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Sharma A, Shankar R, Yadav AK, Pratap A, Ansari MA, Srivastava V. Burden of Chronic Nonhealing Wounds: An Overview of the Worldwide Humanistic and Economic Burden to the Healthcare System. INT J LOW EXTR WOUND 2024:15347346241246339. [PMID: 38659348 DOI: 10.1177/15347346241246339] [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: 04/26/2024]
Abstract
Chronic wounds have long been a significant public health concern, but the true impact of these wounds is unknown since research designs and measuring techniques vary, leading to inconsistent estimates. The definition of a wound is a loss of epithelial continuity caused by damage to the tissue. The following conditions can cause chronic wounds: panniculitis, pyoderma gangrenosum, traumatic, neurological, metabolic, hematologic, neoplastic, or infection-related. The growing global incidence of diabetes and the aging population necessitate greater attention to chronic wounds. Regrettably, it is sad that significant healthcare institutions have overlooked wound research. The study of health-related illnesses and occurrences in particular populations, including their distribution, frequency, and determinants, and the application of this research to control health problems.
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Affiliation(s)
- Aditya Sharma
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ravi Shankar
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Kumar Yadav
- Centre of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arvind Pratap
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Mumtaz Ahmad Ansari
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vivek Srivastava
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Zhou JQ, Huang LF, Lu YC, Li Q, Ma X, Tang JJ, Niu YW, Lu SL. Prevalence and prognosis of hard-to-heal wounds with comorbidities in China. J Wound Care 2022; 31:S7-S15. [PMID: 36240874 DOI: 10.12968/jowc.2022.31.sup10.s7] [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: 06/16/2023]
Abstract
OBJECTIVE Regular retrospective analysis is necessary for potential improvement in clinical practice for the treatment of hard-to-heal wounds. Comorbidities and outcomes have demonstrated spatial and temporal diversity, emphasising the importance of updates in epidemiology. The complexity of healing hard-to-heal wounds has long been known, and so we sought evidence-based improvement on the current principles of treatment. METHOD Demographic and clinical information of patients from the WoundCareLog database was collected. Patients who met the inclusion criteria and completed follow-up after treatment were included. Comorbidities were diagnosed and classified into eight categories based on ICD-10. We compared the demographic and aetiological characteristics between patients with and without comorbidities by t-test and Chi-squared test. The impact of comorbidities on wound healing were evaluated with a multivariate Cox model. RESULTS A total of 2163 patients met the inclusion criteria and were enrolled, of whom 37.0% were aged 61-80 years, 36.0% were aged 41-60 years and 60.8% were male. The lower extremities and buttocks were the most commonly affected areas with hard-to-heal wounds. Non-traumatic wounds accounted for 66.6% of cases, and infection, pressure and diabetes were the most common causes. Paralysis and diabetes were the most important factors which led to a prolonged healing process and inferior clinical outcomes. CONCLUSION Comorbidities of hard-to-heal wounds were treated as separate contributors and their weighted effect on outcome was calculated through correlation analysis. Paralysis and diabetes were the most unfavourable comorbidities affecting the treatment of non-traumatic hard-to-heal wounds. Our study highlighted the priority of comorbidity treatment through data-driven approaches. It provides potential value in developing better public health strategies and preventive medicine.
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Affiliation(s)
- Jing-Qi Zhou
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Fang Huang
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ye-Chen Lu
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Li
- Siemens Healthcare Corporation, Shanghai, China
| | - Xian Ma
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Jun Tang
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Wen Niu
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shu-Liang Lu
- Department of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Center of Wound Healing, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Silina EV, Stupin VA, Suzdaltseva YG, Aliev SR, Abramov IS, Khokhlov NV. Application of Polymer Drugs with Cerium Dioxide Nanomolecules and Mesenchymal Stem Cells for the Treatment of Skin Wounds in Aged Rats. Polymers (Basel) 2021; 13:1467. [PMID: 34062803 PMCID: PMC8125777 DOI: 10.3390/polym13091467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
The urgency of the problem of wound healing is not in doubt, given the global trend of an increase in the number of operations and injuries with skin damage, as well as the lack of universal means of treating wounds. STUDY OBJECTIVE To compare the effectiveness of the developed drugs, smart polymeric nano-drug with cerium oxide nanoparticles (SPN), and smart polymeric nano-drug in combination with mesenchymal stem cells (SPN + SC) on the healing process of skin wounds. MATERIAL AND METHODS An experimental study was carried out using Wistar rats of post-reproductive age, which had dermis and epidermis removed on their backs. There were four groups of wounds in total: control, treatment with mesenchymal stem cells (SC), SPN, and SPN + SC. RESULTS A positive therapeutic effect of polymeric drugs on the dynamics of wound area reduction was established, which was most typical for wounds of the SPN group and, particularly, the SPN + SC group. On the third day, an anti-inflammatory effect was revealed in the SC and the SPN + SC groups in particular, which was expressed in a reduced leukocyte infiltration and an increase in the level of microcirculation during this period. The fastest transition from the phase of exudation to proliferation was recorded in the SPN and SPN + SC groups. Histologically, these groups showed faster regeneration, including the epithelialization of wounds. CONCLUSION The results obtained in the course of the study open up possibilities for the development of fundamentally new, highly effective wound healing agents.
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Affiliation(s)
- Ekaterina Vladimirovna Silina
- Department of Human Pathology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Victor Aleksandrovich Stupin
- Department of Hospital Surgery No. 1, N.I. Pirogov Russian National Research Medical University (RNRMU), 117997 Moscow, Russia; (V.A.S.); (S.R.A.); (I.S.A.); (N.V.K.)
| | - Yulia Gennadievna Suzdaltseva
- Department of Epigenetics, Vavilov Institute of General Genetics of the Russian Academy of Sciences, Gubkin str. 3, 119991 Moscow, Russia;
| | - Salekh Rovshanovich Aliev
- Department of Hospital Surgery No. 1, N.I. Pirogov Russian National Research Medical University (RNRMU), 117997 Moscow, Russia; (V.A.S.); (S.R.A.); (I.S.A.); (N.V.K.)
| | - Igor Sergeevich Abramov
- Department of Hospital Surgery No. 1, N.I. Pirogov Russian National Research Medical University (RNRMU), 117997 Moscow, Russia; (V.A.S.); (S.R.A.); (I.S.A.); (N.V.K.)
| | - Nikolay Valerievich Khokhlov
- Department of Hospital Surgery No. 1, N.I. Pirogov Russian National Research Medical University (RNRMU), 117997 Moscow, Russia; (V.A.S.); (S.R.A.); (I.S.A.); (N.V.K.)
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Prevalence of Chronic Skin Wounds and Their Risk Factors in an Inpatient Hospital Setting in Northern China. Adv Skin Wound Care 2020; 33:1-10. [DOI: 10.1097/01.asw.0000694164.34068.82] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ren H, Ding Y, Hu H, Gao T, Qin Z, Hu Y, Cao R, Liang L, Li C, Mei S. Relationships among economic stress, social support, age and quality of life in patients with chronic wounds: A moderated mediation model. J Adv Nurs 2020. [PMID: 32400891 DOI: 10.1111/jan.14413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/10/2020] [Accepted: 04/28/2020] [Indexed: 12/01/2022]
Abstract
AIMS The aims of this study were as follows: (a) to determine if social support mediates the relationship between economic stress and quality of life; and (b) to explore whether participants' ages would moderate the indirect relationship between economic stress and quality of life through social support. DESIGN A questionnaire-based, cross-sectional study. METHODS From January 2015-June 2016, a total of 300 patients with chronic wounds were recruited from three hospitals. Data regarding economic stress, social support and quality of life were collected through survey questionnaires. The moderated mediation analysis was examined using the Hayes' PROCESS macro modelling tool, based on the bias-corrected bootstrapping method. RESULTS Economic stress was negatively correlated with quality of life and social support. The indirect effect of economic stress on quality of life through social support was negative. Furthermore, age moderated the relationship between economic stress and quality of life, as well as the relationship between economic stress and social support. CONCLUSION Reducing economic stress and improving social support are important strategies for improving quality of life in patients with chronic wounds, especially for younger patients. IMPACT Patients with chronic wounds experience considerable economic stress and severely impaired quality of life; however, little is known about the inner mechanisms of this relationship. This study emphasized the importance of providing social support in coping with the damage that economic stress causes to health. Clinical nurses should strengthen the comprehensive assessment of the socioeconomic status of patients and adjust nursing plans timely, to reduce the economic burden of patients based on the rational use of wound care materials. Moreover, when nursing for patients with chronic wounds, especially the elders, caregivers should strengthen the evaluation of social support and develop interventions to improve social support.
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Affiliation(s)
- Hui Ren
- School of Public Health, Jilin University, Changchun, China.,The First Hospital of Jilin University, Changchun, China
| | - Yanming Ding
- Peking University First Hospital, Beijing, China
| | - Haiyan Hu
- The First Hospital of Jilin University, Changchun, China
| | - Tingting Gao
- School of Public Health, Jilin University, Changchun, China
| | - Zeying Qin
- School of Public Health, Jilin University, Changchun, China
| | - Yueyang Hu
- School of Public Health, Jilin University, Changchun, China
| | - Ruilin Cao
- School of Public Health, Jilin University, Changchun, China
| | - Leilei Liang
- School of Public Health, Jilin University, Changchun, China
| | - Chuanen Li
- School of Public Health, Jilin University, Changchun, China
| | - Songli Mei
- School of Public Health, Jilin University, Changchun, China
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New Treatment of Wound Healing With Allogenic Acellular Human Skin Graft: Preclinical Assessment and In Vitro Study. Transplant Proc 2020; 52:2204-2207. [PMID: 32340748 DOI: 10.1016/j.transproceed.2020.02.115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/13/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Nonhealing wounds can be a major clinical problem. Impaired wound healing is often related to massive tissue injury, concomitant wound healing deficiencies (chronic wounds), burn injury, or congenital conditions. We propose a novel biological dressing as an alternative surgical approach. The dressing is a form of an allogenic human skin graft equivalent with further use of allogeneic stem cells classified as an advanced therapy medicinal product. This new allogenic acellular human skin graft has been specifically developed to address the clinical indications for dressing wound lesions and promoting tissue repair in specific rare genetic diseases. METHODS This case report illustrates the use of an acellular human skin allograft seeded with multipotent stem cells in the treatment of tissue injuries (burns), congenital conditions, and chronic wounds. Donor-tissue processing yields an acellular dermal matrix with integral collagen bundling and organization, as well as an intact basement membrane complex. RESULTS Preclinical observations show prolonged viability of acellular human skin grafts with multipotent stem cells. This was confirmed with histological and electron-microscopic evaluation of biopsies, which demonstrated host-cell infiltration and neovascularization of the biological dressing. Moreover, the dressings were characterized by low immunogenicity, as confirmed by histology exam and T-cell proliferation assays in vitro. CONCLUSION Our data confirmed the safety and efficacy of the evaluated acellular human skin grafts, which may be used in patients with rare diseases, such as epidermolysis bullosa, burn injuries, and chronic wounds.
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Osmarin VM, Boni FG, Bavaresco T, Lucena ADF, Echer IC. Use of the Nursing Outcomes Classification - NOC to assess the knowledge of patients with venous ulcer. Rev Gaucha Enferm 2019; 41:e20190146. [PMID: 31800800 DOI: 10.1590/1983-1447.2020.20190146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 06/27/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the knowledge of patients with venous ulcers (VU) on their chronic disease, treatment, and prevention of complications, according to the Nursing Outcomes Classification-NOC. METHODS This is a cross-sectional study conducted between 2017 and 2018 in a Brazilian hospital. The sample consisted of 38 patients with VU attended in outpatient nursing consultations. The study analyzed sociodemographic, clinical and nine indexes from the Knowledge: Chronic Disease Management (1847) of the NOC, assessed using a five-point Likert scale, analyzed using descriptive statistics. RESULTS The mean of the result Knowledge: Chronic Disease Management (1847) was 3.56±1.42. The clinical index Procedures involved in treatment regimen had the highest mean 4.18±0.21, followed by Pain management strategies with 3.92±0.27. In the association between knowledge and healing, the best scores were in patients with at least one healed VU. CONCLUSION The knowledge of the patients was moderate and it was necessary to promote educational actions according to individual demands.
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Affiliation(s)
- Viviane Maria Osmarin
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Fernanda Guarilha Boni
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Taline Bavaresco
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Amália de Fátima Lucena
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.,Hospital de Clínicas de Porto Alegre (HCPA), Comissão do Processo de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Isabel Cristina Echer
- Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.,Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Enfermagem Cardiovascular, Nefrologia e Imagem. Porto Alegre, Rio Grande do Sul, Brasil
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Gao J, Wang L, Xia C, Yang X, Cao Z, Zheng L, Ko R, Shen C, Yang C, Cheng C. Cold atmospheric plasma promotes different types of superficial skin erosion wounds healing. Int Wound J 2019; 16:1103-1111. [PMID: 31207094 DOI: 10.1111/iwj.13161] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/15/2019] [Accepted: 05/25/2019] [Indexed: 12/18/2022] Open
Abstract
Superficial skin erosion wounds are very common in the clinic, and conventional treatments are not always effective; thus, effective and novel therapy is needed. Cold atmospheric plasma (CAP) has been recognised as a promising approach to wound healing. The purpose of this study is to show the potential clinical application of CAP for the healing of different kinds of superficial skin wounds. Seven patients with different kinds of superficial skin wounds (two patients with pyoderma gangrenosum, two patients with trauma would, one patient with giant genital wart, one patient with diabetic foot, and one patient with chronic eczema) were recruited to this study. All patients accepted and received CAP treatment every other day till the wound healed. The expected results were complete wound healing after CAP treatment. All patients achieved complete wound healing after several rounds (range from two to eight) of CAP treatment, and there was no side effect observed. CAP may provide a new and effective choice to solve the problem of the healing of superficial wounds that are not only caused by trauma but also because of eczema. CAP has certain value in the treatment of superficial skin diseases in the future.
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Affiliation(s)
- Jing Gao
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Liyun Wang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Chuankai Xia
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Xingyu Yang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Zhicheng Cao
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Lei Zheng
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Randy Ko
- Department of Dermatology, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Changbing Shen
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Department of Dermatology, Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,Musculoskeletal Research Center, Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, Massachusetts
| | - Chunjun Yang
- Department of Dermatology, The Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Cheng Cheng
- Applied Plasma Division, Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
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Brain D, Tulleners R, Lee X, Cheng Q, Graves N, Pacella R. Cost-effectiveness analysis of an innovative model of care for chronic wounds patients. PLoS One 2019; 14:e0212366. [PMID: 30840658 PMCID: PMC6402622 DOI: 10.1371/journal.pone.0212366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/31/2019] [Indexed: 11/27/2022] Open
Abstract
Current provision of services for the care of chronic wounds in Australia is disjointed and costly. There is large variability in the way that services are provided, and little evidence regarding the cost-effectiveness of a specialist model of care for treatment and management. A decision-analytic model to evaluate the cost-effectiveness of a specialist wound care clinic as compared to usual care for chronic wounds is presented. We use retrospective and prospective data from a cohort of patients as well as information from administrative databases and published literature. Our results show specialist wound clinics are cost-effective for the management of chronic wounds. On average, specialist clinics were $3,947 cheaper than usual clinics and resulted in a quality adjusted life year gain of 0.04 per patient, per year. Specialist clinics were the best option under multiple scenarios including a different cost perspective and when the cost of a hospital admission was reduced. Current models of care are inefficient and represent low value care, and specialist wound clinics represent a good investment compared to current approaches for the management of chronic wounds in Australia.
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Affiliation(s)
- David Brain
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Wound Management Innovations Cooperative Research Centre, Brisbane, Australia
- * E-mail:
| | - Ruth Tulleners
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Wound Management Innovations Cooperative Research Centre, Brisbane, Australia
| | - Xing Lee
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Qinglu Cheng
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Wound Management Innovations Cooperative Research Centre, Brisbane, Australia
| | - Nicholas Graves
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Wound Management Innovations Cooperative Research Centre, Brisbane, Australia
| | - Rosana Pacella
- Australian Centre for Health Services Innovation (AusHSI), Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Wound Management Innovations Cooperative Research Centre, Brisbane, Australia
- The University of Chichester, West Sussex, United Kingdom
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Xie T, Ye J, Rerkasem K, Mani R. The venous ulcer continues to be a clinical challenge: an update. BURNS & TRAUMA 2018; 6:18. [PMID: 29942813 PMCID: PMC6003071 DOI: 10.1186/s41038-018-0119-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/11/2018] [Indexed: 01/18/2023]
Abstract
Venous ulcers are a common chronic problem in many countries especially in Northern Europe and USA. The overall prevalence of this condition is 1% rising to 3% in the over 65 years of age. Over the last 25 years, there have been many developments applicable to its diagnosis and treatment. These advances, notwithstanding healing response and recurrence, are variable, and the venous ulcer continues to be a clinical challenge. The pathogenesis of venous ulcers is unrelieved or ambulatory venous hypertension resulting mostly from deep venous thrombosis leading to venous incompetence, lipodermatosclerosis, leucocyte plugging of the capillaries, tissue hypoxia and microvascular dysfunction. It is not known what initiates venous ulcers. Triggers vary from trauma of the lower extremity to scratching to relieve itchy skin over the ankle region. Venous ulcers can be painful, and this condition presents an increasing burden of care. A systematic analysis of the role of technology used for diagnosis and management strongly supports the use of compression as a mainstay of standardised care. It further shows good evidence for the potential of some treatment procedures to accelerate healing. This article reviews the pathogenetic mechanisms, current diagnostic methods and standard care and its limitations.
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Affiliation(s)
- Ting Xie
- 1Wound Healing Centre at Emergency Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junna Ye
- 2Department of Rheumatology and Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kittipan Rerkasem
- 3NCD Centre of Excellence, Research Institute of Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,4NCD Centre and Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rajgopal Mani
- 4NCD Centre and Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,5Academic Division of Human Health and Development, Faculty of Medicine, University of Southampton, Southampton, UK.,6Shanghai Jiao Tong University, Shanghai Jiao Tong School of Medicine, Shanghai, China
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Wound healing applications of biogenic colloidal silver and gold nanoparticles: recent trends and future prospects. Appl Microbiol Biotechnol 2018; 102:4305-4318. [DOI: 10.1007/s00253-018-8939-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 12/21/2022]
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