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Baker C, Nugent B, Grainger D, Hewis J, Malamateniou C. Systematic review of MRI safety literature in relation to radiofrequency thermal injury prevention. J Med Radiat Sci 2024. [PMID: 38937923 DOI: 10.1002/jmrs.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/17/2024] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is a rapidly evolving modality, generally considered safe due to lack of ionising radiation. While MRI technology and techniques are improving, many of the safety concerns remain the same as when first established. Patient thermal injuries are the most frequently reported adverse event, accounting for 59% of MRI incidents to the Food and Drug Administration (FDA). Surveys indicate many incidents remain unreported. Patient thermal injuries are preventable and various methods for their mitigation have been published. However, recommendations can be variable, fragmented and confusing. The aim of this systematic review was to synthesise the evidence on MRI safety and associated skin injuries and offer comprehensive recommendations for radiographers to prevent skin thermal injuries. METHODS Four journal databases were searched for sources published January 2010-May 2023, presenting information on MRI safety and thermal injuries. RESULTS Of 26,801 articles returned, after careful screening and based on the eligibility criteria, only 79 articles and an additional 19 grey literature sources were included (n = 98). Included studies were examined using thematic analysis to determine if holistic recommendations can be provided to assist in preventing skin burns. This resulted in three simplified recommendations: Remove any electrically conductive items Insulate the patient to prevent any conductive loops or contact with objects Communicate regularly CONCLUSION: By implementing the above recommendations, it is estimated that 97% of skin burns could be prevented. With thermal injuries continuing to impact MRI safety, strategies to prevent skin burns and heating are essential. Assessing individual risks, rather than blanket policies, will help prevent skin thermal injuries occurring, improving patient care.
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Affiliation(s)
- Cassandra Baker
- Qscan Radiology, Brisbane, Queensland, Australia
- Division of Midwifery and Radiography, Department of Radiography, City University of London School of Health & Psychological Sciences, London, UK
| | - Barbara Nugent
- Division of Midwifery and Radiography, Department of Radiography, City University of London School of Health & Psychological Sciences, London, UK
- MRI Safety Matters, Edinburgh, UK
| | - David Grainger
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Johnathan Hewis
- School of Dentistry and Medical Sciences, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Christina Malamateniou
- Division of Midwifery and Radiography, Department of Radiography, City University of London School of Health & Psychological Sciences, London, UK
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Yousefian F, Hesari R, Jensen T, Obagi S, Rgeai A, Damiani G, Bunick CG, Grada A. Antimicrobial Wound Dressings: A Concise Review for Clinicians. Antibiotics (Basel) 2023; 12:1434. [PMID: 37760730 PMCID: PMC10526066 DOI: 10.3390/antibiotics12091434] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Wound management represents a substantial clinical challenge due to the growing incidence of chronic skin wounds resulting from venous insufficiency, diabetes, and obesity, along with acute injuries and surgical wounds. The risk of infection, a key impediment to healing and a driver of increased morbidity and mortality, is a primary concern in wound care. Recently, antimicrobial dressings have emerged as a promising approach for bioburden control and wound healing. The selection of a suitable antimicrobial dressing depends on various parameters, including cost, wound type, local microbial burden and the location and condition of the wound. This review covers the different types of antimicrobial dressings, their modes of action, advantages, and drawbacks, thereby providing clinicians with the knowledge to optimize wound management.
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Affiliation(s)
| | - Roksana Hesari
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Taylor Jensen
- St. George’s University School of Medicine, West Indies P.O. Box 7, Grenada
| | - Sabine Obagi
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA
| | - Ala Rgeai
- Hai Al-Andalus Primary Healthcare Center, Tripoli 13555, Libya
| | - Giovanni Damiani
- Italian Center of Precision Medicine and Chronic Inflammation, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Christopher G. Bunick
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA
- Program in Translational Biomedicine, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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Baran E, Górska A, Birczyński A, Hudy W, Kulinowski W, Jamróz W, Węglarz WP, Kulinowski P. In Vitro Wound Dressing Stack Model as a First Step to Evaluate the Behavior of Dressing Materials in Wound Bed-An Assessment of Mass Transport Phenomena in Hydrogel Wound Dressings. MATERIALS (BASEL, SWITZERLAND) 2021; 14:7702. [PMID: 34947294 PMCID: PMC8706781 DOI: 10.3390/ma14247702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/29/2021] [Accepted: 12/10/2021] [Indexed: 12/04/2022]
Abstract
Wound dressings when applied are in contact with wound exudates in vivo or with acceptor fluid when testing drug release from wound dressing in vitro. Therefore, the assessment of bidirectional mass transport phenomena in dressing after application on the substrate is important but has never been addressed in this context. For this reason, an in vitro wound dressing stack model was developed and implemented in the 3D printed holder. The stack was imaged using magnetic resonance imaging, i.e., relaxometric imaging was performed by means of T2 relaxation time and signal amplitude 1D profiles across the wound stack. As a substrate, fetal bovine serum or propylene glycol were used to simulate in vivo or in vitro cases. Multi-exponential analysis of the spatially resolved magnetic resonance signal enabled to distinguish components originating from water and propylene glycol in various environments. The spatiotemporal evolution of these components was assessed. The components were related to mass transport (water, propylene glycol) in the dressing/substrate system and subsequent changes of physicochemical properties of the dressing and adjacent substrate. Sharp changes in spatial profiles were detected and identified as moving fronts. It can be concluded that: (1) An attempt to assess mass transport phenomena was carried out revealing the spatial structure of the wound dressing in terms of moving fronts and corresponding layers; (2) Moving fronts, layers and their temporal evolution originated from bidirectional mass transport between wound dressing and substrate. The setup can be further applied to dressings containing drugs.
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Affiliation(s)
- Ewelina Baran
- Institute of Technology, The Pedagogical University of Kraków, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (A.B.); (W.H.); (W.K.)
| | - Anna Górska
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland;
| | - Artur Birczyński
- Institute of Technology, The Pedagogical University of Kraków, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (A.B.); (W.H.); (W.K.)
| | - Wiktor Hudy
- Institute of Technology, The Pedagogical University of Kraków, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (A.B.); (W.H.); (W.K.)
| | - Wojciech Kulinowski
- Institute of Technology, The Pedagogical University of Kraków, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (A.B.); (W.H.); (W.K.)
| | - Witold Jamróz
- Department of Pharmaceutical Technology and Biopharmaceutics, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland;
| | - Władysław P. Węglarz
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Kraków, Poland;
| | - Piotr Kulinowski
- Institute of Technology, The Pedagogical University of Kraków, Podchorążych 2, 30-084 Kraków, Poland; (E.B.); (A.B.); (W.H.); (W.K.)
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Pan Y, Zhao X, Li X, Cai P. Green-Based Antimicrobial Hydrogels Prepared from Bagasse Cellulose as 3D-Scaffolds for Wound Dressing. Polymers (Basel) 2019; 11:polym11111846. [PMID: 31717464 PMCID: PMC6918262 DOI: 10.3390/polym11111846] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 01/17/2023] Open
Abstract
Developing the ideal biomaterials for wound dressing still remains challenging nowadays due to the non-biodegradable features and the lack of antimicrobial activity of conventional synthetic polymer-based dressing materials. To tackle those problems, a novel and green-based antimicrobial hydrogel dressing was synthesized in this work via modifying sugarcane bagasse cellulose with guanidine-based polymer, followed by crosslinking antimicrobial-modified cellulose with unmodified one at various ratios. The resulting hydrogels were comprehensively characterized with swelling measurements, compression test, Fourier transform infrared spectroscopy, and scanning electron microscopy. The results indicated that the dressing possessed the degree of swelling up to 2000% and the compress strength as high as 31.39 Kpa, at 8:2 ratio of pristine cellulose to modified cellulose. The antibacterial activities of the dressing against E. coli were assessed using both shaking flask and ring diffusion methods. The results demonstrated that the dressings were highly effective in deactivating bacterium without leaching effect. Moreover, these hydrogels are biocompatible with live cell viability responses of (NIH3T3) cells above 76% and are very promising as wound dressing.
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Affiliation(s)
- Yuanfeng Pan
- Guangxi Key Lab of Petrochemical Resource Processing and Process Intensification Tech., School of Chemistry and Chemical Eng., Guangxi University, Nanning 530004, China;
- Correspondence: ; Tel.: +86-13687881316
| | - Xiao Zhao
- Guangxi Key Lab of Petrochemical Resource Processing and Process Intensification Tech., School of Chemistry and Chemical Eng., Guangxi University, Nanning 530004, China;
| | - Xiaoning Li
- Department of Environmental Science and Engineering, North China Electric Power University, Baoding 071003, China;
| | - Pingxiong Cai
- College of Petroleum and Chemical Engineering, Beibu Gulf University, Qinzhou 535006, China;
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Zheng J, Xia M, Kainz W, Chen J. Wire-based sternal closure: MRI-related heating at 1.5 T/64 MHz and 3 T/128 MHz based on simulation and experimental phantom study. Magn Reson Med 2019; 83:1055-1065. [PMID: 31468593 DOI: 10.1002/mrm.27963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/23/2019] [Accepted: 08/01/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The paper investigates factors that affect the RF-induced heating for commonly used wire-based sternal closure under 1.5 T and 3 T MRI systems and clarifies the heating mechanisms. METHODS Numerical simulations based on the finite-difference time-domain method and experimental measurements in ASTM (American Society for Testing and Materials) phantom were used in the study. Various configurations of the wire-based sternal closure in the phantom were studied based on parameter sweeps to understand key factors related to the RF-induced heating. In vivo simulations were further performed to explore the RF-induced heating in computational human phantoms for clinically relevant scenarios. RESULTS The wire-based sternal closure can lead to peak 1-g averaged spatial absorption ratio of 106.3 W/kg and 75.2 W/kg in phantom and peak 1-g averaged specific absorption rate of 32.1 W/kg and 62.1 W/kg in computational human models near the device at 1.5 T and 3 T, respectively. In phantom, the simulated maximum temperature rises for 15-minute RF exposure are 9.4°C at 1.5 T and 5.8°C at 3 T. Generally, the RF-induced heating will be higher when the electrical length of the device is close to the resonant length or when multiple components are spaced closely along the longitudinal direction. CONCLUSION The RF-induced heating related to wire-based sternal closure can be significant due to the antenna effect and capacitive mutual coupling effect related to the specific geometries of devices.
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Affiliation(s)
- Jianfeng Zheng
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas
| | - Meiqi Xia
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas
| | - Wolfgang Kainz
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Ji Chen
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas
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