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Diener H, Eberlein T, Münter KC, Maier-Hasselmann A, Grünerbel A, Fischoeder C, Pohl J, Rohloff M, Storck M. [Design of a clinical study to demonstrate the therapeutic benefit of another wound treatment product]. MMW Fortschr Med 2024; 166:17-26. [PMID: 39112836 DOI: 10.1007/s15006-024-4090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
BACKGROUND Due to new legal requirements, a patient-relevant benefit for other wound treatment products (sPW) must be demonstrated through clinical studies if reimbursement at the expense of the statutory health insurance is sought in the non-inpatient sector. METHOD An interdisciplinary group with expertise in clinical wound care has developed general recommendations for the design of suitable studies. In addition to regulatory documents, previous studies that have already been recognized as proof of benefit in other areas served as a basis. RESULTS Randomized controlled trials that cover at least the most common types of chronic wounds (arterial, venous, diabetic or pressure sore) are recommended as the best method for gathering evidence. Despite the heterogeneous etiology of chronic wounds, the results should also be transferable to other wound types. The test intervention does not usually consist of the sPW alone, but of a combined wound treatment that follows a treatment plan that is as clearly defined as possible. In the comparison group, all wound treatment options (besides the sPW) must also be available and used according to a similar predefined treatment plan. Depending on the intended purpose and treatment goal, complete wound closure should, if possible, be recorded as the cardinal - although not always as the primary - endpoint. In justified cases, e.g. in the case of intermediate use as part of phase-appropriate wound therapy for chronic wounds, a significant reduction in the wound area can also be considered for benefit assessment. Quality of life (e.g. pain) can also justify a benefit and can therefore be recorded as a primary outcome parameter in clinical trials. The duration of the clinical trial should be adapted to the central endpoints, the medical or nursing goal of wound care and the intended purpose of the sPW. A benefit does not always arise from microbiological, physiological, laboratory or histological parameters or imaging findings.
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Affiliation(s)
- Holger Diener
- Gefäßchirurgie und endovaskuläre Chirurgie, Wundkompetenzzentrum, Krankenhaus Buchholz, Buchholz, Deutschland
| | - Thomas Eberlein
- Akademie für Zertifiziertes Wundmanagement Akademie-ZWM AG, Embrach, Schweiz
| | | | | | - Arthur Grünerbel
- Vorstand Fußnetz Bayern und Vorstand der DiaBay, Diabeteszentrum München Süd, München, Deutschland
| | | | - Juliane Pohl
- BVMed | Bundesverband Medizintechnologie e.V., Berlin, Deutschland
| | - Miriam Rohloff
- BVMed | Bundesverband Medizintechnologie e.V., Berlin, Deutschland
| | - Martin Storck
- Klinik für Gefäßchirurgie, Vaskuläre und endovaskuläre Chirurgie, Städtisches Klinikum Karlsruhe gGmbH, Moltkestraße 90, 76133, Karlsruhe, Deutschland.
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Gunasegaran N, Goh WT, Tan WX, Saipollah H, Chong HR, Sunari RN, Chong TT, Ang SY, Aloweni F. Patients with venous leg ulcers can be managed safely in the community ----results of an observational comparison study in Singapore. J Tissue Viability 2024:S0965-206X(24)00114-1. [PMID: 39164151 DOI: 10.1016/j.jtv.2024.07.009] [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: 10/13/2023] [Revised: 07/08/2024] [Accepted: 07/21/2024] [Indexed: 08/22/2024]
Abstract
AIM To examine the healing outcomes of patients with venous leg ulcers requiring compression bandaging in community care versus tertiary care. METHOD This was an analytical observational cohort study. Venous leg ulcer (VLU) patients who required compression bandaging were recruited from an outpatient vascular clinic between May 2021 and August 2022. Eligible patients received two-or four-layer compression bandaging and followed up with the community care or tertiary care centre nurses. The primary outcome was the difference in the total surface area of the VLU after 12 weeks, and the secondary outcome was the patient's quality of life, as measured by the Cardiff Wound Impact Schedule (CWIS). RESULTS Forty-seven VLU patients were recruited; 27 received compression bandaging in the community care and 20 by the tertiary care centre. Mean age 70 years old (SD 11.04). The two most prevalent comorbidities were hypertension (51.06 %) and diabetes mellitus (38.29 %). Among those who completed follow-up (12 weeks), the median difference of the total surface area of the VLU between community-based care (p = 0.02) versus tertiary-based care (0.003) was significant. However, there was no difference in the healing status between community and tertiary-based care (p = 0.68). There was no difference in the quality of life of patients between groups. CONCLUSION This first tropical study comparing VLU healing outcomes between community and tertiary care found no significant difference in healing with compression bandaging by nurses in either setting. However, the small sample size and high dropout rate limit the generalizability of the findings, necessitating a larger-scale study with longer follow-up. Despite these limitations, the study is a crucial step toward improving wound care services in Singapore, and highlights the need for further research to guide future community wound care implementation.
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Affiliation(s)
| | - Wee Ting Goh
- Nursing Division, Singapore General Hospital, Singapore.
| | | | | | - Hui Ru Chong
- Nursing Division, Singapore General Hospital, Singapore.
| | | | - Tze Tec Chong
- Department of Vascular Surgery, Singapore General Hospital, Singapore.
| | - Shin Yuh Ang
- Nursing Division, Singapore General Hospital, Singapore.
| | - Fazila Aloweni
- Nursing Division, Singapore General Hospital, Singapore.
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Nowak M, Piechota D, Baranska-Rybak W. Gdansk Wound-QoL Questionnaire: Pilot Study on Health-Related Quality of Life of Patients with Chronic Ulcers with Emphasis on Professional Physician-Patient Relations. Dermatol Pract Concept 2024; 14:dpc.1403a138. [PMID: 39122485 PMCID: PMC11314753 DOI: 10.5826/dpc.1403a138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Chronic wounds lower health-related quality of life (QoL), as they affect various aspects of life due to pain, odor, tedious treatment, and stigma from society. Implementing proper treatment, where patient is well informed and active is a key for best outcomes. OBJECTIVES The aim of the study was to evaluate health-related QoL among the patients with chronic ulcers, with the use of new scale Gdansk Wound QoL. METHODS We enrolled 108 patients who met the inclusion criteria. Before the education on day 0 patients were asked to fill in Gdansk Wound-QoL questionnaire, that was developed in cooperation between dermatologists, general and plastic surgeons, as well as wound nurses, as well as fill the follow-up Gdansk Would-QoL questionnaire on day 30, which was also the end of the study. RESULTS Study participants (N = 108) were on average 76.1 ± 10.8 years and all of whom had a venous ulcer on their lower limbs of average wound area of 10.8 cm2. QoL, according to the Gdansk Wound-QoL questionnaire, increased on average by 36.7% after 30 days trial. Moreover, on the follow-up visit 94.4% of the patients stated that their knowledge on the disease has increased and everyone was satisfied with the course of treatment proposed by the current doctor. Furthermore, 44.4% of the study group increased their activity at the end of the study. CONCLUSIONS This pilot descriptive observational study shows that Gdansk Wound-QoL questionnaire can provide professionals in wound care good feedback on health-related QoL of patients with chronic wounds. This information has the potential to enhance patients well-being and overall comfort.
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Affiliation(s)
- Marcela Nowak
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
- Department of Dermatology and Venereology in Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Dorota Piechota
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
| | - Wioletta Baranska-Rybak
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
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Hung CC, Chen CM, Chang YH, Lee SH, Chang CH, Chen YJ. Development and validation of a Chinese version chronic wound health-related quality of life instrument: A methodological study. J Clin Nurs 2024; 33:1820-1829. [PMID: 38054584 DOI: 10.1111/jocn.16948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/12/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023]
Abstract
AIMS AND OBJECTIVES To develop a Chinese version of a chronic wound health-related quality of life (QoL) instrument and to examine the psychometric properties of this instrument. BACKGROUND Existing QoL instruments are not tailored to the linguistic and cultural characteristics of Chinese-speaking patients; a version addressing this gap will increase clinical understanding of their healthcare experience and may help guide chronic wound care. DESIGN A methodological study. METHODS The method advanced by DeVellis (2017) was used to develop the instrument. An initial pool of 38 items was created. To optimize scale length and test reliability and validity, exploratory and confirmatory factor analyses were conducted. A total of 23 items formed the final pool. After two rounds of expert discussions, the average content validity index of the final 23 items was .89. RESULTS A total of 226 patients completed the instrument and were divided into two groups for further analysis. Exploratory factor analysis revealed that 15 items remained in four factors (social activity restrictions, physical and psychological disturbance, wound burden and daily life limitation), which accounted for 64.87% of the variance. Confirmatory factor analysis revealed an acceptable fit of the hypothesized factor structure and the convergent and discriminant validities were achieved. Cronbach's α coefficients for each factor were .807, .773, .799 and .713, respectively. CONCLUSION The Chinese version of a chronic wound health-related QoL instrument consists of 15 items in four subscales and demonstrates good reliability and validity. RELEVANCE TO CLINICAL PRACTICE This instrument can be used intermittently or continuously to evaluate the treatment effect of chronic wounds by assessing health-related QoL. Scholars in Chinese-speaking regions may find this culturally compatible instrument useful when conducting studies related to chronic wounds. PATIENT OR PUBLIC CONTRIBUTION Two hundred twenty-six participants provided their perspectives on health-related QoL.
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Affiliation(s)
- Chang-Chiao Hung
- School of Nursing & Nursing Department, Chang Gung University of Science and Technology & Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Chien-Ming Chen
- Burn Center & Department of Plastic Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Ya-Hui Chang
- Department of Nursing, China Medical University Beigang Hospital, Beigang Township, Taiwan, ROC
| | - Shiao-Haung Lee
- Department of Nursing, China Medical University Beigang Hospital, Beigang Township, Taiwan, ROC
| | - Chia-Hao Chang
- School of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan, ROC
| | - Yea-Jyh Chen
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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Pasek J, Szajkowski S, Cieślar G. Quality of Life in Patients with Venous Leg Ulcers Treated by Means of Local Hyperbaric Oxygen Therapy or Local Ozone Therapy-A Single Center Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2071. [PMID: 38138174 PMCID: PMC10744587 DOI: 10.3390/medicina59122071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Venous leg ulcers pose a significant medical problem worldwide. The complexity of the problem determines the need for further interdisciplinary activities that will improve the quality of life for treated patients. This study compared the quality of life of patients with venous leg ulcers who received local hyperbaric oxygen therapy or local ozone therapy procedures as part of comprehensive treatment. Materials and Methods: The study included 129 patients (62 men and 57 women) with venous leg ulcers. Group I underwent local hyperbaric oxygen therapy (HBOT), and Group II underwent local ozone therapy (OZONE). In both groups, the patients' quality of life was assessed before the start of the treatment cycle, as well as 10 weeks and 6 months after the completion of the treatment, by means of the EQ-5D-5L questionnaire and the Polish shortened version of the SF-36 scale. Results: After completing the respective therapeutic cycle, both groups showed statistically significant (p < 0.001) improvement in quality of life, according to the EQ-5D-5L questionnaire and the SF-36 scale. Differences were noted between the 1st examination (before treatment) and the 2nd examination (10 weeks after treatment), as well as the 3rd examination (6 months after treatment). In the EQ-5D-5L assessment of anxiety and depression, self-care, and activities of daily living 6 months after the end of treatment, better results were found in the group of patients treated with local hyperbaric oxygen therapy (p < 0.001). In this group, 6 months after the end of the treatment, a statistically significantly higher result on the EQ-VAS scale was also obtained (73.09 ± 19.8 points vs. 68.03 ± 17.37 points, p = 0.043). However, in the SF-36 assessment performed 6 months after the end of treatment, better results-a statistically significantly lower value of the quality of life index-were recorded in the group of patients treated with local ozone therapy (103.13 ± 15.76 points vs. 109.89 ± 15.42 points, p < 0.015). Conclusions: Hyperbaric oxygen therapy and local ozone therapy procedures have a beneficial effect on improving the quality of life of patients with venous leg ulcers.
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Affiliation(s)
- Jarosław Pasek
- Collegium Medicum im dr Władysława Biegańskiego, Jan Długosz University in Częstochowa, 13/15 Armii Krajowej St., 42-200 Częstochowa, Poland
| | - Sebastian Szajkowski
- Faculty of Medical and Social Sciences, Warsaw Medical Academy of Applied Sciences, 8 Rydygiera St., 01-793 Warszawa, Poland;
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Stefana Batorego St., 41-902 Bytom, Poland;
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Vallejo A, Wallis M, McMillan D. Use of low-frequency contact ultrasonic debridement with and without polyhexamethylene biguanide in hard-to-heal leg ulcers: an RCT. J Wound Care 2022; 31:670-681. [PMID: 36001700 DOI: 10.12968/jowc.2022.31.8.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The primary aim of this research was to investigate the combination effect of polyhexamethylene biguanide (PHMB) and low-frequency contact ultrasonic debridement (LFCUD) on the bacterial load in hard-to-heal wounds in adults, compared with ultrasonic debridement alone. Secondary outcomes included wound healing, quality of life (QoL) and pain scores. METHOD In this single-blinded, randomised, controlled trial participants were randomised to two groups. All participants received LFCUD weekly for six weeks, plus six weeks of weekly follow-up. The intervention group received an additional 15-minute topical application of PHMB post-LFCUD, at each dressing change and in a sustained dressing product. The control group received non-antimicrobial products and the wounds were cleansed with clean water or saline. Wound swabs were taken from all wounds for microbiological analysis at weeks 1, 3, 6 and 12. RESULTS A total of 50 participants took part. The intervention group (n=25) had a lower bacterial load at week 12 compared with the control group (n=25) (p<0.001). There was no difference in complete wound healing between the groups (p=0.47) or wound-related QoL (p=0.15). However, more wounds deteriorated in the control group (44%) compared with the intervention group (8%, p=0.01). A higher proportion of wounds reduced in size in the intervention group (61% versus 12%, p=0.019). Pain was lower in the intervention group at week six, compared with controls (p=0.04). CONCLUSION LFCUD without the addition of an antimicrobial agent such as PHMB, cannot be recommended. Further research requires longer follow-up time and would benefit from being powered sufficiently to test the effects of multiple covariates.
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Affiliation(s)
- Alison Vallejo
- Wound Solutions Clinic, School of Nursing, Midwifery and Paramedicine, The University of the Sunshine Coast, Locked Bag 4, Maroochydore, QLD 4558, Australia
| | - Marianne Wallis
- Wound Solutions Clinic, School of Nursing, Midwifery and Paramedicine, The University of the Sunshine Coast, Locked Bag 4, Maroochydore, QLD 4558, Australia
| | - David McMillan
- INFLAME Biomedical Research Cluster, School of Health and Sports Sciences, The University of the Sunshine Coast, Maroochydore, QLD 4558, Australia
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Arman EB, Augustin M, Mohr N, Debus SE, Breuer P, Blome C. Development and validation of a disease-specific quality of life questionnaire for patients with peripheral artery disease (QOLPAD). J Patient Rep Outcomes 2022; 6:54. [PMID: 35622190 PMCID: PMC9142721 DOI: 10.1186/s41687-022-00451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim of this study was to develop and validate a short and feasible questionnaire to measure health-related quality of life (HRQoL) in patients with peripheral artery disease (PAD). The content of the new instrument is intended to correspond with the simultaneously developed instrument Patient Benefit Index for PAD (PBI-PAD), which evaluates treatment goals and benefits in this patient group. METHODS Fifty patients stated their disease burden on free-text questionnaires, which was used by an interdisciplinary expert panel to develop 12 items for the new instrument, named Quality of Life questionnaire for patients with peripheral artery disease (QOLPAD). The validity of the instrument was tested in patients from Germany with PAD stages I to IV who completed the QOLPAD, EuroQol questionnaire (EQ-5D-3L; EuroQol visual analogue scale (EQ VAS)), and Vascular Quality of Life questionnaire (VascuQoL) before (baseline) and three months after (follow-up) treatment. RESULTS One hundred and three patients were included at baseline (mean age: 68.6 years; 68% male), among whom, 57 provided data at follow-up. Most patients (86.4%) rated the completion of QOLPAD as being easy. Internal consistency was satisfactory, with a Cronbach's alpha of 0.74 (baseline) and 0.84 (follow-up). Convergent validity was indicated by significant correlations with the EQ-5D-3L (baseline: - 0.62; follow-up: - 0.81), EQ VAS (baseline: - 0.44, follow-up: - 0.79), VascuQoL global score (baseline: - 0.77; follow-up: - 0.87), global rating of impairment (baseline: 0.64; follow-up: 0.71), and PAD stage (baseline: 0.40; follow-up: 0.67). Sensitivity to change was confirmed by significant correlations of change in the QOLPAD with changes in convergent criteria; however, the high number of dropouts limits the generalizability of this finding. CONCLUSION This study provided evidence that the QOLPAD is internally consistent and valid in patients receiving treatment for PAD in Germany.
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Affiliation(s)
- Ebru-Berrin Arman
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Nicole Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Sebastian E. Debus
- Department of Vascular Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Peter Breuer
- Department of Vascular and Endovascular Surgery, Asklepios Klinik Wandsbek, Hamburg, Germany
| | - Christine Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
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Mellergaard M, Fauverghe S, Scarpa C, Pozner VL, Skov S, Hebert L, Nielsen M, Bassetto F, Téot L. Evaluation of Fluorescent Light Energy for the Treatment of Acute Second-degree Burns. Mil Med 2021; 186:416-423. [PMID: 33499452 DOI: 10.1093/milmed/usaa299] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/20/2020] [Accepted: 12/08/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The use of photobiomodulation has been proposed to improve wound healing for the last two decades. Recent development in photobiomodulation has led to the development of a novel biophotonic platform that utilizes fluorescent light energy (FLE) within the visible spectrum of light for healing of skin inflammation and wounds. MATERIALS AND METHODS In this article, FLE was used in preliminary analysis on 18 case studies of acute second-degree burns and in a pilot study using an ex vivo human skin model. Efficacy of FLE on wound healing and tissue remodeling was evaluated by monitoring improvements in the treated tissues, assessing pain for the patients, and by performing human genome microarray analysis of FLE-treated human skin samples. RESULTS Healing was reported for all 18 patients treated with FLE for acute second-degree burns without reported adverse effects or development of infections. Furthermore, preliminary ex vivo skin model data suggest that FLE impacts different cellular pathways including essential immune-modulatory mechanisms. CONCLUSIONS The results presented in this article are encouraging and suggest that FLE balances different stages of wound healing, which opens the door to initiating randomized controlled clinical trials for establishing the efficacy of FLE treatment in different phases of wound healing of second-degree burns.
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Affiliation(s)
- Maiken Mellergaard
- Klox Technologies, 2750 Ballerup, Denmark.,Immunology, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | | | - Carlotta Scarpa
- Clinic of Plastic and Reconstructive Surgery, Padova University-Hospital, 35121 Padova, Italy
| | - Vladimir Luca Pozner
- Plastic Surgery Department, Burn Unit, University-Hospital Montpellier, 34295 Montpellier, France
| | - Søren Skov
- Immunology, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Lise Hebert
- Klox Technologies, Inc., Laval, Quebec H7V 4A7, Canada
| | | | - Franco Bassetto
- Clinic of Plastic and Reconstructive Surgery, Padova University-Hospital, 35121 Padova, Italy
| | - Luc Téot
- Plastic Surgery Department, Burn Unit, University-Hospital Montpellier, 34295 Montpellier, France
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[Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC) : S2k guideline of the German Phlebology Society (DGP) in cooperation with the following professional associations: DDG, DGA, DGG, GDL, DGL, BVP. German version]. Hautarzt 2021; 72:137-152. [PMID: 33301064 DOI: 10.1007/s00105-020-04734-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Rabe E, Földi E, Gerlach H, Jünger M, Lulay G, Miller A, Protz K, Reich-Schupke S, Schwarz T, Stücker M, Valesky E, Pannier F. Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC) : S2k guideline of the German Phlebology Society (DGP) in cooperation with the following professional associations: DDG, DGA, DGG, GDL, DGL, BVP. Hautarzt 2021; 72:37-50. [PMID: 33386416 PMCID: PMC8692288 DOI: 10.1007/s00105-020-04706-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 02/02/2023]
Affiliation(s)
- E Rabe
- Emeritus Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn (AöR), Venusberg-Campus 1, 53127, Bonn, Germany.
| | - E Földi
- Földiklinik, Rösslehofweg 2-6, 79856, Hinterzarten, Germany
| | - H Gerlach
- , Zehntstr. 25, 68519, Viernheim, Germany
| | - M Jünger
- Klinik und Poliklinik f. Hautkrankheiten, Universitätsmedizin, Ferdinand Sauerbruchstraße, 17475, Greifswald, Germany
| | - G Lulay
- Klinik für Gefäß- u. Endovaskularchirurgie, Phlebologie-Lymphologie, Frankenburgstr. 31, 48431, Rheine, Germany
| | - A Miller
- Dermatologische Praxis, Wilmersdorfer Str. 62, 10627, Berlin, Germany
| | - K Protz
- Wundforschung, Universitätsklinikum Hamburg-Eppendorf, Bachstr. 75, 22083, Hamburg, Germany
| | - S Reich-Schupke
- Privatpraxis für Haut- und Gefäßmedizin, Wundtherapie, Hertener Str. 27, 45657, Recklinghausen, Germany
| | - T Schwarz
- Praxis für Gefäßmedizin, Konrad Goldmann Str. 5b, 79100, Freiburg, Germany
| | - M Stücker
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef Hospital, Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Germany
| | - E Valesky
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - F Pannier
- Praxis für Dermatologie & Phlebologie, Helmholtzstr. 4-6, 53123, Bonn, Germany
- Dermatologische Universitätsklinik Köln, Cologne, Germany
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12
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Oehme F, Rühle A, Börnert K, Hempel S, Link BC, Babst R, Metzger J, Beeres FJP. Simple Wound Irrigation in the Postoperative Treatment for Surgically Drained Spontaneous Soft Tissue Abscesses: A Prospective, Randomized Controlled Trial. World J Surg 2020; 44:4041-4051. [PMID: 32812137 DOI: 10.1007/s00268-020-05738-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Soft tissue abscesses are among the most frequently encountered medical problems treated by different surgeons. Standard therapy remains incision and drainage with sterile saline irrigation during postoperative wound healing period. Aim of this prospective randomized controlled trial was to compare sterile irrigation versus nonsterile irrigation. STUDY DESIGN A single center randomized controlled trial was performed to investigate postoperative wound irrigation. The control group used sterile irrigation, and the intervention group used nonsterile irrigation. Primary endpoints were reinfection and reintervention rates, assessed during follow-up controls for up to 2 years. Secondary endpoints were the duration of wound healing, inability to work, pain and quality of life. RESULTS Between 04/2016 and 05/2017, 118 patients were randomized into two groups, with 61 allocated to the control- and 57 to the intervention group. Reinfection occurred in a total of 4 cases (6.6%) in the sterile protocol and 4 (7%) in the nonsterile protocol. Quality of life and pain values were comparable during the wound healing period, and patients treated according to the nonsterile irrigation protocol used significantly fewer wound care service teams. Despite equal wound persistence rates, a substantially shorter amount of time off from work was reported in the nonsterile protocol group (p value 0.086). CONCLUSION This prospective, randomized trial indicates that a nonsterile irrigation protocol for patients operated on for soft tissue abscesses is not inferior to the standard sterile protocol. Moreover, a nonsterile irrigation protocol leads to a shorter period of inability to work with comparable pain and quality of life scores during the wound healing period.
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Affiliation(s)
- F Oehme
- Department for Visceral, Thoracic and Vascular Surgery at the University Hospital Dresden, Carl Gustav Carus University Dresden, P.O. Box 01307, Dresden, Germany. .,Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland.
| | - A Rühle
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, P.O. Box 69120, Heidelberg, Germany.,Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
| | - K Börnert
- Department of Trauma Surgery, Cantonal Hospital Obwalden, Brünigstrasse 181, P.O. Box 6060, 6060, Sarnen, Switzerland.,Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
| | - S Hempel
- Department for Visceral, Thoracic and Vascular Surgery at the University Hospital Dresden, Carl Gustav Carus University Dresden, P.O. Box 01307, Dresden, Germany
| | - B-C Link
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
| | - R Babst
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
| | - J Metzger
- Department of General Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
| | - F J-P Beeres
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Spitalstrasse 16, P.O. Box 6000, 6000, Lucerne, Switzerland
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Krupová L, Pokorná A. Quality of life in patients with non-healing wounds, with particular focus on assesment tools - a literature review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Improvement in wound healing, pain, and quality of life after 12 weeks of SNF472 treatment: a phase 2 open-label study of patients with calciphylaxis. J Nephrol 2019; 32:811-821. [PMID: 31401795 DOI: 10.1007/s40620-019-00631-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 07/13/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Calciphylaxis in end-stage renal disease is characterized by painful necrotic skin ulcers and high mortality. There are no approved therapies. SNF472, an intravenous formulation of myo-inositol hexaphosphate, inhibits the formation and growth of hydroxyapatite crystals, the final common pathway in the pathogenesis of vascular calcification. METHODS In this open-label, single-arm study, calciphylaxis patients on thrice-weekly hemodialysis and standard care, received intravenous SNF472 3 times per week for 12 weeks. The primary endpoint was wound healing assessed using the quantitative Bates-Jensen Wound Assessment Tool (BWAT). Pain visual analog scale (VAS), quality of life (wound-QoL), and qualitative wound image review were secondary endpoints. Quantitative changes from baseline were analyzed by paired t-tests using multiple imputation to account for missing observations. RESULTS Fourteen patients received SNF472. Improvements from baseline to week 12 were observed for mean BWAT score (- 8.1; P < 0.001), pain VAS (- 23.6 mm; P = 0.015) and wound-QoL global score (- 0.90; P = 0.003). Of the 9 patients with ulcerated lesions at baseline who completed treatment, wound image review showed improvement for 7. SNF472 was well tolerated with no serious treatment-related adverse events. The most common adverse events were infections which occur frequently in patients on hemodialysis. None of these were considered as treatment-related. CONCLUSIONS SNF472 was well-tolerated and improvements from baseline to week 12 in wound healing, pain, and quality of life were observed. A randomized, double-blind, placebo-controlled trial is planned to evaluate SNF472 in patients with calciphylaxis.
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