga
Significance: This review provides current overview of the emerging role of innate immunity in driving fibrosis, and preventing its resolution, in scleroderma (systemic sclerosis, SSc). Understanding the mechanisms of dysregulated innate immunity in fibrosis and SSc will provide opportunities for therapeutic interventions using novel agents and repurposed existing drugs. Recent Advances: New insights from genomic and genetic studies implicate components of innate immune signaling such as pattern recognition receptors (PRRs), downstream signaling intermediates, and endogenous inhibitors, in fibrosis in SSc...
October 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29062591/toll-like-receptor-function-in-acute-wounds
#5
REVIEW
Lin Chen, Luisa A DiPietro
Significance: Inflammation is an integral part of immune response and supports optimal wound healing in adults. Inflammatory cells such as neutrophils, macrophages, dendritic cells, lymphocytes, and mast cells produce important cytokines, chemokines, and growth factors. These immune cells interact with keratinocytes, fibroblasts, and endothelial cells (ECs), as well as the extracellular matrix within a complicated network that promotes and regulates wound healing. Aberrant and persistent inflammation may result in delayed wound healing, scar formation, or chronic wounds...
October 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29062590/toll-like-receptor-signaling-in-burn-wound-healing-and-scarring
#6
REVIEW
Peter D'Arpa, Kai P Leung
Significance: Damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs) emanate from burn-injured tissue and enter systemic circulation. Locally and systemically, they activate pattern-recognition receptors, including toll-like receptors (TLRs), to stimulate cytokine secretion, which in the severest burns typically results in extreme systemic cytokine levels, a dysfunctioning immune system, infection, impaired healing, and excessive scarring. This system-wide disruption of homeostasis can advance to life-threatening, multiorgan dysfunction syndrome...
October 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29062589/integration-of-canonical-and-noncanonical-pathways-in-tlr4-signaling-complex-regulation-of-the-wound-repair-program
#7
REVIEW
Paula J McKeown-Longo, Paul J Higgins
Significance: Chronic inflammation and maladaptive repair contribute to the development of fibrosis that negatively impacts quality of life and organ function. The toll-like receptor (TLR) system is a critical node in the tissue response to both exogenous (pathogen-associated) and endogenous (damage-associated) molecular pattern factors (PAMPs and DAMPs, respectively). The development of novel TLR ligand-, pathway-, and/or target gene-specific therapeutics may have clinical utility in the management of the exuberant inflammatory/fibrotic tissue response to injury without compromising the host defense to pathogens...
October 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/29062588/tlr4-ligands-selectively-synergize-to-induce-expression-of-il-8
#8
Lauren M Valenty, Christine M Longo, Carol Horzempa, Anthony Ambesi, Paula J McKeown-Longo
Objective: Dysfunctional remodeling of the extracellular matrix contributes to the formation of TLR-dependent feed forward loops that drive chronic inflammation. We have previously shown that two Type III domains of Fibronectin, FnEDA and FnIII-1c, cooperate to induce the synergistic release of interleukin 8 (IL-8) from dermal fibroblasts. We now identify steps in the TLR4 pathway where synergy can be demonstrated as well as additional kinases functioning in fibronectin activation of TLR4 signaling. We also evaluate the ligand and cell-type specificity of this synergistic response...
October 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28894637/epidermal-stem-cells-in-skin-wound-healing
#9
REVIEW
Yuanyuan Li, Jamie Zhang, Jiping Yue, Xuewen Gou, Xiaoyang Wu
Significance: Skin serves as a protective barrier for mammals. Epidermal stem cells are responsible for maintaining skin homeostasis. When cutaneous injuries occur, skin homeostasis and integrity are damaged, leading to dire consequences such as acute, chronic, or infected wounds. Skin wound healing is an intrinsic self-saving chain reaction, which is crucial to facilitating the replacement of damaged or lost tissue. Recent Advances: An immense amount of research has uncovered the underlying mechanisms behind the complex and highly regulated wound healing process...
September 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28894636/fournier-s-gangrene-a-review-and-outcome-comparison-from-2009-to-2016
#10
REVIEW
Mark Ferretti, Akhil A Saji, John Phillips
Objective: The outcome of Fournier's gangrene (FG) may be affected by comorbidities, demographics, and choice of treatment modality. We sought to evaluate our institution's management protocol of FG measured by mortality rate (MR) and length of hospital stay (LHS) in a retrospective cohort study. Approach: A database of 20 FG cases at our institution throughout the 2009-2016 study period was assembled by a retrospective review of medical records. A Fournier's Gangrene Severity Index Score (FGSIS) was calculated for each case...
September 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28894635/topical-naltrexone-is-a-safe-and-effective-alternative-to-standard-treatment-of-diabetic-wounds
#11
Patricia J McLaughlin, Jarrett D Cain, Michelle B Titunick, Joseph W Sassani, Ian S Zagon
Objective: Diabetes affects more than 29 million individuals in the United States, resulting in healthcare costs approaching $245 billion. Approximately 15% of these individuals will develop a chronic, non-healing foot ulcer (diabetic foot ulcer [DFU]) that, if untreated, may lead to amputation. The current treatments for DFU are expensive, have significant side-effects, and often result in non-compliance. A new topical treatment is described that accelerates cutaneous wound repair and is disease modifying by targeting underlying aberrant diabetic pathways...
September 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28831330/impact-of-traumatic-lower-extremity-injuries-beyond-acute-care-movement-based-considerations-for-resultant-longer-term-secondary-health-conditions
#12
REVIEW
Courtney M Butowicz, Christopher L Dearth, Brad D Hendershot
Significance: Advances in field-based trauma care, surgical techniques, and protective equipment have collectively facilitated the survival of a historically large number of service members (SMs) following combat trauma, although many sustained significant composite tissue injuries to the extremities, including limb loss (LL) and limb salvage (LS). Beyond the acute surgical and rehabilitative efforts that focus primarily on wound care and restoring mobility, traumatic LL and LS are associated with several debilitating longer term secondary health conditions (e...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28831329/targeted-muscle-reinnervation-to-improve-pain-prosthetic-tolerance-and-bioprosthetic-outcomes-in-the-amputee
#13
REVIEW
J Byers Bowen, Corinne E Wee, Jaclyn Kalik, Ian L Valerio
Scope and Significance: There are ∼185,000 amputations each year and nearly 2 million amputees currently living in the United States. Approximately 25% of these amputees will experience chronic pain issues secondary to localized neuroma pain and/or phantom limb pain. Problem: The significant discomfort caused by neuroma and phantom limb pain interferes with prosthesis wear, subjecting amputees to the additional physical and psychological morbidity associated with chronic immobility. Although numerous neuroma treatments are described, none of these methods are consistently effective in eliminating symptoms...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28831328/a-unique-application-of-negative-pressure-wound-therapy-used-to-facilitate-patient-engagement-in-the-amputation-recovery-process
#14
Jessica Wise, Alicia White, Daniel J Stinner, John R Fergason
Amputation rates during recent military conflicts were at an all-time high, but medical treatment of those amputations and attitudes of service members to get back to duty are also surging ahead. We present the cases of an active duty rescue C130 pilot with an above-the-knee amputation and a retired army sergeant with a below-the-knee amputation. Successful rehabilitation was augmented in both cases by using negative pressure incorporated in a custom prosthetic socket to accelerate incision closure, improve self-efficacy in wound care, and self-management, ultimately leading to faster recovery times, full engagement of the rehabilitation process, and return to active duty...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736684/multimodality-imaging-approaches-for-evaluating-traumatic-extremity-injuries-implications-for-military-medicine
#15
REVIEW
Mitchel R Stacy, Christopher L Dearth
Significance: Military service members are susceptible to traumatic extremity injuries that often result in limb loss. Tremendous efforts have been made to improve medical treatment that supports residual limb function and health. Despite recent improvements in treatment and novel prosthetic devices, many patients experience a wide range of clinical problems within residual limbs that can negatively impact the progress of rehabilitation programs while also impairing functional capacity and overall quality of life...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736683/progress-toward-optimizing-prosthetic-socket-fit-and-suspension-using-elevated-vacuum-to-promote-residual-limb-health
#16
Matthew M Wernke, Ryan M Schroeder, Michael L Haynes, Lonnie L Nolt, Alexander W Albury, James M Colvin
Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736682/standardized-approach-to-quantitatively-measure-residual-limb-skin-health-in-individuals-with-lower-limb-amputation
#17
Cameron L Rink, Matthew M Wernke, Heather M Powell, Mark Tornero, Surya C Gnyawali, Ryan M Schroeder, Jayne Y Kim, Jeffrey A Denune, Alexander W Albury, Gayle M Gordillo, James M Colvin, Chandan K Sen
Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial (n = 5) and transfemoral (n = 5) amputation were compared to able-limb controls (n = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance)...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28616361/hyperbaric-oxygen-therapy-side-effects-defined-and-quantified
#18
REVIEW
Marvin Heyboer, Deepali Sharma, William Santiago, Norman McCulloch
Significance: Hyperbaric oxygen therapy (HBOT) is an important advanced therapy in the treatment of problem wounds, including diabetic foot ulcers and late effect radiation injury. HBOT remains among the safest therapies used today. Nonetheless, there are side effects associated with HBOT. It is important for providers to be able to identify, understand, and quantify these side effects for prevention, management, and informed consent. Recent Advances: The past two decades have seen significant advancements in our understanding of the underlying mechanisms of HBOT...
June 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28616360/current-advancements-and-strategies-in-tissue-engineering-for-wound-healing-a-comprehensive-review
#19
REVIEW
Jasmine Ho, Claire Walsh, Dominic Yue, Alan Dardik, Umber Cheema
Significance: With an aging population leading to an increase in diabetes and associated cutaneous wounds, there is a pressing clinical need to improve wound-healing therapies. Recent Advances: Tissue engineering approaches for wound healing and skin regeneration have been developed over the past few decades. A review of current literature has identified common themes and strategies that are proving successful within the field: The delivery of cells, mainly mesenchymal stem cells, within scaffolds of the native matrix is one such strategy...
June 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28616359/bioactive-antimicrobial-peptides-as-therapeutics-for-corneal-wounds-and-infections
#20
REVIEW
Gina L Griffith, Anne Kasus-Jacobi, H Anne Pereira
Significance: More than 2 million eye injuries and infections occur each year in the United States that leave civilians and military members with reduced or complete vision loss due to the lack of effective therapeutics. Severe ocular injuries and infections occur in varied settings including the home, workplace, and battlefields. In this review, we discuss the potential of developing antimicrobial peptides (AMPs) as therapeutics for the treatment of corneal wounds and infections for which the current treatment options are inadequate...
June 1, 2017: Advances in Wound Care
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