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To realize the potential for the use of N-chlorotaurine (NCT) in healthcare, a better understanding of the long-term stability of the compound in water is needed. An array of analytical procedures is required that can measure changes in NCT concentration over time and allow for the detection and identification of contaminants and likely degradation end products. We used UV-Vis and NMR spectroscopy, HPLC, and LCMS to establish the stability of NCT in solutions subjected to prolonged ambient and elevated temperatures. Stability proved to be dependent on concentration with half-lives of ~120 days and ~236 days for 1% and 0.5% solutions of NCT at ~20 °C. Regardless of initial pH, all solutions shifted toward and maintained a pH of ~8.3 at 20 °C and 40 °C. NCT at 500 µg/mL and 250 µg /mL inhibited biofilm formation by Pseudomonas aeruginosa and Staphylococcus aureus but did not disperse established biofilms. NCT exposure to the biofilms had profound effects on the viability of both bacteria, reducing live organisms by >90%. Exposure of Interleukin-6 (IL-6) to 11 µM NCT reduced the binding of IL-6 to an immobilized specific antibody by ~48%, which is 5× the amount required for HOCl to bring about the same effect in this test system. Our data demonstrate the potency of the compound as an antimicrobial agent with potential benefits in the management of infected chronic wounds and suggest that NCT may contribute to anti-inflammatory processes in vivo by direct modification of cytokine mediators. [ABSTRACT FROM AUTHOR]

Background and aims: Bacteria in wounds can lead to stagnation of wound healing as well as to local or even systemic wound infections up to potentially lethal sepsis. Consequently, the bacterial load should be reduced as part of wound treatment. Therefore, the efficacy of simple mechanical wound debridement should be investigated in terms of reducing bacterial colonisation. Patients and methods: Patients with acute or chronic wounds were assessed for bacterial colonisation with a fluorescence camera before and after mechanical wound debridement with sterile cotton pads. If bacterial colonisation persisted, a second, targeted wound debridement was performed. Results: A total of 151 patients, 68 (45.0%) men and 83 (55.0%) women were included in this study. The male mean age was 71.0 years and the female 65.1 years. By establishing a new analysis method for the image files, we could document that the bacterial colonised areas were distributed 21.9% on the wound surfaces, 60.5% on the wound edges (up to 0.5 cm) and 17.6% on the wound surroundings (up to 1.5 cm). One mechanical debridement achieved a significant reduction of bacterial colonised areas by an average of 29.6% in the wounds, 18.9% in the wound edges and 11.8% in the wound surroundings and was increased by performing it a second time. Conclusions: It has been shown that even a simple mechanical debridement with cotton pads can significantly reduce bacterial colonisation without relevant side effects. In particular, the wound edges were the areas that were often most contaminated with bacteria and should be included in the debridement with special attention. Since bacteria remain in wounds after mechanical debridement, it cannot replace antimicrobial therapy strategies, but offer a complementary strategy to improve wound care. Thus, it could be shown that simple mechanical debridement is effective in reducing bacterial load and should be integrated into a therapeutic approach to wounds whenever appropriate. [ABSTRACT FROM AUTHOR]

From previous studies, we have shown that viable colony forming units of bacteria and bacterial biofilms are reduced after sequential treatment with a surfactant‐based dressing. Here, we sought to test the impact on visible bacterial pigments and the ultrastructural impact following the sequential treatment of the same surfactant‐based dressing. Mature Pseudomonas aeruginosa biofilms were grown on ex vivo porcine skin explants, and an imaging‐based analysis was used to compare the skin with and without a concentrated surfactant. In explants naturally tinted by bacterial chromophores, wiping alone had no effect, while the use of a surfactant‐based dressing reduced coloration. Similarly, daily wiping led to increased immunohistochemical staining for P. aeruginosa antigens, but not in the surfactant group. Confocal immunofluorescent imaging revealed limited bacterial penetration and coating of the dermis and loose pieces of sloughing material. Ultrastructural analysis confirmed that the biofilms were masking the extracellular matrix (ECM), but the surfactant could remove them, re‐exposing the ECM. The masking of the ECM may provide another non‐inflammatory explanation for delayed healing, as the ECM is no longer accessible for wound cell locomotion. The use of a poloxamer‐based surfactant appears to be an effective way to remove bacterial chromophores and the biofilm coating the ECM fibres. [ABSTRACT FROM AUTHOR]

Background: Xylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida. Case presentation: A 43-year-old woman with a past medical history of severe opioid use disorder and stimulant use disorder presented to a student-run clinic at a Miami SSP for wound care. She had multiple ulcerations diffusely over her bilateral forearms with surrounding erythema and warmth. Seven weeks later, she presented to clinic again for wound care because her wounds had progressed. At this visit, a XTS was used to confirm the presence of xylazine in her urine. Wound care management and harm reduction strategies employed at both visits were informed by best clinical judgement due to lack of formal guidelines at the time. Wound outcomes are unknown as the patient has not returned to clinic. Conclusions: Many PWUD at highest risk for acute and chronic health consequences of xylazine-adulterated fentanyl do not have access to healthcare outside of low barrier clinics and SSPs due to lack of insurance or mistrust of the traditional healthcare system due to stigma. There is an urgent need for access to XTS for PWUD and clinical practice guidelines for the treatment of xylazine-related wounds in outpatient clinics. [ABSTRACT FROM AUTHOR]

The availability of new products and strategies to manage wounds has taken a quantum leap in recent years. Healthcare professionals now have an extensive range of products to choose from, but while positive this also raises dilemmas in real-world clinical practice to decide on the most appropriate treatment for a given patient. Clinical trials confirm the effectiveness of the unique combination of hyaluronic acid and amino acids (Vulnamin®) in a range of wounds, but are these results replicated in real-world clinical practice? International experts presented their clinical experience with the use of the combination in difficult-to-treat wounds. The objective was to reach a consensus on how and when to use the unique combination products to provide a cost-effective, convenient option, in all healthcare settings that improves QoL for patients and their carers. [ABSTRACT FROM AUTHOR]

WOUND‐Q is a condition‐specific patient‐reported outcome measure developed for all types of chronic wounds, located anywhere on the body. To establish reliability and validity of a patient‐reported outcome measure, multiple pieces of evidence are required. The purpose of this study was to examine the measurement properties of 9 of the 13 WOUND‐Q scales and perform a test–retest reproducibility study in an international sample. In August 2022, we invited members of an international online community (Prolific.com) with any type of chronic wound to complete a survey containing the WOUND‐Q scales, the Wound‐QoL and EQ‐5D. A test–retest survey was performed 7 days after the first survey. It was possible to examine the reliability and validity of eight of the nine WOUND‐Q scales by Rasch Measurement Theory (RMT). To examine test–retest reproducibility intraclass correlation coefficients (ICCs), the standard error of the measurement and the smallest detectable change were calculated. In total, 421 patients from 22 different countries with 11 different types of chronic wounds took part in this study. Our analyses provided further evidence of the reliability and validity of the scales measuring wound characteristics (assessment, drainage, smell), health‐related quality of life (life impact, psychological, sleep, social) and wound treatment (dressing). [ABSTRACT FROM AUTHOR]

High bacterial loads within chronic wounds increase the risk of infection and complication. Detection and localization of bacterial loads through point‐of‐care fluorescence (FL) imaging can objectively inform and support bacterial treatment decisions. This single time‐point, retrospective analysis describes the treatment decisions made on 1000 chronic wounds (DFUs, VLUs, PIs, surgical wounds, burns, and others) at 211 wound‐care facilities across 36 US states. Clinical assessment findings and treatment plans derived from them, as well as subsequent FL‐imaging (MolecuLight®) findings and any associated treatment plan changes, were recorded for analysis. FL signals indicating elevated bacterial loads were observed in 701 wounds (70.8%), while only 293 (29.6%) showed signs/symptoms of infection. After FL‐imaging, treatment plans changed in 528 wounds as follows: more extensive debridement (18.7%), more extensive hygiene (17.2%), FL‐targeted debridement (17.2%), new topical therapies (10.1%), new systemic antibiotic prescriptions (9.0%), FL‐guided sampling for microbiological analysis (6.2%), and changes in dressing selection (3.2%). These real‐world findings of asymptomatic bacterial load/biofilm incidence, and of the frequent treatment plan changes post‐imaging, are in accordance with clinical trial findings using this technology. These data, from a range of wound types, facilities, and clinician skill sets, suggest that point‐of‐care FL‐imaging information improves bacterial infection management. [ABSTRACT FROM AUTHOR]

A new recombinant proteolytic enzyme, isolated from maggot saliva, with fibrinolytic action has been investigated through a series of non‐clinical toxicology and in‐vitro/in‐vivo pharmacology studies to explore its potential safety and efficacy as an enzymatic debridement agent for use in chronic wounds. Studies indicate that the enzyme has a good safety profile. When locally administered, it is not detrimental to wound healing, is non‐sensitising and is rapidly inactivated in the systemic circulation. Adverse effects are limited, at very high concentrations, to transient erythema at the site of application. In‐vitro testing indicates that the enzyme, whilst selective for fibrin, has additional proteolytic action against collagen and elastin, with enzymatic action for all three substrates being dose dependent. In‐vivo, we used an established MRSA biofilm model, in which microbiological counts were used as a surrogate for debridement efficacy. Here, we showed that higher concentrations of the enzyme in a formulated proprietary gel, significantly reduced MRSA counts over a period of 2 to 14 days, and significantly improved the vascularity of the wound at 14 days. Together, these data support the potential for this maggot‐derived proteolytic enzyme as a clinically effective debriding agent. [ABSTRACT FROM AUTHOR]

This study was designed to establish the composition of wound dressing based on poly(2‐hydroxyethylmethacrylate)‐chitosan (PHEM‐CS) hydrogels‐loaded cerium oxide nanoparticle (CeONPs) composites for cutaneous wound healing on nursing care of the chronic wound. The as‐synthesised PHEM‐CS/CeONPs hydrogels nanocomposites were characterised by using UV–visible spectroscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, and thermo gravimetric analysis. The influence of PHEM‐CS/CeONPs hydrogels nanocomposites on the gelation time, swelling ratio, in vitro degradation, and mechanical properties was investigated. The as‐prepared PHEM‐CS/CeONPs hydrogels nanocomposites dressing shows high antimicrobial activity against Staphylococcus aureus and Escherichia coli. Similar trends were observed for the treatment of biofilms where PHEM‐CS/CeONPs hydrogels nanocomposites displayed better efficiency. Furthermore, the biological properties of PHEM‐CS/CeONPs hydrogels nanocomposites had non‐toxic in cell viability and excellent cell adhesion behaviour. After 2 weeks, the wounds treated with the PHEM‐CS/CeONPs hydrogels nanocomposite wound dressing achieved a significant closure to 98.5 ± 4.95% compared with the PHEM‐CS hydrogels with nearly 71 ± 3.55% of wound closure. Hence, this study strongly supports the possibility of using this novel PHEM‐CS/CeONPs hydrogels nanocomposites wound dressing for efficient cutaneous wound healing on chronic wound infection and nursing care. [ABSTRACT FROM AUTHOR]

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pseudomonas aeruginosa can colonize the body when wounds disrupt the skin barrier, compromising immune status, and expressing virulence factors that aid its establishment in the host. Honey is highly medicinal and capable of promoting healing in infected wounds that defy conventional antibiotic therapy. This study assessed the antibacterial activities of honey against multi-drug resistant virulent P. aeruginosa isolates recovered from wounds. Sixty-one P. aeruginosa isolates were recovered, and their virulence factors were determined using phenotypic screening methods. Antibiotic susceptibility testing was evaluated with the Kirby-Bauer disc-diffusion method, while the antibacterial activities of honey were determined by agar-well and disc-diffusion techniques. The components of the honey samples were evaluated using Gas Chromatography-Mass Spectrometry (GC-MS). All isolates were multidrug-resistant (MDR) with 100% resistance to ticarcillin, tigecycline, and nitrofurantoin; the highest susceptibility to piperacillin, meropenem, and imipenem at 4.9%, 6.6%, and 9.8% respectively; and Multiple Antibiotic Resistance Indices (MARI) of = 0.2. All isolates produced hemolysin, but none produced DNase. All the sixty-one isolates extruded multiple virulence factors via phenotypic screening and 96.7% possessed = 50% of virulence determinants analyzed. GC-MS analyses revealed three variants of honey. The isolates exhibited resistance to the honey samples; the most effective honey sample types being H5 and H6. Possession of multiple virulence factors, multi-resistance to antibiotics, and to honey, which is well acclaimed for its wound healing characteristics by isolates raises the probability of invasion to deeper tissues and development of complications, underscoring the necessity to prevent contamination of wounds, a significant cause of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Management of locally infected heel-pressure ulcers (HPUs) remains challenging, and given the increasing occurrence of infections resistant to antibiotic therapy and patients' unwillingness to surgery, innovative and effective approaches must be considered. Medical-grade honey (MGH) could be an alternative therapeutic approach due to its broad-spectrum antimicrobial activity and healing properties. This study aimed to present the high effectiveness and safety of MGH for the conservative treatment of clinically infected HPUs. In this case series, we have prospectively studied nine patients with local signs of infected HPUs. In all cases, HPUs persisted for more than 4 weeks, and previous treatments with topical antibiotics or antiseptic products were ineffective. All patients were at high-risk to develop HPU infection due to their advanced age (median age of 86 years), several comorbidities, and permanent immobility. All wounds were treated with MGH products (L-Mesitran), leading to infection resolution within 3–4 weeks and complete wound healing without complication. Considering the failure of previous treatments and the chronic nature of the wounds, MGH was an effective treatment. MGH-based products are clinically and cost-effective for treating hard-to-heal pressure ulcers such as HPUs. Thus, MGH can be recommended as an alternative or complementary therapy in wound healing. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute and chronic wounds caused by assorted reasons impact patient's quality of life. Films are one of the main types of moisture retentive dressings for wounds. To improve the healing of the wound, films must ensure there is no microorganism contamination, protect from negative environmental effects, and support optimal moisture content. The aim of this study was to formulate optimal film-forming gel compositions that would have good physico-chemical properties and be suitable for wound treatment. Nitrocellulose, castor oil, ethanol (96%), ethyl acetate, and cinnamon leaf essential oil were used to create formulations. During the study, the drying rate, adhesion, flexibility, tensile strength, cohesiveness, swelling, water vapor penetration, pH value, and morphology properties of films were examined. Results showed that optimal concentrations of nitrocellulose for film-forming gel production were 13.4% and 15%. The concentrations of nitrocellulose and cinnamon leaf essential oil impacted the films' physicochemical properties (drying rate, swelling, adhesion, flexibility, etc.). The swelling test showed that films of formulations could absorb significant amounts of simulant wound exudate. Film-forming gels and films showed no microbial contamination and were stable three months after production. [ABSTRACT FROM AUTHOR]

The skin serves as the body's first line of defense, guarding against mechanical, chemical, and thermal damage to the interior organs. It includes a highly developed immune response that serves as a barrier against pathogenic infections. Wound healing is a dynamic process underpinned by numerous cellular activities, including homeostasis, inflammation, proliferation, and remodeling, that require proper harmonious integration to effectively repair the damaged tissue. Following cutaneous damage, microorganisms can quickly enter the tissues beneath the skin, which can result in chronic wounds and fatal infections. Natural phytomedicines that possess considerable pharmacological properties have been widely and effectively employed forwound treatment and infection prevention. Since ancient times, phytotherapy has been able to efficiently treat cutaneous wounds, reduce the onset of infections, and minimize the usage of antibiotics that cause critical antibiotic resistance. There are a remarkable number of wound-healing botanicals that have been widely used in the Northern Hemisphere, including Achiella millefolium, Aloe vera, Althaea officinalis, Calendula officinalis, Matricaria chamomilla, Curcuma longa, Eucalyptus, Jojoba, plantain, pine, green tea, pomegranate, and Inula. This review addresses the most often used medicinal plants from the Northern Hemisphere that facilitate the treatment of wounds, and also suggests viable natural alternatives that can be used in the field of wound care. [ABSTRACT FROM AUTHOR]

Copper has intrinsic antimicrobial properties. Wound dressings impregnated with cuprous oxide microparticles (hereafter termed COD) have been cleared for the management of acute and chronic wounds by the FDA and other regulatory bodies. The COD reduced the viable microbial titers of a wide spectrum of microbes by more than 10,000-fold (4-logs) within 3 h of exposure at 37 °C (p < 0.001). Similar microbial titer reductions were achieved by 3-year naturally aged COD dressings, showing the stability of the biocidal efficacy over time. The potent biocidal efficacy of the COD was maintained even after 7 daily consecutive inoculations of the dressings with ~106 CFU. COD with an adhesive contour blocked the passage of bacteria from the exterior environment to the wound bed side of the dressing even after 7 daily consecutive inoculations of different bacteria on the outer surface of the dressings. Taken together, the study demonstrates the wide spectrum potent in vitro biocidal efficacy of the cuprous oxide impregnated dressings against a wide panel of microorganisms. [ABSTRACT FROM AUTHOR]

Introduction. Marjolin's ulcer is a skin malignancy that occurs on a scar or chronic wound. It most commonly occurs on a burn scar. Squamous cell carcinoma is the most common type of this tumor in more than 90% of cases. The rate of this rare malignant transformation is 1-2%. Marjolin's ulcer is more aggressive than other skin cancers. Wide excision is the treatment of choice. Recurrences are common. We present a large exophytic carcinoma of the lower leg as a rare form of this tumor according to the size and type together with reconstruction results. Case report. A 52-year-old man was presented with a large exophytic tumor on the left lower leg. The tumor was located at the site of the previous gunshot injury. The latent period w as 2 2 y ears. T umor s ize w as 14 × 12 cm. Wide excision was performed (2-cm surgical margin), including the deep fascia, and the defect was closed by a split-thickness skin graft from the opposite thigh. Histology showed well-differentiated squamous cell carcinoma. There were no regional or distant metastases. One year after surgery, there was no recurrence of the tumor. Conclusion. Early diagnosis of Marjolin's ulcer and wide excision are mandatory. Surgical margins for excision should be 2 cm, and excision should include deep fascia. Multiple and repeated biopsies of chronic wounds are advised. There is no consensus on the staging of Marjolin's ulcer and lymph node dissection. [ABSTRACT FROM AUTHOR]

The National Wound Care Strategy Programme (NWCSP) seeks for improvement in the care of patients with wounds (The National Wound Care Strategy Programme -- Lower Limb Recommendations, 2020). The recommendations offer a clear framework for the development for local delivery in clinical care settings. The Skin Integrity Team at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (DBTH) developed clinical pathways through collaboratively system leadership with the Doncaster Place Wound Care Alliance, ensuring secondary care was included and potential and historical barriers overcome, to implement the NWCSP recommendations. Here we describe the process of the translating national recommendations into clinical pathway and the issues that led to the development of a secondary care focused version. [ABSTRACT FROM AUTHOR]

Diabetic foot ulceration is a common complication of an uncontrolled diabetic regimen and is considered a serious type of wound. Matrix metalloprteinases (MMPs) are the common key enzymes in wound management, overexpression of MMPs can lead to chronic wounds and ulcers. Calendula officinalis extract has established its efficacy in treating wounds in folk medicine. In this research work, we will focus on the chemical constituents of this promising herb and will investigate its abilities to target matrix metalloprteinase-8 (MMP-8) and matrix metalloprteinase-9 (MMP-9) proteins through the usage of computer-aided drug design tools. In the current study, several promising dual inhibitors are identified, such as quercetin, isoquercetin, isorhamnetin, and isorhamnetin 3-O glycoside, they showed to be good inhibitors for both enzyme subtypes with greater docking score energies than RND-336, which has been reported as a selective MMP-9 inhibitor. Binding scores and amino acid interactions in addition to molecular dynamics (MD) will be discussed in detail through this research work. [ABSTRACT FROM AUTHOR]

Objective: Verify the occurrence of depressive symptoms in the elderly with chronic wounds. Methodology: A descriptive, cross-sectional, quantitative study conducted with 40 elderly people at a University Hospital, using the Geriatric Depression Scale and a structured questionnaire with sociodemographic, clinical variables, lesion characteristics and a brief history of mental health. Results: There was a predominance of females (72.5%), brown (50.0%), Catholic (65.0%), married (50.0%), with incomplete primary education (55.0%), retired (92.5%), income between 1 and 2 minimum wages (62.5%), metabolic diseases (55.0%) and cardiac diseases (25.0%). The wounds were 55.0% venous ulcers, of which 85.0% are in the lower limb. Regarding the Scala scores, 40.0% presented symptoms suggestive of Depression. The elderly with venous wounds and located in the lower limb presented higher score of the depression median. Conclusion: Venous ulcers of the leg was a risk factor for the occurrence of Depression, which occurred in half of the elderly surveyed. [ABSTRACT FROM AUTHOR]

Featured Application: The objective of the work is to assess the use of non-thermal multi plasma jets for the treatment of infected and chronic wounds in the context of hospital centers. This work is a contribution to the development and implementation of non-thermal plasma technology for decontamination in the perspective of nosocomial and chronic wound innovative therapies. Multi jets devices based on Plasma Gun® technology in static and scanning operation modes and bacterial lawns inoculated with resistant and non-resistant bacterial strains were designed and used. A pilot toxicity study exploring plasma treatment of wound bearing patients, performed with a low voltage plasma applicator, is documented as a first step for the translation of in vitro experiments to clinical care. Bacterial inactivation was demonstrated for Staphylococcus aureus, Pseudomonas aeruginosa and drug resistant S. aureus, P. aeruginosa and Escherichia Coli strains collected from patient wounds at Orleans (France) hospital. A few square centimeter large contaminated samples were inactivated following a single plasma exposure as short as one minute. Samples inoculated with a single but also a mix of three resistant pathogens were successfully inactivated not only right after their contamination but for mature lawns as well. Similar bactericidal action was demonstrated for antibiotic-resistant and non-resistant P. aeruginosa. The time exposure dependent increase of the inhibition spots, following multi jets exposure, is discussed as either the accumulation of reactive species or the likely combinatory action of both the reactive species and transient electric field delivery on inoculated samples. [ABSTRACT FROM AUTHOR]

Recent studies showed that the COVID‐19 pandemic caused collateral damage in health care in terms of reduced hospital submissions or postponed treatment of other acute or chronic ill patients. An anonymous survey was sent out by mail to patients with chronic wounds in order to evaluate the impact of the pandemic on wound care. Sixty‐three patients returned the survey. In 14%, diagnostic workup or hospitalisation was cancelled or postponed. Thirty‐six percent could not seek consultation by their primary care physician as usual. The use of public transport or long travel time was not related to limited access to medical service (P =.583). In ambulatory care, there was neither a significant difference in the frequency of changing wound dressings (P =.67), nor in the person, who performed wound care (P =.39). There were no significant changes in wound‐specific quality of life (P =.505). No patient used telemedicine in order to avoid face‐to‐face contact or anticipate to pandemic‐related restrictions. The COVID‐19 pandemic impaired access to clinical management of chronic wounds in Germany. It had no significant impact on ambulatory care or wound‐related quality of life. Telemedicine still plays a negligible role in wound care. [ABSTRACT FROM AUTHOR]

Patient‐reported outcome measures (PROMs) for chronic wounds mainly focus on specific types of wounds. Our team developed the WOUND‐Q for use with all types of wounds in any anatomic location. We conducted 60 concept elicitation interviews with patients in Canada, Denmark, the Netherlands, and the United States. Analysis identified concepts of interest to patients and scales were formed and refined through cognitive interviews with 20 patients and input from 26 wound care experts. Scales were translated into Danish and Dutch. An international field‐test study collected data from 881 patients (1020 assessments) with chronic wounds. Rasch measurement theory (RMT) analysis was used to refine the scales and examine psychometric properties. RMT analysis supported the reliability and validity of 13 WOUND‐Q scales that measure wound characteristics (assessment, discharge, and smell), health‐related quality of life (life impact, psychological, sleep impact, and social), experience of care (information, home care nurses, medical team, and office staff), and wound treatment (dressing and suction device). The WOUND‐Q can be used to measure outcomes in research and clinical practice from the perspective of patients with any type of wound. [ABSTRACT FROM AUTHOR]

Negative pressure wound therapy (NPWT) promotes healing by evenly applying negative pressure on the surface of the wound. The system consists of a sponge, a semiocclusive barrier, and a fluid collection system. Its effectiveness is explained by four main mechanisms of action, including macrodeformation of the tissues, drainage of extracellular inflammatory fluids, stabilization of the environment of the wound, and microdeformation. Rarely will complications linked to NPWT occur, but special care must be taken to prevent events such as toxic shock syndrome, fistulization, bleeding, and pain. New NPWT modalities have been recently developed to make NPWT suitable for a wider variety of wounds. These include NPWT with instillation therapy (NPWTi-d), different cleansing options, and application of NPWT on primarily closed incisions. Finally, vacuum-assisted wound closure therapy has been demonstrated to be efficient for various clinical settings, such as the management of diabetic foot ulcers, pressure ulcerations, chronic wounds, and skin grafts. [ABSTRACT FROM AUTHOR]

Background and Aim: Horse wounds can be easily infected with bacteria depending on the nature of its cause such as laceration, abrasion, or puncture as well as the nature of its environment. Various treatments are available in managing open wounds, including the usage of topical antibiotics and antiseptics. However, antibiotic resistance has been a major concern attributed with chronic wound infection. The aim of this study was to test the efficacy of ionized water at different pH against the growth of common bacteria from horse wounds. Materials and Methods: Ten swab samples from equine infected wounds were collected and bacteria isolation and identification were performed. The antibacterial effect of the ionized water of pH 2.5, 4.5, 7.0, and 11.5 was tested on Staphylococcus aureus, Staphylococcus pseudintermedius, Staphylococcus intermedius, Escherichia coli, Pantoea agglomerans, and Klebsiella pneumoniae. The time-kill profiles of the ionized waters were determined at time 0, 2, 4, 6, and 8 h. Results: Ionized water of pH 2.5 and 4.5 showed antibacterial activity against S. aureus, S. pseudintermedius, and S. intermedius with significant (p>0.05) reduction in colony-forming unit/mL within 2-8 h. The degree of bactericidal effect of the acidic ionized water differs between the species with S. intermedius more susceptible. However, there was no antibacterial effect at pH 2.5, 4.5, 7.0, and 11.5 on the Gram-negative bacteria tested. Conclusion: Ionized water of pH 2.5 and 4.5 is effective in minimizing the growth of Gram-positive bacteria; thus it could be of clinical importance as an antiseptic for surface wound lavage in horses. [ABSTRACT FROM AUTHOR]

Smart wound dressings aim to enable early diagnosis and treatment of wound infections to accelerate wound healing. This paper summarizes the latest research progress of smart wound dressings, including smart dressings for monitoring different parameters of wounds, smart dressings that can realize wound management, and advanced smart wound dressings that integrate monitoring and treatment into one, and systematically discusses and analyzes them. [Display omitted] • A comprehensive review of the latest developments in intelligent wound dressings. • Explored various wound dressing design concepts and developed applications. • Discussed the future prospects and challenges of intelligent wound dressings. Wound management has long been a significant concern within the healthcare industry. However, conventional passive wound dressings often fail to meet the requirements for effective wound management. As a result, there is a growing emergence of intelligent wound dressings that aim to address this issue. These smart wound dressings incorporate one or more electrochemical or optical sensors, enabling real-time monitoring of wound conditions. Furthermore, they also integrate various stimulation techniques, including photostimulation, electrostimulation, and pharmacological stimulation, in order to facilitate accelerated wound healing. This integration of sensing and stimulation capabilities holds immense potential for personalized wound care. This paper offers a comprehensive review of recent advancements in the field of wearable, novel dressings designed for the purpose of chronic wound monitoring and management. It examines various design concepts and applications that have been developed. Additionally, the paper discusses the future prospects and challenges associated with wearable bioelectronics in wound care, as well as their potential for clinical utilization. Furthermore, it explores the areas in which further development and research are needed, with a focus on establishing the priorities for the next generation of wound dressings. [ABSTRACT FROM AUTHOR]

Due to the changes in delivering medical care during the Coronavirus disease 2019 (COVID‐19) pandemic, such as the heavy reliance on telehealth, it is worth exploring if this is suitable when treating complex wounds. A literature rapid review was performed to explore the existing evidence around alternative service delivery modalities. While there are organisations that have successful telehealth systems and infrastructure, for services that do not already widely use telehealth it is difficult to implement a standardised system in the current state of emergency. The evidence reviewed demonstrates that telehealth appears to currently have a limited place in chronic wound management; therefore, standardisation on determining suitability in conjunction with evaluation of telehealth during this period is needed to shape implementation of telehealth systems in the future. [ABSTRACT FROM AUTHOR]

We report on an innovative, fabric-based conformable, and easily fabricated electroceutical wound dressing that inhibits bacterial biofilm infections and shows significant promise for healing chronic wounds. Cyclic voltammetry demonstrates the ability of the electroceutical to produce reactive oxygen species, primarily HOCl that is responsible for bacterial inhibition. In vitro investigation with the lawn biofilm grown on a soft tissue mimic assay shows the efficacy of the dressing against both Gram-positive and Gram-negative bacteria in the biofilm form. In vivo, the printed electroceutical dressing was utilized as an intervention treatment for a canine subject with a non-healing wound due to a year-long persistent polymicrobial infection. The clinical case study with the canine subject exhibited the applicability in a clinical setting with the results showing infection inhibition within 11 days of initial treatment. This printed electroceutical dressing was integrated with a Bluetooth® enabled circuit allowing remote monitoring of the current flow within the wound bed. The potential to monitor wounds remotely in real-time with a Bluetooth® enabled circuit proposes a new physical biomarker for management of infected, chronic wounds. [2020-0129] [ABSTRACT FROM AUTHOR]

Malnutrition is a negative confounding factor influencing wound healing. The prevalence of malnutrition increases with age, as do chronic wounds. The aim of this prospective study was to analyse the nutritional status of patients with chronic wounds. Data collection of sociodemographic and nutritional parameters was based on an inter‐professionally developed questionnaire as well as the Mini Nutritional Assessment (MNA). A total of 90 patients with chronic wounds of different aetiologies were included. Pain and dental health were found to be significant factors: Patients with malnutrition or the risk of malnutrition had significantly lower tooth and oral health scores (rs = −0.218, P =.039), and higher pain levels at rest (rs = 0.339, P <.001), while dressing (rs = 0.268, P =.014), and upon exercising (rs = 0.303, P =.005). Our data address the impact of nutrition on chronic wounds and confirm the relationship between pain, dental health, and nutritional status. Clinicians should be aware of adequate pain management and dental health care in chronic wound patients. Further studies, particularly on characterisation of preventive and therapeutic measures in the nutrition of chronic wound patients, are of great importance. [ABSTRACT FROM AUTHOR]

Chronic wounds impact on a person's quality of life and wound pain adds to that distress. It can be acute pain during wound care or background pain as a result of the chronic problem. Pain can be nociceptive and/or neuropathic. There are currently no validated tools for assessing pain in a person with a chronic wound. In this second article, what is required in the assessment of pain, in individuals with chronic wounds is presented. It also considers some of the tools recommended by the British Pain Society and Faculty of Pain Medicine's in their outcome measure (2019) recommendations, for assessing the biopsychosocial aspects of pain and some of the tools that are recommended for adults with cognitive impairment. [ABSTRACT FROM AUTHOR]

Epidermolysis Bullosa (EB) is a group of rare genetic skin fragility disorders. This article focuses mainly on patients affected by the most severe subtype, recessive dystrophic EB. Wound management can be challenging and frequently needs to be adapted due to non- cutaneous and other factors which impact wound healing in this cohort of patients. [ABSTRACT FROM AUTHOR]

Traditional quality measures for chronic wounds have focused on objective outcomes that are challenging to risk adjust, lack patient input, and have limited ability to inform quality improvement interventions. Patient‐reported experience measures (PREMs) provide information from the patient perspective regarding health care quality and have potential to improve patient‐centredness, increase care efficiency, and generate actionable data for quality improvement. The purpose of this study was to understand patient experiences and health care processes that impact quality of care among patients with chronic wounds. Sixty patients at least 18 years of age with various wound aetiologies were recruited from Canada, Denmark, The Netherlands, and the United States as part of a larger phase 1 qualitative study to develop a patient‐reported outcome measure for chronic wounds (WOUND‐Q). All patients had a chronic wound for at least 3 months, were fluent in their native speaking language, and able to participate in a one‐on‐one semi‐structured interview. Interviews were digitally recorded and transcribed verbatim. Interpretive description was used to identify recurrent themes relating to patient experience and quality of care. We identified five domains (care coordination, establishing/obtaining care, information delivery, patient‐provider interaction, and treatment delivery) and 21 sub‐domains (access to patient information, interdisciplinary communication, encounter efficiency, provider availability, specialist referral, staff professionalism, travel/convenience, modality, reciprocity, understandability/consistency, accountability, continuity, credentials, rapport, appropriateness, complication management, continuity, environment/setting, equipment and supply needs, expectation, and patient‐centred) as potential opportunities to measure and improve quality of care in the chronic wound population. PREMs for chronic wounds represent an important opportunity to engage patients and longitudinally assess quality across clinical settings and providers. Future research should focus on developing PREMs to complement traditional objective and patient‐reported outcome measures for chronic wounds. [ABSTRACT FROM AUTHOR]

Background Surgical reconstruction of chronic wounds is often infeasible due to infection, comorbidities, or poor viability of local tissues. The aim of this study was to describe the authors' technique for improving the regenerative and antimicrobial potential of a combination of modified nanofat and platelet-rich plasma (PRP) in nonhealing infected wounds. Methods Fourteen patients met the inclusion criteria. Fat tissue was harvested from the lower abdomen following infiltration of a solution of 1,000 mL of NaCl solution, 225 mg of ropivacaine, and 1 mg of epinephrine. Aspiration was performed using a 3-mm cannula with 1-mm holes. The obtained solution was decanted and mechanically emulsified, but was not filtered. Non-activated leukocyte-rich PRP (naLR-PRP) was added to the solution before injection. Patients underwent three sessions of injection of 8-mL naLR-PRP performed at 2-week intervals. Results Thirteen of 14 patients completed the follow-up. Complete healing was achieved in seven patients (53.8%). Four patients (30.8%) showed improvement, with a mean ulcer width reduction of 57.5%±13.8%. Clinical improvements in perilesional skin quality were reported in all patients, with reduced erythema, increased thickness, and increased pliability. An overall wound depth reduction of 76.6%±40.8% was found. Pain was fully alleviated in all patients who underwent re-epithelization. A mean pain reduction of 42%±33.3% (as indicated by visual analog scale score) was found in non-re-epithelized patients at a 3-month follow-up. Conclusions The discussed technique facilitated improvement of both the regenerative and the antimicrobial potential of fat grafting. It proved effective in surgically-untreatable infected chronic wounds unresponsive to conventional therapies. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of chronic wounds constitutes a massive financial burden to society and our health-care system. Therefore, efficient wound care is of great importance to all kinds of medical fields. The implementation and modification of negative-pressure wound therapy can be seen as a major improvement in wound healing. Many different NPWT applications evolved trying to address various wound etiologies. Areas covered: This review aims to give an overview of various NPWT applications, show its effects on wound healing, and discuss future modifications. Expert opinion: NPWT as a delivery device for cold plasma, growth factors, or targeted stem cells to the wound bed and the ability to monitor the inflammatory activity, bacterial load and wound healing factors can be seen as possible future steps to individualized wound care. In addition, it requires high-quality experimental studies to develop the ideal foam in terms of microstructure, pore size, and material properties. [ABSTRACT FROM AUTHOR]

Chronic wounds are a major complication for diabetes mellitus (DM) patients, which cause discomfort and an increase in medical costs. The purpose of this study is to investigate the medical application and possible mechanisms of a cold atmospheric plasma jet in healing DM chronic wounds. In this paper, the genetic diabetic BKS.DB mice are used as the diabetic wound healing animal model, which have a stable glucose level and can avoid the effects or complications induced by surgical and chemical interventions. The helium atmospheric-pressure dielectric-barrier-discharge (AP-DBD) plasma jet is employed to treat the diabetic mice wounds with the fixed treatment time and distance of 15 s and 20.0 mm, respectively. The wound healing, histological, immunohistochemical, and cytokine analyses are conducted to evaluate the efficacy of the helium AP-DBD plasma jet on the chronic wound healing of the genetic diabetic mice. The experimental results show that the helium AP-DBD plasma jet treatment of wounds of genetic diabetic mice can regulate the secretion of transforming growth factor- $\beta $ (TGF- $\beta$) and fibroblast growth factors (FGFs), limit the inflammatory response and excessive cell proliferation, accelerate the process of re-epithelialization, and consequently, promote the chronic wound healing process. [ABSTRACT FROM AUTHOR]

Biofilms are prevalent in non‐healing chronic wounds and implicated in delayed healing. Tolerance to antimicrobial treatments and the host's immune system leave clinicians with limited interventions against biofilm populations. It is therefore essential that effective treatments be rigorously tested and demonstrate an impact on biofilm across multiple experimental models to guide clinical investigations and protocols. Cadexomer iodine has previously been shown to be effective against biofilm in various in vitro models, against methicillin‐resistant Staphylococcus aureus biofilm in mouse wounds, and clinically in diabetic foot ulcers complicated by biofilm. Similarities between porcine and human skin make the pig a favoured model for cutaneous wound studies. Two antiseptic dressings and a gauze control were assessed against mature biofilm grown on ex vivo pig skin and in a pig wound model. Significant reductions in biofilm were observed following treatment with cadexomer iodine across both biofilm models. In contrast, silver carboxymethylcellulose dressings had minimal impact on biofilm in the models, with similar results to the control in the ex vivo model. Microscopy and histopathology indicate that the depth of organisms in wound tissue may impact treatment effectiveness. Further work on the promising biofilm efficacy of cadexomer iodine is needed to determine optimal treatment durations against biofilm. [ABSTRACT FROM AUTHOR]

This paper details the systematic approach used to develop a viable clinical prototype of a therapeutic ultrasound applicator and discusses the rationale and deliberations that led to the design strategy. The applicator was specifically devised to treat chronic wounds and—to the best of the author’s knowledge—is the first truly wearable device with a proven record of reducing healing time, directly translating to a reduction of healthcare costs. The prototype operates in the kHz (20–100) range of frequencies and uses noncavitational and nonthermal levels of ultrasound energy. Hence, in the absence of inertial cavitation and temperature elevation, the tissue-ultrasound interaction is considered to be dependent on stable cavitation (if any) and radiation force. The peak acoustic output pressure amplitude is limited to 55 kPa, corresponding to a spatial peak–temporal peak intensity of 100 mW/cm2. This level of intensity is considered to be safe to apply for extended (up to 4 h) periods of time. The patch-like applicator design is suitable to be embedded in wound dressing. With its lightweight (<20 g) and circular (40 mm dia) disk-shape architecture, the applicator is well suited for chronic wound treatment. A small ($n = 8$) pilot study on the effects of the applicator on diabetic ulcers (DUs) healing time is presented. The average time to wound closure was 4.7 weeks for subjects treated with the active ultrasound applicator, compared to 12 weeks for subjects treated with a sham applicator, suggesting that patients with DUs may benefit from the proposed treatment. [ABSTRACT FROM AUTHOR]

Chronic non‐healing wounds are a burden in the Long‐Term Care (LTC) sector, increasing costs, morbidity, and mortality and causing pain and suffering. The objective of this LTC Innovation pilot was to test the value of a promising new neuromuscular stimulation device in elevating the experience and satisfaction of the residents, engaging and empowering the nursing staff, and improving healing and/or reducing costs. Small, wireless, and worn at the knee, this muscle pump activator is self‐contained, wearable, and battery‐powered to increase lower‐leg blood circulation (up to 60% of that achieved by walking). It has no wires, weighs just 10 g, and is easy to use. Nurses in four LTC homes identified residents with non‐healing lower leg wounds. Consent was obtained, and on‐site training was delivered. Eleven residents were recruited. Only seven met the inclusion criteria for venous/mixed or diabetic foot ulcers. Of the seven who met the criteria and were adherent with best practices and the muscle pump activator, four healed 100%, and one healed 90%. Two patients with other aetiologies, who were also adherent, healed. All adherent residents had an average weekly decrease in wound size of 9.75% and were extremely happy with the results. Three residents who were non‐adherent had a 9.25% increase in wound size per week. One patient with diabetic foot ulcers developed skin changes at the end of life and passed away. Nursing staff and cognisant residents can easily adjust the pulse of muscle pump activator, and application and removal are simple. Most residents feel engaged with the therapy "because they feel it working". The LTC corporation feels that it is a great adjunctive solution for many types of lower‐leg wounds (venous, mixed, diabetic, pressure) in addition to best practices in the LTC and Retirement home sectors. [ABSTRACT FROM AUTHOR]

Infected tissues in the feet of people with diabetes in the form of a diabetic foot ulcer (DFU) present a complex pathology for clinicians to manage. This is partly attributed to the multi‐factorial nature of the disease, which may include; altered foot architecture leading to excessive plantar pressures and frictional forces peripheral arterial disease and loss of protective sensation. In addition, to the above co‐morbid variables, it is understood that a delayed wound healing state may be perpetuated by the presence of microorganisms residing in the wound tissue. The microbiology of chronic DFUs has often been reported as being polymicrobial. Of growing interest is the presence and potential role of anaerobic microorganisms in the pathology of DFUs and how they may contribute to the infective process or delayed healing. The presence of anaerobes in DFUs has been greatly underestimated, largely due to the limitations of conventional culture methods in identifying them from samples. Advancements in molecular and microscopy techniques have extended our view of the wound microbiome in addition to observing the growth and behaviour (planktonic or biofilm) of microorganisms in situ. This review paper will reflect on the evidence for the role and significance of anaerobes in DFUs and infection. A focus of this review will be to explore recent advancements in molecular genomics and microscopy techniques in order to better assess the roles of anaerobic bacteria in chronic DFUs and in biofilm‐based wound care. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and compare the effects of extracorporeal shock wave therapy (ESWT) and conventional wound therapy (CWT) for acute and chronic soft tissue wounds. All English‐language articles on ESWT for acute and chronic soft tissue wounds indexed in PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, Physiotherapy Evidence Database, and HealthSTAR published prior to June 2017 were included, as well as corresponding articles cited in reference lists of related review articles. The methodological quality of the selected studies was assessed with the Cochrane Collaboration's “risk of bias” tool. Study design, subject demographics, wound aetiology, treatment protocols, assessment indexes, and follow‐up duration were extracted. The fixed or random‐effects model was used to calculate the pooled effect sizes according to studies’ heterogeneity. Ten randomised controlled trials (RCTs) involving 473 patients were included in this systematic review and meta‐analysis. The meta‐analysis showed that ESWT statistically significantly increased the healing rate of acute and chronic soft tissue wounds 2.73‐fold (odds ratio, OR = 3.73, 95% confidence interval, CI: 2.30‐6.04, P < .001) and improved wound‐healing area percentage by 30.45% (Standardized Mean Difference (SMD) = 30.45; 95% CI: 23.79‐37.12; P < .001). ESWT reduced wound‐healing time by 3 days (SMD = −2.86, 95% CI:‐3.78 to −1.95, P < .001) for acute soft tissue wounds and 19 days (SMD = −19.11, 95% CI: −23.74 to −14.47, P < .001) for chronic soft tissue wounds and the risk of wound infection by 53% (OR = 0.47, 95% CI: 0.24‐0.92, P = .03) when compared with CWT alone. Serious adverse effects were not reported. ESWT showed better therapeutic effects on acute and chronic soft tissue wounds compared with CWT alone. However, higher‐quality and well‐controlled RCTs are needed to further assess the role of ESWT for acute and chronic soft tissue wounds. [ABSTRACT FROM AUTHOR]

Although rare in the UK, there are certain types of infective organisms that can cause chronic wounds. In these circumstances, conventional wound care is rarely successful and the causative organism needs to be targeted with specific therapy. Often, these organisms are contracted abroad and may be seen in returning travellers or immigrants. In addition, patients who are immunosuppressed are at risk of opportunistic infections. Thorough patient assessment is key to establish a diagnosis, but a high index of suspicion may also be needed. This article describes three cases in which unusual infective organisms were the principal cause of chronic wounds. [ABSTRACT FROM AUTHOR]

The study directly compared the feasibility and performance of three instruments measuring health-related quality of life ( HRQoL) in chronic ulcers: the Freiburg Life Quality Assessment for wounds ( FLQA-w), the Cardiff Wound Impact Schedule ( CWIS) and the Würzburg Wound Score ( WWS). The questionnaires were evaluated in a randomly assigned order in a longitudinal observational study of leg ulcer patients. Psychometric properties (internal consistency, responsiveness and construct validity) were analysed. Patient acceptance was recorded. Analysis of n = 154 patients revealed good internal consistency (Cronbach's alpha ≥ 0·85) for all instruments. There were minor floor effects in all questionnaires (<1%) and some ceiling effects in the CWIS. Construct validity was satisfactory, for example, correlation with EuroQoL-5D was r = 0·70 in the FLQA-w, r = 0·47/0·67/0·68 in the CWIS dimensions and r = 0·60 in the WWS. The proportion of missing values was higher in the CWIS, and overall patient acceptance was highest in the FLQA-w for wounds (54% best preferences) and lowest in the WWS (14%). In conclusion, the FLQA-w, the CWIS and the WWS are reliable, sensitive and valid instruments for the assessment of HRQoL in leg ulcers. However, they show differences in clinical feasibility and patient acceptance. [ABSTRACT FROM AUTHOR]

The annual cost to the NHS for managing the 2.2 million wounds and their associated comorbidities is estimated to be between £4.5 billion and £5.1 billion. Improving the quality of wound care should reduce healthcare spending and improve patients' quality of life. The new NHS England wound care management project, which is part of the Leading Change, Adding Value nursing and midwifery framework, seeks to reduce unwarranted variation in the assessment and treatment of wounds across the patient pathway by developing a number of wound-focussed initiatives. This article introduces the project and outlines the development of an evidence-based wound assessment minimum data set that will be monitored by a wound assessment Commissioning for Quality and Innovation (CQUIN) indicator. This initiative demonstrates the need for good quality economic data to identify clinical issues of concern that can then be addressed by appropriate policy initiatives to improve patient care and make the best possible use of NHS resources. [ABSTRACT FROM AUTHOR]

The cost of leg ulcers in the UK was estimated to be £1.94 billion (Guest et al, 2016). Leg ulcers are a common ailment that have a negative impact on patients' quality of life, often resulting in lengthy healthcare professional consultations, out-patient appointments and hospital admissions. An evaluation was undertaken to establish the clinical outcomes and experiences for patients and healthcare professionals of using an electroceutical treatment in the community setting. The treatment had a significant effect on the patient group with all patients experiencing either complete healing and/or reduction in wound size, pain and exudate as well as decreased nursing visits. This in turn had a positive effect on patients' quality of life and demonstrated a cost improvement for the Trust. [ABSTRACT FROM AUTHOR]

Exudate management in chronic wounds and hard-to-heal wounds is a vital process and community nurses need to be aware of the best practice evidence as well as correct product choice. This is particularly important when attempting to provide the optimum moist healing environment and achieve a balance of moisture in the wound bed. Another important element in chronic wounds is the promotion of autolytic debridement, which helps to ensure that healing is not complicated by any devitalised tissue, which can harbour bacteria and impede new tissue growth. This article investigates best practice in the treatment of chronic wounds, with a focus on the management of moisture in the wound bed. The author also looks at one dressing in particular, Cutimed HydroControl® (BSN medical, an SCA company), which uses an osmotic effect and a high moisture vapour transmission rate (MVTR) to ensure that excessive wound exudate is drawn away from the wound bed, while also ensuring that fresh exudate is produced to promote autolytic debridement and maintain moisture levels in dry wounds. Cutimed HydroControl is able to avoid inappropriate dressing use by facilitating the needs of both exuding and dry wounds, thereby ensuring an optimum moist wound environment. [ABSTRACT FROM AUTHOR]

This article focuses on the work of a team of community nurses running a primary care drop-in centre. As well as a full range of clinic services, the team sees a lot of leg ulcer patients for compression bandaging. A common problem with traditional compression bandaging is the amount of time that community nurses have to spend on the procedure, as well as the dangers of maintaining pressure and bandage slippage between dressing appointments, which can result in discomfort for patients and even skin damage in some cases. This also has implications for patient concordance. This article looks at a review by the team of a new compression system (juxtacures®; medi UK), which offers measurable and adjustable compression and a greater involvement by patients in their own care, which in turn can minimise the time nurses need to spend on dressing changes. [ABSTRACT FROM AUTHOR]

The management of exudate in acute and chronic wounds is a common issue for community nurses, with too much exudate resulting in issues with infection and the breakdown of periwound skin; while too little moisture risks the wound bed becoming too dry. Nurses need to find the most cost-effective and clinically proven treatment regimen when treating wounds that produce different levels of exudate, minimising dressing changes and patient discomfort. While it can be difficult to make a choice about which dressing to use because of the vast array on offer, it is important to match the dressing to the wound and use the most appropriate dressing for the levels of exudate being produced. Similarly, using a more responsive approach to wound management -- adapting treatment as the wound changes -- will result in a more cost-effective approach. Advancis Medical have a range of wound management dressings that are suitable for different wound types and can handle varying levels of exudate. This allows nurses to use a step-up, step-down approach to the management of exudate as the most cost-effective dressing regimen. [ABSTRACT FROM AUTHOR]

Chronic wounds are known to represent a significant burden to patients and National Health Service ( NHS) alike. However, previous attempts to estimate the costs associated with the management of chronic wounds have been based on literature studies or broad estimates derived from incidence rates and extrapolations from relatively small-scale studies. The aim of this study is therefore to determine the extent of resource utilisation by patients classed as having chronic wounds within Wales using linked routine data - available through the Secure Anonymised Information Linkage ( SAIL) database - to estimate the costs associated with the management of these patients by the NHS in Wales. The SAIL database brings together, and anonymously links, a wide range of person-based data from general practitioner ( GP) practices within Wales, which includes primary and secondary care consultations to create an encrypted anonymised linking field for each individual. This linkage allows the patient pathway to be tracked through the NHS system both retrospectively and prospectively from a specific reference date. The estimated costs were derived by extrapolating to an all-Wales level from the results gleaned from the SAIL database using the respective READ codes to capture relevant patients with chronic wounds. The number of patients identified as having chronic wounds within the SAIL database was 78 090, which equates to 190 463 across Wales as a whole and a prevalence of 6% of the Welsh population. The total cost of managing patients with chronic wounds in Wales amounted to £328·8 million - an average cost of £1727 per patient and 5·5% of total expenditure on the health service in Wales. A relatively few READ codes represented a significant proportion of expenditure, with diabetic foot ulcers, leg ulcers, foot ulcers, varicose eczema, bed sores and postoperative wound care constituting 93% of total expenditure. When a more conservative perspective was used in relation to classification of chronic wounds, the total cost amounted to £303 million. However, these are likely to be underestimates because of the lack of information for patients with treatments lasting over 6 months and not including patients who might have entered the health care system of wound management elsewhere - such as patients contracting pressure ulcers in hospitals and having surgical wound infections. [ABSTRACT FROM AUTHOR]