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Kabir MA, Samad S, Ahmed F, Naher S, Featherston J, Laird C, Ahmed S. Mobile Apps for Wound Assessment and Monitoring: Limitations, Advancements and Opportunities. J Med Syst 2024; 48:80. [PMID: 39180710 PMCID: PMC11344716 DOI: 10.1007/s10916-024-02091-x] [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: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 08/26/2024]
Abstract
With the proliferation of wound assessment apps across various app stores and the increasing integration of artificial intelligence (AI) in healthcare apps, there is a growing need for a comprehensive evaluation system. Current apps lack sufficient evidence-based reliability, prompting the necessity for a systematic assessment. The objectives of this study are to evaluate the wound assessment and monitoring apps, identify limitations, and outline opportunities for future app development. An electronic search across two major app stores (Google Play store, and Apple App Store) was conducted and the selected apps were rated by three independent raters. A total of 170 apps were discovered, and 10 were selected for review based on a set of inclusion and exclusion criteria. By modifying existing scales, an app rating scale for wound assessment apps is created and used to evaluate the selected ten apps. Our rating scale evaluates apps' functionality and software quality characteristics. Most apps in the app stores, according to our evaluation, do not meet the overall requirements for wound monitoring and assessment. All the apps that we reviewed are focused on practitioners and doctors. According to our evaluation, the app ImitoWound got the highest mean score of 4.24. But this app has 7 criteria among our 11 functionalities criteria. Finally, we have recommended future opportunities to leverage advanced techniques, particularly those involving artificial intelligence, to enhance the functionality and efficacy of wound assessment apps. This research serves as a valuable resource for future developers and researchers seeking to enhance the design of wound assessment-based applications, encompassing improvements in both software quality and functionality.
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Affiliation(s)
- Muhammad Ashad Kabir
- School of Computing, Mathematics and Engineering, Charles Sturt University, Bathurst, 2795, NSW, Australia.
| | - Sabiha Samad
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chattogram, 4349, Chattogram, Bangladesh
| | - Fahmida Ahmed
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chattogram, 4349, Chattogram, Bangladesh
| | - Samsun Naher
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chattogram, 4349, Chattogram, Bangladesh
| | - Jill Featherston
- School of Medicine, Cardiff University, Cardiff, CF14 4YS, Wales, United Kingdom
| | - Craig Laird
- Principal Pedorthist, Walk Easy Pedorthics Pty. Ltd., Tamworth, 2340, NSW, Australia
| | - Sayed Ahmed
- Principal Pedorthist, Foot Balance Technology Pty Ltd, Westmead, 2145, NSW, Australia
- Offloading Clinic, Nepean Hospital, Kingswood, 2750, NSW, Australia
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Huang J, Fan C, Ma Y, Huang G. Exploring Thermal Dynamics in Wound Healing: The Impact of Temperature and Microenvironment. Clin Cosmet Investig Dermatol 2024; 17:1251-1258. [PMID: 38827629 PMCID: PMC11144001 DOI: 10.2147/ccid.s468396] [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: 03/12/2024] [Accepted: 05/18/2024] [Indexed: 06/04/2024]
Abstract
Exploring the critical role of thermal dynamics in wound healing, this manuscript navigates through the complex biological responses initiated upon wound infliction and how temperature variations influence the healing trajectory. Integrating biothermal physics, clinical medicine, and biomedical engineering, it highlights the significance of thermal management in wound care, emphasizing the wound microenvironment's division into internal and external domains and their collaborative impact on tissue repair. Innovations in real-time wound temperature monitoring, especially through intelligent wireless sensor dressings, are spotlighted as transformative, enabling precise wound condition management. The text underscores the necessity for further research to elucidate thermal regulation's molecular and cellular mechanisms on healing processes. It advocates for standardized protocols for localized heating treatments, integrating them into personalized wound care strategies to enhance therapeutic outcomes, improve patient well-being, and achieve cost-effective healthcare practices. This work presents a forward-looking perspective on refining wound management through sophisticated, evidence-based interventions, emphasizing the interplay between thermal dynamics and wound healing.
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Affiliation(s)
- Jun Huang
- Department of Clinical Medicine, Shandong Second Medical University (Weifang Medical University), Weifang, 261000, People’s Republic of China
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Chunjie Fan
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Yindong Ma
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Guobao Huang
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
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Galdino-Júnior H, Martins de Oliveira Segundo E, Gomes Malaquias S, Vinaud MC, Pereira LV, Guimarães RA, Bachion MM. Effect of Heated Saline Solution on Pain Intensity, Wound Bed Temperature, and Comfort during Chronic Wound Dressing Changes: Crossover Randomized Clinical Trial. Adv Skin Wound Care 2024; 37:1-8. [PMID: 38648246 DOI: 10.1097/asw.0000000000000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To evaluate the use of heated saline solution during wound cleaning on the intensity of pain related to the procedure, the temperature of the wound bed, and the comfort of patients with chronic wounds. Further, to investigate patient preference in relation to the temperature of the solution used for cleaning. METHODS Crossover, single-blind, clinical trial with 32 people with chronic wounds. Providers cleaned the wounds with room temperature and heated saline solution. Participants were randomized into group 1 A/B (heated solution first, room temperature second) or group 2 B/A (room temperature solution first, heated solution second), with a 10-minute washout period. Investigators evaluated pain intensity, wound bed temperature, and patient-reported comfort and preference. RESULTS The heated solution was preferred (P = .04) and more often referred to as comfortable (P = .04) by the participants. There was no difference in pain intensity before and after cleaning with room temperature (2.03; P = .155) and heated saline (2.25; P = .44). The heated solution increased the temperature of the wound bed by 0.5 °C. CONCLUSIONS Although heating saline solution could be an important comfort measure during dressing changes, quantitatively, the temperature of the solution did not significantly change the temperature of the wound bed nor the intensity of pain patients experienced.
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Affiliation(s)
- Hélio Galdino-Júnior
- Hélio Galdino-Júnior, MPH, RN, is Associate Professor, Federal University of Goiás, Goiânia, Goiás, Brazil. Emilson Martins de Oliveira Segundo, MSN, RN, is ICU Nursing Coordinator, Hospital Ortopédico Promed-Hapvida NotreDame Intermédica, Goiânia. Also at the Federal University of Goiás, Suelen Gomes Malaquias, MSN, RN, is Adjunct Professor; Marina Clare Vinaud, PhD, is Associate Professor; Lilian Varanda Pereira, PhD, RN, is Full Professor; Rafael Alves Guimarães, PhD, RN, is Adjunct Professor; and Maria Márcia Bachion, PhD, RN, is Full Professor. The authors have disclosed no financial relationships related to this article. Submitted January 5, 2023; accepted in revised form March 14, 2023
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Vélez González JJ, Berger M, Schiele S, Rubeck A, Müller G, Welzel J, Schuh S. Dynamic optical coherence tomography of chronic venous ulcers. J Eur Acad Dermatol Venereol 2024; 38:223-231. [PMID: 37669869 DOI: 10.1111/jdv.19496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Chronic ulcers, especially venous leg ulcers, are a major burden on the healthcare system. To date there are only few non-invasive established procedures for evaluation of blood perfusion in wounds. Dynamic optical coherence tomography (D-OCT) provides images of the skin's superficial vascularisation. OBJECTIVES This study aims to investigate if and how the D-OCT measurement of chronic wounds can provide new information about the vascularisation during the healing process. METHODS We examined 16 venous ulcers over 16 weeks and evaluated the vessel morphology and density using D-OCT at the wound bed, borders, two centimetres adjacent to the wound und at non-ulcerated skin on the contralateral leg. RESULTS In D-OCT scans clumps were unique and the most common vessel type in the wound area of venous ulcers, whereas lines and serpiginous vessels were the most common in non-ulcerated skin. At the wound border mottle and cluster patterns occurred more frequently. Healthy skin showed a significant increase of mesh pattern. Vessel density significantly increased at the wound area compared to non-ulcerated skin. During the healing process the wound border showed the most vascular changes while only an increase in curves was observed in the wound centre. Non-healing wounds had fewer dots and blobs at the borders, fewer dots, coils, clumps, lines and serpiginous vessels at the centre and fewer dots in adjacent skin. Temperature analysis showed higher temperatures in non-ulcerated skin, followed by the wound margin and centre. Non-healing wounds showed the lowest temperatures in the wound centre. CONCLUSIONS These results highlight the non-invasive use of D-OCT for the examination and monitoring of wound healing in chronic venous ulcers. D-OCT imaging of blood vessels may offer the potential to detect disorders of wound healing at an early stage, differentiate ulcers of different genesis and to tailor more individualized, patient-oriented therapy.
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Affiliation(s)
| | - Maximilian Berger
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Anna Rubeck
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
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Li J, Huang X, Yang Y, Zhou J, Yao K, Li J, Zhou Y, Li M, Wong TH, Yu X. Wearable and battery-free wound dressing system for wireless and early sepsis diagnosis. Bioeng Transl Med 2023; 8:e10445. [PMID: 38023725 PMCID: PMC10658553 DOI: 10.1002/btm2.10445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 10/30/2022] [Indexed: 02/04/2023] Open
Abstract
Sepsis is a severe organ dysfunction typically caused by wound infection which leads to septic shock, organ failure or even death if no early diagnosis and property medical treatment were taken. Herein, we report a soft, wearable and battery-free wound dressing system (WDS) for wireless and real-time monitoring of wound condition and sepsis-related biomarker (procalcitonin [PCT]) in wound exudate for early sepsis detection. The battery-free WDS powered by near-field communication enables wireless data transmission, signal processing and power supply, which allows portable intelligent wound caring. The exudate collection associates with soft silicone based microfluidic technologies (exudate collection time within 15 s), that can filtrate contamination at the cell level and enable a superior filtration rate up to 95% with adopting microsphere structures. The battery-free WDS also includes state-of-the-art biosensors, which can accurate detect the pH value, wound temperature, and PCT level and thus for sepsis diagnosis. In vivo studies of SD rats prove the capability of the WDS for continuously monitoring wound condition and PCT concentration in the exudate. As a result, the reported fully integrated WDS provides a potential solution for further developing wearable, multifunctional and on-site disease diagnosis.
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Affiliation(s)
- Jiyu Li
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
- Hong Kong Center for Cerebra‐Cardiovascular Health EngineeringHong Kong Science ParkNew TerritoriesHong Kong
| | - Xingcan Huang
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
| | - Yawen Yang
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
| | - Jingkun Zhou
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
- Hong Kong Center for Cerebra‐Cardiovascular Health EngineeringHong Kong Science ParkNew TerritoriesHong Kong
| | - Kuanming Yao
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
| | - Jian Li
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
- Hong Kong Center for Cerebra‐Cardiovascular Health EngineeringHong Kong Science ParkNew TerritoriesHong Kong
| | - Yingying Zhou
- Department of Biomedical EngineeringHong Kong Polytechnic UniversityKowloonHong Kong
| | - Meixi Li
- Leshan Hospital of Traditional Chinese MedicineLeshanChina
| | - Tsz Hung Wong
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
| | - Xinge Yu
- Department of Biomedical EngineeringCity University of Hong KongKowloon TongHong Kong
- Hong Kong Center for Cerebra‐Cardiovascular Health EngineeringHong Kong Science ParkNew TerritoriesHong Kong
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Derwin R, Patton D, Strapp H, Moore Z. Wound pH and temperature as predictors of healing: an observational study. J Wound Care 2023; 32:302-310. [PMID: 37094930 DOI: 10.12968/jowc.2023.32.5.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The aim of this study was to measure wound pH, wound temperature and wound size together to gain further understanding of their impact as predictors of wound healing outcomes. METHOD This study employed a quantitative non-comparative, prospective, descriptive observational design. Participants with both acute and hard-to-heal (chronic) wounds were observed weekly for four weeks. Wound pH was measured using pH indicator strips, wound temperature was measured using an infrared camera and wound size was measured using the ruler method. RESULTS Most of the 97 participants (65%, n=63) were male; participant's ages ranged between 18 and 77 years (mean: 42±17.10. Most of the wounds observed were surgical 60%, (n=58) and 72% (n=70) of the wounds were classified as acute, with 28% (n=27) classified as hard-to-heal wounds. At baseline, there was no significant difference in pH between acute and hard-to-heal wounds; overall the mean pH was 8.34±0.32, mean temperature was 32.86±1.78°C) and mean wound area was 910.50±1132.30mm2. In week 4, mean pH was 7.71±1.11, mean temperature was 31.90±1.76°C and mean wound area was 339.90±511.70mm2. Over the study follow-up period, wound pH ranged from 5-9, from week 1 to week 4, mean pH reduced by 0.63 units from 8.34 to 7.71. Furthermore, there was a mean 3% reduction in wound temperature and a mean 62% reduction in wound size. CONCLUSION The study demonstrated that a reduction in pH and temperature was associated with increased wound healing as evidenced by a corresponding reduction in wound size. Thus, measuring pH and temperature in clinical practice may provide clinically meaningful data pertaining to wound status.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | | | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- School of Nursing & Midwifery, Griffith University, Queensland, Australia
- School of Health Sciences, Faculty of Life and Health Sciences Ulster University, Northern Ireland
- Cardiff University, Cardiff, Wales
- Department of Nursing, Fakeeh College for Medical Sciences, Jeddah, KSA
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- Lida Institute, Shanghai, China
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Schoeller J, Wuertz-Kozak K, Ferguson SJ, Rottmar M, Avaro J, Elbs-Glatz Y, Chung M, Rossi RM. Ibuprofen-loaded electrospun poly(ethylene- co-vinyl alcohol) nanofibers for wound dressing applications. NANOSCALE ADVANCES 2023; 5:2261-2270. [PMID: 37056625 PMCID: PMC10089083 DOI: 10.1039/d3na00102d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
Chronic wounds are characterized by a prolonged inflammation phase preventing the normal processes of wound healing and natural regeneration of the skin. To tackle this issue, electrospun nanofibers, inherently possessing a high surface-to-volume ratio and high porosity, are promising candidates for the design of anti-inflammatory drug delivery systems. In this study, we evaluated the ability of poly(ethylene-co-vinyl alcohol) nanofibers of various chemical compositions to release ibuprofen for the potential treatment of chronic wounds. First, the electrospinning of poly(ethylene-co-vinyl alcohol) copolymers with different ethylene contents (32, 38 and 44 mol%) was optimized in DMSO. The morphology and surface properties of the membranes were investigated via state-of-the-art techniques and the influence of the ethylene content on the mechanical and thermal properties of each membrane was evaluated. Furthermore, the release kinetics of ibuprofen from the nanofibers in a physiological temperature range revealed that more ibuprofen was released at 37.5 °C than at 25 °C regardless of the ethylene content. Additionally, at 25 °C less drug was released when the ethylene content of the membranes increased. Finally, the scaffolds showed no cytotoxicity to normal human fibroblasts collectively paving the way for the design of electrospun based patches for the treatment of chronic wounds.
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Affiliation(s)
- Jean Schoeller
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles 9014 St. Gallen Switzerland
- ETH Zürich, Institute for Biomechanics 8093 Zürich Switzerland
| | - Karin Wuertz-Kozak
- Rochester Institute of Technology (RIT), Department of Biomedical Engineering Rochester NY 14623 USA
| | | | - Markus Rottmar
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces 9014 St. Gallen Switzerland
| | - Jonathan Avaro
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Center for X-ray Analytics 8600 Dübendorf Switzerland
| | - Yvonne Elbs-Glatz
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Center for X-ray Analytics 8600 Dübendorf Switzerland
| | - Michael Chung
- School of Engineering, The University of Edinburgh King's Buildings EH9 3JL Edinburgh UK
| | - René M Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles 9014 St. Gallen Switzerland
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Prasad Mahindrakar B, Goswami AG, Huda F, Naithani M, Basu S. Wound pH and Surface Temperature as a Predictive Biomarker of Healing in Diabetic Foot Ulcers. INT J LOW EXTR WOUND 2023. [DOI: 10.1177/15347346231156962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Aim To monitor wound pH and surface temperature as predictors of wound healing in diabetic foot ulcers (DFU). Methods Prospective, observational, time-bound study of 18 months, enrolling patients aged 18 to 60 years with uninfected DFU. The wound was assessed at baseline and after that, every week for 4 weeks according to the leg ulcer measurement tool (LUMT). Concurrently, wound surface pH and temperature were measured. The data were analyzed using descriptive statistics, and a P-value < .05 was considered statistically significant. Results Fifty-four patients with DFU were included in the study with a mean age of 55 years and a male to female ratio of 1.57. The wound showed progressive improvement, a maximum mean LUMT score of 48.89 (± 2.81) at the initial evaluation and decreased progressively to the mean of 19.80 at week 4 (± 3.43), both of which were statistically significant ( P-value < .001). Similarly, the median wound pH progressively reduced from 7.7 at baseline to 7.20 in the fourth week, and median wound temperature decreased from 90°F (32.22 °C) at baseline to 85°F (29.44 °C) in the fourth week, both of which were statistically significant ( P-value < .001). Conclusion Progressive and significant change in wound pH to acidic and drop in wound surface temperature, both corresponding to improvement in the status of DFU, maximum at 4 weeks, make them valuable predictors of wound healing. However, further, more extensive studies are required to establish a concrete relationship.
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Affiliation(s)
| | | | - Farhanul Huda
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Manisha Naithani
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, India
| | - Somprakas Basu
- Department of Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Aliyev O, Aghazada A, Demirkıran CB, Uzer G, Citak M, Tuncay İ, Yıldız F. Could intermittent change of conventional dressing affect risk of periprosthetic joint infection after primary total joint arthroplasty? Arch Orthop Trauma Surg 2022; 142:1681-1687. [PMID: 34247306 DOI: 10.1007/s00402-021-04061-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/03/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Periprosthetic joint infection (PJI) is one of the most dreaded and challenging complications after total joint arthroplasty (TJA). The aim of this study was to evaluate the effect of keeping the dressing without change on the occurrence of PJI in patients undergoing TJA. METHODS 4877 Patients with a minimum follow-up of 90 days were included to investigate the effect of dressing on the PJI occurring within 3 months of surgery. Patients were divided into two consecutive groups as the intermittent change of traditional dressing (group 1-before 2019) and keeping dressing for 5 days without change (group 2-after 2019). A backward stepwise logistic regression model was used to estimate independent risk factors for PJI. RESULTS Group 1 and group 2 consisted of 4172 and 705 patients, and the numbers of diagnosed PJI cases in the groups were 40 (1.0%) and 10 (1.4%), respectively (p = 0.1). The backward stepwise logistic regression model analysis revealed that keeping the dressing unchanged and removing it after the first week postoperatively was not an independent risk factor for the occurrence of PJI. Older age, diabetes mellitus and coronary artery diseases were independent risk factors for PJI (p < 0.05). CONCLUSION Our study results present, that intermittent change of conventional dressing is unnecessary, because it does not decrease the risk of PJI after TJA. LEVEL OF EVIDENCE Level III Therapeutic.
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Affiliation(s)
- Orkhan Aliyev
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Aghamazahir Aghazada
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Cemil Burak Demirkıran
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Gökçer Uzer
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Mustafa Citak
- ENDO-Klinik Hamburg, Holstenstraße 2, 22767, Hamburg, Germany.
| | - İbrahim Tuncay
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Fatih Yıldız
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
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Stretchable printed device for the simultaneous sensing of temperature and strain validated in a mouse wound healing model. Sci Rep 2022; 12:10138. [PMID: 35710701 PMCID: PMC9203561 DOI: 10.1038/s41598-022-13834-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Temperature and strain are two vital parameters that play a significant role in wound diagnosis and healing. As periodic temperature measurements with a custom thermometer or strain measurements with conventional metallic gauges became less feasible for the modern competent health monitoring, individual temperature and strain measurement modalities incorporated into wearables and patches were developed. The proposed research in the article shows the development of a single sensor solution which can simultaneously measure both the above mentioned parameters. This work integrates a thermoelectric principle based temperature measurement approach into wearables, ensuring flexibility and bendability properties without affecting its thermo-generated voltage. The modified thermoelectric material helped to achieve stretchability of the sensor, thanks to its superior mechano-transduction properties. Moreover, the stretch-induced resistance changes become an additional marker for strain measurements so that both the parameters can be measured with the same sensor. Due to the independent measurement parameters (open circuit voltage and sensor resistance), the sensing model is greatly attractive for measurements without cross-sensitivity. The highly resilient temperature and strain sensor show excellent linearity, repeatability and good sensitivity. Besides, due to the compatibility of the fabrication scheme to low-temperature processing of the flexible materials and to mass volume production, printed fabrication methodologies were adopted to realize the sensor. This promises low-cost production and a disposable nature (single use) of the sensor patch. For the first time, this innovative temperature-strain dual parameter sensor concept has been tested on mice wounds in vivo. The preliminary experiments on mice wounds offer prospects for developing smart, i.e. sensorized, wound dressings for clinical applications.
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Darvishi S, Tavakoli S, Kharaziha M, Girault HH, Kaminski CF, Mela I. Advances in the Sensing and Treatment of Wound Biofilms. Angew Chem Int Ed Engl 2022; 61:e202112218. [PMID: 34806284 PMCID: PMC9303468 DOI: 10.1002/anie.202112218] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Indexed: 12/02/2022]
Abstract
Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor-based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point-of-care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound-induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.
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Affiliation(s)
- Sorour Darvishi
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Shima Tavakoli
- Department of Chemistry-Ångstrom LaboratoryUppsala UniversitySE75121UppsalaSweden
| | - Mahshid Kharaziha
- Department of Materials EngineeringIsfahan University of TechnologyIsfahan84156-83111Iran
| | - Hubert H. Girault
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Clemens F. Kaminski
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
| | - Ioanna Mela
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
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Darvishi S, Tavakoli S, Kharaziha M, Girault HH, Kaminski CF, Mela I. Advances in the Sensing and Treatment of Wound Biofilms. ANGEWANDTE CHEMIE (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 134:e202112218. [PMID: 38505642 PMCID: PMC10946914 DOI: 10.1002/ange.202112218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Indexed: 03/21/2024]
Abstract
Wound biofilms represent a particularly challenging problem in modern medicine. They are increasingly antibiotic resistant and can prevent the healing of chronic wounds. However, current treatment and diagnostic options are hampered by the complexity of the biofilm environment. In this review, we present new chemical avenues in biofilm sensors and new materials to treat wound biofilms, offering promise for better detection, chemical specificity, and biocompatibility. We briefly discuss existing methods for biofilm detection and focus on novel, sensor-based approaches that show promise for early, accurate detection of biofilm formation on wound sites and that can be translated to point-of-care settings. We then discuss technologies inspired by new materials for efficient biofilm eradication. We focus on ultrasound-induced microbubbles and nanomaterials that can both penetrate the biofilm and simultaneously carry active antimicrobials and discuss the benefits of those approaches in comparison to conventional methods.
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Affiliation(s)
- Sorour Darvishi
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Shima Tavakoli
- Department of Chemistry-Ångstrom LaboratoryUppsala UniversitySE75121UppsalaSweden
| | - Mahshid Kharaziha
- Department of Materials EngineeringIsfahan University of TechnologyIsfahan84156-83111Iran
| | - Hubert H. Girault
- Department of Chemistry and Chemical EngineeringÉcole Polytechnique Fédérale de Lausanne1951SionSwitzerland
| | - Clemens F. Kaminski
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
| | - Ioanna Mela
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgePhilippa Fawcett DriveCambridgeCB3 0ASUK
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13
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Sutton E, Ganie S, Chan C, Kaur A, Nussbaum E. Photobiomodulation and diabetic foot and lower leg ulcer healing: A narrative synthesis. Foot (Edinb) 2021; 48:101847. [PMID: 34390946 DOI: 10.1016/j.foot.2021.101847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/22/2021] [Accepted: 07/05/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE To provide a comprehensive narrative review and critical appraisal of research investigating photobiomodulation (PBM), formerly known as low level laser therapy which includes lasers and light emitting diodes (LEDs), as a treatment to promote diabetic foot and lower leg ulcer (DFU) healing for humans. MATERIALS AND METHODS Pubmed, CINAHL, Scopus, and OVID Medline databases were used to find relevant studies published between January 2000 and January 2020. Reference lists of identified articles were scanned for additional studies that might have been missed in the database searches. RESULTS A total of 13 studies, with a total of 417 participants, were included in this review. DISCUSSION The studies were critically appraised using the PEDro scale, which revealed weaknesses in study designs such as small sample sizes and problems with reproducibility with respect to the laser protocols. Characteristics of PBM that improved wound healing were wavelengths of 630 nm-660 nm and infrared wavelengths of 850 or 890 nm, and radiant exposure levels of 3 J/cm2-7 J/cm2. PBM was beneficial for superficial and deep DFUs. Controlled blood glucose levels and adherence to best practices (pressure off-loading, optimized wound dressing changes, appropriate debridement, etc.) could have been a factor in the beneficial outcomes. CONCLUSION Regardless of the laser characteristics chosen, in the majority of studies PBM as a treatment for DFUs improved healing rate when compared with standard wound care alone. However, weaknesses across the studies indicate that further research is required.
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Affiliation(s)
- Eliana Sutton
- Faculty of Health Sciences, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada
| | - Sharifah Ganie
- Faculty of Health Sciences, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada
| | - Charlene Chan
- Faculty of Health Sciences, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada
| | - Anureet Kaur
- Faculty of Health Sciences, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada
| | - Ethne Nussbaum
- Department of Physical Therapy, MClSc Program in Wound Healing, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada; KITE, Toronto Rehab Institute, University Health Network, 550 University Ave, Toronto, ON, M5G 2A2, Canada.
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14
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Zhang Y, Li T, Zhao C, Li J, Huang R, Zhang Q, Li Y, Li X. An Integrated Smart Sensor Dressing for Real-Time Wound Microenvironment Monitoring and Promoting Angiogenesis and Wound Healing. Front Cell Dev Biol 2021; 9:701525. [PMID: 34422823 PMCID: PMC8378138 DOI: 10.3389/fcell.2021.701525] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
Prolonged chronic wound healing not only places great stress on patients but also increase the health care burden. Fortunately, the emergence of tissue-engineered dressings has provided a potential solution for these patients. Recently, the relationship between the wound microenvironment and wound healing has been gradually clarified. Therefore, the state of wounds can be roughly ascertained by monitoring the microenvironment in real time. Here, we designed a three-layer integrated smart dressing, including a biomimetic nanofibre membrane, microenvironment sensor and β-cyclodextrin-containing gelatine methacryloyl (GelMA + β-cd) UV-crosslinked hydrogel. The hydrogel helped increase the expression of vascular endothelial growth factor (VEGF) through hypoxia-inducible factor-1α (HIF-1α) to promote neovascularization and wound healing. The microenvironment sensor, combined with the biological dressings, exhibited satisfactory measurement accuracy, stability, durability and biocompatibility. A BLE4.0 antenna was used to receive, display and upload wound microenvironment data in real time. Such integrated smart dressings can not only achieve biological functions but also monitor changes in the wound microenvironment in real time. These dressings can overcome the challenge of not knowing the state of the wound during the healing process and provide support for clinical work.
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Affiliation(s)
- Yuheng Zhang
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.,Air Force Hospital of Western Theater Command, Chengdu, China
| | - Tian Li
- Air Force Hospital of Western Theater Command, Chengdu, China.,School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Congying Zhao
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Jinqing Li
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Rong Huang
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Qianru Zhang
- School of Software Center for High Performance Computing, Northwestern Polytechnical University, Xi'an, China
| | - Yongqian Li
- Key Laboratory of Micro/Nano Systems for Aerospace, Ministry of Education, Northwestern Polytechnical University, Xi'an, China
| | - Xueyong Li
- Department of Burn and Plastic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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15
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Zhang Y, Lin B, Huang R, Lin Z, Li Y, Li J, Li X. Flexible integrated sensing platform for monitoring wound temperature and predicting infection. Microb Biotechnol 2021; 14:1566-1579. [PMID: 33945203 PMCID: PMC8313280 DOI: 10.1111/1751-7915.13821] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 01/09/2023] Open
Abstract
Wound infection is a challenging clinical problem that imposes substantial economic and psychological burdens on patients. However, the wound covered by a dressing is in an 'unknown' state. Recently, researchers have focused on understanding the condition of the wound without removing the dressing. Here, we presented a flexible integrated sensing platform (FISP) that can monitor multiple indicators, including local temperature. The platform consists of a flexible sensor chip (FSC), a controlled printed circuit board (CPCB) and a customized application installed on a smartphone that can receive and display data from the sensor chip through Bluetooth Low Energy 4.0 (BLE4.0) and upload real-time wound information. This device exhibits satisfactory measurement accuracy, stability, durability, skin compliance and biocompatibility. It was applied to infected wounds on the back of rabbits to reveal the temperature changes characteristic of wounds infected with different bacteria, and this information was compared with the changes in the core body temperature of animals. We found differences in the temperature among wounds infected with different pathogens and the temperature of the wound infection occurred earlier than the change in anal temperature. The combined application of the FISP and dressings might help identify the 'unknown' state of wounds in the clinic.
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Affiliation(s)
- Yuheng Zhang
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
| | - Bin Lin
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
| | - Rong Huang
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
| | - Zhixiao Lin
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
| | - Yongqian Li
- Key Laboratory of Micro/Nano Systems for Aerospace of the Ministry of EducationNorthwestern Polytechnical UniversityXi’an, Shaanxi710072China
| | - Jinqing Li
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
| | - Xueyong Li
- Department of Burn and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi’an710000China
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16
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Mariani F, Serafini M, Gualandi I, Arcangeli D, Decataldo F, Possanzini L, Tessarolo M, Tonelli D, Fraboni B, Scavetta E. Advanced Wound Dressing for Real-Time pH Monitoring. ACS Sens 2021; 6:2366-2377. [PMID: 34076430 PMCID: PMC8294608 DOI: 10.1021/acssensors.1c00552] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/24/2021] [Indexed: 12/16/2022]
Abstract
The rapid evolution of wearable technologies is giving rise to a strong push for textile chemical sensors design targeting the real-time collection of vital parameters for improved healthcare. Among the most promising applications, monitoring of nonhealing wounds is a scarcely explored medical field that still lacks quantitative tools for the management of the healing process. In this work, a smart bandage is developed for the real-time monitoring of wound pH, which has been reported to correlate with the healing stages, thus potentially giving direct access to the wound status without disturbing the wound bed. The fully textile device is realized by integrating a sensing layer, including the two-terminal pH sensor made of a semiconducting polymer and iridium oxide particles, and an absorbent layer ensuring the delivery of a continuous wound exudate flow across the sensor area. The two-terminal sensor exhibits a reversible response with a sensitivity of (59 ± 4) μA pH-1 in the medically relevant pH range for wound monitoring (pH 6-9), and its performance is not substantially affected either by the presence of the most common chemical interferents or by temperature gradients from 22 to 40 °C. Thanks to the robust sensing mechanism based on potentiometric transduction and the simple device geometry, the fully assembled smart bandage was successfully validated in flow analysis using synthetic wound exudate.
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Affiliation(s)
- Federica Mariani
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
| | - Martina Serafini
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
| | - Isacco Gualandi
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
| | - Danilo Arcangeli
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
| | - Francesco Decataldo
- Dipartimento
di Fisica e Astronomia, Università di Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Luca Possanzini
- Dipartimento
di Fisica e Astronomia, Università di Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Marta Tessarolo
- Dipartimento
di Fisica e Astronomia, Università di Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Domenica Tonelli
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
| | - Beatrice Fraboni
- Dipartimento
di Fisica e Astronomia, Università di Bologna, Viale Berti Pichat 6/2, 40127 Bologna, Italy
| | - Erika Scavetta
- Dipartimento
di Chimica Industriale “Toso Montanari”, Università di Bologna, Viale del Risorgimento 4, 40136 Bologna, Italy
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17
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Pan F, Amarjargal A, Altenried S, Liu M, Zuber F, Zeng Z, Rossi RM, Maniura-Weber K, Ren Q. Bioresponsive Hybrid Nanofibers Enable Controlled Drug Delivery through Glass Transition Switching at Physiological Temperature. ACS APPLIED BIO MATERIALS 2021; 4:4271-4279. [PMID: 35006839 DOI: 10.1021/acsabm.1c00099] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To avoid excessive usage of antibiotics and antimicrobial agents, smart wound dressings permitting controlled drug release for treatment of bacterial infections are highly desired. In search of a sensitive stimulus to activate drug release under physiological conditions, we found that the glass transition temperature (Tg) of a polymer or polymer blend can be an ideal parameter because a thermal stimulus can regulate drug release at the physiological temperature of 37 °C. A well-tuned Tg for a controlled drug release from fibers at 37 °C was achieved by varying the blending ratio of Eudragit® RS 100 and poly(methyl methacrylate). Octenidine, an antimicrobial agent often used in wound treatment, was encapsulated into the polymer blend during the electrospinning process and evaluated for its controlled release based on modulation of temperature. The thermal switch of the nanofibrous membranes can be turned "on" at physiological temperature (37 °C) and "off" at room temperature (25 °C), conferring a controlled release of octenidine. It was found that octenidine can be released in an amount at least 8.5 times higher (25 mg·L-1) during the "on" stage compared to the "off" stage after 24 h, which was regulated by the wet Tg (34.8-36.5 °C). The "on"/"off" switch for controlled drug release can moreover be repeated at least 5 times. Furthermore, the fabricated nanofibrous membranes displayed a distinctive antibacterial activity, causing a log3 reduction of the viable cells for both Gram negative and positive pathogens at 37 °C, when the thermal switch was "on". This study forms the groundwork for a treatment concept where no external stimulus is needed for the release of antimicrobials at physiological conditions, and will help reduce the overuse of antibiotics by allowing controlled drug release.
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Affiliation(s)
- Fei Pan
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Altangerel Amarjargal
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.,Power Engineering School, Mongolian University of Science and Technology, Baga Toiruu 34, 14191 Ulaanbaatar, Mongolia
| | - Stefanie Altenried
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Mengdi Liu
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland.,Department of Earth- and Environmental Sciences, Ludwig Maximilian University of Munich, Theresienstrasse 41, 80333 Munich, Germany
| | - Flavia Zuber
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Zhihui Zeng
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Cellulose & Wood Materials, Ueberlandstrasse 129, 8600 Duebendorf, Switzerland
| | - René M Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Katharina Maniura-Weber
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Qun Ren
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biointerfaces, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
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18
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Dahlmanns S, Reich-Schupke S, Schollemann F, Stücker M, Leonhardt S, Teichmann D. Classification of chronic venous diseases based on skin temperature patterns. Physiol Meas 2021; 42. [PMID: 33735841 DOI: 10.1088/1361-6579/abf020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/18/2021] [Indexed: 11/11/2022]
Abstract
Objective. Infrared thermography has the potential to complement the classification of chronic venous diseases (CVD), but lacks sophisticated insights on the association between recorded skin temperatures and the severity of CVD. This research aims to identify temperature patterns in the lower legs of patients that are distinct in specific forms of CVD, including florid ulcers.Approach. Infrared images were acquired in a clinical trial with 36 patients and segmented using a region selection algorithm. The regions were analyzed with respect to seven predefined features. The most prominent thermal features were translated into rules to classify CVD.Main results. Patients with mild forms of CVD show local increases in skin temperature by more than 1.5 °C. These regions were 2.0 °C warmer when CVD is more severe. Temperature variations of on average 0.4 °C occurred within venous leg ulcers. Furthermore, these wounds were 1.1 °C-6.3 °C colder than periwound skin.Significance. Temperature patterns characterized by differences in temperature that occur within a few centimeters or millimeters are distinct to specific stages of CVD. These patterns are present in the locations of varicose veins and tissue damages.Significance. The findings increase the body of knowledge on the potential for the early detection of CVD using infrared thermography. Applying the presented algorithms and rules, infrared thermography may become a complementary tool for the objective classification of CVD.
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Affiliation(s)
- Stephan Dahlmanns
- Chair for Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen D-52074, Germany
| | | | - Franziska Schollemann
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen D-52074, Germany
| | - Markus Stücker
- Department of Dermatology, Ruhr-University Bochum, Bochum D-44791, Germany
| | - Steffen Leonhardt
- Chair for Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen D-52074, Germany
| | - Daniel Teichmann
- SDU Health Informatics and Technology, Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense DK-5230, Denmark.,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States of America
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19
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Flexible Hybrid Electrodes for Continuous Measurement of the Local Temperature in Long-Term Wounds. SENSORS 2021; 21:s21082741. [PMID: 33924527 PMCID: PMC8070585 DOI: 10.3390/s21082741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 01/22/2023]
Abstract
Long-term wounds need a continuous assessment of different biophysical parameters for their treatment, and there is a lack of affordable biocompatible devices capable of obtaining that uninterrupted flow of data. A portable prototype that allows caregivers to know the local temperature behavior of a long-term wound over time and compare it with different reference zones has been developed. Alternative flexible substrates, screen-printing techniques, polymeric inks, and an embedded system have been tested to achieve potential indicators of the status and evolution of chronic wounds. The final system is formed by temperature sensors attached to a flexible and stretchable medical-grade substrate, where silver conductive tracks have been printed as interconnections with the data-acquisition unit. In addition, a specific datalogger has been developed for this system. The whole set will enable health personnel to acquire the temperature of the wound and its surroundings in order to make decisions regarding the state and evolution of the wound.
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20
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Perera E, Rodriguez-Viera L, Montero-Alejo V, Perdomo-Morales R. Crustacean Proteases and Their Application in Debridement. Trop Life Sci Res 2020; 31:187-209. [PMID: 32922675 PMCID: PMC7470474 DOI: 10.21315/tlsr2020.31.2.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Digestive proteases from marine organisms have been poorly applied to biomedicine. Exceptions are trypsin and other digestive proteases from a few cold-adapted or temperate fish and crustacean species. These enzymes are more efficient than enzymes from microorganism and higher vertebrates that have been used traditionally. However, the biomedical potential of digestive proteases from warm environment species has received less research attention. This review aims to provide an overview of this unrealised biomedical potential, using the debridement application as a paradigm. Debridement is intended to remove nonviable, necrotic and contaminated tissue, as well as fibrin clots, and is a key step in wound treatment. We discuss the physiological role of enzymes in wound healing, the use of exogenous enzymes in debridement, and the limitations of cold-adapted enzymes such as their poor thermal stability. We show that digestive proteases from tropical crustaceans may have advantages over their cold-adapted counterparts for this and similar uses. Differences in thermal stability, auto-proteolytic stability, and susceptibility to proteinase inhibitors are discussed. Furthermore, it is proposed that the feeding behaviour of the source organism may direct the evaluation of enzymes for particular applications, as digestive proteases have evolved to fill a wide variety of feeding habitats, natural substrates, and environmental conditions. We encourage more research on the biomedical application of digestive enzymes from tropical marine crustaceans.
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Affiliation(s)
- Erick Perera
- Nutrigenomics and Fish Growth Endocrinology, Institute of Aquaculture Torre de la Sal, IATS-CSIC, Castellón, Valencia, Spain
| | | | - Vivian Montero-Alejo
- Department of Biochemistry, Center for Pharmaceuticals Research and Development, Havana, Cuba
| | - Rolando Perdomo-Morales
- Department of Biochemistry, Center for Pharmaceuticals Research and Development, Havana, Cuba
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21
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Lochab V, Jones TH, Dusane DH, Peters CW, Stoodley P, Wozniak DJ, Subramaniam VV, Prakash S. Ultrastructure imaging of Pseudomonas aeruginosa lawn biofilms and eradication of the tobramycin-resistant variants under in vitro electroceutical treatment. Sci Rep 2020; 10:9879. [PMID: 32555250 PMCID: PMC7303171 DOI: 10.1038/s41598-020-66823-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022] Open
Abstract
Electrochemically generated bactericidal compounds have been shown to eradicate bacterial lawn biofilms through electroceutical treatment. However, the ultrastructure of biofilms exposed to these species has not been studied. Moreover, it is unknown if the efficacy of electroceutical treatment extends to antibiotic-resistant variants that emerge in lawn biofilms after antibiotic treatment. In this report, the efficacy of the in vitro electroceutical treatment of Pseudomonas aeruginosa biofilms is demonstrated both at room temperature and in an incubator, with a ~4 log decrease (p < 0.01) in the biofilm viability observed over the anode at both conditions. The ultrastructure changes in the lawn biofilms imaged using transmission electron microscopy demonstrate significant bacterial cell damage over the anode after 24 h of electroceutical treatment. A mix of both damaged and undamaged cells was observed over the cathode. Finally, both eradication and prevention of the emergence of tobramycin-resistant variants were demonstrated by combining antibiotic treatment with electroceutical treatment on the lawn biofilms.
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Affiliation(s)
- Varun Lochab
- Department of Mechanical & Aerospace Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Travis H Jones
- Department of Mechanical & Aerospace Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Devendra H Dusane
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, USA
| | - Casey W Peters
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, USA
| | - Paul Stoodley
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, USA
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA
- National Centre for Advanced Tribology, Mechanical Engineering, University of Southampton, Southampton, UK
| | - Daniel J Wozniak
- Department of Microbial Infection & Immunity, The Ohio State University, Columbus, Ohio, USA
| | - Vish V Subramaniam
- Department of Mechanical & Aerospace Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Shaurya Prakash
- Department of Mechanical & Aerospace Engineering, The Ohio State University, Columbus, Ohio, USA.
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22
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Radischat N, Augustin M, Herberger K, Wille A, Goroncy-Bermes P. Influence of human wound exudate on the bactericidal efficacy of antiseptic agents in quantitative suspension tests on the basis of European Standards (DIN EN 13727). Int Wound J 2020; 17:781-789. [PMID: 32133774 DOI: 10.1111/iwj.13336] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 01/22/2023] Open
Abstract
The antimicrobial efficacy of antiseptics used in wound management is tested in vitro under standardised conditions according to DIN EN 13727, with albumin and sheep erythrocytes used as organic challenge. However, these testing conditions do not adequately simulate the wound bed environment. Thus, the aim of this study was to compare the efficacy of different antiseptics such as octenidine dihydrochloride (OCT), chlorhexidine digluconate (CHX), polyhexamethylene biguanide (PHMB), and povidone-iodine under challenge with human wound exudate instead of standardised organic load in an in vitro setting according to DIN EN 13727. Moreover, protein contents, pH, and temperature were compared with standardised testing conditions. The tested antiseptic agents were reduced to different extents based on their bactericidal efficacy, when challenged with human wound exudate compared with standardised conditions. Overall, 0.10% OCT showed the highest effects reaching full efficacy after 30 seconds. CHX and PHMB were the least efficient. Next to the protein content, other components of wound exudate, such as the microflora, seem to influence the efficacy of antiseptics. In summary, the optimisation of in vitro testing conditions in future applications, to more adequately simulate the wound bed environment, will allow a more realistic picture on the potential performance of antiseptics in clinical practice.
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Affiliation(s)
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Katharina Herberger
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Andreas Wille
- Institute for Hygiene and Environment, Hamburg, Germany
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Schwartz D, Gefen A. An integrated experimental-computational study of the microclimate under dressings applied to intact weight-bearing skin. Int Wound J 2020; 17:562-577. [PMID: 31991530 DOI: 10.1111/iwj.13309] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/21/2019] [Accepted: 01/10/2020] [Indexed: 12/15/2022] Open
Abstract
Pressure ulcers (PUs) are one of the most prevalent adverse events in acute and chronic care. The root aetiological cause of PUs is sustained cell and tissue deformations, which triggers a synergistic tissue damage cascade that accelerates over relatively short time periods. Changes in skin microclimate conditions are known to indirectly contribute to PU-risk levels or to exacerbation of existing wounds. It is therefore surprising that information concerning heat accumulation under dressings is poor. Here, we aimed to investigate the effects of dressings on the microclimate of weight-bearing buttocks skin in 1-hour supine lying sessions. Using a novel and originally developed experimental-computational approach, we compared the combined influence of the mechanical and thermal properties of a polymeric membrane dressing (PolyMem, Ferris Mfg. Corp., Fort Worth, TX) on skin microclimate under and near the dressings with those of a standard placebo foam dressing. We specifically identified the thermal conductivity properties of dressings as being highly important in the context of protective dressing performances, given its association with potential heat accumulation under dressings. Accordingly, this article highlights, for the first time in the literature, the relevance of thermal properties of a dressing in effectively mitigating the risk of developing PUs or aggravating an injury, and offers a systematic, methodological bioengineering process for assessing the thermal performances of dressings.
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Affiliation(s)
- Dafna Schwartz
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
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Nunes CADB, Melo PG, Malaquias SG, Amaral KVÁ, Alves GR, Meira AA, Cardoso AL, Pereira LV, Bachion MM. Effectiveness of two bundles in venous leg ulcer healing: A randomized controlled trial. JOURNAL OF VASCULAR NURSING 2019; 37:232-245. [DOI: 10.1016/j.jvn.2019.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 01/08/2023]
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Bambaradeniya YTB, Karunaratne WAIP, Tomberlin JK, Goonerathne I, Kotakadeniya RB, Magni PA. Effect of Temperature and Tissue Type on the Development of the Forensic Fly Chrysomya megacephala (Diptera: Calliphoridae). JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:1571-1581. [PMID: 31219576 DOI: 10.1093/jme/tjz097] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Indexed: 06/09/2023]
Abstract
Chrysomya megacephala Fabricius is one of the most common myiasis-causing and carrion-feeding fly species in the tropics. This species has a worldwide distribution due to globalization and therefore is of critical importance to the public health sector and forensic investigations. Development studies carried worldwide show that Ch. megacephala reared at similar temperatures may require different amounts of time to complete their cycle of growth. The present study determined for the first time the life-history information of this species in Sri Lanka. Chrysomya megacephala colonies were reared on three different food sources (bovine muscle, swine muscle, and swine liver) considering the most common forensic entomology rearing mediums and the capability of Ch. megacephala to cause myiasis in cattle. Furthermore, colonies were reared at four temperature regimes representing several specific development conditions of this blowfly: 1) 20°C representing the estimation of the lower developmental threshold for this species in Sri Lanka; 2) 25 and 27°C representing typical room/environmental temperatures in Sri Lanka; and 3) 38°C as this is the typical living animal temperature, representing myiasis conditions. Results show that temperature significantly affected larval length and width over time; however, tissue type was not a significant factor. The fastest development was recorded at 38°C for immature feeding on bovine muscle (162.15 h), followed by those fed swine liver (184.15 h) and swine muscle (208.00 h). The calculated minimum temperature threshold for Ch. megacephala was 13°C. Data generated will be crucial for future forensic investigations involving living or deceased individuals colonized by this species.
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Affiliation(s)
- Y Tharindu B Bambaradeniya
- Department of Zoology, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | - Induwara Goonerathne
- Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rasika B Kotakadeniya
- Department of Surgery, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paola A Magni
- Discipline of Medical, Molecular and Forensic Sciences, Murdoch University, Murdoch, WA, Australia
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Bredow J, Hoffmann K, Oppermann J, Hellmich M, Eysel P, Zarghooni K. Evaluation of Absorbent Versus Conventional Wound Dressing. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 115:213-219. [PMID: 29669676 DOI: 10.3238/arztebl.2018.0213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 06/22/2017] [Accepted: 01/03/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lower-limb endoprosthetic operations and spinal operations are among the more common types of orthopedic procedures. Postoperative woundhealing disturbances and infections can lead to longer periods of hospital stay and recovery as well as to higher morbidity and mortality. METHODS 209 patients who had been judged to have an indication for a primary knee or hip endoprosthesis or for a primary spinal operation were included in this randomized trial (ClinicalTrials.gov: NCT01988818) over the period June 2014- February 2015. After randomization, patients in the intervention group were given a trial dressing (Mepilex-Border Post-Op) and those in the control group were given a conventional adhesive dressing (Cosmopor). The primary endpoint was blister formation. RESULTS In the overall study population, only a single case of blister formation was seen. The affected patient belonged to the intervention group but was mistakenly given a control dressing and developed blisters on the 6th day after surgery. Dressings were changed less frequently in the intervention group, and this difference was statistically significant (p<0.001). The patients, nurses, and physicians all expressed greater satisfaction with the trial dressings than with the control dressings (p<0.001). CONCLUSION The intervention group did not differ from the control group with respect to the primary endpoint, postoperative blister formation. The patients, nurses, and physicians all judged the dressing used in the intervention group more favorably than the conventional dressing.
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Affiliation(s)
- Jan Bredow
- Department of Orthopedics and Trauma Surgery, University Hospital Cologne, Germany; Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Germany; Spine Surgery, Schön Klinik Düsseldorf SE & Co. KG, Düsseldorf, Germany
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Halstead FD, Webber MA, Oppenheim BA. Use of an engineered honey to eradicate preformed biofilms of important wound pathogens: an in vitro study. J Wound Care 2019; 26:442-450. [PMID: 28795889 DOI: 10.12968/jowc.2017.26.8.442] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We previously reported on the ability of SurgihoneyRO (SHRO), an engineered honey, to prevent biofilm formation in vitro, but data were lacking regarding the activity against preformed biofilms. This study aims to assess whether SHRO has any antibacterial activity against mature, preformed biofilms and whether there is any evidence to support the observed clinical effectiveness when SHRO has been used anecdotally on acute and chronic wounds where biofilm is most likely present. METHOD We tested the in vitro antibacterial activity of SHRO against the mature biofilms of 16 clinically relevant wound pathogens, in terms of impacts on biofilm seeding and biofilm biomass. The honey was serially double diluted from 1:3 down to 1:6144, and the lowest dilution achieving a statistically significant reduction in biomass of ≥50%, compared with untreated controls, was recorded. RESULTS All 16 bacterial isolates were susceptible to SHRO, with reduced biofilm seeding observed for all, and percentage reductions ranging from 58% (ACI_C59) to 94.3% (MDR_B) for the strongest concentration of honey (1:3). Furthermore at this concentration, biofilm seeding of the test biofilm was reduced by 80-94.3% (when compared with the positive control) for 12/16 isolates. We additionally demonstrated that SHRO has antibiofilm impacts, with the 24 hour exposure resulting in disruption of the biofilm, reduced seeding and reduced biomass. CONCLUSION SHRO is effective at reducing seeding of preformed biofilms of clinically important wound pathogens in vitro, and also has antibiofilm activity. This supports the anecdotal clinical data for antibiofilm efficacy, and supports the use of SHRO as a promising topical wound care agent.
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Affiliation(s)
- F D Halstead
- Clinical Scientist, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK
| | - M A Webber
- Research Leader, NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK; Institute of Food Research, Norwich Research Park, Colney Lane, Norwich, NR4 7UA, UK
| | - B A Oppenheim
- Consultant Microbiologist, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK
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Bambaradeniya YTB, Karunaratne WAIP, Tomberlin JK, Goonerathne I, Kotakadeniya RB. Effect of Temperature and Tissue Type on the Development of Myiasis Causing Fly; Chrysomya bezziana (Diptera: Calliphoridae). JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:625-631. [PMID: 30517705 DOI: 10.1093/jme/tjy212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Indexed: 06/09/2023]
Abstract
Chrysomya bezziana Villeneuve is the major human myiasis producer in tropical countries, including Sri Lanka. Although of great medical and veterinary importance, only a single study has been published on the development of C. bezziana. This limitation is due in part to the difficulty of maintaining this species in a colony outside of using a living host. In this study, a novel technique that overcomes this limitation is presented along with development data for C. bezziana fed on three different meat types: swine muscle, swine liver, and bovine muscle at two temperature regimes: 35 and 37°C. The optimum development of C. bezziana was recorded at 35°C in bovine muscle (262.20 h) followed by swine muscle (286.00 h) and swine liver (307.00 h). Data from the current study indicate tissue type significantly impacts change in length and width of larvae over time, whereas the two temperatures examined had no significant effect.
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Affiliation(s)
- Y T B Bambaradeniya
- Faculty of Science, Department of Zoology, University of Peradeniya, Peradeniya, Sri Lanka
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - W A I P Karunaratne
- Faculty of Science, Department of Zoology, University of Peradeniya, Peradeniya, Sri Lanka
| | - J K Tomberlin
- Department of Entomology, Texas A & M University, College Station, TX
| | - I Goonerathne
- Faculty of Medicine, Department of Forensic Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - R B Kotakadeniya
- Faculty of Medicine, Department of Surgery, University of Peradeniya, Peradeniya, Sri Lanka
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Bogie KM. The Modular Adaptive Electrotherapy Delivery System (MAEDS): An Electroceutical Approach for Effective Treatment of Wound Infection and Promotion of Healing. Mil Med 2019; 184:92-96. [DOI: 10.1093/milmed/usy276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/24/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Infected wounds are painful and cannot heal, with antibiotics showing reduced efficacy. Appropriate wound electrotherapy may limit incident planktonic and polymicrobial colonization, inhibit biofilm formation and accelerate healing.
Methods
The Modular Adaptive Electrotherapy Delivery System (MAEDS) is a lightweight, flexible, battery-powered disposable bandage which delivers controlled reliable electrotherapy to the wound for up to 7 days. Large full-thickness excisional wounds (6 cm diameter) were created in a porcine model and freshly cultured 0.5 McFarland green fluorescent protein-labeled Pseudomonas aeruginosa evenly applied to the wound bed. Control wounds received standard wound care, Tegaderm HP Transparent Dressing (3 M Health Care, St. Paul, MN, USA) applied in a sterile fashion. Treatment wounds received MAEDS electrotherapy for up to 28 days or until healed. Onboard Bluetooth facilitated remote real-time monitoring of MAEDS function. Dressing changes occurred on postoperative day (POD) 1, 3, 5, 7, 10, 14, 21, and 28. Punch biopsies were taken at the wound margin and center. Bacterial samples were processed to determine infection status.
Results
Acute infected wounds treated with MAEDS electrotherapy were 92% smaller than baseline by POD21. Healing rate was significantly faster (p < 0.01) and infection significantly decreased (p < 0.0001) at POD10, relative to control wounds.
Conclusion
The MAEDS electrotherapy can significantly inhibit infection and enhance healing rate in acute infected wounds.
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Affiliation(s)
- Kath M Bogie
- Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center 10701 East Blvd, Cleveland, OH
- Department of Orthopaedics, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH
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Wilson MR, Nigam Y, Knight J, Pritchard DI. What is the optimal treatment time for larval therapy? A study on incubation time and tissue debridement by bagged maggots of the greenbottle fly, Lucilia sericata. Int Wound J 2019; 16:219-225. [PMID: 30379404 PMCID: PMC7948740 DOI: 10.1111/iwj.13015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 01/14/2023] Open
Abstract
The effective use of larvae of the greenbottle fly, Lucilia sericata, in wound debridement requires a working knowledge of how feeding changes over time. Using a laboratory assay and bagged larval dressings, the effect of incubation time on larval feeding rates and body mass was investigated for up to 120 hours at 32°C. The mass of tissue digested increased significantly in incremental 24-hour periods up to 72 hours, with no significant consumption occurring afterwards. Larval mass increased only up to 48 hours. A further test comparing the efficacy of a single 96-hour application of larvae against two consecutive 48-hour applications found that the mass of tissue digested in the latter was 14.3% higher than the former, a difference that was statistically significant. Current clinical guidance suggests a 4-day application period for bagged larvae. Based on these results, an incubation time of 72 hours (3 days) for bagged larvae would be the most effective at the study temperature. However, it is acknowledged that wound temperature can vary, whereby feeding rates would likely differ. In view of this, we conclude that a period of 3 to 4 days is optimum for the application of larvae, and current guidelines should be adhered to.
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Affiliation(s)
| | - Yamni Nigam
- College of Human and Health SciencesSwansea UniversitySwanseaUK
| | - John Knight
- College of Human and Health SciencesSwansea UniversitySwanseaUK
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A Wearable Textile Thermograph. SENSORS 2018; 18:s18072369. [PMID: 30037070 PMCID: PMC6068546 DOI: 10.3390/s18072369] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 01/15/2023]
Abstract
In medicine, temperature changes can indicate important underlying pathologies such as wound infection. While thermographs for the detection of wound infection exist, a textile substrate offers a preferable solution to the designs that exist in the literature, as a textile is very comfortable to wear. This work presents a fully textile, wearable, thermograph created using temperature-sensing yarns. As described in earlier work, temperature-sensing yarns are constructed by encapsulating an off-the-shelf thermistor into a polymer resin micro-pod and then embedding this within the fibres of a yarn. This process creates a temperature-sensing yarn that is conformal, drapeable, mechanically resilient, and washable. This work first explored a refined yarn design and characterised its accuracy to take absolute temperature measurements. The influence of contact errors with the refined yarns was explored seeing a 0.24 ± 0.03 measurement error when the yarn was held just 0.5 mm away from the surface being measured. Subsequently, yarns were used to create a thermograph. This work characterises the operation of the thermograph under a variety of simulated conditions to better understand the functionality of this type of textile temperature sensor. Ambient temperature, insulating material, humidity, moisture, bending, compression and stretch were all explored. This work is an expansion of an article published in The 4th International Conference on Sensor and Applications.
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Gethin G, O'Connor GM, Abedin J, Newell J, Flynn L, Watterson D, O'Loughlin A. Monitoring of pH and temperature of neuropathic diabetic and nondiabetic foot ulcers for 12 weeks: An observational study. Wound Repair Regen 2018; 26:251-256. [DOI: 10.1111/wrr.12628] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Georgina Gethin
- Alliance for Research and Innovation in Wounds, NUI Galway; Galway Ireland
- School of Nursing and Midwifery; NUI Galway; Galway Ireland
| | - Gerard M. O'Connor
- Alliance for Research and Innovation in Wounds, NUI Galway; Galway Ireland
- School of Physics; NUI Galway; Galway Ireland
| | - Jaynal Abedin
- College of Engineering and Infomatics; NUI Galway; Galway Ireland
| | - John Newell
- School of Mathematics; Statistics, and Applied Mathematics, NUI Galway; Galway Ireland
| | - Louisa Flynn
- Merlin Park Hospital; Podiatry Unit; Galway Ireland
| | | | - Aorghus O'Loughlin
- Alliance for Research and Innovation in Wounds, NUI Galway; Galway Ireland
- Bons Secours Hospital; Galway Ireland
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Ibelli T, Templeton S, Levi-Polyachenko N. Progress on utilizing hyperthermia for mitigating bacterial infections. Int J Hyperthermia 2018; 34:144-156. [DOI: 10.1080/02656736.2017.1369173] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Taylor Ibelli
- Zanvyl Kreiger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | | | - Nicole Levi-Polyachenko
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Sciences, Winston-Salem, NC, USA
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Bambaradeniya YTB, Karunaratne WAIP, Tomberlin JK, Goonerathne I, Kotakadeniya RB. Temperature and Tissue Type Impact Development of Lucilia cuprina (Diptera: Calliphoridae) in Sri Lanka. JOURNAL OF MEDICAL ENTOMOLOGY 2018; 55:285-291. [PMID: 29186534 DOI: 10.1093/jme/tjx211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
Abstract
Lucilia cuprina (Wiedemann; Diptera: Calliphoridae) is a facultative ecto-parasitic fly, distributed throughout the temperate and subtropical regions of the world. This blow fly species is of medical, veterinary, and forensic importance due to it being used in maggot debridement therapy (MDT), a causative agent of myiasis, and a decomposer of vertebrate carrion. The current study examined the combined effects of temperature and tissue type on the development of L. cuprina. Specimens were reared on three tissue types; swine muscle, swine liver, and bovine muscle at 20°C, 25°C, 27°C, and 38°C. The optimum condition for L. cuprina development was for immatures reared on bovine muscle (287.4 h) followed by those reared on swine muscle (288.0 h) and swine liver (288.4 h) at 27°C. The minimum temperature threshold of L. cuprina was deduced to be 14°C. No significant differences in larval width and length over time were determined for the tissue type.
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Affiliation(s)
| | | | | | - Induwara Goonerathne
- Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Rasika B Kotakadeniya
- Department of Surgery, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
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Abstract
Patients admitted to critical care units are at high risk for increased morbidity and mortality from skin and deep wound infections. Despite considerable progress, wound healing remains a challenge to many clinicians. Nurses working in critical care environments need to understand the anatomic and physiologic basis for wound healing, distinguish wound inflammation from wound infection, recognize the presence of biofilms, and implement evidence-based wound care in order to promote successful outcomes in this patient population.
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Affiliation(s)
- Jean E Cefalu
- Nursing Department, School of Nursing, Louisiana State University Health Sciences Center, 1900 Gravier Street, Suite 4A6, New Orleans, LA 70112, USA.
| | - Kendra M Barrier
- School of Nursing, Louisiana State University Health Sciences Center, 1900 Gravier Street, Suite 4C1, New Orleans, LA 70112, USA
| | - Alison H Davis
- School of Nursing, Louisiana State University Health Sciences Center, 1900 Gravier Street, Suite 506, New Orleans, LA 70112, USA
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Levi-Polyachenko N, Jacob R, Day C, Kuthirummal N. Chitosan wound dressing with hexagonal silver nanoparticles for hyperthermia and enhanced delivery of small molecules. Colloids Surf B Biointerfaces 2016; 142:315-324. [DOI: 10.1016/j.colsurfb.2016.02.038] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
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Halstead FD, Webber MA, Rauf M, Burt R, Dryden M, Oppenheim BA. In vitro activity of an engineered honey, medical-grade honeys, and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates. J Wound Care 2016; 25:93-4, 96-102. [PMID: 26878302 DOI: 10.12968/jowc.2016.25.2.93] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Honey is recognised to be a good topical wound care agent owing to a broad-spectrum of antimicrobial activity combined with healing properties. Surgihoney RO (SH1) is a product based on honey that is engineered to produce enhanced reactive oxygen species (ROS) and has been reported to be highly antimicrobial. The objective was to investigate the ability of the engineered honey and its comparators to prevent biofilm formation in vitro. METHOD We tested the ability of three medical-grade honeys SH1, Activon manuka honey (MH) and Medihoney manuka honey (Med), alongside five antimicrobial dressings (AMDs) to prevent the formation of biofilms by 16 isolates. Honeys were serially double diluted from 1:3 down to 1:6144 and the lowest dilution achieving a statistically significant reduction in biomass of at least 50%, compared with untreated controls, was recorded. RESULTS Although all the honeys were antibacterial and were able to prevent the formation of biofilms, SH1 was the most potent, with efficacy at lower dilutions than the medical honeys for five isolates, and equivalent dilutions for a further six. Additionally, SH1 was superior in antibacterial potency to three commercially available AMDs that contain honey. CONCLUSION SH1 is effective at preventing bioflms from forming and is superior to medical honeys and AMDs in in vitro tests. DECLARATION OF INTEREST Surgihoney RO was provided free of charge for testing by Matoke Holdings, UK and the hospital pharmacy provided the other honeys and dressings. This paper presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
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Affiliation(s)
- F D Halstead
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M A Webber
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M Rauf
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - R Burt
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK.,Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M Dryden
- Department of Microbiology and Infection, Hampshire Hospitals NHS Foundation Trust, UK.,Rare and Imported Pathogens Department, Public Health England, Porton Down, UK
| | - B A Oppenheim
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK
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Reis TC, Castleberry S, Rego AMB, Aguiar-Ricardo A, Hammond PT. Three-dimensional multilayered fibrous constructs for wound healing applications. Biomater Sci 2016; 4:319-30. [PMID: 26584183 PMCID: PMC4729609 DOI: 10.1039/c5bm00211g] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Electrospun materials are promising scaffolds due to their light-weight, high surface-area and low-cost fabrication, however, such scaffolds are commonly obtained as ultrathin two-dimensional non-woven meshes, lacking on topographical specificity and surface side-dependent properties. Herein, it is reported the production of three-dimensional fibrous materials with an asymmetrical inner structure and engineered surfaces. The manufactured constructs evidence fibrous-based microsized conical protrusions [length: (10 ± 3) × 10(2) μm; width: (3.8 ± 0.8) × 10(2) μm] at their top side, with a median peak density of 73 peaks per cm(2), while their bottom side resembles to a non-woven mesh commonly observed in the fabrication of two-dimensional electrospun materials. Regarding their thickness (3.7 ± 0.1 mm) and asymmetric fibrous inner architecture, such materials avoid external liquid absorption while promoting internal liquid uptake. Nevertheless, such constructs also observed the high porosity (89.9%) and surface area (1.44 m(2) g(-1)) characteristic of traditional electrospun mats. Spray layer-by-layer assembly is used to effectively coat the structurally complex materials, allowing to complementary tailor features such as water vapor transmission, swelling ratio and bioactive agent release. Tested as wound dressings, the novel constructs are capable of withstanding (11.0 ± 0.3) × 10(4) kg m(-2) even after 14 days of hydration, while actively promote wound healing (90 ± 0.5% of wound closure within 48 hours) although avoiding cell adhesion on the dressings for a painless removal.
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Affiliation(s)
- Tiago C Reis
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal. and Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Steven Castleberry
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
| | - Ana M B Rego
- CQFM and IN, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - Ana Aguiar-Ricardo
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal.
| | - Paula T Hammond
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA.
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Salvo P, Smajda R, Dini V, Saxby C, Voirin G, Romanelli M, Di Francesco F. A D-optimal design to model the performances of dressings and devices for negative pressure wound therapy. J Tissue Viability 2016; 25:83-90. [PMID: 26818777 DOI: 10.1016/j.jtv.2016.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/23/2015] [Accepted: 01/04/2016] [Indexed: 10/01/2022]
Abstract
A D-optimal design was used to identify and model variables that affect the transit time of wound exudate through an illustrative dressing used for negative pressure wound therapy. Many authors have addressed the clinical benefits of negative pressure wound therapy, but limited information is available on how to assess performances of dressings. In this paper, the transit time of wound exudate through a dressing was chosen as a model parameter to show how experimental design (DOE) can be used for this purpose. Results demonstrated that rate of exudate production, temperature and dressing thickness were the variables with the largest impact on transit time. The DOE approach could be used to model other dressing properties, like for example capability of absorbing excess exudate or breathability.
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Affiliation(s)
- P Salvo
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi 13, 56124, Pisa, Italy.
| | - R Smajda
- CSEM SA, Rue Jaquet-Droz 1, 2002 Neuchâtel, Switzerland
| | - V Dini
- Wound Healing Research Unit, Department of Dermatology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
| | - C Saxby
- Smith & Nephew, Hessle Road 101, Hull, England, UK
| | - G Voirin
- CSEM SA, Rue Jaquet-Droz 1, 2002 Neuchâtel, Switzerland
| | - M Romanelli
- Wound Healing Research Unit, Department of Dermatology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
| | - F Di Francesco
- Department of Chemistry and Industrial Chemistry, University of Pisa, Via Moruzzi 13, 56124, Pisa, Italy.
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Halstead FD, Rauf M, Bamford A, Wearn CM, Bishop JR, Burt R, Fraise AP, Moiemen NS, Oppenheim BA, Webber MA. Antimicrobial dressings: Comparison of the ability of a panel of dressings to prevent biofilm formation by key burn wound pathogens. Burns 2015; 41:1683-1694. [DOI: 10.1016/j.burns.2015.06.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/05/2015] [Accepted: 06/05/2015] [Indexed: 02/06/2023]
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Ramírez MS, Müller GL, Pérez JF, Golic AE, Mussi MA. More Than Just Light: Clinical Relevance of Light Perception in the Nosocomial PathogenAcinetobacter baumanniiand Other Members of the GenusAcinetobacter. Photochem Photobiol 2015; 91:1291-301. [DOI: 10.1111/php.12523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/21/2015] [Indexed: 12/31/2022]
Affiliation(s)
- María Soledad Ramírez
- Facultad de Ciencias Médicas; Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM-CONICET); Universidad de Buenos Aires; Buenos Aires Argentina
- Department of Biological Science; Center for Applied Biotechnology Studies; California State University Fullerton; Fullerton CA
| | - Gabriela Leticia Müller
- Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
- Centro de Estudios Fotosintéticos y Bioquímicos (CEFOBI-CONICET); Rosario Argentina
| | - Jorgelina Fernanda Pérez
- Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
| | | | - María Alejandra Mussi
- Facultad de Ciencias Bioquímicas y Farmacéuticas; Universidad Nacional de Rosario; Rosario Argentina
- Centro de Estudios Fotosintéticos y Bioquímicos (CEFOBI-CONICET); Rosario Argentina
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Halstead FD, Rauf M, Moiemen NS, Bamford A, Wearn CM, Fraise AP, Lund PA, Oppenheim BA, Webber MA. The Antibacterial Activity of Acetic Acid against Biofilm-Producing Pathogens of Relevance to Burns Patients. PLoS One 2015; 10:e0136190. [PMID: 26352256 PMCID: PMC4566994 DOI: 10.1371/journal.pone.0136190] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 07/31/2015] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Localised infections, and burn wound sepsis are key concerns in the treatment of burns patients, and prevention of colonisation largely relies on biocides. Acetic acid has been shown to have good antibacterial activity against various planktonic organisms, however data is limited on efficacy, and few studies have been performed on biofilms. OBJECTIVES We sought to investigate the antibacterial activity of acetic acid against important burn wound colonising organisms growing planktonically and as biofilms. METHODS Laboratory experiments were performed to test the ability of acetic acid to inhibit growth of pathogens, inhibit the formation of biofilms, and eradicate pre-formed biofilms. RESULTS Twenty-nine isolates of common wound-infecting pathogens were tested. Acetic acid was antibacterial against planktonic growth, with an minimum inhibitory concentration of 0.16-0.31% for all isolates, and was also able to prevent formation of biofilms (at 0.31%). Eradication of mature biofilms was observed for all isolates after three hours of exposure. CONCLUSIONS This study provides evidence that acetic acid can inhibit growth of key burn wound pathogens when used at very dilute concentrations. Owing to current concerns of the reducing efficacy of systemic antibiotics, this novel biocide application offers great promise as a cheap and effective measure to treat infections in burns patients.
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Affiliation(s)
- Fenella D. Halstead
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, United Kingdom
- Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Maryam Rauf
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, United Kingdom
- Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Naiem S. Moiemen
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Birmingham Children’s Hospital, Birmingham, United Kingdom
- The Healing Foundation Burns Research Centre, Birmingham, United Kingdom
| | - Amy Bamford
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- The Healing Foundation Burns Research Centre, Birmingham, United Kingdom
| | - Christopher M. Wearn
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- The Healing Foundation Burns Research Centre, Birmingham, United Kingdom
| | - Adam P. Fraise
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Peter A. Lund
- Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Beryl A. Oppenheim
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Mark A. Webber
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, United Kingdom
- Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Ramírez MS, Traglia GM, Pérez JF, Müller GL, Martínez MF, Golic AE, Mussi MA. White and blue light induce reduction in susceptibility to minocycline and tigecycline in Acinetobacter spp. and other bacteria of clinical importance. J Med Microbiol 2015; 64:525-537. [DOI: 10.1099/jmm.0.000048] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/27/2015] [Indexed: 01/17/2023] Open
Affiliation(s)
- María Soledad Ramírez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
- Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM-CONICET), Facultad de Ciencias Médicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - German Matías Traglia
- Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM-CONICET), Facultad de Ciencias Médicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Jorgelina Fernanda Pérez
- Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Argentina
| | - Gabriela Leticia Müller
- Centro de Estudios Fotosintéticos y Bioquímicos (CEFOBI-CONICET), 2000 Rosario, Argentina
- Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Argentina
| | | | - Adrián Ezequiel Golic
- Centro de Estudios Fotosintéticos y Bioquímicos (CEFOBI-CONICET), 2000 Rosario, Argentina
| | - María Alejandra Mussi
- Centro de Estudios Fotosintéticos y Bioquímicos (CEFOBI-CONICET), 2000 Rosario, Argentina
- Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Argentina
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McInnes SJP, Turner CT, Al-Bataineh SA, Airaghi Leccardi MJI, Irani Y, Williams KA, Cowin AJ, Voelcker NH. Surface engineering of porous silicon to optimise therapeutic antibody loading and release. J Mater Chem B 2015; 3:4123-4133. [DOI: 10.1039/c5tb00397k] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Infliximab antibodies released from porous silicon microparticles can sequester the proinflammatory cytokine, tumor necrosis factor-α (TNF-α), which is elevated in uveitis and non-healing chronic wounds.
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Affiliation(s)
- Steven J. P. McInnes
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology
- Mawson Institute
- University of South Australia
- Adelaide
- Australia
| | - Chris T. Turner
- Mawson Institute
- University of South Australia
- Adelaide
- Australia
| | | | - Marta J. I. Airaghi Leccardi
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology
- Mawson Institute
- University of South Australia
- Adelaide
- Australia
| | - Yazad Irani
- Department of Ophthalmology
- Flinders University
- Bedford Park
- Australia
| | | | | | - Nicolas H. Voelcker
- ARC Centre of Excellence in Convergent Bio-Nano Science and Technology
- Mawson Institute
- University of South Australia
- Adelaide
- Australia
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46
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Validation of Commercially Available Infrared Thermometers for Measuring Skin Surface Temperature Associated with Deep and Surrounding Wound Infection. Adv Skin Wound Care 2015; 28:11-6. [DOI: 10.1097/01.asw.0000459039.81701.b2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Soykan EA, Butzelaar L, de Kroon TL, Beelen RHJ, Ulrich MMW, Mink van der Molen AB, Niessen FB. Minimal extracorporeal circulation (MECC) does not result in less hypertrophic scar formation as compared to conventional extracorporeal circulation (CECC) with dexamethasone. Perfusion 2013; 29:249-59. [PMID: 24214029 DOI: 10.1177/0267659113511656] [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: 11/15/2022]
Abstract
INTRODUCTION Cardiopulmonary bypass surgery is associated with a systemic inflammatory response through the interaction of air, blood and synthetic components in the bypass system and the physical trauma of surgery. An alternative cardiopulmonary bypass system, minimal extracorporeal circulation (MECC), has shown promising results in terms of reducing the inflammatory response. We hypothesized that this system may reduce pathological excessive scarring. To study this assumption, the effects of MECC and the effects of conventional extracorporeal circulation (CECC) with dexamethasone on skin scarring were compared in a standardized wound-healing model. METHODS AND RESULTS Pre-sternal scars were evaluated prospectively at four and 12 months postoperatively. The height and width of the scars were measured, using a slide caliper and sonography. The scars were scored using the validated Patient and Observer Scar Assessment Scale. Additional risk factors for hypertrophic scar formation were identified by means of a questionnaire. During surgery, MECC was used in 45 patients and CECC/dexamethasone in 42 patients. Four months postoperatively, 22 patients of the MECC group (49%) and 18 patients in the CECC/dexamethasone group (43%) had developed hypertrophic scars. Twelve months postoperatively, the hypertrophic scars in four patients of the MECC group and in two patients of the CECC/dexamethasone group had become normotrophic. In 18 patients of the MECC group (38%) and 16 patients of the CECC group (41%) the scars remained hypertrophic at 12 months. These differences between the two groups were not statistically significant. CONCLUSION MECC does not reduce hypertrophic scar formation compared with CECC with dexamethasone, but its use is more beneficial than the use of CECC/dexamethasone because of the circulatory and immunological advantages and because treatment with dexamethasone can be omitted.
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Affiliation(s)
- E A Soykan
- Department of Plastic and Reconstructive Surgery, VU University Medical Centre, Amsterdam, the Netherlands
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Celeste CJ, Deschesne K, Riley CB, Theoret CL. Skin Temperature during Cutaneous Wound Healing in an Equine Model of Cutaneous Fibroproliferative Disorder: Kinetics and Anatomic-Site Differences. Vet Surg 2012; 42:147-53. [DOI: 10.1111/j.1532-950x.2012.00966.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Christophe J. Celeste
- Comparative Tissue Healing Laboratory; Département de Biomédecine; Faculté de Médecine Vétérinaire; Université de Montréal; Saint-Hyacinthe; Canada
| | - Karine Deschesne
- Comparative Tissue Healing Laboratory; Département de Biomédecine; Faculté de Médecine Vétérinaire; Université de Montréal; Saint-Hyacinthe; Canada
| | - Christopher B. Riley
- School of Animal and Veterinary Sciences; University of Adelaide; Roseworthy Campus; Roseworthy; Australia
| | - Christine L. Theoret
- Comparative Tissue Healing Laboratory; Département de Biomédecine; Faculté de Médecine Vétérinaire; Université de Montréal; Saint-Hyacinthe; Canada
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Ackermann M, Wolloscheck T, Wellmann A, Li VW, Li WW, Konerding MA. Priming with a combination of proangiogenic growth factors improves wound healing in normoglycemic mice. Int J Mol Med 2011; 27:647-53. [PMID: 21373751 DOI: 10.3892/ijmm.2011.641] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 12/20/2010] [Indexed: 12/19/2022] Open
Abstract
Growth factors and/or angiogenic factors are supposed to improve wound healing. The aim of our study was to evaluate the effects of subcutaneous pretreatment with combinatory proangiogenic factors on wound closure, mechanical properties, vessel density and morphology. Twenty-eight Balb/c mice were divided equally into two groups. A mixture of VEGF (35.0 µg), bFGF (2.5 µg) and PDGF (3.5 µg) was administered subcutaneously 3, 5 and 7 days to 14 mice before full thickness skin punch biopsy wounding, whereas 14 control animals received three injections of 0.2 ml saline solution. Wound sizes were assessed daily and the repaired tissues were harvested 7 days after complete wound closure. Complete closure (≥ 95% healing of initial wound area) was reached in all proangiogenic pretreated animals on day 10, whereas controls needed 13 days for complete closure. Tensile strengths were nearly twofold higher compared to the controls (p ≤ 0.01). The punch biopsy material revealed 4.2-fold higher vessel densities in the proangiogenic pretreated group. On day 17, the vessel densities in the proangiogenic pretreated wounds were also 3.2-fold higher compared to the untreated controls. No significant differences were seen in the collagen ratio. Pretreatment with proangiogenic factors revealed several significant effects on wound healing: faster time to closure, a higher vessel density and a better functional outcome. These results suggest a beneficial effect of pretreatment with combinatory growth factors in mouse skin wounds without impaired wound healing. This might be exploited in further investigations in diabetic healing as a therapeutic approach for elective surgery.
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Affiliation(s)
- Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract
In the UK there is an increasing ageing population, bringing with it a host of degenerative conditions such as dementia. Dementia is a common condition among older people. In the UK there are estimated to be over 750 000 people with dementia and numbers are expected to double in the next 30 years (Comas-Herrera et al, 2007). The term 'dementia' is used to describe a syndrome which may be caused by a number of illnesses and is associated with ongoing decline of the brain and its abilities. There are many types of dementia, the most common are Alzheimer's disease, vascular dementia and dementia with Lewy bodies. The most common form of dementia is Alzheimer's which accounts for 62% of all cases. Vascular dementia either alone or co-existent with Alzheimer's, is the second most common subtype of dementia (Knapp et al, 2007). Dementia is associated with complex needs especially in the later stages, and can have a devastating effect on the individual, their family and friends. The care needs often challenge the skills and capacity of carers especially when normal every-day activities decline. Food and drink are fundamental to living. Consequently observing individuals struggling with eating and drinking not only poses difficulties for professionals but also raises emotional issues for the individual and their family.
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