Search

Objective: The effective assessment of wounds, both acute and hard-to-heal, is an important component in the delivery by wound care practitioners of efficacious wound care for patients. Improved wound diagnosis, optimising wound treatment regimens, and enhanced prevention of wounds aid in providing patients with a better quality of life (QoL). There is significant potential for the use of artificial intelligence (AI) in health-related areas such as wound care. However, AI-based systems remain to be developed to a point where they can be used clinically to deliver high-quality wound care. We have carried out a narrative review of the development and use of AI in the diagnosis, assessment and treatment of hard-to-heal wounds. We retrieved 145 articles from several online databases and other online resources, and 81 of them were included in this narrative review. Our review shows that AI application in wound care offers benefits in the assessment/diagnosis, monitoring and treatment of acute and hard-to-heal wounds. As well as offering patients the potential of improved QoL, AI may also enable better use of healthcare resources. [ABSTRACT FROM AUTHOR]

Effective management of exudate is crucial for ensuring timely wound healing. Summarised in this product focus are 11 clinical studies (incorporating the experience of 179 patients), indicating that the ActivHeal® PHMB Foam dressing range (Advanced Medical Solutions Ltd.) is effective at treating infected wounds, managing wound exudate, debridement/wound cleansing, and enhancing the quality of life in patients with a various wound types, including venous leg ulcers (VLU), diabetic foot ulcers (DFU), pressure ulcers (PU), burns and postoperative surgical wounds. The use of the antimicrobial agent polyhexamethylene biguanide (PHMB) provides an effective defence against a broad spectrum of microorganisms, including antibiotic-resistant microorganisms, commonly associated with wound colonisation and infection. This evaluation does not aim to be a systematic or narrative review but rather a selection of the most pertinent publications summarising the clinical evidence supporting ActivHeal PHMB Foam range for the treatment of various chronic and acute wounds. [ABSTRACT FROM AUTHOR]

Objective: Most surgical wounds heal by primary or secondary intention. Surgical wounds can present specific and unique challenges including wound dehiscence and surgical site infection (SSI), either of which can increase risk of morbidity and mortality. The use of antimicrobials to treat infection in these wounds is prevalent, but there is now an imperative to align treatment with reducing antimicrobial resistance and antimicrobial stewardship (AMS). The aim of this review was to explore the published evidence identifying general considerations/criteria for an ideal post-surgical wound dressing in terms of overcoming potential wound healing challenges (including infection) while supporting AMS objectives. Method: A scoping review examining evidence published from 1954–2021, conducted by two authors acting independently. Results were synthesised narratively and have been reported in line with PRISMA Extension for Scoping Reviews. Results: A total of 819 articles were initially identified and subsequently filtered to 178 for inclusion in the assessment. The search highlighted six key outcomes of interest associated with post-surgical wound dressings: wound infection; wound healing; physical attributes related to comfort, conformability and flexibility; fluid handling (e.g., blood and exudate); pain; and skin damage. Conclusion: There are several challenges that can be overcome when treating a post-surgical wound with a dressing, not least the prevention and treatment of SSIs. However, it is imperative that the use of antimicrobial wound dressings is aligned with AMS programmes and alternatives to active antimicrobials investigated. [ABSTRACT FROM AUTHOR]

A retrospective audit of clinical data of patients was taken who required treatment for the management of moderately to highly exuding wounds. The inclusion criteria for this retrospective audit included patients (n=30) from the Worcestershire Health & Care NHS Trust that have already been treated and that required a wound dressing for the management of moderately to highly exuding wounds. Results and discussion: The results of the "in use" evaluations showed a high use of foam secondary dressings with adjunct treatments to manage exudate. However, 65% of these treatments did not meet the clinical objectives related to exudate management. The assessment of how effectively the patient's treatment regimens managed exudate produced by the various wounds showed that exudate management was rated as "poor" or only "adequate" in the majority of cases. It is noteworthy that a proportion of patients suffered from peri-wound skin conditions, e.g. eczema, maceration and excoriation. Over 95% of patients received peri-wound skin treatments to prevent/treat these conditions. As a consequence, these additional treatments add to the product costs and nursing time required. The use of appropriate wound dressings for the management of moderate to high levels of exudate would have prevented these severe skin conditions and likely significantly reduce treatment costs. Conclusion: This paper shows that 65% of the patients included in this audit failed to meet the clinical objective of exudate management. Adverse event sequelae such as skin maceration/excoriation occurred and, consequently, direct and indirect costs associated with treating these patients increased. Using a more appropriate wound dressing such as superabsorbent polymer demonstrated significantly reduced costs when compared to these audit costs. [ABSTRACT FROM AUTHOR]

Since the first use of superabsorbent polacrylate polymers (SAP) in wound care, the number of SAP-containing wound dressings has increased significantly. The manufacturing process and chemical variability of these SAPs has resulted in them having diverse properties. The fluid-handling capabilities are a key property of SAPs, which help manage exudate-producing wounds such as ulcers. As well as the properties of the material itself, how it is structured within the dressing and whether it is combined with other components influences the fluid-handling capability of SAP. HydroClean® plus is a dressing that uses pre-swollen SAP to rinse, cleanse and absorb at wound sites. Here we propose a mechanism for the action of this wound dressing from the evidence available. [ABSTRACT FROM AUTHOR]

This article provides an explanation and visual demonstration of the differences between the pathology and presentation of hydration versus maceration in wounds. This is described in order that the clinician can distinguish between the two and optimise wound treatment. [ABSTRACT FROM AUTHOR]

A number of clinical studies and case reports have shown that HydroClean plus effectively cleanses wounds of necrotic tissue, fibrinous slough and bacteria-laden wound exudates. Due to the innovative technology inherent in the polyacrylate superabsorbent material at the core of these dressings, the wound is actively cleansed by the rinsing and absorbing effect of this pad core. Optimisation of the moist wound environment and promotion of autolytic debridement supports the formation of new granulation tissue and leads to progression of wound healing response. This product focus explores the evidence supporting HydroClean plus and hydro-responsive wound dressings. [ABSTRACT FROM AUTHOR]

The aim of the research is to assess the benefit-harm of superabsorbent polymers wound dressings based on polyacrylate polymers (SAPs) compared with standard of care (SoC) dressing mix for patients with moderate-to-highly exuding hard-to-heal leg ulcers. The SoC dressings mix was composed of other superabsorbents in 29% of cases, antimicrobials 26%, foams 20%, alginates 5%, and other dressings 19% weighted according to their frequency. We have used the decision-analytic modeling method, Markov process, as an adequate analytical solution for medical prognosis. We have combined the systematic literature search to identify the most relevant inputs for the analysis, with available patient-level clinical data concerning benefits of superabsorbent to generate a robust prediction of patient-relevant outcomes, including healing rates and health-related quality of life. Besides, we have qualitatively described adverse events associated with those treatments. Our research indicates that SAPs when compared with SoC dressing mix in a patient with moderate-to-highly excluding leg ulcers are leading to an improved healing rate with an absolute risk difference of 2.20% in 6 months and a relative risk of 1.07 in favor of SAP dressings. The attributable fraction among those exposed to SAP dressings of 6.6%, meaning that 6.6% of the healed ulcers could be attributed to having had the SAP dressing treatment instead of the SoC dressing treatment. Besides, SAP dressings lead to improved quality of life measured as incremental quality-adjusted life weeks (QALWs) of 0.13 QALWs.