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Wound Care

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41 papers 25 to 100 followers All research related to diabetic foot and other wounds
By Yasser Abbas Sr Consultant general surgery
Nicholas D Barwell, Marion C Devers, Brian Kennon, Helen E Hopkinson, Claire McDougall, Matthew J Young, Hannah M A Robertson, Duncan Stang, Stephanie J Dancer, Andrew Seaton, Graham P Leese
BACKGROUND: Healthcare events related to diabetic foot disease carry a burden of morbidity, mortality and economic cost. Prompt identification of clinical infection with appropriate tissue sampling limits use of broad spectrum empirical antibiotics and improves antibiotic stewardship. Staphylococcus aureus remains the commonest infecting organism and high-dose flucloxacillin remains the empirical antibiotic of choice for antibiotic naïve patients. Barriers to microbe-specific treatment include: adequate tissue sampling, delays in culture results, drug allergies and the emergence of multidrug-resistant organisms which can complicate the choice of targeted antibiotics...
September 11, 2017: International Journal of Clinical Practice
Robert G Frykberg, Gary W Gibbons, Jodi L Walters, Dane K Wukich, Farrell C Milstein
Complex diabetic foot ulcers (DFUs) with exposed tendon or bone remain a challenge. They are more susceptible to complications such as infection and amputation and require treatments that promote rapid development of granulation tissue and, ultimately, reepithelialisation. The clinical effectiveness of viable cryopreserved human placental membrane (vCHPM) for DFUs has been established in a level 1 trial. However, complex wounds with exposed deeper structures are typically excluded from randomised controlled clinical trials despite being common in clinical practice...
June 2017: International Wound Journal
Suzanne Av Van Asten, Adam Nichols, Javier La Fontaine, Kavita Bhavan, Edgar Jg Peters, Lawrence A Lavery
In this study, we assessed the effectiveness of inflammatory markers to diagnose and monitor the treatment of osteomyelitis in the diabetic foot. We evaluated 35 consecutive patients admitted to our hospital with infected foot ulcers. Patients were divided in two groups based on the results of bone culture and histopathology: osteomyelitis and no osteomyelitis. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy...
February 2017: International Wound Journal
Mehmet Kaplan, Onder Ozcan, Ethem Bilgic, Elif Tugce Kaplan, Tugba Kaplan, Fatma Cigdem Kaplan
BACKGROUND: The Limberg flap (LF) procedure is widely performed for the treatment of sacrococcygeal pilonidal sinus (SPS); however, recurrences continues to be observed. The aim of this study was to assess the relationship between LF designs and the risk of SPS recurrence. METHODS: Sixty-one cases with recurrent disease (study group) and 194 controls, with a minimum of 5 recurrence-free years following surgery (control group), were included in the study. LF reconstructions performed in each group were classified as off-midline closure (OMC) and non-OMC types...
November 2017: American Journal of Surgery
Yuji Inoue, Minoru Hasegawa, Takeo Maekawa, Andres Le Pavoux, Yoshihide Asano, Masatoshi Abe, Takayuki Ishii, Takaaki Ito, Taiki Isei, Shinichi Imafuku, Ryokichi Irisawa, Masaki Ohtsuka, Mikio Ohtsuka, Fumihide Ogawa, Takafumi Kadono, Masanari Kodera, Tamihiro Kawakami, Masakazu Kawaguchi, Ryuichi Kukino, Takeshi Kono, Keisuke Sakai, Masakazu Takahara, Miki Tanioka, Takeshi Nakanishi, Yasuhiro Nakamura, Akira Hashimoto, Masahiro Hayashi, Manabu Fujimoto, Hiroshi Fujiwara, Koma Matsuo, Naoki Madokoro, Osamu Yamasaki, Yuichiro Yoshino, Takao Tachibana, Hironobu Ihn
The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders.
April 2016: Journal of Dermatology
Ahmet Yılmaz, Erol Çenesizoğlu
OBJECTIVE: The aim of this study was to investigate the effectiveness of cryotherapy applied for the purpose of matricectomy following partial nail removal in treatment of ingrown nails. METHODS: Between 2010 and 2013, 76 ingrown toenails of 62 patients were included in this prospective study. Following partial toenail removal, matricectomy with cryotherapy was performed. The lateral nail matrix was frozen for 45 seconds with open spray and spot-freezing technique using liquid nitrogen...
2016: Acta Orthopaedica et Traumatologica Turcica
Randall D Wolcott, John D Hanson, Eric J Rees, Lawrence D Koenig, Caleb D Phillips, Richard A Wolcott, Stephen B Cox, Jennifer S White
The extent to which microorganisms impair wound healing is an ongoing controversy in the management of chronic wounds. Because the high diversity and extreme variability of the microbiota between individual chronic wounds lead to inconsistent findings in small cohort studies, evaluation of a large number of chronic wounds using identical sequencing and bioinformatics methods is necessary for clinicians to be able to select appropriate empiric therapies. In this study, we utilized 16S rDNA pyrosequencing to analyze the composition of the bacterial communities present in samples obtained from patients with chronic diabetic foot ulcers (N = 910), venous leg ulcers (N = 916), decubitus ulcers (N = 767), and nonhealing surgical wounds (N = 370)...
January 2016: Wound Repair and Regeneration
M J Hughes, E M Harrison, N J Peel, B Stutchfield, S McNally, C Beattie, S J Wigmore
BACKGROUND: Analgesia after liver surgery remains controversial. A previous randomized trial of continuous wound infiltration (CWI) versus thoracic epidural analgesia (TEA) after liver surgery (LIVER trial) showed a faster recovery time in the wound infiltration group but better early postoperative pain scores in the TEA group. High-level evidence is, however, limited and opinion remains divided. The aim was to determine whether there is a difference in functional recovery time between patients having CWI plus abdominal nerve blocks versus TEA after liver resection...
December 2015: British Journal of Surgery
Marco Matteoli, Claudia Scaringi, Paola Carella, Luca Fruttaldo, Ulrico Angeloni, Massimo Laurenza
BACKGROUND: Homeless people live in poverty, with limited access to public health services. They are likely to experience chronic medical conditions, such as diabetes mellitus; however, they do not always receive the necessary services to prevent complications. This study was designed to determine the effectiveness of a volunteer health service outreach to reduce disparity in diabetic foot care for homeless people. METHODS: The research was conducted on 21 patients with diabetic ulcers of 930 homeless people visited between 2008 and 2013...
September 2015: Journal of the American Podiatric Medical Association
Robert G Frykberg, Jaminelli Banks
Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients. Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing...
September 1, 2015: Advances in Wound Care
Mark Fairweather, Yvonne I Heit, Justin Buie, Laura M Rosenberg, Alexandra Briggs, Dennis P Orgill, Monica M Bertagnolli
BACKGROUND: Cyclooxygenase-2 (COX-2) is an inducible enzyme that is rapidly upregulated in response to injury, resulting in the production of prostaglandin E2 (PGE2), a primary mediator of inflammation and wound healing. The selective COX-2 inhibitor, celecoxib, is was used to treat pain and inflammation. When used to treat injuries, we postulated that loss of PGE2 activity by COX-2 inhibition would have detrimental effects on wound healing. Our objective was to study the effect of selective COX-2 inhibition with celecoxib on cutaneous wound healing...
April 2015: Journal of Surgical Research
Fang Zhang, Kai-Yang Lv, Xiao-Chen Qiu, Peng-Fei Luo, Xing-Feng Zheng, Shi-Hui Zhu, Zhao-Fan Xia
BACKGROUND: Microskin autografts with conventional wrap and compression are used extensively in the treatment of skin and tissue defects. This comparative study aimed at investigation of the clinical application of negative pressure wound therapy (NPWT) in combination with microskin autografts for repair of acute and chronic wounds. METHODS: A prospective case-control study was performed from December 1, 2010-December 31, 2013 in Changhai Hospital, Shanghai. We compared a study group of patients received microskin autografting covered by NPWT with that of a control group of patients received microskin autografting covered by a conventional gauze...
May 1, 2015: Journal of Surgical Research
Isabelle Scholl, Jördis M Zill, Martin Härter, Jörg Dirmaier
BACKGROUND: Existing models of patient-centeredness reveal a lack of conceptual clarity. This results in a heterogeneous use of the term, unclear measurement dimensions, inconsistent results regarding the effectiveness of patient-centered interventions, and finally in difficulties in implementing patient-centered care. The aim of this systematic review was to identify the different dimensions of patient-centeredness described in the literature and to propose an integrative model of patient-centeredness based on these results...
2014: PloS One
Sonia Gulati, Ashia Qureshi, Anurag Srivastava, Kamal Kataria, Pratik Kumar, Acharya Balakrishna Ji
To compare the healing of chronic wounds with honey dressing vs. Povidone iodine dressing in adult subjects with chronic wounds of ≥6 weeks of duration, attending wound care clinic in Surgical Out Patient Department of All India Institute of Medical Sciences, Surgical Out Patient Department of Jai Prakash Narayan Apex Trauma center, New Delhi. Forty five subjects were randomized into two groups i.e., Honey & Povidone iodine dressing group. Dressing was done on alternate day basis for 6 weeks of followup period...
June 2014: Indian Journal of Surgery
Ana M Misic, Sue E Gardner, Elizabeth A Grice
Significance: Bacterial burden is believed to play a significant role in impaired wound healing of chronic wounds and the development of infection-related complications. The standard of care in the clinic relies upon cultivation-dependent methods to identify microorganisms. These assays are biased toward microorganisms that thrive in isolation under laboratory conditions. Recent Advances: Significant advances in genomic technologies have enabled less-biased, culture-independent approaches to characterize microbial communities, or microbiomes...
July 1, 2014: Advances in Wound Care
Suzanne Reed, Richard Shell, Karyn Kassis, Kimberly Tartaglia, Rebecca Wallihan, Keely Smith, Larry Hurtubise, Bryan Martin, Cynthia Ledford, Scott Bradbury, Henry Hank Bernstein, John D Mahan
The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts...
July 2014: Current Problems in Pediatric and Adolescent Health Care
Liza R Braun, Whitney A Fisk, Hadar Lev-Tov, Robert S Kirsner, Roslyn R Isseroff
BACKGROUND: Diabetic foot ulcers (DFUs) are extremely debilitating and difficult to treat. Multidisciplinary management, patient education, glucose control, debridement, offloading, infection control, and adequate perfusion are the mainstays of standard care endorsed by most practice guidelines. Adjunctive therapies represent new treatment modalities endorsed in recent years, though many lack significant high-powered studies to support their use as standard of care. OBJECTIVE: This update intends to identify recent, exclusively high level, evidence-based evaluations of DFU therapies...
July 2014: American Journal of Clinical Dermatology
Debra Albert, Dave Priganc
Strategic planning is a process often left to senior hospital leadership, with limited input from unit-level, bedside patient care providers. This frequent approach to strategic planning misses the opportunity to engage a wide range of employees, build a shared sense of commitment, produce a collaborative team environment, and to generate greater acceptance of the plan. The Patient Care Services division at the University of Chicago Medicine used a strategic planning process that incorporated 360-degree input from both within the Patient Care Services division and outside of the division...
July 2014: Nursing Administration Quarterly
Pedro Miguel Ds Valente, Anand Deva, Quan Ngo, Karen Vickery
Chronic wounds remain a significant medical and financial burden in hospitals of today. A major factor in the transition from an acute to a chronic wound is its bacterial bioburden. Developments in molecular techniques have shown that chronic wounds remain colonised by many species of bacteria and that the bacteria within these chronic wounds exist in two forms. Treatments of chronic wounds have maintained a challenging field and significant ongoing research is being conducted. With the development of an in vitro wound model, we applied topical negative pressure (TNP) dressings to a spectrum of common bacterial biofilms found in chronic wounds and studied the synergistic efficacy between the application of TNP and silver-impregnated foam against these biofilms...
February 2016: International Wound Journal
F Biancari, T Juvonen
OBJECTIVE: The efficacy of angiosome-targeted revascularization to achieve healing of ischemic tissue lesions of the foot and limb salvage is controversial. This issue has been investigated in this meta-analysis. METHODS: A systematic review of the literature and meta-analysis of data on angiosome-targeted lower limb revascularization for ischemic tissue lesions of the foot were performed. RESULTS: Nine studies reported on data of interest...
May 2014: European Journal of Vascular and Endovascular Surgery
2016-05-09 10:48:17
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