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Background: In armed conflicts, infected wounds constitute a large portion of the surgical workload. Treatment consists of debridements, change of dressings, and antibiotics. Many surgeons advocate for the use of honey as an adjunct with the rationale that honey has bactericidal and hyperosmotic properties. However, according to a Cochrane review from 2015 there is insufficient data to draw any conclusions regarding the efficacy of honey in treatment of wounds. We, therefore, decided to evaluate if honey is non-inferior to gentamicin in the treatment of infected wounds in a highly translatable porcine wound model. Material and methods: 50 standardized wounds on two pigs were infected with S. aureus and separately treated with either topically applied Manuka honey or intramuscular gentamicin for eight days. Treatment efficacy was evaluated with quantitative cultures, wound area measurements, histological, immunohistochemical assays, and inflammatory response. Results: Topically applied Manuka honey did not reduce bacterial count or wound area for the duration of treatment. Intramuscular gentamicin initially reduced bacterial count (geometric mean 5.59*,0.37 - 4.27 *,0.80 log10 (GSD) CFU/g), but this was not sustained for the duration of the treatment. However, wound area was significantly reduced with intramuscular gentamicin at the end of treatment (mean 112.8 +/- 30.0-67.7 +/- 13.2 (SD) mm(2)). ANOVA-analysis demonstrated no variation in bacterial count for the two treatments but significant variation in wound area (p = 0.0001). The inflammatory response was more persistent in the pig with wounds treated with topically applied Manuka honey than in the pig treated with intramuscular gentamicin. Conclusion: At the end of treatment S. aureus count was the same with topically applied Manuka honey and intramuscular gentamicin. The wound area was unchanged with topically applied Manuka honey and decreased with intramuscular gentamicin. Topically applied Manuka honey could consequently be non inferior to intramuscular gentamicin in reducing S. aureus colonization on the wounds surface, but not in reducing wound size. The use of Manuka honey dressings to prevent further progression of a wound infection may therefore be of value in armed conflicts, where definite care is not immediately available. Funding agencies: Kamprad Family Foundation [20170287]; Swedish government [LIO-700121]; county councils, the ALF-agreement [LIO-700121]

Cell migration is a process that underlies the development and maintenance of multicellular organisms, with profound implications in various pathologies. The study of cell migration is fundamental in various fields of basic biology and pharmaceutical development. Wound healing assay is an indirect way to assess cell migration. Conventional methods, such as the scratch test, are inexpensive and easy to execute but have the disadvantages of being poorly reproducible and difficult to perform on a high-throughput scale. Meanwhile, commercial strategies are expensive. In the present work, we developed a lab-made wound healing assay device that is inexpensive, easy to handle, and reproducible. We designed 3D-printed stoppers compatible with cell culture in 96-well plates. These stoppers did not affect HaCaT cells viability. The stopper-produced initial wound size was reproducible on a high-throughput scale. Also, stoppers demonstrated their effectiveness to evaluate cell migration and allowed differentiating treatments with and without fetal bovine serum. Finally, proliferation assay was determined in this wound healing model. In conclusion, our lab-made 3D-printed stopper-based assay is a more economical alternative to currently available strategies for developing reproducible, high-throughput assays to assess cell migration and proliferation.

This study aims to evaluate the healing effect of topical Apigenin cream 2% in the skin of rabbits. Twenty Four healthy Newzealand adult male rabbits approximately at the same age were involved in this study. All animals were anesthetized using a mixture of 40 mg/kg ketamine injection and xylazine 4 mg/kg intramuscularly. The skin of the dorsum area of each rabbit was shaved; then, three incisions (1cm in length) were made. Wounds were left without suturing to heal by secondary intention healing, and each animal had three wounds (wounds divided into three groups according to the type of treatment): one treated with Apigenin cream twice a day, the other with cold cream twice a day, and the third wound was left untreated. The application of cream was repeated daily; the wound size and the ratio of wound contraction were assessed at the first, fourth, and seventh days of study. The results revealed that the group treated with apigenin showed significantly better wound healing capacity in the skin of rabbits; wound size and wound contraction ratio was superior in the Apigenin group compared to control positive and negative groups. It can be concluded that apigenin cream has beneficial value for improving the wound healing potential of skin in rabbits.

Serum alkaline phosphatase (ALP) levels increases in burn tissue damage. Several bioactive compounds found in Ashitaba, are expected to reduce serum ALP levels and enhance the process of wound healing. This study aims to prove that administration of oral Ashitaba extract can reduce serum ALP levels in rats exposed to burn trauma. This study uses true experimental post-test control group design with a total of 20 Sprague dawley rats as samples. All samples were inflicted with 2nd degree burn wound and divided into 2 groups, treatment group (Ashitaba extract 300 mg/KgBW) and control group. Blood serum were analyzed for ALP levels on the 2nd, 8th and 14th days. Kinetic-IFCC method was used to find serum ALP levels. Data was analyzed using Mann-Whitney Test, paired T-test amd independence T-test. Scalded wound size was measured macroscopically over the course of 21 days to find contracture rate. In conclusion, Ashitaba extract is not proven to significantly reduce the serum ALP levels, increase contracture rate and enhance burn wound healing process. However, there was slight increase in contracture rate in treatment group as compared to control group. In addition, there was a lower ALP levels in treatment group as compared to control group in day 8.

Aim. This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel®) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel®), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. Results. Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. Conclusions. Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.

Introduction: Wounds are a breakdown of tissue integrity / continuity that can lead to infection. Virgin Coconut Oil is a processed coconut product made by processing fresh coconut flesh at low temperature and has a high nutritional content. Ozone therapy is an alternative therapy that has disinfectant properties and can induce strong oxidative stress. Methods: This study was conducted on 50 Sprague-Dawley rats that had injuries. We performed full thickness wounds and administered ozonated doses of VCO to mice. We looked at shrinkage of wounds and TGF Beta levels in mice. Assessment was carried out on day 7 and day 14 to assess the wound and TGF-beta immunohistochemically. Results: There was a significant difference in the wound shrinkage variable between the negative control group and the group that received VCO offerings both on day 7 and day 14. We also found a significant difference in the TGF-beta variable between the negative control group and the group that received VCO offerings both on day 7 and day 14. Conclusion: The administration of ozonated virgin coconut oil was effective in increasing the expression of TGF-? in the full thickness defect of Sprague Dawley rats and was effective in increasing the reduction in wound size in the full thickness defect of Sprague Dawley rats.

Background: Post traumatic raw area is a very troublesome condition to treat which requires long term regular dressings, higher antibiotics and close monitoring of patient vitals. This study evaluates the efficacy of modified Vacuum-assisted closure (VAC) combined with a closed suction irrigation system for treating an post-traumatic wound and infection. Methods: We conducted a retrospective study of 20 patients with post-traumatic raw areas from 2020 to 2021 at a single tertiary center. All patients included in the study received modified VAC treatment (VAC combined with a closed suction irrigation system, CSIS) until the wound can be closed secondarily. Detailed information was obtained from the medical records. Results: Reduction in wound size was significant after 1 week of VAC with CSIS treatment. The patients had excellent wound beds after an average of 3 -6 days(1 or 2 cycles of VAC with CSIS) All wounds healed completely and were infection free after an average of 15 days, and the average hospital stay was 22 days. Wounds remained infection free after coverage. Conclusions: This study shows that VAC combined with a CSIS is a superior method to treat raw areas compared to conventional VAC. This improved VAC procedure provides an excellent granulation to facilitate wound healing, hasten closure and shorten the hospital stay.

Amniotic tissues have been long utilised to treat chronic wounds; however, there are few studies evaluating how the wound microenvironment responds to these therapies. The goal of this study was to evaluate the changes in wounds treated with a hypothermically stored amniotic membrane (HSAM). In this prospective single‐arm study, 15 female patients with venous leg ulcers were treated with HSAM from male donors and standard of care for 12 weeks. Over the course of the study, wound exudate was collected and evaluated using proteomic microarrays. Biopsies were collected during the course of treatment to detect the presence of HSAM tissue. By 4 weeks, 60% of subjects achieved 50% or greater reduction in wound size, and by 12 weeks, 53% of subjects achieved 100% re‐epithelialization. HSAM DNA was detected in 20% of biopsies as determined by the detection TSPY4, indicating HSAM was no longer present within the wound bed approximately 7 days from the last treatment for the majority of wounds. Proteomic analysis of wound exudate found that wounds on a healing trajectory had significantly higher levels of MMP‐10, MMP‐7, and TIMP‐4 and significantly lower levels of CX3CL1, FLT‐3 L, IL‐1ra, IL‐1a, IL‐9, IL‐2, IL‐3, MCP‐1, and TNF‐b compared with other wounds.

Background Tigilanol tiglate (TT) is a novel small molecule for intratumoral treatment of nonmetastatic mast cell tumors (MCTs) in dogs. In a randomized controlled clinical study, 75% of dogs that received a single TT treatment achieved complete resolution of the MCT by 28 days, with no recurrence in 93% of dogs at 84 days. Critical to TT's efficacy was the area of the wound (tissue deficit) after slough of the necrotic tumor relative to pretreatment tumor volume. Objectives To analyze data collected during the previous study to (a) describe wounds after slough of treated MCTs and (b) identify determinants of wound area and speed of wound healing. Methods Wound presence, condition, and area were determined from clinical records of 117 dogs over 84 days after a single intratumoral TT treatment. Results Tumor slough occurred 3 to 14 days after treatment, exposing granulation tissue in the wound bed. Wound area after tumor slough in general was related to pretreatment tumor volume, with maximal recorded wound area fully evident in 89% of dogs by day 7. In dogs achieving complete tumor resolution, all wounds were left to heal by secondary intention. Bandaging and other wound management interventions only were required in 5 dogs. Time to healing (ie, full re-epithelialization of treatment site) depended on wound area and location on the body, with most wounds being fully healed between 28 and 42 days after treatment. Conclusions Wound area and healing after slough of TT-treated tumors follow a consistent clinical pattern for most dogs.

This study was aimed to evaluate the wound healing effects of alpha mangostin ointment using excision wound model. Twenty rats were divided into four groups of five rats each; group I was treated with ointment base (control), whereas group II, group III and group IV were treated with 10% (w/w) povidone-iodine (standard), alpha mangostin 1% (w/w), and alpha mangostin 2 % (w/w) respectively for wound healing evaluations. The size of the wound area was measured, and the reduction in the wound size was calculated, and the tissues examined histologically. The significant difference in the wound size reduction between the control and treated group (p

Pressure ulcers are agonizing and hard to treat. Forestalling pressure ulcers is essential in keeping up solace and treating them is rapidly fundamental. Aloe vera is a trademark source which can be of huge points of interest it isn't simply functional and besides viably open, yet the examination is done to notice the abatement in the recuperating time with the usage of aloe vera gel. The present study aims to assess the impact of aloe vera gel on pressure ulcers. A quantitative approach with one group pre-test-posttest research design was used to conduct the study in Thiruvallur District Head Quarter Government Hospital. 60 samples were chosen by using a convenient sampling technique. Semi-structured questionnaire was used to assemble the in sequence regarding demographic variables. The pre-assessment of the pressure ulcer was measured using PUSH Scale using the ruler and the trace paper. The wound assessment consists of wound size, exudates amount and tissue type. Routine wound dressing procedure was done using aloe vera gel and the post assessment was done on 1st, 5th and 10th day. The study results show significant improvement in the level of wound healing after the intervention at the level of p

Objective To investigate the application of transposition flaps in the reconstruction of perianal skin defects after tumor resection. Methods From September 2018 to December 2019, 16 cases of perianal skin defects were repaired with unilateral or bilateral transposition flaps. The wound size before closure ranged from 4 cm × 8 cm to 7 cm × 10 cm. Fourteen patients achieved primary healing. Wound dehiscence occurred in one patient at the flap tip, whereas a slight infection occurred in another patient, which healed after a dressing change. During the follow-up period of 3–6 months, all patients were satisfied with the perianal area both aesthetically and functionally. Conclusion Transposition flaps are a promising option for the repair of perianal skin defects after tumor removal. Owing to the simplicity of the flap design, the wide popularity of this flap type among surgeons is anticipated.

VAC studies have always been unclear due to lack of content and its actual use for wounds. Conventional VAC therapy is usually an exorbitant pick due to high priced machines and unnecessary hospital stay irrespective of the wound size. Meanwhile, the larger sized wounds would definitely need a proper hospital stay, a VAC machine a healthcare worker who knows to handle it; why not use a handy equipment for smaller sized wounds which could be handled by the patient itself? Enter, HANDY-VAC, a low cost equipment which is convenient, requires no hospital stay and most importantly can be handled by the patient itself.

Background: The management of chronic non- healing wounds has always been a cause of concern for the patients and treating team as well. There had been a marked increase in patients presenting with chronic non -healing wounds of varied etiology. The conventional methods of treatment have been in use traditionally include different medicated dressing application since the long-time yet desired results are not achievable always and some other applications like collagen are mostly not affordable to the poor local population. Vacuum-assisted closure using negative pressure being considered as a suitable alternative management for treating chronic non-healing wounds and the results are comparatively better in relatively lesser time than the conventional techniques. Objective: To assess the impact of (VAC) in the management of non-healing Ulcers To compare the advantage of VAC over conventional dressings in ulcer management Methods: Prospective controlled study of 60 patients aged between 40 and 60 were randomly divided into two groups (Wagner grade 2-5) VAC dressing was kept for over 2-5 weeks. Ulcers were treated until the wound closed spontaneously, surgically or until completion of the 50 days, whichever was earlier. Results: By the seventh week, discharge disappeared in 94 % in VAC and only 56 % in conventional dressing group. Granulation tissue appeared in 100 % of patients in the VAC group and only 63 % in the conventional dressing group. The patients treated with VAC dressing in our study showed comparable wound reduction capabilities with an average wound size reduction of 58 % in comparison to conventional dressing group which had an average wound size reduction of 26 %. Majority of wounds in the VAC group got closed in 7 weeks. Patient satisfaction was very good in the VAC group compared to those patients managed with conventional dressing group. Conclusion: The application of VAC is feasible, reliable and affordable with a better outcome in the management of chronic non-healing ulcers.

Objective: The current research is an attempt to evaluate the wound healing activity of Electrohomeopathic drug Green electricity (GE) in Wistar rats. No data have been reported till date on the wound healing effect of GE. Hence the present research focuses on the scientific investigation of the wound healing activity of GE in rats. Methods: Excision and incision wounds were inflicted upon albino rats. In the excision wound model, the wound contraction, Scar residue, area and time of complete epithelization were measured subsequently on day 0, 3,6,9,12,15, 18 and 21 after inflicting the wound. Wound contraction was calculated as a percentage change in the initial wound size. In the incision wound model, the tensile strength was measured on the 10th post wounding day. Results: It was noted that the effect produced by the GE Showed significant wound healing (p

The aim of the study was to analyze the results of spinal artery damage treatment of the injured. Materials and methods. An 2-year analysis of treating 7 patients with vertebral artery injuries admitted to the City Hospital (GB) No. 26 of St. Petersburg was carried out. The problems of diagnosing and treating these injuries have been identified. The solutions to these problems have been suggested. Two clinical cases of successful treatment of injured patients with spinal artery damage have been presented. Results. Theres a possibility of damaging vertebral arteries in neck injuries thus defining the need for introducing high-informative methods of inspection (a spiral computer tomography contrast angiography, a Magnetic Resonance Imaging) and low-invasive (X-ray endovascular) interventions in urgent surgery. The implementation of complex instrumental examinations, their nature, the number of them and urgency should be determined by a surgeon individually considering the recommendations of related specialists. Conclusions. Regardless of the wound size and the patients condition, examination and treatment of patients with neck injuries should be carried out in large hospitals with angiosurgeon and other narrow specialists in the panel of doctors with the 24-hour surveillance, as well as access to full examination and high-tech urgent operational interventions.

Purpose The aim of the present study was to evaluate the potential wound healing activity of the hydroalcoholic extract of Salvia haenkei on in vitro and in vivo experimental models. Materials and methods Preliminary analytical characterization of the hydroalcoholic extract of Salvia haenkei was made by reversed-phase high performance liquid chromatography (RP-HPLC) that permitted identification of a qualitative fingerprint of the extract of aerial parts. The wound healing activity of the hydroalcoholic extract of Salvia haenkei was evaluated in vitro by the scratch assay on human dermal fibroblasts and human epidermal keratinocytes and in vivo by standardized mouse excisional splinting model. Real-time PCR (RT-PCR) experiments were performed to analyze gene expression levels of inflammatory markers. Results The scratch assay tests showed that the treatment with the hydroalcoholic extract of Salvia haenkei did not induce an increase in the fibroblasts migration rate with respect to the positive control. Instead, the hydroalcoholic extract of Salvia haenkei was effective in improving the wound closure rate on keratinocyte cell cultures with an almost total invasion of the scratch after 48 h of treatment; whereas the positive control, at the same time point, showed only a 67% reduction of the wound size. In vivo experiments showed that the groups treated with the extract of Salvia haenkei completely re-epithelized the wound in 2.7 days, a timing that was comparable with the action of the positive control that took only 2.1 days. Gene expression analysis showed that Salvia haenkei positively regulated the signaling pathway of the nuclear factor-κB (NF-κB) transcription factor. Conclusion The results suggested that the hydroalcoholic extract of Salvia haenkei induced a clear wound healing effect.

Summary Diabetic foot ulcer morbidity and mortality are dramatically increasing worldwide, reinforcing the urgency to propose more effective interventions to treat such a devastating condition. Previously, using a diabetic mouse model, we demonstrated that administration of bone marrow mesenchymal stem cells derivatives is more effective than the use of bone marrow mesenchymal stem cells alone. Here, we used the aforementioned treatments on three patients with grade 2 diabetic foot ulcers and assessed their beneficial effects, relative to the conventional approach. In the present study, two doses of cell derivatives, one dose of mesenchymal stem cells or one dose of vehicle (saline solution with 5% of human albumin), were intradermally injected around wounds. Wound healing process and changes on re-epithelialization were macroscopically evaluated until complete closure of the ulcers. All ulcers were simultaneously treated with conventional treatment (PolyMen® dressing). Patients treated with either cell derivatives or mesenchymal stem cells achieved higher percentages of wound closure in shorter times, relative to the patient treated with the conventional treatment. The cell derivative and mesenchymal stem cells approaches resulted in complete wound closure and enhanced skin regeneration at some point between days 35 and 42, although no differences between these two treatments were observed. Moreover, wounds treated with the conventional treatment healed after 161 days. Intradermal administration of cell derivatives improved wound healing to a similar extent as mesenchymal stem cells. Thus, our results suggest that mesenchymal stem cell derivatives may serve as a novel and potential therapeutic approach to treat diabetic foot ulcers. Learning points: In diabetic mouse models, the administration of mesenchymal stem cells derivatives have been demonstrated to be more effective than the use of marrow mesenchymal stem cells alone. Mesenchymal stem cells have been explored as an attractive therapeutic option to treat non-healing ulcers. Mesenchymal stem cells derivatives accelerate the re-epithelialization on diabetic foot ulcers.

This study combined phytosanitary surveys, laboratory analyses, and mathematical modeling to show how hail-induced wounds can foster the infections of the blight pathogen Cryphonectria parasitica, locally associated with extensive dieback of chestnut (Castanea sativa). Orchards and coppices located within and outside the assessed dieback area in a single location in the North West of Italy were inspected to appraise the abundance of hail-induced wounds and C. parasitica infections. The incidence of C. parasitica was significantly higher within the dieback area compared with outside (92% versus 60%; P < 0.05). Hail-induced wounds were observed on small branches and shoots of all trees sampled within the dieback area, whereas they were less abundant outside (20% of trees), suggesting either that the dieback was directly associated with the injuries caused by the hailstorms or that those injuries may have facilitated infections of C. parasitica. Isolations conducted on 359 branches and shoots showed that hail-induced wounds served as infection courts for C. parasitica and that infections depended on the size rather than on the number of hail wounds. We fitted a logistic model showing that hail-induced wounds whose perimeter was larger than 66 mm were at particular risk of C. parasitica infection. A newly designed geometrical-based model is proposed to relate hailstones size, hail wound perimeter, and the risk of infection. We established that hail-induced wounds are entry points for virulent and hypovirulent strains of C. parasitica, since 6.5% of isolates were infected by Cryphonectria hypovirus-1.

Introduction: Pressure ulcer (PU) is a result of prolonged pressure and shear over a bony prominence resulting in tissue injury of varying depth. To date, there is no standardized wound dressings for PU. Due to its availability and affordability, honey is suitable as PU wound dressing considering its anti-oxidant, anti-inflammatory, and antibacterial properties. This review article will provide evidence of the superiority of honey dressing.Methods: Literature source was searched through online databases with relevant keywords and then appraised for their validity, importance, and applicability. Total of three articles were appraised.Results: All articles agreed that application of honey on PU wounds reduced wound size and alleviate pain. Honey-impregnated gauze dressing promoted faster pain relief throughout treatment and less discomfort during each dressing change. Healing rate was proven 4 times faster with honey compared to other topical ointments. However, the antibacterial effect of honey was not significantly confirmed in the study. Nonetheless, topical application of honey successfully accelerates wound healing in PU.Conclusion: Honey is a promising alternative for topical dressings in patients with PU.

Introducción: Las heridas con defectos de coberturas suponen un gran desafío a la hora de elegir un buen tratamiento que reduzca el riesgo de infección e incremente la capacidad de granulación del tejido. El objetivo de este estudio fue demostrar la utilidad del digluconato de clorhexidina para la granulación de tejidos. Materiales y Métodos: Se incluyeron 18 heridas de 16 pacientes que cumplían con los criterios de inclusión. Se realizaron curaciones ambulatorias con gasas embebidas en digluconato de clorhexidina al 20%, cada 48-72 h, hasta lograr la adecuada granulación de tejido y se tomaron fotografías de la evolución clínica de las heridas. Resultados: Se observó una adecuada granulación de las heridas en una media de 9.2 días (rango 4-25), independientemente del tamaño o de las comorbilidades. Ninguna herida presentó signos clínicos de infección durante el período de curación. Conclusiones: El uso de digluconato de clorhexidina es un adecuado método por tener en cuenta para tratar heridas, de forma ambulatoria, y así disminuir los costos hospitalarios del sistema de salud.

Introduction: Burn can happen in any area and causes dominant changes in the quality of normal tissues. The aim of present article is evaluation and comparison the effect of milk, natural honey, and combination of honey–milk on healing of burnt wound. Method and Material: A 4-week trial study was carried out on 10 Albino New Zealand rabbits. All dry burned wound was created on the back of the scapula by a 1 * 1 cm metal block. First group received honey dressing, second group milk dressing, third group honey–milk dressing, and the fourth group 5% sulfadiazine dressing. Sampling was performed at days 1, 10, and 20. Measurement of wound size was done in days 1, 7, 14, 21, 28. The obtained data and information were analyzed by two-way ANOVA and Duncan tests using SPSS. Results: Result show that combination of milk-honey dressing had most significant effect on the improvement of wound healing in the recipient rabbits after a 4-week study. The size of burn wound in four different group was: Honey milk combination 0.428 cm2, honey 0.547 cm2, milk 0.579 cm2 and sulfadiazine 0.873 cm2. Conclusion: All dressing can accelerate wound healing and have promotive effect on wound healing but the combination of honey–milk had the greatest effect. Honey, milk, and sulfadiazine had next grade of effectiveness.

Background: The essential role of oxygen in wound healing is well documented, and recent developments in the delivery of topical oxygen therapy have made this a more viable treatment in practice. This article examines the role of topical oxygen – the NATROX® Oxygen Wound Therapy System in wound healing and looks at the impact of increased oxygenation on ulcer healing through a case series where the NATROX system was used in patients with ischemic foot ulcers. Materials and Methods: Topical oxygen therapy was evaluated in patients with ischemic foot ulcers in a tertiary referral specialist center. Results: During this case series of six patients, four patients had a complete healing before the study completion and two patients wounds were on a healing trajectory (average reduction in wound size of 60 %) during the follow-up, which eventually healed. Conclusion: NATROX® is an innovative topical oxygen delivery system that warranty further research to assess its potential impact on wound healing.

Self-assembly is an unparalleled step in designing macromolecular analogs of nature's simple amphiphiles. Tailoring hydrogel systems - a material with ample potential for wound healing applications - to simultaneously alleviate infection and prompt wound closure is vastly appealing. The poly (DEAEMA-co-AAc) (PDEA) is examined with a cutaneous excisional wound model alterations in wound size, and histological assessments revealed a higher wound healing rate, including dermis proliferation, re-epithelialization, reduced scar formation, and anti-inflammatory properties. Moreover, a mechanism for the formation of spherical and worm-like micelles (WLMs) is delineated using a suite of characterizations. The excellent porosity and ability to absorb exudates impart the PDEA with reliable wound healing. Altogether, this system demonstrates exceptional promise as an infection-mitigating, cell-stimulating, homeostasis-maintaining dressing for accelerated wound healing. The aim and objective of this study is to understand the mechanism of self-assembly in synthesized WLMs from PDEA and their application in wound healing.

Purpose Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD. Methods A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study. Results Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group. Conclusion Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.

Introduction Post-exposure prophylaxis using rabies immunoglobulin (RIG) is universal recommendation for category III exposures. This study was conducted to determine quantity of RIG used to infiltrate animal bite wounds in relation to longest dimension and area of wound. Methods Children aged 2–18 years reporting within 7 days of category III animal bite were included. eRIG (300 IU/ml) was used in all subjects. A predesigned proforma was filled for clinical and epidemiological details of subjects. Maximum length and width of wounds was measured by using non-stretchable measuring tape. RIG was infiltrated in wounds as per WHO recommendations and volume infiltrated was noted. Results and conclusion A total of 100 subjects were enrolled. The mean (±SD) volume of RIG infiltrated in wounds per unit length was 0.75 (±0.21) ml/cm and per unit area was 3.18 (±1.75) ml/cm2. Regression equations were calculated. Proposed equations y = 0.6x + 0.3, where y is the volume of RIG (ml) and x is the length of the wound (cm) and y = 0.9x + 1.1, where y is the volume of RIG (ml) and x is the area of the wound (cm2) can prove to be a useful tool in RIG volume calculation for primary health care providers.

Chronic wounds can be difficult to heal and are often accompanied by pain and discomfort. Multiple skin substitutes or cellularized/tissue-based skin products have been used in an attempt to facilitate closure of complex wounds. Allografts from cadaveric sources have been a viable option in achieving such closure. However, early assessment of graft incorporation has been difficult clinically, often with delayed evidence of failure. Visual cues to assess graft integrity have been limited and remain largely superficial at the skin surface. Furthermore, currently used optical imaging techniques can penetrate only a few millimeters deep into tissue. Ultrasound (US) imaging offers a potential solution to address this limitation. This work evaluates the use of US to monitor wound healing and allograft integration. We used a commercially available dual-mode (US and photoacoustic) scanner operating only in US mode. We compared the reported wound size from the clinic with the size measured using US in 45 patients. Two patients from this cohort received an allogenic skin graft and underwent multiple US scans over a 110-d period. All data were processed by two independent analysts; one of them was blinded to the study. We measured change in US intensity and wound contraction as a function of time. Our results revealed a strong correlation (R2=0.81, p < 0.0001) between clinically and US-measured wound sizes. Wound contraction >91% was seen in both patients after skin grafting. An inverse relationship between wound size and US intensity (R2=0.77, p < 0 .0001) indicated that the echogenicity of the wound bed increases as healthy cells infiltrate the allograft matrix, regenerating and leading to healthy tissue and re-epithelization. This work indicates that US can be used to measure wound size and visualize tissue regeneration during the healing process.

Volumetric soft tissue and muscle wounds can arise from trauma or necrotizing soft tissue infection. Quantifying the size of these wounds can be challenging, as they often have irregular borders and contours and invariably involve skin loss. 3-dimensional Computed Tomography (3dCT) has been used to characterize the volume of numerous tissue structures, but these use cases invariably involve structures for which clear anatomic borders exist. This is not the case for volumetric soft tissue or muscle wounds, where the volume of the wound being assessed, which is actually a void representing the absence of tissue, does not contain an explicit border at the superficial surface. We present a method that allows quantification of the void size of volumetric muscle wounds using CT scans processed with the software package 3D Slicer. This quantification allows us to chart the progression of healing in such wounds with sequential scans. The development of a means to quantify wound size and healing rate is a necessary capability in order to assess the efficacy of potential therapeutic interventions aimed at enhancing healing of such wounds.

The plasma healing of acute wound on 56 hairless mice is examined and initiated by several externally controlled physical parameters such as driving frequency and power, duration and interval of plasma treatment, a fraction of air mixture, the gap distance between plasma and wound, and others. The variation of these physical parameters results in a different amount of reactive oxygen and nitrogen species (RONS), which stimulate the regulation of RONS in mouse tissue before revealing several important bioindicators in the process of wound healing. While focusing on an important physical indicator such as the wound size, the limited examination with 56 mice showed promising results [much improved over the previous mice experiments by single-frequency plasma (SP)] by Dual-frequency plasma (DP) with 2% air mixture to argon, which effectively correlates with the observation of optical emission spectra. Circular acute wounds treated by DP (2%) were reduced to 24% in just 8 h after the treatment and further reduced to 5% within a few days.

Objective: Venous leg ulcers (VLUs) comprise 80% of leg ulcers. One of the key parameters that can promote healing of VLUs is tissue oxygenation. To date, clinicians have employed visual inspection of the wound site to determine the healing progression of a wound. Clinicians measure the wound size and check for epithelialization. Imaging for tissue oxygenation changes surrounding the wounds can objectively complement the subjective visual inspection approach. Herein, a handheld noncontact near-infrared optical scanner (NIROS) was developed to measure tissue oxygenation of VLUs during weeks of treatment. Approach: Continuous-wave-based diffuse reflectance measurements were processed using Modified Beer-Lambert's law to obtain changes in tissue oxygenation (in terms of oxy-, deoxy-, total hemoglobin, and oxygen saturation). The tissue oxygenation contrast obtained between the wound and surrounding tissue was longitudinally mapped across weeks of treatment of four VLUs (healing and nonhealing cases). Results: It was observed that wound to background tissue oxygenation contrasts in healing wounds diminished and/or stabilized, whereas in the nonhealing wounds it did not. In addition, in a very slow-healing wound, wound to background tissue oxygenation contrasts fluctuated and did not converge. Innovation: Near-infrared imaging of wounds to assess healing or nonhealing of VLUs from tissue oxygenation changes using a noncontact, handheld, and low-cost imager has been demonstrated for the first time. Conclusion: The tissue oxygenation changes in wound with respect to the surrounding tissue can provide an objective subclinical physiological assessment of VLUs during their treatment, along with the gold-standard visual clinical assessment.

Latar Belakang : Diabetes Melitus (DM) adalah penyakit kronis serius yang terjadi ketika pankreas tidak menghasilkan cukup insulin (hormon yang mengatur glukosa darah), atau ketika tubuh tidak dapat secara efektif menggunakan insulin yang dihasilkannya. Menurut International Diabetes Federation, terdapat 425 juta orang yang menderita diabetes di dunia dan akan meningkat sebesar 629 juta orang pada tahun 2045. Terdapat lebih dari 10.276.100 kasus diabetes di Indonesia pada tahun 2017 dari total populasi dewasa sebesar 166.531.000 yang berarti terdapat prevalensi penderita diabetes sebesar 6,7% dan menduduki peringkat 6 dari 10 negara teratas untuk jumlah penderita diabetes. Penderita diabetes memiliki peningkatan risiko sejumlah masalah kesehatan yang serius. Banyak yang mengeluhkan terjadinya ulkus diabetik yaitu luka terbuka pada penderita DM sehingga diabetes melitus menjadi penyebab terjadinya amputasi kaki pada penderita DM. Amputasi terjadi 15 kali lebih sering pada penderita diabetes daripada non diabetes. Pada tahun 2032, seiring dengan peningkatan jumlah penyandang diabetes di dunia, terjadi peningkatan kaki diabetik. Perawatan kaki yang dilakukan secara efektif dapat mencegah resiko ulkus menjadi amputasi. Dengan dilakukan manajemen yang komprehensif, sebagian besar amputasi yang berkaitan dengan diabetes dapat dicegah. Bahkan ketika amputasi berlangsung, kaki yang tersisa dan kehidupan orang tersebut dapat diselamatkan dengan perawatan tindak lanjut yang baik.Tujuan : Untuk memberikan gambaran perawatan luka serta menilai proses perawatan dan perkembangan luka kaki diabetes pada pasien diabetes melitus selama 5 minggu perawatan.Metode : penelitian ini merupakan jenis penelitian yang dilakukan secara prospektif yang dimulai dari tanggal 10 September – 9 Oktober 2018 di Klinik Perawatan Luka Griya Afiat, Makassar. Status Demografi dan pengkajian luka didapatkan melalui wawancara langsung kepada pasien dan keluarga serta menilai luka menggunakan format Asuhan Keperawatan Luka dari Klinik Griya Afiat.Hasil : Pada minggu pertama perawatan, Keadaan luka memiliki banyak undermining. Berdasarkan struktur lapisan kulit, luka berada pada full thickness. Penampilan klinis lain ditemukan adanya slough/infeksi, disertai odor, kulit sekitar luka mengalami maserasi, serta edema. Teknik debridemen yang digunakan yaitu Conservatif Sharp Wound Debridement (CSWD) dan autolysis. Dressing yang digunakan pada perawatan luka yaitu hidrofobik dan salep zink sebagai dressing primer, kasa steril dan diaper sebagai balutan sekunder, serta kasa gulung sebagai balutan tersier. Untuk perawatan periwound digunkan salep zink. Terjadi perubahan ukuran yang berbeda-beda pada tiap luka dan meningkatnya proses granulasi dan epitelisasi tiap minggu perawatan hingga minggu kelima perawatan, keadaan luka mulai mengalami peningkatan epitelisasi dan mengalami perubahan ukuran luka terutama pada undermining, presentasi slough menurun, tanda infeksi lokal mulai berkurang.Kesimpulan : Selama proses perawatan luka selama 5 minggu, Proses penyembuhan luka mengalami progress yang baik. Pada minggu pertama dan kedua mengalami fase inflamasi, pada minggu ketiga hingga kelima mengalami proses poliferasi. waktu proses penyembuhan luka berjalan lambat, terjadi perubahan ukuran dan kedalaman yang berbeda-beda pada beberapa luka di setiap minggu perawatan, luka tidak berpotensi amputasi dengan tidak terdapatnya luka nekrotik selama 5 minggu perawatan, tanda-tanda infeksi lokal pada luka semakin berkurang di setiap minggu perawatan, terdapat edema pada kaki kiri yang mengalami luka diabetik serta kaki kanan sehingga diperlukan pemeriksaan lebih lanjut untuk mengatasi faktor lain yang menghambat proses penyembuhan.Keywords : Diabetes Milletus, Luka Kaki Diabetes, Post Autoamputasi.

After a tissue is wounded, cells surrounding the wound adopt distinct wound-healing behaviors to repair the tissue. Considerable effort has been spent on understanding the signaling pathways that regulate immune and tissue-resident cells as they respond to wounds, but these signals must ultimately originate from the physical damage inflicted by the wound. Tissue wounds comprise several types of cellular damage, and recent work indicates that different types of cellular damage initiate different types of signaling. Hence to understand wound signaling, it is important to identify and localize the types of wound-induced cellular damage. Laser ablation is widely used by researchers to create reproducible, aseptic wounds in a tissue that can be live-imaged. Because laser wounding involves a combination of photochemical, photothermal and photomechanical mechanisms, each with distinct spatial dependencies, cells around a pulsed-laser wound will experience a gradient of damage. Here we exploit this gradient to create a map of wound-induced cellular damage. Using genetically-encoded fluorescent proteins, we monitor damaged cellular and sub-cellular components of epithelial cells in living Drosophila pupae in the seconds to minutes following wounding. We hypothesized that the regions of damage would be predictably arrayed around wounds of varying sizes, and subsequent analysis found that all damage radii are linearly related over a 3-fold range of wound size. Thus, around laser wounds, the distinct regions of damage can be estimated after measuring any one. This report identifies several different types of cellular damage within a wounded epithelial tissue in a living animal. By quantitatively mapping the size and placement of these different types of damage, we set the foundation for tracing wound-induced signaling back to the damage that initiates it.

Objective:Endoscopic resection (ER) is more difficult and has a higher rate of complications, such as perforation and bleeding. The aim of this study was to evaluate the safety and feasibility of a bipolar polypectomy snare for ER.Methods:Initial ER procedures in live pigs were carried out. Then, a human feasibility study was performed in patients with colorectal polyps. Finally, the finite element method was used to evaluate the safety and effectiveness of the new bipolar snare.Results:In the live animal model, there were no significant differences in wound size and cutting time between monopolar and bipolar groups. The histological results (histological scores) of the two groups in porcine experiments were almost the same except that the incision flatness of bipolar group was better than that of the monopolar group. Incidence of bleeding and perforation was similar between the two groups in pigs' and patients' study. At last, the finite element model showed that the vertical thermal damage depth produced by bipolar snare system was approximately 71–76% of that produced by monopolar snare system at the same power.Conclusions:The novel bipolar snare is feasible in patients with colorectal polyps and can be an alternative choice for ERs.

Evaluating and tracking wound size is a fundamental metric for the wound assessment process. Good location and size estimates can enable proper diagnosis and effective treatment. Traditionally, laboratory wound healing studies include a collection of images at uniform time intervals exhibiting the wounded area and the healing process in the test animal, often a mouse. These images are then manually observed to determine key metrics —such as wound size progress– relevant to the study. However, this task is a time-consuming and laborious process. In addition, defining the wound edge could be subjective and can vary from one individual to another even among experts. Furthermore, as our understanding of the healing process grows, so does our need to efficiently and accurately track these key factors for high throughput (e.g., over large-scale and long-term experiments). Thus, in this study, we develop a deep learning-based image analysis pipeline that aims to intake non-uniform wound images and extract relevant information such as the location of interest, wound only image crops, and wound periphery size over-time metrics. In particular, our work focuses on images of wounded laboratory mice that are used widely for translationally relevant wound studies and leverages a commonly used ring-shaped splint present in most images to predict wound size. We apply the method to a dataset that was never meant to be quantified and, thus, presents many visual challenges. Additionally, the data set was not meant for training deep learning models and so is relatively small in size with only 256 images. We compare results to that of expert measurements and demonstrate preservation of information relevant to predicting wound closure despite variability from machine-to-expert and even expert-to-expert. The proposed system resulted in high fidelity results on unseen data with minimal human intervention. Furthermore, the pipeline estimates acceptable wound sizes when less than 50% of the images are missing reference objects.Author summaryKnowledge of the wound size changes over-time allows us to observe important insights such as rate of closure, time to closure, and expansion events, which are key indicators for predicting healing status. To better perform wound measurements it is essential to utilize a technique that returns accurate and consistent results every time. Over the last years, collecting wound images is becoming easier and more popular as digital cameras and smartphones are more accessible. Commonly, scientists/clinicians trace the wound in these images manually to observe changes in the wound, which is normally a slow and labor-intensive process and also requires a trained eye. The clinical goal is to more efficiently and effectively treat wounds by employing easy to use and precise wound measurement techniques. Therefore, the objective should be devising automatic and precise wound measurement tools to be used for wound assessment. To this end, we leveraged a combination of various state-of-the-art computer vision and machine learning-based methods for developing a versatile and automatic wound assessment tool. We applied this tool to analyze the images of wound inflicted lab mice and showed that our developed tool automated the overall wound measurement process, therefore, resulting in high fidelity results without significant human intervention. Furthermore, we compared results to two expert measurements. We found variability in measurement even across experts further validating the need for a consistent approach. However, qualitative behavior, which is most important for predicting wound closure, is preserved.

Recurring damage to the aerial organs of plants necessitates their prompt repair, particularly their vasculature. While vascular regeneration assays for aerial plant parts such as the stem and inflorescence stalk are well established, those for leaf vasculature remain unexplored. Recently, we established a new vascular regeneration assay in growing leaves and discovered the underlying molecular mechanism. Here, we describe the detailed stepwise method for the incision and regeneration assay used to study leaf vascular regeneration. By using a combination of micro-surgical perturbations, brightfield microscopy, and other experimental approaches, we further show that the age of the leaf as well as the position and size of the injury determine the overall success rate of regeneration. This easy-to-master vascular regeneration assay is an efficient and rapid method to study the mechanism of vascular regeneration in growing leaves. The assay can be readily combined with cellular and molecular biology techniques.

BackgroundRecurring damage to aerial organs of plants necessitates their prompt repair, particularly their vasculature. While vascular regeneration assay in aerial plant parts such as stem and inflorescence stalk are well established, those on leaf vasculature remained unexplored. Recently we established a new vascular regeneration assay in growing leaf and discovered the underlying molecular mechanism.ResultsHere we describe the detailed stepwise method of incision and the regeneration assay used for studying the leaf vascular regeneration. By using a combination of micro-surgical perturbations, brightfield microscopy and other experimental approaches, our new findings show that the regeneration efficiency decreases with aging of the leaf, and increases with the nearness of the wound towards the proximal end of the leaf.ConclusionThis easy-to-master vascular regeneration assay is an efficient and rapid method to study the mechanism of vascular regeneration in growing leaves. It can be readily adapted for other plant species and can be combined with cellular and molecular biology techniques.

Background: Platelet-rich plasma (PRP) and its derivatives are an emerging biotechnology whereby concentrated platelets provide damaged tissue with growth factors, cytokines, and other mediators to improve healing outcomes. Although there is strong evidence in the benefits of autologous PRP for both acute and chronic wounds, allogeneic PRP has been studied far less in comparison. Summary: In this mini-review, we discuss critical steps of allogenic PRP (and its derivatives) preparation. We performed a non-systematic review of the literature to identify animal and human subject studies testing allogenic PRP for wound treatment. We searched OVID Medline and PubMed for articles using the keywords “wound, ulcer, lesion, skin, and cutaneous” and “PRP, or platelet-rich plasma, or platelet-rich fibrin, or PRF, or platelet releasate” and “homologous, allogeneic or allogenic,” which were limited to non-review articles and English language. Two studies in animal models and 8 studies in patients were reviewed. There were inconsistencies in preparation methods, treatment regimens, and some lacked a control group in their studies. Despite these variations, none of the studies identified any major side effects or adverse events. The treatment resulted in a reduced time to heal and/or reduced wound size in most cases. Key Messages: In situations where autologous PRP is not available or suitable, allogeneic PRP appears to provide a safe alternative. Its efficacy, however, requires larger-scale studies with appropriate controls. Standardization in PRP preparation and treatment regime are also needed to be able to interpret allogenic PRP efficacy.

Background Chronic wounds have a major impact on patients’ health-related quality of life (HRQoL). Therefore, measuring HRQoL is an indispensable part of the treatment of patients with chronic wounds. The aim of this study was to translate and validate the Wound-QoL, a wound-specific HRQoL questionnaire, in a Dutch population. Methods The Wound-QoL was translated into Dutch according to the international standards. Patients with chronic wounds were asked to complete questionnaires at baseline (T0) and after six weeks (T1), including Wound-QoL, EQ-5D-3L (a generic questionnaire to measure HRQoL) and a visual analogue scale (VAS) measuring wound pain. If patients were not able to complete the questionnaire by themselves, it was read out to them by a nurse. Further data were obtained from medical records. Results Of the 120 patients included, 64 (53.3%) completed the questionnaire by themselves. To 55 patients (45.8%), the questionnaire was read out. The internal consistency of the Wound-QoL global score was high at both time points (T0: Cronbach’s α = 0.89, T1: Cronbach’s α = 0.92). The item selectivity for global score ranged from r = 0.25 to r = 0.77 at T0 and from r = 0.40 to r = 0.79 at T1. Overall, the self-completion and read-out subgroups showed similar internal consistency and item selectivity scores. With regard to convergent validity, significant correlations were found between Wound-QoL and EQ-5D-3L (T0: r = − 0.45, p p p = 0.012, T1: r = 0.37, p = 0.001) at both time points. Responsiveness analyses showed significant correlations between changes in Wound-QoL and changes in EQ-5D-3L (r = − 0.37, p p = 0.044) and wound size (r = 0.24, p = 0.013). The self-completion and read-out subgroups showed differences in convergent validity and responsiveness. Conclusions The results indicate that the Dutch version of the Wound-QoL has positive psychometric properties. However, more research is needed to further explore the differences between self-completed and read-out questionnaires.

Cold atmospheric plasma (CAP) was shown to decrease bacterial load in chronic wounds. It was also presented as a novel approach to healing wounds in both in vitro and in vivo experiments. We aimed to examine the first randomized clinical trial for the use of CAP in diabetic foot ulcers. Patients (n = 44) were randomly double-blinded, and assigned to receive standard care (SC, n = 22) without or with CAP, to be applied three times a week for three consecutive weeks (SC + CAP, n = 22), using block randomization with mixing block sizes of four. The trial was conducted at the Diabetes Research Center in Tehran, Iran. CAP was generated from ionized helium gas in ambient air, and driven by a high voltage (10 kV) and high frequency (6 kHz) power supply. Primary outcomes were wound size, number of cases reaching wound size of

Significance: We introduce and evaluate emerging devices and modalities for wound size imaging and also promising image processing tools for smart wound assessment and monitoring. Recent Advances: Some commercial devices are available for optical wound assessment but with limited possibilities compared to the power of multimodal imaging. With new low-cost devices and machine learning, wound assessment has become more robust and accurate. Wound size imaging not only provides area and volume but also the proportion of each tissue on the wound bed. Near-infrared and thermal spectral bands also enhance the classical visual assessment. Critical Issues: The ability to embed advanced imaging technology in portable devices such as smartphones and tablets with tissue analysis software tools will significantly improve wound care. As wound care and measurement are performed by nurses, the equipment needs to remain user-friendly, enable quick measurements, provide advanced monitoring, and be connected to the patient data management system. Future Directions: Combining several image modalities and machine learning, optical wound assessment will be smart enough to enable real wound monitoring, to provide clinicians with relevant indications to adapt the treatments and to improve healing rates and speed. Sharing the wound care histories of a number of patients on databases and through telemedicine practice could induce a better knowledge of the healing process and thus a better efficiency when the recorded clinical experience has been converted into knowledge through deep learning.

Objective: While myriads of studies have suggested that a survey of wound pH environment could indicate wound healing activities, it is not clear whether wound alkalinity can be used as a prognostic indicator of nonhealing wounds. Currently available systems cannot reliably assess the pH environment across wounds, which is the objective of this study. Approach: A disposable device, DETEC® pH, was developed and characterized on its ability to map wound alkalinity by pressing a freshly recovered wound dressing against its test surface. By comparing the wound's alkalinity and size reduction rates (∼7 days) following pH measurement, we assessed the capability of wound alkalinity to prognosticate subsequent short-term wound size reduction rates. Results: The device had high accuracy and specificity in determining the alkalinity of simulated wound fluids soaked onto wound dressing. The type of wound dressing type had an insignificant effect on its detection sensitivity. Upon testing discarded wound dressings from human patients, the device quickly determined alkaline and acidic wounds. Finally, statistical analyses of wound size reduction rates in wounds with various alkalinities confirmed that wound alkalinity has a strong influence on, at least, short-term wound healing activity. Innovation: Without directly contacting the patient, this device provides a quick assessment of wound alkalinity to prognosticate immediate and short-term wound healing activities. Conclusion: DETEC® pH may serve as a prognosis device for wound care specialists during routine wound assessment to predict wound healing progress. This information can assist the decision-making process in a clinical setting and augur well for chronic wound treatment. DETEC® pH can also be used as an aid for home health care nurses or health care providers to screen nonhealing wounds outside clinics.