伤口世界
- 星期二, 23 4月 2024
ActivHeal® PHMB Foam dressing range: a product evaluation
Effective management of exudate is crucial for ensuring timely wound healing. Summarised in this product focus are 11 clinical studies (incorporating the experience of 179 patients), indicating that the ActivHeal® PHMB Foam dressing range (Advanced Medical Solutions Ltd.) is effective at treating infected wounds, managing wound exudate, debridement/wound cleansing, and enhancing the quality of life in patients with a various wound types, including venous leg ulcers (VLU), diabetic foot ulcers (DFU), pressure ulcers (PU), burns and postoperative surgical wounds. The use of the antimicrobial agent polyhexamethylene biguanide (PHMB) provides an effective defence against a broad spectrum of microorganisms, including antibiotic-resistant microorganisms, commonly associated with wound colonisation and infection. This evaluation does not aim to be a systematic or narrative review but rather a selection of the most pertinent publications summarising the clinical evidence supporting ActivHeal PHMB Foam range for the treatment of various chronic and acute wounds.
Rebecca Forder
Senior Clinical Research Manager, Advanced Medical Solutions, Winsford, UK
Alan A Rogers
Independent Wound Care Consultant, Flintshire, UK
Karen Ousey
Professor of Skin Integrity, Director for the Institute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, UK
Mark G Rippon
Visiting Clinical Research Fellow, Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Queensgate, Huddersfield, UK
Key words
- ActivHeal PHMB Foam
- Exudate management
- Infected wounds
- Wound healing
Declaration of interest
This publication was supported by Advanced Medical solutions.
- 星期一, 22 4月 2024
Negative pressure wound therapy with vancomycin wound instillation: a case report
Negative pressure wound therapy (NPWT) supports the healing process by removing fluid and drawing out the infection from a wound, promoting the growth of new tissue. The device works by providing and distributing negative pressure evenly across the wound bed, either through the application of an open cell foam or a gauze dressing. NPWT provides a warm, moist wound bed while removing wound fluid that contains factors that inhibit cell growth, enhances wound oxygenation and improves the flow of blood and nutrients to the wound. NPWT also creates mechanical forces that influence the wound macroscopically, inducing cell proliferation, cell migration to the wound and angiogenesis. For infected wounds, the device can be used to instil antibiotics. In this article, a 57-year-old Caucasian woman with respiratory failure developed sepsis secondary to an intra-abdominal infection with abscess. Vancomycin 1mg/mL wound instillation, instilled as 100mL every 3 hours with a dwell time of 10 minutes, was administered concomitantly with intravenous vancomycin in the successful management of this patient.
Alison Bunnell
Doctor of Pharmacy Candidate 2022, North Dakota State University, Fargo, ND, USA
Erin Beauclair
Doctor of Pharmacy Candidate 2022, North Dakota State University, Fargo, ND, USA
Breanna Jones
Doctor of Pharmacy, Pharmacy Department, Sanford Medical Center Fargo, Fargo, ND, USA
Emily Greenstein
Advanced Practice Registered Nurse and Certified Nurse Practitioner, Wound Care, Sanford Medical Center Fargo, Fargo, ND, USA
Justin M Jones
Doctor of Pharmacy, Pharmacy Department, Sanford Medical Center Fargo, Fargo, ND, USA
Andrea R Clarens
Doctor of Pharmacy Pharmacy Department, Sanford Bemidji Medical Center, Bemidji, MN, USA
Key words
- Acute kidney injury
- Computed tomography
- Kidney Disease Improving Global Outcomes
- Negative pressure wound therapy
Declaration Emily Greenstein reports she has been a consultant for Urgo medical, 3M and Coloplast. 3M manufactures V. A.C VeraFlo. None of these manufacture or distribute vancomycin instillation described in this manuscript.
- 星期五, 19 4月 2024
Do peripheral arterial disease and smoking impede diabetic ulcer healing?
Background: In some patients, diabetic foot ulcers may heal slowly despite tight control of blood glucose and normal limb circulation, implying the presence of multifactorial, unidentified factors to wound healing. Previous efforts to identify these factors using binary variables, such as amputation or specific healing timelines, inadequately reflect the complexities of wound healing capacity.
Aims: We aimed to identify factors associated with delayed diabetic foot ulcer healing.
Methods: Eight factors were assumed to affect diabetic foot ulcer healing; patient age, age at the onset of diabetes, sex, peripheral arterial disease (PAD), HbA1c, smoking as measured by the Brinkman index (BI), dialysis and bone infection. They were analysed using linear regression and multivariable analysis against three healing indices: total healing period (THP), granulation time (GT) and time to contraction onset (TCO).
Results: PAD and BI correlated positively with all three indices. Patients with PAD exhibited significantly extended THP, GT and TCO. An increase of 100 in BI corresponded with a 1.53 day increase in GT. Conclusion: PAD was associated with delayed healing according to every measure analysed, while BI was linked with slower granulation. Besides THP, the measurements of GT — and possibly TCO — could evaluate some aspects of healing capacity of diabetic ulcers.
Kazufumi Tachi
Senior Lecturer, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
Koichi Gonda
Professor, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
Takashi Kochi
Chief Surgeon, Department of Plastic Surgery, Sendai City Hospital, Sendai, Japan
Jyunya Niwa
Research Associate, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
Key words
Diabetic foot ulcer
New index of wound healing
Brinkman index
Declarations
All authors have no conflicts of interest to declare.
- 星期四, 18 4月 2024
The use of transparent porous cellulose membrane in a surgical site infection in postoperative bicaval orthotopic heart transplant patient in Mexico: a case report
Surgical site infections of post-transplanted heart patients, as well as wound care, have little scientific evidence in Mexico, although adequate treatment in infected wounds with advanced wound dressings or cellulose membranes that allow us to clearly assess the incision can reduce hospital stay, pain, anxiety and the infection itself, together with appropriate antibiotic therapy. The aim of this case report is to describe the management and care of the surgical site infection (Gram-negative bacillus) following a heart transplant that includes the transparent cellulose membrane.
Dalila Diana Bautista Uribe
Nurse Specialised in Wounds, Stomata and Burns, Centro Médico Siglo XXI Cardiología, Mexico City, CDMX, Mexico
Key words
- Surgical site infection
- Bacterial cellulose membrane
- Heart transplant
- 星期三, 17 4月 2024
Powdered porcine urinary bladder matrix for treating chronic diabetic wounds: clinical case studies
This article is based on a presentation by Professor Steven Jeffery at the annual Wounds UK conference in Harrogate, on 7 November 2023. Professor Jeffery presented clinical studies on how a bioengineered wound therapy with a porcine urinary bladder matrix (UBM) may facilitate healing of chronic wounds.
Steven LA Jeffery
Medical Director Pioneer Wound Telehealth and Professor of Wound Study, Birmingham City University
John McRobert
Clinical Research Director, Pioneer Wound Telehealth
Key words
- Chronic diabetic wounds
- Urinary bladder matrix
- Macrophages
- Wound healing
- Meeting report
- Wound care services
This meeting report has been funded by an educational grant from Integra
- 星期二, 16 4月 2024
Evaluation of a technology lipido-colloid non-adherent dressing with silver in the management of burn patients — a case series from India
Management, as well as prevention, of wound infection is key in the promotion of the healing process. In India, over one million people are moderately or severely burnt every year, and managing the challenging burn wounds is a daily reality for clinicians in the country. Silver has been used as an antimicrobial in burn wound management for decades and modern advanced dressings can provide safe prevention and management of infection in these cases. This article reports the cases of two adults, an infant and a child with burns, at risk of infection and managed with a Technology Lipido-Colloid non-adherent dressing with silver (TLC-Ag; UrgoTul Ag/Silver). The main benefits observed when using the evaluated dressing in these patients included rapid wound healing but also patient-related outcomes, such as decrease in pain and atraumatic removal.
Dr Venkateswaran
Plastic Surgeon, Jupiter Hospital, Mumbai, India
Dr Ravichander Rao A
Plastic Surgeon, Care Hospital, Hyderabad, India
Dr Krishna Kumar
Plastic, Aesthetics, Burns, Hand and Reconstructive Microsurgeon, Kovai Medical Centre & Hospital, Coimbatore, India
Dr Sankamithra
Consultant Plastic Surgeon, Lakshmi Medical center, Pollachi, India
Key words
- Burns
- Lipido-colloid non-adherent dressing
- Silver
Declarations
All authors have no particular conflicts of interest to declare regarding these cases.