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Chen Q, Zhou K. Acetic Acid Use in Chronic Wound Healing: A Multiple Case Series. J Wound Ostomy Continence Nurs 2022; 49:286-289. [PMID: 35255076 DOI: 10.1097/won.0000000000000863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Acetic acid is bacteriostatic or bactericidal to many gram-negative and gram-positive microorganisms, especially Pseudomonas. Nevertheless, it has also been found to possess cytotoxic effects in concentrations as low as 0.25% inhibiting the epithelialization process during wound healing. CASES In this multiple case series, we present 2 cases of chronic traumatic leg wounds treated with gauze moistened with acetic acid (0.25%), which were covered with a securing dressing and compression stockinet. Both patients were told to apply gauze moistened with acetic acid (0.25%) twice daily. In both cases, the wound progressed to blue-green drainage and wet yellow slough tissue to near-complete beefy granulation tissue. At this point, acetic acid was replaced with collagen or petrolatum dressing until complete wound closure was achieved. The treatment of these wounds illustrated successful use of acetic acid for chronic wound care. CONCLUSION Our experience with these cases suggests that appearance of blue-green wound drainage and wet yellow slough tissue is a reasonable indication for the use of gauze moistened with acetic acid (0.25%). Further research is needed to test the efficacy of these principles in guiding acetic acid use in wound care.
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Affiliation(s)
- Qiuyun Chen
- Qiuyun Chen, MA, BA, School of Humanities, Beijing University of Chinese Medicine, Beijing, China
- Kehua Zhou, MD, DPT, Department of Hospital Medicine, ThedaCare Regional Medical Center-Appleton, Appleton, Wisconsin
| | - Kehua Zhou
- Qiuyun Chen, MA, BA, School of Humanities, Beijing University of Chinese Medicine, Beijing, China
- Kehua Zhou, MD, DPT, Department of Hospital Medicine, ThedaCare Regional Medical Center-Appleton, Appleton, Wisconsin
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2
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de Souza GS, de Jesus Sonego L, Santos Mundim AC, de Miranda Moraes J, Sales-Campos H, Lorenzón EN. Antimicrobial-wound healing peptides: Dual-function molecules for the treatment of skin injuries. Peptides 2022; 148:170707. [PMID: 34896165 DOI: 10.1016/j.peptides.2021.170707] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022]
Abstract
Chronic non-healing wounds caused by microbial infections extend the necessity for hospital care and constitute a public health problem and a great financial burden. Classic therapies include a wide range of approaches, from wound debridement to vascular surgery. Antimicrobial peptides (AMPs) are a preserved trait of the innate immune response among different animal species, with known effects on the immune system and microorganisms. Thus, AMPs may represent promising candidates for the treatment of chronic wounds with dual functionality in two of the main agents that lead to this condition, proliferation of microorganisms and uncontrolled inflammation. Here, our goal is to critically review AMPs with wound healing properties. We strongly believe that these dual-function peptides alone, or in combination with other wound healing strategies, constitute an underexplored field that researchers can take advantage of.
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Affiliation(s)
| | | | | | | | - Helioswilton Sales-Campos
- Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Universidade Federal de Goiás, Goiás, Brazil
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3
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Rajendran SB, Challen K, Wright KL, Hardy JG. Electrical Stimulation to Enhance Wound Healing. J Funct Biomater 2021; 12:40. [PMID: 34205317 PMCID: PMC8293212 DOI: 10.3390/jfb12020040] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 12/11/2022] Open
Abstract
Electrical stimulation (ES) can serve as a therapeutic modality accelerating the healing of wounds, particularly chronic wounds which have impaired healing due to complications from underlying pathology. This review explores how ES affects the cellular mechanisms of wound healing, and its effectiveness in treating acute and chronic wounds. Literature searches with no publication date restrictions were conducted using the Cochrane Library, Medline, Web of Science, Google Scholar and PubMed databases, and 30 full-text articles met the inclusion criteria. In vitro and in vivo experiments investigating the effect of ES on the general mechanisms of healing demonstrated increased epithelialization, fibroblast migration, and vascularity around wounds. Six in vitro studies demonstrated bactericidal effects upon exposure to alternating and pulsed current. Twelve randomized controlled trials (RCTs) investigated the effect of pulsed current on chronic wound healing. All reviewed RCTs demonstrated a larger reduction in wound size and increased healing rate when compared to control groups. In conclusion, ES therapy can contribute to improved chronic wound healing and potentially reduce the financial burden associated with wound management. However, the variations in the wound characteristics, patient demographics, and ES parameters used across studies present opportunities for systematic RCT studies in the future.
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Affiliation(s)
- Saranya B. Rajendran
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4AT, UK;
| | - Kirsty Challen
- Emergency Department, Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Sharoe Green Lane, Preston, Lancashire PR2 9HT, UK;
| | - Karen L. Wright
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire LA1 4YG, UK
| | - John G. Hardy
- Department of Chemistry, Faculty of Science and Technology, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
- Materials Science Institute, Lancaster University, Lancaster, Lancashire LA1 4YB, UK
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4
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Pernot CCEG, Zwiers I, Ten Cate-Hoek AJ, Wittens CHA. The need for a timely diagnostic workup for patients with venous leg ulcers. J Wound Care 2019; 27:758-763. [PMID: 30398937 DOI: 10.12968/jowc.2018.27.11.758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To explore the need for an extended diagnostic workup in patients with venous leg ulcers (VLUs) and to establish the prevalence of the underlying causes of VLU. METHOD This retrospective cohort study analysed data from patients with VLU. The visual analogue scale (VAS) was used for pain assessment. The ankle-brachial index (ABI) was measured to exclude patients with arterial pathology. A duplex was performed. All patients received a wound treatment plan and ambulatory compression therapy. Continuous variables were presented as mean±standard deviation (SD) or median and interquartile range (IQR). Mann-Whitney U test and Kruskal-Wallis were used. When normally distributed, an independent sample t-test was used. RESULTS A total of 70 patients were recruited. Of these, 18 (25.7%) experienced a VLU once and 52 (74.3%) had a recurrent VLU. Treatment of the underlying lesions was performed in almost 30% of patients. Patients who were treated showed almost two times slower healing rates compared with those who were not treated for an underlying pathology. The mean time in patient referral exceeded two years, and patients who did not see their GP were treated by nurses who did not provide regular feedback the GP; as a result, compression therapy was not always adequate. CONCLUSION Patients with a VLU showing no signs of healing after 2 months should be referred to a dedicated wound care centre to avoid delays.
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Affiliation(s)
- Carina C E G Pernot
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Ineke Zwiers
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Arina J Ten Cate-Hoek
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands. Thrombosis Expertise Center, Heart and Vascular Center, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Cees H A Wittens
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. School for Public Health and Prim Care, Fac, Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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5
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Wu LW, Chen WL, Huang SM, Chan JYH. Platelet-derived growth factor-AA is a substantial factor in the ability of adipose-derived stem cells and endothelial progenitor cells to enhance wound healing. FASEB J 2018; 33:2388-2395. [PMID: 30265575 DOI: 10.1096/fj.201800658r] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Nonhealing wounds with various forms of complications have been a major challenge for patients with different diseases, and few data are available regarding the clinical significance of platelet-derived growth factor-AA (PDGF-AA) in the enhanced wound healing with stem cells, and the precise molecular mechanism remains unclear. The study aims to investigate the role of PDGF-AA in adipose-derived stem cells (ASCs) and endothelial progenitor cells (EPCs) enhancing wound healing. In this study, ASCs and EPCs were applied to treat wounds in an animal wound model with a wound-healing assay. We knocked down PDGF-AA expression in ASCs using the PDGF-AA short hairpin RNA technique and investigated the related molecular mechanism. The wound model and wound-healing assay of the study showed that transplantation of ASCs could enhance wound healing. The results showed that the PDGF-AA knockdown ASC group had much less improvement of wound healing than other groups treated with wild-type ASCs in wound tissues. The regulation of PDGF-AA in ASCs may contribute to improve wound healing through the PI3K/Akt/eNOS signaling pathway. The data indicated that PDGF-AA might play a vital role in ASCs and EPCs enhancing wound healing, possibly by its effects on angiogenesis. It would be a potential approach using PDGF-AA for clinical treatment of chronic wounds.-Wu, L.-W., Chen, W.-L., Huang, S.-M., Chan, J. Y.-H. Platelet-derived growth factor AA is a substantial factor in the ability of adipose-derived stem cells and endothelial progenitor cells to enhance wound healing.
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Affiliation(s)
- Li-Wei Wu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, China.,Division of Family Medicine, Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Taipei, Taiwan, China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,School of Medicine, National Defense Medical Center, Taipei, Taiwan, China
| | - Wei-Liang Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,School of Medicine, National Defense Medical Center, Taipei, Taiwan, China
| | - Shih-Ming Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, China.,Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan, China.,Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan, China
| | - James Yi-Hsin Chan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, China.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China.,Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan, China
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6
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Cantin-Warren L, Guignard R, Cortez Ghio S, Larouche D, Auger FA, Germain L. Specialized Living Wound Dressing Based on the Self-Assembly Approach of Tissue Engineering. J Funct Biomater 2018; 9:jfb9030053. [PMID: 30223550 PMCID: PMC6165032 DOI: 10.3390/jfb9030053] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/30/2018] [Accepted: 09/10/2018] [Indexed: 12/24/2022] Open
Abstract
There is a high incidence of failure and recurrence for chronic skin wounds following conventional therapies. To promote healing, the use of skin substitutes containing living cells as wound dressings has been proposed. The aim of this study was to produce a scaffold-free cell-based bilayered tissue-engineered skin substitute (TES) containing living fibroblasts and keratinocytes suitable for use as wound dressing, while considering production time, handling effort during the manufacturing process, and stability of the final product. The self-assembly method, which relies on the ability of mesenchymal cells to secrete and organize connective tissue sheet sustaining keratinocyte growth, was used to produce TESs. Three fibroblast-seeding densities were tested to produce tissue sheets. At day 17, keratinocytes were added onto 1 or 3 (reference method) stacked tissue sheets. Four days later, TESs were subjected either to 4, 10, or 17 days of culture at the air–liquid interface (A/L). All resulting TESs were comparable in terms of their histological aspect, protein expression profile and contractile behavior in vitro. However, signs of extracellular matrix (ECM) digestion that progressed over culture time were noted in TESs produced with only one fibroblast-derived tissue sheet. With lower fibroblast density, the ECM of TESs was almost completely digested after 10 days A/L and lost histological integrity after grafting in athymic mice. Increasing the fibroblast seeding density 5 to 10 times solved this problem. We conclude that the proposed method allows for a 25-day production of a living TES, which retains its histological characteristics in vitro for at least two weeks.
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Affiliation(s)
- Laurence Cantin-Warren
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
| | - Rina Guignard
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
| | - Sergio Cortez Ghio
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
| | - Danielle Larouche
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
| | - François A Auger
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
| | - Lucie Germain
- Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Centre, Département de Chirurgie, Faculté de Médecine, Université Laval, 1401 18e Rue, Québec, Québec G1J 1Z4, Canada.
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7
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Piaggesi A, Låuchli S, Bassetto F, Biedermann T, Marques A, Najafi B, Palla I, Scarpa C, Seimetz D, Triulzi I, Turchetti G, Vaggelas A. Advanced therapies in wound management: cell and tissue based therapies, physical and bio-physical therapies smart and IT based technologies. J Wound Care 2018; 27:S1-S137. [DOI: 10.12968/jowc.2018.27.sup6a.s1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Alberto Piaggesi
- Prof, Director, EWMA Scientific Recorder (Editor), Diabetic Foot Section of the Pisa University Hospital, Department of Endocrinology and Metabolism, University of Pisa, Lungarno Pacinotti 43, 56126 Pisa, Italy
| | - Severin Låuchli
- Chief of Dermatosurgery and Woundcare, EWMA Immediate Past President (Co-editor), Department of Dermatology, University Hospital, Zurich, Råmistrasse 100, 8091 Zärich, Schwitzerland
| | - Franco Bassetto
- Prof, Head of Department, Clinic of Plastic and Reconstructive Surgery, University of Padova, Via Giustiniani, 35100 Padova
| | - Thomas Biedermann
- Tissue Biology Research Unit, Department of Surgery, University Children's Hospital Zurich, August Forel-Strasse 7, 8008 Zürich, Switzerland
| | - Alexandra Marques
- University of Minho, 3B's Research Group in Biomaterials, Biodegradables and Biomimetics, Avepark - Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR, Portugal
| | - Bijan Najafi
- Professor of Surgery, Director of Clinical Research, Division of Vascular Surgery and Endovascular Therapy, Director of Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX 77030-3411, US
| | - Ilaria Palla
- Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Carlotta Scarpa
- Clinic of Plastic and Reconstructive Surgery, University of Padova, Via Giustiniani, 35100 Padova
| | - Diane Seimetz
- Founding Partner, Biopharma Excellence, c/o Munich Technology Center, Agnes-Pockels-Bogen 1, 80992 Munich, Germany
| | - Isotta Triulzi
- Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Giuseppe Turchetti
- Fulbright Scholar, Institute of Management, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, 56127 Pisa, Italy
| | - Annegret Vaggelas
- Consultant, Biopharma Excellence, c/o Munich Technology Center, Agnes-Pockels-Bogen 1, 80992 Munich, Germany
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8
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Khan T, Shin L, Woelfel S, Rowe V, Wilson BL, Armstrong DG. Building a scalable diabetic limb preservation program: four steps to success. Diabet Foot Ankle 2018; 9:1452513. [PMID: 29696071 PMCID: PMC5912709 DOI: 10.1080/2000625x.2018.1452513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 02/25/2018] [Indexed: 01/22/2023]
Abstract
Over the past generation, limb preservation programs and diabetic foot services have begun to proliferate within academic health science centers as well as within health-care systems in general. We describe four key components for a successful program that, developed sequentially with temporal overlap, can allow the program to scale. The first component includes establishment of a ‘hot foot line’ for urgent emergency department/inpatient referral. The second includes development of a wound-healing clinic to address outpatient care through to remission. The third component focuses on the diabetic foot in remission to maximize ulcer-free days following healing. The fourth and final component focuses on implementation of local and widespread screening clinics to identify and triage patients into appropriate therapeutic and surveillance programs for healing, remission, and primary prevention. Along with developing each of these components, we describe discrete methods to quantify success.
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Affiliation(s)
- Tanzim Khan
- The Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA
| | - Laura Shin
- Department of Orthopaedics, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
| | - Stephanie Woelfel
- Division of Biokinesiology and Physical Therapy, University of Southern California (USC), Los Angeles, CA, USA
| | - Vincent Rowe
- The Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA
| | - Brittany L Wilson
- The Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA
| | - David G Armstrong
- The Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of University of Southern California (USC), Los Angeles, CA, USA
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9
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Li W, Ma Y, Yang Q, Pan Y, Meng Q. Moist exposed burn ointment for treating pressure ulcers: A multicenter randomized controlled trial. Medicine (Baltimore) 2017; 96:e7582. [PMID: 28723796 PMCID: PMC5521936 DOI: 10.1097/md.0000000000007582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pressure ulcers often seriously affect the quality of life of patients. Moist Exposed Burn Ointment (MEBO) has been developed to treat patients with pressure ulcers. The present study aimed to evaluate the efficacy and safety of MEBO in the treatment of pressure ulcers in Chinese patients. METHODS Seventy-two patients with pressure ulcers were randomly assigned to 2 groups who received a placebo or MEBO for 2 months. The primary outcomes included the wound surface area (WSA) and pressure ulcer scale for healing (PUSH) tool. The secondary outcomes included a visual analog scale (VAS), questionnaire of ulcer status, and adverse effects. RESULTS Sixty-seven patients completed the study. After 2 months of treatment, the difference of mean change from the baseline was greater for MEBO (vs placebo) for WSA mean (SD) -6.0 (-8.8, -3.3), PUSH Tool -2.6 (-4.7, -1.5), and VAS score -2.9 (-4.4, -1.7). On the basis of the questionnaire, the pressure ulcers were "completely healed" (50.0% vs 16.7%) (P < .05) in patients after 2 months of treatment with MEBO versus placebo. No major adverse effects were found in the 2 groups. CONCLUSION We showed that MEBO is effective and well tolerated for improving wound healing in Chinese patients with pressure ulcers.
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Affiliation(s)
- Wei Li
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
| | - Yubo Ma
- Department of Orthopedics, Hongqi Hospital of Mudanjiang Medical College, Mudanjiang
| | - Qi Yang
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
| | - Yu Pan
- Department of Study Center, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qinggang Meng
- Department of Medical Science Institute of Harbin, the First Hospital of Harbin, Harbin Medical University, Harbin
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10
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Zhou K, Schenk R, Brogan MS. The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience. Eur J Clin Invest 2016; 46:1017-1023. [PMID: 27709618 DOI: 10.1111/eci.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/02/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Electric stimulation (E-stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E-stim treatment. MATERIALS AND METHODS This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E-stim and conventional care were included. The Kaplan-Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. RESULTS With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50-75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E-stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). CONCLUSIONS This study provided preliminary data on wound healing trajectory and predictors with combined E-stim and conventional care. E-stim seemed to expedite wound healing; however, further research studies are needed.
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Affiliation(s)
- Kehua Zhou
- Physical Therapy Wound Care Clinic, Daemen College, Amherst, NY, USA.,Department of Health Promotion, Daemen College, Amherst, NY, USA
| | - Ronald Schenk
- Department of Physical Therapy, Daemen College, Amherst, NY, USA
| | - Michael S Brogan
- Department of Physical Therapy, Daemen College, Amherst, NY, USA
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11
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Zhou K, Jia P. Depressive symptoms in patients with wounds: A cross-sectional study. Wound Repair Regen 2016; 24:1059-1065. [DOI: 10.1111/wrr.12484] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/25/2016] [Accepted: 09/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Kehua Zhou
- Department of Health Promotion; Daemen College; Amherst New York
- Daemen College Physical Therapy Wound Clinic, Daemen College; Amherst New York and
| | - Peng Jia
- Faculty of Geo-information Science and Earth Observation (ITC); University of Twente; Enschede The Netherlands
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