1
|
Xie Q, Yan C, Liu G, Bian L, Zhang K. In Situ Triggered Self-Contraction Bioactive Microgel Assembly Accelerates Diabetic Skin Wound Healing by Activating Mechanotransduction and Biochemical Pathway. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2406434. [PMID: 39039968 DOI: 10.1002/adma.202406434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/12/2024] [Indexed: 07/24/2024]
Abstract
Chronic nonhealing skin wounds, characterized by reduced tissue contractility and inhibited wound cell survival under hyperglycemia and hypoxia, present a significant challenge in diabetic care. Here, an advanced self-contraction bioactive core-shell microgel assembly with robust tissue-adhesion (SMART-EXO) is introduced to expedite diabetic wound healing. The SMART-EXO dressing exhibits strong, reversible adhesion to damaged tissue due to abundant hydrogen and dynamic coordination bonds. Additionally, the core-shell microgel components and dynamic coordination bonds provide moderate rigidity, customizable self-contraction, and an interlinked porous architecture. The triggered in situ self-contraction of the SMART-EXO dressing enables active, tunable wound contraction, activating mechanotransduction in the skin and promoting the optimal fibroblast-to-myofibroblast conversion, collagen synthesis, and angiogenesis. Concurrently, the triggered contraction of SMART-EXO facilitates efficient loading and on-demand release of bioactive exosomes, contributing to re-epithelialization and wound microenvironment regulation in diabetic mice. RNA-seq results reveal the activation of critical signaling pathways associated with mechanosensing and exosome regulation, highlighting the combined biomechanical and biochemical mechanisms. These findings underscore SMART-EXO as a versatile, adaptable solution to the complex challenges of diabetic wound care.
Collapse
Affiliation(s)
- Qingqiao Xie
- School of Biomedical Sciences and Engineering, Guangzhou International Campus, South China University of Technology, Guangzhou, 511442, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, 510006, P. R. China
- Guangdong Provincial Key Laboratory of Biomedical Engineering, South China University of Technology, Guangzhou, 510006, P. R. China
| | - Chenchen Yan
- The Fourth Affiliated Hospital of Soochow University, Suzhou, 215000, P. R. China
| | - Guohui Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China
| | - Liming Bian
- School of Biomedical Sciences and Engineering, Guangzhou International Campus, South China University of Technology, Guangzhou, 511442, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, 510006, P. R. China
- Guangdong Provincial Key Laboratory of Biomedical Engineering, South China University of Technology, Guangzhou, 510006, P. R. China
| | - Kunyu Zhang
- School of Biomedical Sciences and Engineering, Guangzhou International Campus, South China University of Technology, Guangzhou, 511442, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, 510006, P. R. China
- Guangdong Provincial Key Laboratory of Biomedical Engineering, South China University of Technology, Guangzhou, 510006, P. R. China
| |
Collapse
|
2
|
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.
Collapse
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
| | | | | | | | | | | | | |
Collapse
|
3
|
Gefen A, Alves P, Beeckman D, Cullen B, Lázaro-Martínez JL, Lev-Tov H, Najafi B, Santamaria N, Sharpe A, Swanson T, Woo K. How Should Clinical Wound Care and Management Translate to Effective Engineering Standard Testing Requirements from Foam Dressings? Mapping the Existing Gaps and Needs. Adv Wound Care (New Rochelle) 2024; 13:34-52. [PMID: 35216532 PMCID: PMC10654650 DOI: 10.1089/wound.2021.0173] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/20/2022] [Indexed: 02/07/2023] Open
Abstract
Significance: Wounds of all types remain one of the most important, expensive, and common medical problems, for example, up to approximately two-thirds of the work time of community nurses is spent on wound management. Many wounds are treated by means of dressings. The materials used in a dressing, their microarchitecture, and how they are composed and constructed form the basis for the laboratory and clinical performances of any advanced dressing. Recent Advances: The established structure/function principle in material science is reviewed and analyzed in this article in the context of wound dressings. This principle states that the microstructure determines the physical, mechanical, and fluid transport and handling properties, all of which are critically important for, and relevant to the, adequate performances of wound dressings. Critical Issues: According to the above principle, once the clinical requirements for wound care and management are defined for a given wound type and etiology, it should be theoretically possible to translate clinically relevant characteristics of dressings into physical test designs resulting specific metrics of materials, mechanical, and fluid transport and handling properties, all of which should be determined to meet the clinical objectives and be measurable through standardized bench testing. Future Directions: This multidisciplinary review article, written by an International Wound Dressing Technology Expert Panel, discusses the translation of clinical wound care and management into effective, basic engineering standard testing requirements from wound dressings with respect to material types, microarchitecture, and properties, to achieve the desirable performance in supporting healing and improving the quality of life of patients.
Collapse
Affiliation(s)
- Amit Gefen
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Paulo Alves
- Centre for Interdisciplinary Research in Health, Catholic University of Portugal, Porto, Portugal
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University and Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden
| | | | | | - Hadar Lev-Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Hospital Miller School of Medicine, Miami, Florida, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Nick Santamaria
- School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Sharpe
- Podiatry Department, Salford Royal NHS Foundation Trust, Salford Care Organisation, Salford, United Kingdom
| | - Terry Swanson
- Nurse Practitioner, Warrnambool, Victoria, Australia
| | - Kevin Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
4
|
Holubová A, Chlupáčová L, Krocová J, Cetlová L, Peters LJF, Cremers NAJ, Pokorná A. The Use of Medical Grade Honey on Infected Chronic Diabetic Foot Ulcers-A Prospective Case-Control Study. Antibiotics (Basel) 2023; 12:1364. [PMID: 37760661 PMCID: PMC10525154 DOI: 10.3390/antibiotics12091364] [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: 07/14/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Non-healing wounds are usually colonised and contaminated by different types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical grade honey (MGH). MGH has antioxidant, antimicrobial, anti-inflammatory, and immunomodulatory features. This study aims to evaluate the effect of MGH therapy on infected non-healing wounds, especially for diabetic foot syndrome. Prospective, observational case series (n = 5) of patients with wounds of diabetic foot syndrome are presented. There were five males with an average age of 61.6 years. All wounds were treated with MGH, and the healing trajectory was rigorously and objectively monitored. In all cases, there was a gradual disappearance of odour, pain, and exudation. Moreover, the wound areas significantly reduced within 40 days and there was a decrease in glycated haemoglobin and glycaemia values. All these outcomes resulted in improved quality of life of the patients. Despite bacterial colonisation, antibiotic treatment was not necessary. All wounds were completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in diabetic foot syndrome wounds, does not increase glycated haemoglobin or glycaemia levels, and thus constitutes an effective alternative to the use of antibiotics in the treatment of locally infected wounds.
Collapse
Affiliation(s)
- Adéla Holubová
- Faculty of Health and Social Sciences, University of South Bohemia, 370 11 České Budějovice, Czech Republic;
- DiaPodi Care, spol. s r.o., 392 01 Soběslav, Czech Republic;
| | | | - Jitka Krocová
- Department of Nursing and Midwifery, Faculty of Health Studies, University of West Bohemia, 301 00 Pilsen, Czech Republic;
| | - Lada Cetlová
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
| | | | - Niels A. J. Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, The Netherlands;
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Andrea Pokorná
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| |
Collapse
|
5
|
Barrett S, Rippon MG, Rogers AA. Effectiveness of wound contact layers in enabling undisturbed wound management: a case series. J Wound Care 2023; 32:134-144. [PMID: 36930187 DOI: 10.12968/jowc.2023.32.3.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Wound contact layers (WCLs) are intended to protect and support wounds during the healing process. An open, non comparative, case series clinical evaluation was undertaken to assess the impact of these dressings on establishing an undisturbed wound environment that supports effective wound management, and to allow the establishment of limits of duration of the wear time for the experimental WCLs. METHOD The primary objectives of this clinical evaluation were to assess the ability of the WCLs to prevent tissue disturbance to the wound and surrounding skin and for the clinicians to have confidence to extend the wear time of the WCL dressings. For them to have confidence in leaving the dressings in place for extended periods, the assessment of the wound and periwound skin condition and an assessment of patient comfort was performed: assessment of wound and periwound condition in relation to tissue adherence of the dressing to the wound resulting in tissue damage/bleeding (to wound and/or periwound skin) and cellular infiltration into the WCL; assessment of patient wearing comfort and satisfaction; assessment of WCL wear time, relating to times between dressing changes as judged by the clinician. RESULTS Based upon five parameters used to assess the extent to which the WCLs Atrauman, Atrauman Silicone and Atrauman Ag (HARTMANN, Germany) disturbed the underlying tissues-bleeding, wound tissue damage, periwound skin damage, tissue ingrowth and dressing adherence-the majority (>95%) of assessments indicated low or no disturbance of tissue. Over the 14 days of study assessment, the mean (±standard deviation) wear time was 7.3±1.2 days for the Atrauman group, 9.9±2.8 days for the Atrauman Silicone group, and 5.8±1.0 days for the Atrauman Ag group. All dressings were well tolerated by patients and rated highly in terms of in-use dressing performance. CONCLUSION The results indicate that Atrauman WCLs are suitable for the management of a variety of wounds as they promote an undisturbed wound environment, including extended wear time.
Collapse
Affiliation(s)
- Simon Barrett
- Humber NHS Foundation Trust, The Grange Hessle, Hull, UK
| | - Mark G Rippon
- Huddersfield University, Huddersfield, UK
- Daneriver Consultancy Ltd, Holmes Chapel, Cheshire, UK
| | | |
Collapse
|
6
|
Sili A, Zaghini F, Monaco D, Molin AD, Mosca N, Piredda M, Fiorini J. Specialized nurse-led care of chronic wounds during hospitalization and after discharge: A randomized controlled trial. Nurs Manag (Harrow) 2023; 54:46-54. [PMID: 36854004 DOI: 10.1097/01.numa.0000918196.97750.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Alessandro Sili
- At the Tor Vergata University Hospital in Rome, Italy, Alessandro Sili is the nursing and health professions director, and Francesco Zaghini is a research nurse. Dario Monaco is a PhD student in the Department of Biomedicine and Prevention at the University of Rome Tor Vergata. Alberto Dal Molin is an associate professor in the Department of Translational Medicine at the University of Piemonte Orientale in Novara. Nella Mosca is a wound care nurse at Tor Vergata University Hospital. Michela Piredda is an associate professor in the Research Unit Nursing Science at Campus Bio-Medico, Roma University. Jacopo Fiorini is a research nurse and vascular access nurse specialist at Tor Vergata University Hospital
| | | | | | | | | | | | | |
Collapse
|
7
|
Prakashan D, Roberts A, Gandhi S. Recent advancement of nanotherapeutics in accelerating chronic wound healing process for surgical wounds and diabetic ulcers. Biotechnol Genet Eng Rev 2023:1-29. [PMID: 36641600 DOI: 10.1080/02648725.2023.2167432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/08/2023] [Indexed: 01/16/2023]
Abstract
One of the greatest challenges faced during surgical procedures is closing and healing of wounds, which are essential in the field of orthopaedics, trauma, intensive care and general surgery. One of the main causes of death has been linked to chronic wounds, especially in immunosuppressant or diabetic patients. Due to increasing chronic wound fatality along with different pathologies associated with them, the current therapeutic methods are insufficient which has established an eminent need for innovative techniques. Traditionally, wound healing was carried out using formulations and ointments containing silver combined with different biomaterial, but was found to be toxic. Hence, the advent of alternative nanomaterial-based therapeutics for effective wound healing have come into existence. In this review, we have discussed an overview of wound infections such as different wound types, the wound healing process, dressing of wounds and conventional therapies. Furthermore, we have explored various nanotechnological advances made in wound healing therapy which include the use of promising candidates such as organic, inorganic, hybrid nanoparticles/nanocomposites and synthetic/natural polymer-based nanofibers. This review further highlights nanomaterial-based applications for regeneration of tissue in wound healing and can provide a base for researchers worldwide to contribute to this advancing medical area of wound therapy.
Collapse
Affiliation(s)
- Drishya Prakashan
- DBT-National Institute of Animal Biotechnology (NIAB), Hyderabad, Telangana, India
- DBT-Regional Centre for Biotechnology (RCB), Faridabad, Haryana, India
| | - Akanksha Roberts
- DBT-National Institute of Animal Biotechnology (NIAB), Hyderabad, Telangana, India
- DBT-Regional Centre for Biotechnology (RCB), Faridabad, Haryana, India
| | - Sonu Gandhi
- DBT-National Institute of Animal Biotechnology (NIAB), Hyderabad, Telangana, India
- DBT-Regional Centre for Biotechnology (RCB), Faridabad, Haryana, India
| |
Collapse
|
8
|
Sili A, Zaghini F, Monaco D, Dal Molin A, Mosca N, Piredda M, Fiorini J. Specialized Nurse-led Care of Chronic Wounds During Hospitalization and After Discharge: A Randomized Controlled Trial. Adv Skin Wound Care 2023; 36:24-29. [PMID: 36537771 DOI: 10.1097/01.asw.0000897444.78712.fb] [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: 06/17/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of specialized nurse-led care of patients with chronic wounds, provided both during hospitalization and postdischarge, on wound healing and readmission rates. METHODS An unblinded randomized controlled trial was conducted. Participants were patients with chronic wounds, randomly assigned to either the experimental group (cared for by wound care nurses both during hospitalization and postdischarge) or to the control group (cared for according to standard practice). Wound healing was identified as the primary outcome. RESULTS Overall, 1,570 patients were randomized, 1,298 of whom were included in the per-protocol analysis (707 in the experimental group and 591 in the control group). Nurse-led wound care quadrupled the probability of healing and reduced the number of treatment weeks and hospital readmissions. CONCLUSIONS Chronic wound care that was entrusted to specialized nurses improved outcomes in terms of wound healing, repair and regeneration, length of treatment, and rate of readmission, compared with standard practice. Future studies should evaluate the impact of care provided by specialized wound care nurses on patients' quality of life and healthcare costs. Nurse managers should promote the implementation of chronic wound clinical-care pathways entrusted to specialized nurses to improve patients' clinical outcomes and reduce hospital readmissions.
Collapse
Affiliation(s)
- Alessandro Sili
- At the Tor Vergata University Hospital, Rome, Italy, Alessandro Sili, PhD, RN, is Nursing and Health Professions Director; and Francesco Zaghini, PhD, RN, is Research Nurse. Dario Monaco, MSN, RN, is PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata. Alberto Dal Molin, PhD, RN, is Associate Professor, Department of Translational Medicine, University of Piemonte Orientale, Novara. Nella Mosca, MSN, RN, is Wound Care Nurse, Tor Vergata University Hospital. Michela Piredda, PhD, RN, is Associate Professor, Research Unit Nursing Science, Campus Bio-Medico, Roma University. Jacopo Fiorini, PhD, RN, is Research Nurse and Vascular Access Nurse Specialist, Tor Vergata University Hospital
| | | | | | | | | | | | | |
Collapse
|
9
|
A strain-programmed patch for the healing of diabetic wounds. Nat Biomed Eng 2022; 6:1118-1133. [PMID: 35788686 DOI: 10.1038/s41551-022-00905-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
Diabetic foot ulcers and other chronic wounds with impaired healing can be treated with bioengineered skin or with growth factors. However, most patients do not benefit from these treatments. Here we report the development and preclinical therapeutic performance of a strain-programmed patch that rapidly and robustly adheres to diabetic wounds, and promotes wound closure and re-epithelialization. The patch consists of a dried adhesive layer of crosslinked polymer networks bound to a pre-stretched hydrophilic elastomer backing, and implements a hydration-based shape-memory mechanism to mechanically contract diabetic wounds in a programmable manner on the basis of analytical and finite-element modelling. In mouse and human skin, and in mini-pigs and humanized mice, the patch enhanced the healing of diabetic wounds by promoting faster re-epithelialization and angiogenesis, and the enrichment of fibroblast populations with a pro-regenerative phenotype. Strain-programmed patches might also be effective for the treatment of other forms of acute and chronic wounds.
Collapse
|
10
|
Abstract
Debridement of devitalised tissue and wound biofilm is vital to promote healing. This article introduces an innovative debridement product, ChloraSolv Wound Debridement Gel, which is as effective as a blade but also selective, atraumatic and fast-acting and does not require specialist training. Its ease of use makes it suitable for all settings and staff.
Collapse
Affiliation(s)
- Leanne Atkin
- Vascular Nurse Consultant, Mid Yorkshire Hospitals NHS Trust and University of Huddersfield
| |
Collapse
|
11
|
Pressure Injuries and Management after Spinal Cord Injury. J Pers Med 2022; 12:jpm12071130. [PMID: 35887627 PMCID: PMC9325194 DOI: 10.3390/jpm12071130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Spinal cord injury (SCI) results in motor paralysis and sensory loss that places individuals at particularly high risk of pressure injuries. Multiple comorbidities associated with autonomic, cardiovascular, pulmonary, endocrine, gastrointestinal, genitourinary, neurological, and musculoskeletal dysfunction makes it even more likely that pressure injuries will occur. This manuscript will review the structure and function of the integumentary system, and address the multidisciplinary approach required to prevent and manage pressure injuries in this vulnerable population.
Collapse
|
12
|
3D PCL/collagen nanofibrous medical dressing for one-time treatment of diabetic foot ulcers. Colloids Surf B Biointerfaces 2022; 214:112480. [PMID: 35358884 DOI: 10.1016/j.colsurfb.2022.112480] [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: 11/18/2021] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022]
Abstract
Nanofibrous dressings exhibit high specific surface areas, good histocompatibility, enhanced wound healing, and reduced inflammation, which have broad technological implications for treating diabetic foot ulcers (DFUs). However, current nanofibrous dressings still suffer from high resistance to cell infiltration and multiple dressing changes. In this study, polycaprolactone (PCL) and collagen were adopted as electrospinning materials to prepare a 3D PCL/Collagen (PC) nanofibrous dressing (3D-PC) using aqueous phase fibre reassembly technology. The matrix metalloproteinases (MMPs) inhibitor doxycycline hyclate (DCH)-loaded halloysite nanotubes (HNTs) (DCH@HNTs) and antibacterial agent cephalexin (CEX) were loaded onto the dressing to prepare a multifunctional 3D drug-loaded PCL/Collagen nanofibrous dressing to promote DFU wound healing. The obtained 3D nanofibrous dressing exhibited high water absorption capacity and swelling capacity. It showed good antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) in vitro antibacterial test. In addition, the 3D nanofibrous dressing demonstrated good biocompatibility. It could significantly reduce the frequency of dressing changes and improve the healing of DFU wounds compared with the conventional multiple dressing changes method, suggesting a potential candidate for healing diabetic wounds.
Collapse
|
13
|
Rippon MG, Forster J, Rogers AA. Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence—part 2. J Wound Care 2022; 31:330-338. [DOI: 10.12968/jowc.2022.31.4.330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This narrative clinical review summarises the key evidence in support for the use of a hydro-responsive wound dressing, HydroTac (HRWD-2, PAUL HARTMANN AG, Germany) to address key aspects associated with the treatment of both acute and hard-to-heal wounds. This review demonstrates how HRWD-2 can be used in general to address the challenges presented by a wide range of wound types and skin injuries. It highlights the ability of HRWD-2 to regulate an optimal moist wound environment that promotes wound progression and healing. Key aspects covered in this review include the dressing's ability to: promote certain phases of the wound healing response (for example, re-epithelialisation) address the concepts and needs for wound progression as set out in the TIME wound management framework provide an optimal hydration level reduce tissue trauma and pain at dressing change.
Collapse
Affiliation(s)
- Mark G Rippon
- University of Huddersfield, Queensgate, Huddersfield, UK
| | - Jan Forster
- Wound Center Links der Weser, 28277 Bremen, Germany
| | | |
Collapse
|
14
|
Bhadauria SS, Malviya R. Advancement in Nanoformulations for the Management of Diabetic Wound Healing. Endocr Metab Immune Disord Drug Targets 2022; 22:911-926. [PMID: 35249512 DOI: 10.2174/1871530322666220304214106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/01/2021] [Accepted: 01/07/2022] [Indexed: 11/22/2022]
Abstract
People with diabetes have a very slow tendency for wound healing. Wound healing is a vast process where several factors inhibit the sequence of healing. Nano formulation plays a major role during acute and chronic wound healing. The present manuscript aims to discuss the role of nanoformulation in the treatment of diabetic wound healing. Diabetes is a common disease that has harmful consequences which lead to bad health. During the literature survey, it was observed that nanotechnology has significant advantages in the treatment of diabetic wound healing. The present manuscript summarized the role of nanomaterials in wound healing, challenges in diabetic wound healing, physiology of wound healing, a limitation that comes during wound repair, and treatments available for wound healing. After a comprehensive literature survey, it can be concluded that health worker needs more focus on the area of wound healing in diabetic patients. Medical practitioners, pharmaceutical and biomedical researchers need more attention towards the utilization of nanoformulations for the treatment of wound healing, specifically in the case of diabetes.
Collapse
Affiliation(s)
- Shailendra Singh Bhadauria
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Rishabha Malviya
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| |
Collapse
|
15
|
Haque ST, Saha SK, Haque ME, Biswas N. Nanotechnology-based therapeutic applications: in vitro and in vivo clinical studies for diabetic wound healing. Biomater Sci 2021; 9:7705-7747. [PMID: 34709244 DOI: 10.1039/d1bm01211h] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Diabetic wounds often indicate chronic complications that are difficult to treat. Unfortunately, existing conventional treatment modalities often cause unpremeditated side effects, given the need to develop alternative therapeutic phenotypes that are safe or have minimal side effects and risks. Nanotechnology-based platforms, including nanotherapeutics, nanoparticles (NPs), nanofibers, nanohydrogels, and nanoscaffolds, have garnered attention for their groundbreaking potential to decipher the biological environment and offer personalized treatment methods for wound healing. These nanotechnology-based platforms can successfully overcome the impediments posed by drug toxicity, existing treatment modalities, and the physiology and complexity of the wound sites. Furthermore, studies have shown that they play an essential role in influencing angiogenesis, collagen production, and extracellular matrix (ECM) synthesis, which are integral in skin repair mechanisms. In this review, we emphasized the importance of various nanotechnology-based platforms for healing diabetic wounds and report on the innovative preclinical and clinical outcomes of different nanotechnology-based platforms. This review also outlined the limitations of existing conventional treatment modalities and summarized the physiology of acute and chronic diabetic wounds.
Collapse
Affiliation(s)
- Sheikh Tanzina Haque
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| | - Subbroto Kumar Saha
- Department of Biochemistry and Molecular Medicine, University of California, Davis School of Medicine, Sacramento, CA 95817, USA.,Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, 120 Neugdong-ro, Gwangjin-gu, Seoul 05029, Korea.
| | - Md Enamul Haque
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka 1000, Bangladesh.
| | - Nirupam Biswas
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN-46202, USA.,Department of Immunology and Microbial Diseases, Albany Medical College, Albany, NY-12208, USA.
| |
Collapse
|
16
|
Kılıç A, Brown A, Aras I, Hui R, Hare J, Hughes LD, McCracken LM. Using Virtual Technology for Fear of Medical Procedures: A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions. Ann Behav Med 2021; 55:1062-1079. [PMID: 33821879 PMCID: PMC8557375 DOI: 10.1093/abm/kaab016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Innovations in virtual reality (VR) technologies have improved the adaptability of its use in therapeutic settings, and VR has shown to be a promising treatment for fear of medical procedures, with research increasing in this area in recent years. PURPOSE This review aims to collate evidence for the impact of VR on fear of medical procedures. METHODS CENTRAL (Cochrane), MEDLINE, EMBASE, and PsychINFO databases were searched up to October 2020. A mix of experimental and case-control studies were included for review, which evaluated the effectiveness of VR for fear, anxiety, and pain of medical procedures for people with needle phobia, dental phobia, claustrophobia of medical scans, and burn wound care anxiety. Risk of bias (RoB) was assessed by Cochrane and ROBINS-I tools. RESULTS Twenty-eight studies were selected. Some studies included mixed participant groups of young people adults. The interventions varied, with VR used for distraction, hypnosis, or exposure. These were shown to be effective for reducing fear of medical procedures. However, effectiveness for blood-injection-injury phobias and burn wound care patients was unclear. CONCLUSIONS Evidence on the effectiveness of VR suggests that it does decrease fear of medical procedures in some situations. However, the RoB assessment illustrated a poor quality of studies across those included in this review, limiting the ability to draw firm general conclusions from the study findings. There is a need for further research exploring the use of VR technologies in the management of anxiety in physical health care settings.
Collapse
Affiliation(s)
- Ayşenur Kılıç
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Guy’s Hospital, London Bridge, London, UK
| | - Ashley Brown
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Guy’s Hospital, London Bridge, London, UK
| | - Işıl Aras
- School of Orthodontics, Jacksonville University, Jacksonville, FL, USA
| | - Rita Hui
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Guy’s Hospital, London Bridge, London, UK
| | - Jennifer Hare
- Dental Psychology Service, Guy’s and St Thomas’ NHS Trust, London, UK
| | - Lyndsay D Hughes
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Guy’s Hospital, London Bridge, London, UK
| | | |
Collapse
|
17
|
Holubová A, Chlupáčová L, Cetlová L, Cremers NAJ, Pokorná A. Medical-Grade Honey as an Alternative Treatment for Antibiotics in Non-Healing Wounds-A Prospective Case Series. Antibiotics (Basel) 2021; 10:antibiotics10080918. [PMID: 34438968 PMCID: PMC8388796 DOI: 10.3390/antibiotics10080918] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 02/06/2023] Open
Abstract
Non-healing wounds are usually colonised by various types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical-grade honey (MGH), which favourably affects the healing process with its antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory properties. The objective of this study was to evaluate the effect of MGH therapy on the healing process of non-healing wounds of various aetiologies and different wound colonisations. Prospective, observation–intervention case studies (n = 9) of patients with wounds of various aetiologies (venous leg ulcers, diabetic foot ulcers, surgical wound dehiscence) are presented. All wounds were treated with MGH and the healing trajectory was rigorously and objectively monitored. In all cases, pain, odour, and exudation were quickly resolved, which led to an improvement in the quality of life of patients. Despite the proven bacterial microflora in wounds, antibiotic treatment was not necessary. The effects of MGH alleviated the signs of local infection until their complete elimination. In eight out of nine cases, the non-healing wound was completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in wounds of various aetiologies and forms an effective alternative for the use of antibiotics for treating locally infected wounds.
Collapse
Affiliation(s)
- Adéla Holubová
- Faculty of Health and Social Sciences, University of Bohemia, 370 11 České Budějovice, Czech Republic
- DiaPodi Care spol. s r.o., 392 01 Soběslav, Czech Republic;
- Correspondence: ; Tel.: +420-774-672-220
| | | | - Lada Cetlová
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
| | | | - Andrea Pokorná
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| |
Collapse
|
18
|
Pormohammad A, Monych NK, Ghosh S, Turner DL, Turner RJ. Nanomaterials in Wound Healing and Infection Control. Antibiotics (Basel) 2021; 10:antibiotics10050473. [PMID: 33919072 PMCID: PMC8143158 DOI: 10.3390/antibiotics10050473] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 01/05/2023] Open
Abstract
Wounds continue to be a serious medical concern due to their increasing incidence from injuries, surgery, burns and chronic diseases such as diabetes. Delays in the healing process are influenced by infectious microbes, especially when they are in the biofilm form, which leads to a persistent infection. Biofilms are well known for their increased antibiotic resistance. Therefore, the development of novel wound dressing drug formulations and materials with combined antibacterial, antibiofilm and wound healing properties are required. Nanomaterials (NM) have unique properties due to their size and very large surface area that leads to a wide range of applications. Several NMs have antimicrobial activity combined with wound regeneration features thus give them promising applicability to a variety of wound types. The idea of NM-based antibiotics has been around for a decade at least and there are many recent reviews of the use of nanomaterials as antimicrobials. However, far less attention has been given to exploring if these NMs actually improve wound healing outcomes. In this review, we present an overview of different types of nanomaterials explored specifically for wound healing properties combined with infection control.
Collapse
Affiliation(s)
- Ali Pormohammad
- Department of Biological Sciences, Faculty of Science, University of Calgary, 2500 University Dr. N.W., Calgary, AB T2N 1N4, Canada; (A.P.); (N.K.M.)
| | - Nadia K. Monych
- Department of Biological Sciences, Faculty of Science, University of Calgary, 2500 University Dr. N.W., Calgary, AB T2N 1N4, Canada; (A.P.); (N.K.M.)
| | - Sougata Ghosh
- Department of Microbiology, School of Science, RK University, Rajkot 360020, India;
| | - Diana L. Turner
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Raymond J. Turner
- Department of Biological Sciences, Faculty of Science, University of Calgary, 2500 University Dr. N.W., Calgary, AB T2N 1N4, Canada; (A.P.); (N.K.M.)
- Correspondence: ; Tel.: +1-403-220-4308
| |
Collapse
|
19
|
Barros Almeida I, Garcez Barretto Teixeira L, Oliveira de Carvalho F, Ramos Silva É, Santos Nunes P, Viana Dos Santos MR, Antunes de Souza Araújo A. Smart Dressings for Wound Healing: A Review. Adv Skin Wound Care 2021; 34:1-8. [PMID: 33443918 DOI: 10.1097/01.asw.0000725188.95109.68] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To provide an overview of sensors incorporated into wound dressings that can be used to assess and manage healing parameters. DATA SOURCES Authors conducted an extensive literature search of the Science Direct, Scopus, MEDLINE-PubMed, and Web of Science databases. STUDY SELECTION A total of 587 studies that evaluated dressings used to manage wound healing parameters were identified in the search, but only 16 met all of the review criteria and were included in the final analysis. DATA EXTRACTION Chronic wounds were the most common type of injury among studies. Six articles involved a wireless transmission system. DATA SYNTHESIS All studies evaluated the physical and chemical characteristics of the dressings. CONCLUSIONS This review demonstrates the lack of studies examining wound dressing sensors. New studies are required to assess sensors that allow not only wound monitoring, but also the application of drugs in a single dressing, providing a better and more cost-effective treatment for wounds.
Collapse
Affiliation(s)
- Isabella Barros Almeida
- At the Federal University of Sergipe, Sanatório, Aracaju, Brazil, Isabella Barros Almeida, PhD, is a physician; Luciana Garcez Barretto Teixeira, MS, is a doctoral student; Fernanda Oliveira de Carvalho, PhD, is a physiotherapist; Érika Ramos Silva, PhD, is Professor, Department of Physiotherapy; Paula Santos Nunes, PhD, is Professor, Department of Morphology; Márcio Roberto Viana dos Santos, PhD, is Professor, Department of Morphology; and Adriano Antunes de Souza Araújo, PhD, is Professor, Department of Pharmacy. The authors have disclosed no financial relationships related to this article. Submitted July 19, 2020; accepted in revised form September 25, 2020
| | | | | | | | | | | | | |
Collapse
|
20
|
Hosseini ES, Bhattacharjee M, Manjakkal L, Dahiya R. Healing and monitoring of chronic wounds: advances in wearable technologies. Digit Health 2021. [DOI: 10.1016/b978-0-12-818914-6.00014-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|
21
|
Kang S, Noyori S, Noguchi H, Takahashi T, Sanada H, Mori T. Development of an Electrical Impedance Tomography Spectroscopy for Pressure Ulcer Monitoring Tool: Preliminary study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5073-5076. [PMID: 33019127 DOI: 10.1109/embc44109.2020.9176256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study developed a sensor system that measures electrical impedance with a surrounding electrode array that is located around the wound and estimates the depth and classifies the difference in tissues of small regions in the area using tomography combined with spectroscopy method. The system is designed to integrate into the dressing to reduce unnecessary removal of dressings. In the human trial, moisturizer applied area was detected using Random Forest classifier (94.4% accuracy) and differences between every 10 minutes were significant in moisturizer applied area (p<; 0.05). The study confirmed the proof of concept that the system can monitor the change in human skin without attaching the sensor to the target area and indicate the skin area that had changed.
Collapse
|
22
|
Surya M, Zuriati Z, Zahlimar, Poddar S. Nursing aromatherapy using lavender with rose essence oil for post-surgery pain management. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
23
|
Naskar A, Kim KS. Recent Advances in Nanomaterial-Based Wound-Healing Therapeutics. Pharmaceutics 2020; 12:E499. [PMID: 32486142 PMCID: PMC7356512 DOI: 10.3390/pharmaceutics12060499] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023] Open
Abstract
Nanomaterial-based wound healing has tremendous potential for treating and preventing wound infections with its multiple benefits compared with traditional treatment approaches. In this regard, the physiochemical properties of nanomaterials enable researchers to conduct extensive studies on wound-healing applications. Nonetheless, issues concerning the use of nanomaterials in accelerating the efficacy of existing medical treatments remain unresolved. The present review highlights novel approaches focusing on the recent innovative strategies for wound healing and infection controls based on nanomaterials, including nanoparticles, nanocomposites, and scaffolds, which are elucidated in detail. In addition, the efficacy of nanomaterials as carriers for therapeutic agents associated with wound-healing applications has been addressed. Finally, nanomaterial-based scaffolds and their premise for future studies have been described. We believe that the in-depth analytical review, future insights, and potential challenges described herein will provide researchers an up-to-date reference on the use of nanomedicine and its innovative approaches that can enhance wound-healing applications.
Collapse
Affiliation(s)
| | - Kwang-sun Kim
- Department of Chemistry and Chemistry Institute for Functional Materials, Pusan National University, Busan 46241, Korea;
| |
Collapse
|
24
|
Atkin L, Barrett S, Chadwick P, Callaghan R, Rippon MG, Rogers AA, Simm S. Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series. J Wound Care 2020; 29:174-182. [DOI: 10.12968/jowc.2020.29.3.174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: The primary objective of this study was to evaluate the fluid management capabilities of a superabsorbent wound dressing (Zetuvit Plus Silicone), with secondary objectives related to parameters that support whether the dressing enables undisturbed healing. Method: This study was an open labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. Results: A total of 50 patients were included in the study. Results related to the primary objective demonstrated that the superabsorbent wound dressing was able to absorb all levels of exudate across the range (low to high). At each assessment time point these results show that in 98% of assessments the superabsorbent dressing was rated as ‘very good’ (91%) or ‘good’ (7%) at exudate management. Secondary objectives relating to wound bed preparation, healing and management of pain were also positive. Additionally, at the end of each patient treatment, the dressing's fluid management capabilities were rated overall as ‘excellent’ (100% of cases). There was little pain associated with the wound or at dressing change throughout the study and its flexibility/conformability allowed for comfort and patient satisfaction aligned with increased quality of life. Additionally, inclusion of a silicone adhesive layer allowed painless and atraumatic removal of the dressing, increasing patient comfort, both during wear and at dressing removal, and supported the description of enabling undisturbed wound healing. Conclusion: The superabsorbent wound dressing achieved the primary objective relating to wound exudate management in all the assessments undertaken in this study. In addition, the silicone interface allowed for undisturbed healing as evidenced by little or no adherence of the dressing to underlying tissue, preventing damage to periwound skin. Overall, the superabsorbent wound dressing with the addition of the silicone interface could offer advantages over other superabsorbent polymer dressings (that might adhere to the wound surface) or silicone wound dressings (that might not have the absorbent properties of this type of dressing).
Collapse
Affiliation(s)
| | - Simon Barrett
- Tissue Viability Nurse Specialist; Humber NHS Foundation Trust, The Grange Hessle, 11 Hull Road, Hessle, HU13 9LZ
| | | | | | - Mark G Rippon
- Visiting Clinical Research Fellow; Huddersfield University
| | - Alan A Rogers
- Medical Communications Consultant; Flintshire, North Wales
| | - Sue Simm
- Clinical Consultant; Luna Consultants
| |
Collapse
|
25
|
Wang W, Lu KJ, Yu CH, Huang QL, Du YZ. Nano-drug delivery systems in wound treatment and skin regeneration. J Nanobiotechnology 2019; 17:82. [PMID: 31291960 PMCID: PMC6617859 DOI: 10.1186/s12951-019-0514-y] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022] Open
Abstract
Skin damages are defined as one of most common lesions people suffer from, some of wounds are notoriously difficult to eradicate such as chronic wounds and deep burns. Existing wound therapies have been proved to be inadequate and far from satisfactory. The cutting-edge nanotechnology offers an unprecedented opportunity to revolutionize and invent new therapies or boost the effectiveness of current medical treatments. In particular, the nano-drug delivery systems anchor bioactive molecules to applied area, sustain the drug release and explicitly enhance the therapeutic efficacies of drugs, thus making a fine figure in field relevant to skin regeneration. This review summarized and discussed the current nano-drug delivery systems holding pivotal potential for wound healing and skin regeneration, with a special emphasis on liposomes, polymeric nanoparticles, inorganic nanoparticles, lipid nanoparticles, nanofibrous structures and nanohydrogel.
Collapse
Affiliation(s)
- Wei Wang
- Department of Pharmaceutics, Hangzhou Third Hospital, Hangzhou, 310009, China
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Kong-Jun Lu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Chao-Heng Yu
- Department of Burn, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Qiao-Ling Huang
- Department of Pharmaceutics, Hangzhou Third Hospital, Hangzhou, 310009, China.
| | - Yong-Zhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.
| |
Collapse
|
26
|
Smith F, Sharp A. Undertaking a person-centred assessment of patients with chronic wounds. Nurs Stand 2019; 34:77-82. [PMID: 31468929 DOI: 10.7748/ns.2019.e11305] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 12/19/2022]
Abstract
Wounds have traditionally been classified as acute or chronic. While this classification is useful when attempting to estimate healing times, it might lead to an acceptance that some wounds will take longer to heal or might not heal at all. Chronic wounds can adversely affect patients' quality of life, and the management of these wounds may involve significant healthcare resources and costs. Chronic wounds rarely develop in healthy individuals and are often associated with pre-existing conditions that complicate wound healing, such as diabetes mellitus and vascular disease. This article discusses how acute wounds and chronic wounds are differentiated. It details the phases of wound healing and identifies potential barriers to progression through these phases. Enhancing nurses' understanding of chronic wounds will enable them to identify any potential barriers to wound healing early and remove or ameliorate them. While a holistic assessment should also include a thorough assessment of the wound itself, this is beyond the scope of this article.
Collapse
Affiliation(s)
- Fiona Smith
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | - Ailsa Sharp
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland
| |
Collapse
|
27
|
Mehrali M, Bagherifard S, Akbari M, Thakur A, Mirani B, Mehrali M, Hasany M, Orive G, Das P, Emneus J, Andresen TL, Dolatshahi‐Pirouz A. Blending Electronics with the Human Body: A Pathway toward a Cybernetic Future. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2018; 5:1700931. [PMID: 30356969 PMCID: PMC6193179 DOI: 10.1002/advs.201700931] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 05/24/2018] [Indexed: 05/22/2023]
Abstract
At the crossroads of chemistry, electronics, mechanical engineering, polymer science, biology, tissue engineering, computer science, and materials science, electrical devices are currently being engineered that blend directly within organs and tissues. These sophisticated devices are mediators, recorders, and stimulators of electricity with the capacity to monitor important electrophysiological events, replace disabled body parts, or even stimulate tissues to overcome their current limitations. They are therefore capable of leading humanity forward into the age of cyborgs, a time in which human biology can be hacked at will to yield beings with abilities beyond their natural capabilities. The resulting advances have been made possible by the emergence of conformal and soft electronic materials that can readily integrate with the curvilinear, dynamic, delicate, and flexible human body. This article discusses the recent rapid pace of development in the field of cybernetics with special emphasis on the important role that flexible and electrically active materials have played therein.
Collapse
Affiliation(s)
- Mehdi Mehrali
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Sara Bagherifard
- Department of Mechanical EngineeringPolitecnico di Milano20156MilanItaly
| | - Mohsen Akbari
- Laboratory for Innovations in MicroEngineering (LiME)Department of Mechanical EngineeringUniversity of VictoriaVictoriaBCV8P 5C2Canada
- Center for Biomedical ResearchUniversity of VictoriaVictoriaV8P 5C2Canada
- Center for Advanced Materials and Related Technologies (CAMTEC)University of VictoriaVictoriaV8P 5C2Canada
| | - Ashish Thakur
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Bahram Mirani
- Laboratory for Innovations in MicroEngineering (LiME)Department of Mechanical EngineeringUniversity of VictoriaVictoriaBCV8P 5C2Canada
- Center for Biomedical ResearchUniversity of VictoriaVictoriaV8P 5C2Canada
- Center for Advanced Materials and Related Technologies (CAMTEC)University of VictoriaVictoriaV8P 5C2Canada
| | - Mohammad Mehrali
- Process and Energy DepartmentDelft University of TechnologyLeeghwaterstraat 392628CBDelftThe Netherlands
| | - Masoud Hasany
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | - Gorka Orive
- NanoBioCel GroupLaboratory of PharmaceuticsSchool of PharmacyUniversity of the Basque Country UPV/EHUPaseo de la Universidad 701006Vitoria‐GasteizSpain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine (CIBER‐BBN)Vitoria‐Gasteiz28029Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU‐Fundación Eduardo Anitua)Vitoria01007Spain
| | - Paramita Das
- School of Chemical and Biomedical EngineeringNanyang Technological University62 Nanyang DriveSingapore637459Singapore
| | - Jenny Emneus
- Technical University of DenmarkDTU Nanotech2800KgsDenmark
| | - Thomas L. Andresen
- Technical University of DenmarkDTU NanotechCenter for Nanomedicine and Theranostics2800KgsDenmark
| | | |
Collapse
|
28
|
|
29
|
Comparative effectiveness study between negative pressure wound therapy and conventional wound dressing on perforator flap at the Chinese tertiary referral teaching hospital. J Tissue Viability 2017; 26:282-288. [DOI: 10.1016/j.jtv.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 06/14/2017] [Accepted: 07/10/2017] [Indexed: 11/21/2022]
|
30
|
Abstract
Pain is a complex sensation with a variety of qualities rather than a single sensation varying in intensity. People find it difficult to describe their pain mainly because its nature and intensity vary so much, not only between individuals but also for a person over time. This article provides an overview of wound pain, its causes and assessment, with a focus on the procedure of dressing change itself. The wound care industry has manufactured dressings to assist in reducing the pain experience and it is incumbent on health care professionals to make the most appropriate dressing selection for the individual patient and wound, rather than a 'one type of dressing fits all' approach. The choice of primary product is important and is the aspect of focus for this discussion. This paper discusses the use of Flaminal (an enzyme alginogel) to assist practitioners in managing painful wounds.
Collapse
Affiliation(s)
| | - Heather Williams
- Nurse Consultant & Honorary Lecturer Chronic Pain Service Royal Victoria Infirmary Newcastle upon Tyne
| |
Collapse
|
31
|
Maver T, Gradišnik L, Kurečič M, Hribernik S, Smrke D, Maver U, Kleinschek KS. Layering of different materials to achieve optimal conditions for treatment of painful wounds. Int J Pharm 2017; 529:576-588. [DOI: 10.1016/j.ijpharm.2017.07.043] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/08/2017] [Accepted: 07/12/2017] [Indexed: 01/22/2023]
|
32
|
Gardner SE, Abbott LI, Fiala CA, Rakel BA. Factors associated with high pain intensity during wound care procedures: A model. Wound Repair Regen 2017; 25:558-563. [PMID: 28805960 PMCID: PMC5831166 DOI: 10.1111/wrr.12553] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/25/2017] [Indexed: 11/28/2022]
Abstract
The most common wound care procedures (WPCs) performed on open wounds are dressing changes and wound cleansing. Dressing changes cause moderate to severe pain in 74% of patients, nearly half (36%) of whom experience severe pain (rated as 8-10 on a 10-point numeric rating scale). The purpose of this paper is to propose a model of clinically accessible factors that can be tested in order to develop a clinical tool to identify which patients are likely to experience high intensity pain during nonoperative WCPs, such as dressing changes. Although multiple factors are known to be associated with pain, the factors selected for this model were limited to those that (1) are supported based on evidence and/or pain mechanisms and (2) are readily accessible to clinicians/practitioners and can be tested as a prediction tool to be used prior to WCPs. This model may be helpful to identify those likely to experience high intensity pain during WCPs. In this way, use of aggressive pain management strategies, including specialty dressings, pharmacologic analgesics, and/or non-pharmacological strategies, such as high intensity transcutaneous electrical stimulation.
Collapse
Affiliation(s)
| | - Linda I. Abbott
- University of Iowa Hospitals and Clinics, Department of Nursing and University of Iowa, College of Nursing
| | | | | |
Collapse
|
33
|
Razjouyan J, Grewal GS, Talal TK, Armstrong DG, Mills JL, Najafi B. Does Physiological Stress Slow Down Wound Healing in Patients With Diabetes? J Diabetes Sci Technol 2017; 11:685-692. [PMID: 28436270 PMCID: PMC5588845 DOI: 10.1177/1932296817705397] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Poor healing is an important contributing factor to amputation among patients with diabetic foot ulcers (DFUs). Physiological stress may slow wound healing and increase susceptibility to infection. OBJECTIVES The objective was to examine the association between heart rate variability (HRV) as an indicator of physiological stress response and healing speed (HealSpeed) among outpatients with active DFUs. DESIGN AND METHODS Ambulatory patients with diabetes with DFUs (n = 25, age: 59.3 ± 8.3 years) were recruited. HRV during pre-wound dressing was measured using a wearable sensor attached to participants' chest. HRVs were quantified in both time and frequency domains to assess physiological stress response and vagal tone (relaxation). Change in wound size between two consecutive visits was used to estimate HealSpeed. Participants were then categorized into slow healing and fast healing groups. Between the two groups, comparisons were performed for demographic, clinical, and HRV derived parameters. Associations between different descriptors of HRV and HealSpeed were also assessed. RESULTS HealSpeed was significantly correlated with both vagal tone ( r = -.705, P = .001) and stress response ( r = .713, P = .001) extracted from frequency domain. No between-group differences were observed except those from HRV-derived parameters. Models based on HRVs were the highest predictors of slow/fast HealSpeed (AUC > 0.90), while models based on demographic and clinical information had poor classification performance (AUC = 0.44). CONCLUSION This study confirms an association between stress/vagal tone and wound healing in patients with DFUs. In particular, it highlights the importance of vagal tone (relaxation) in expediting wound healing. It also demonstrates the feasibility of assessing physiological stress responses using wearable technology in outpatient clinic during routine clinic visits.
Collapse
Affiliation(s)
- Javad Razjouyan
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Gurtej Singh Grewal
- Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, University of Arizona, Tucson, AZ, USA
| | | | - David G. Armstrong
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Joseph L. Mills
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Bijan Najafi, PhD, MSc, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine; One Baylor Plaza, MS: BCM390, Houston, TX 77030, USA.
| |
Collapse
|
34
|
Slade EA, Thorn RMS, Lovering AM, Young A, Reynolds DM. In vitro discrimination of wound-associated bacteria by volatile compound profiling using selected ion flow tube-mass spectrometry. J Appl Microbiol 2017; 123:233-245. [PMID: 28423217 DOI: 10.1111/jam.13473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/31/2017] [Accepted: 04/12/2017] [Indexed: 01/31/2023]
Abstract
AIMS To determine if bacterial species responsible for clinically relevant wound infection produce specific volatile profiles that would allow their speciation. METHODS AND RESULTS Selected ion flow tube-mass spectrometry (SIFT-MS) in full mass scan mode was used to analyse headspace gases produced by wound-associated bacteria grown in vitro, so as to enable identification of bacterial volatile product ion profiles in the resulting mass spectra. Applying multivariate statistical analysis (hierarchical clustering and principal component analysis) to the resultant mass spectra enabled clear speciation. Moreover, bacterial volatile product ions could be detected from artificially contaminated wound dressing material, although the pattern of product ions detected was influenced by culture conditions. CONCLUSIONS Using selected product ions from the SIFT-MS mass spectra it is possible to discriminate wound-associated bacterial species grown under specific in vitro culture conditions. SIGNIFICANCE AND IMPACT OF THE STUDY The results of this study have shown that wound-associated bacteria can be discriminated using volatile analysis in vitro and that bacterial volatiles can be detected from wound dressing material. This indicates that volatile analysis of wounds or dressing material to identify infecting microbes has potential and warrants further study.
Collapse
Affiliation(s)
- E A Slade
- Faculty of Health and Applied Sciences, University of the West of England Centre for Research in Biosciences, University of the West of England, Bristol, UK
| | - R M S Thorn
- Faculty of Health and Applied Sciences, University of the West of England Centre for Research in Biosciences, University of the West of England, Bristol, UK
| | - A M Lovering
- Antimicrobial Reference Laboratory Southmead Hospital, Westbury-on-Trym, Bristol, UK
| | - A Young
- The Scar Free Foundation Centre for Children's Burns Research, Bristol Royal Hospital for Children, Bristol, UK
| | - D M Reynolds
- Faculty of Health and Applied Sciences, University of the West of England Centre for Research in Biosciences, University of the West of England, Bristol, UK
| |
Collapse
|
35
|
Colegrave M, Rippon M, Richardson C. The effect of Ringer's solution within a dressing to elicit pain relief. J Wound Care 2016; 25:184, 186-8, 190. [DOI: 10.12968/jowc.2016.25.4.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - M.G. Rippon
- School of Human and Health Sciences, Institute of Skin Integrity and Infection Prevention. University of Huddersfield
| | - C. Richardson
- The School of Nursing, Midwifery and Social Work, University of Manchester
| |
Collapse
|
36
|
Smart bandage with wireless connectivity for uric acid biosensing as an indicator of wound status. Electrochem commun 2015. [DOI: 10.1016/j.elecom.2015.03.018] [Citation(s) in RCA: 186] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
|
37
|
Woo KY. Unravelling nocebo effect: the mediating effect of anxiety between anticipation and pain at wound dressing change. J Clin Nurs 2015; 24:1975-84. [PMID: 26032858 DOI: 10.1111/jocn.12858] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to examine the mediating effect of anxiety in the relationship between anticipation and pain in people with chronic wounds. BACKGROUND Pain is common in people with chronic wounds. Anticipation or negative expectation of discomfort has been shown to have an augmenting effect on pain; also known as nocebo hyperalgesia. DESIGN This was a cross-sectional study with repeated measures. METHODS Prior to dressing change, anticipatory pain level was evaluated by a 11-point numerical rating scale and anxiety by the Six-items State-Trait Anxiety Inventory (STAI-6). During wound dressing changes, pain was measured before dressing removal, at dressing removal, at cleansing and dressing application using the numerical scale. RESULTS Analysis was completed based on the data from a convenience sample of 96 patients. Participants reported more pain at cleansing and dressing removal than baseline. High levels of anticipation, anxiety and pain at dressing change for wounds were related to heavy exudate and wound that were covered with necrotic tissue. Finally, the relationship between anticipation and pain perception was mediated by anxiety. CONCLUSION Anticipation of pain triggers anxiety that can lead to increased pain. RELEVANCE TO CLINICAL PRACTICE There is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience.
Collapse
Affiliation(s)
- Kevin Y Woo
- School of Nursing, Queen's University, Cataraqui Building, Kingston, Ontario, Canada
| |
Collapse
|
38
|
Hua Y, Qiu R, Yao WY, Zhang Q, Chen XL. The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs. Pain Manag Nurs 2015; 16:685-91. [PMID: 25972074 DOI: 10.1016/j.pmn.2015.03.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/26/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Abstract
It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. A prospective randomized study. A pediatric center in a tertiary hospital. Sixty-five children, aged from 4 to 16 years, with chronic wounds on their lower limbs. Pain and anxiety scores during dressing changes were recorded by using the Wong-Baker Faces picture scale, visual analogue scale, and pain behavior scale, as well as physiological measurements including pulse rate and oxygen saturation. Time length of dressing change was recorded. Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes.
Collapse
Affiliation(s)
- Yun Hua
- Wuhan Medical Care Center for Women and Children, Hubei, China
| | - Rong Qiu
- Wuhan Medical Care Center for Women and Children, Hubei, China
| | - Wen-Yan Yao
- Wuhan Medical Care Center for Women and Children, Hubei, China
| | - Qin Zhang
- Wuhan Medical Care Center for Women and Children, Hubei, China
| | - Xiao-Li Chen
- HOPE School of Nursing, Wuhan University, Hubei, China.
| |
Collapse
|
39
|
Using negative pressure wound therapy on microskin autograft wounds. J Surg Res 2015; 195:344-50. [DOI: 10.1016/j.jss.2014.12.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 11/16/2014] [Accepted: 12/11/2014] [Indexed: 11/20/2022]
|
40
|
White-Chu EF. Prognostication and Management of Non-Healable Wounds and Wounds at the End of Life. CURRENT GERIATRICS REPORTS 2015. [DOI: 10.1007/s13670-015-0129-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
41
|
Derbyshire A. Using a silicone-based dressing as a primary wound contact layer. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2014; 23 Suppl 20:S14-S20. [PMID: 25382127 DOI: 10.12968/bjon.2014.23.sup20.s14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The use of silicone-based dressings as a primary contact layer for wound care can prevent epithelial stripping, pain and sensitivity and have been widely available for nearly 20 years. Cuticell Contact from BSN medical is the latest silicone-based dressing to add to the armoury of the wound care clinician. Using documented case studies the author explores the reasoning behind why clinicians should consider re-examining the use of silicone dressings.
Collapse
Affiliation(s)
- Adam Derbyshire
- Senior ANP, Albany House Medical Centre, Wellingborough, Northamptonshire
| |
Collapse
|
42
|
Parvaneh S, Grewal GS, Grewal E, Menzies RA, Talal TK, Armstrong DG, Sternberg E, Najafi B. Stressing the dressing: Assessing stress during wound care in real-time using wearable sensors. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.wndm.2014.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
43
|
Abstract
This review and case study report considers the evidence to indicate that the progress of wound healing is negatively affected by the presence of stressors and in circumstances where patients are in pain. It considers the relationship between perceptions of pain, stress and delayed wound healing with a specific focus on guidance for clinical practice. It is appreciated that although the literature has examined these issues in the management of acute wounds, demonstrating that psychological stress can have detrimental effects on the wound-healing process, the evidence to support this link in relation to chronic wounds is limited. The review considers evidence indicating that punch biopsy wounds heal more slowly in subjects under stress on account of caring for family members with long-term illnesses and also considers briefly the relationship between cortisol secretion in response to stress and the consequent influences on cytokine levels and the wound-healing process.
Collapse
Affiliation(s)
- Kyoichi Matsuzaki
- Department of Plastic and Reconstructive Surgery, Kawasaki Municipal Tama Hospital, Kawasaki
| | - Dominic Upton
- Department of Plastic and Reconstructive Surgery, Kawasaki Municipal Tama Hospital, Kawasaki, JapanDepartment of Plastic and Reconstructive Surgery, St. Marianna University School of Medicine, Kawasaki, JapanInstitute of Health and Society, University of Worcester, Worcester, UK
| |
Collapse
|
44
|
Mehmood N, Hariz A, Fitridge R, Voelcker NH. Applications of modern sensors and wireless technology in effective wound management. J Biomed Mater Res B Appl Biomater 2013; 102:885-95. [DOI: 10.1002/jbm.b.33063] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/11/2013] [Accepted: 09/27/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Nasir Mehmood
- School of Engineering, University of South Australia; Adelaide South Australia 5001 Australia
| | - Alex Hariz
- School of Engineering, University of South Australia; Adelaide South Australia 5001 Australia
| | - Robert Fitridge
- Department of Surgery; University of Adelaide, The Queen Elizabeth Hospital; Woodville 5011 Australia
| | - Nicolas H. Voelcker
- Mawson Institute, University of South Australia; Adelaide South Australia 5001 Australia
| |
Collapse
|
45
|
Upton D, Andrews A. Negative pressure wound therapy: improving the patient experience Part 1 of 3. J Wound Care 2013; 22:552-7. [DOI: 10.12968/jowc.2013.22.10.552] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- D. Upton
- Institute of Health and Society, University of Worcester, UK
| | - A. Andrews
- Institute of Health and Society, University of Worcester, UK
| |
Collapse
|
46
|
|
47
|
Current World Literature. Curr Opin Support Palliat Care 2013; 7:116-28. [DOI: 10.1097/spc.0b013e32835e749d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
48
|
Stewart AM, Baker JD, Elliott D. The psychological wellbeing of patients following excision of a pilonidal sinus. J Wound Care 2013; 21:595-6, 598-600. [PMID: 23299269 DOI: 10.12968/jowc.2012.21.12.595] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To explore the effects of a pilonidal sinus wound on patients' psychological wellbeing. METHOD An interpretive descriptive approach, using the Model of Living conceptual framework, guided data collection and analysis. The Model of Living was chosen to elicit information on how a pilonidal sinus wound affected activities of living. Participants were recruited from a database of a community nursing service, using purposive sampling, until data saturation was evident. Semi-structured interviews were used to collect the data. Data were examined for frequent patterns, which were organised into themes. RESULTS Seven males and four females with ages ranging 17-39 years were selected through purposive sampling. Five participants reported that their wound affected their psychological wellbeing. Three themes and eight sub themes were identified from the data: adaption, perception and control. Depression and stress were associated with pain, physical inactivity, body weight changes and delayed wound healing. CONCLUSION A pilonidal sinus wound can affect the psychological wellbeing of patients through pain,physical inactivity, changed body weight and delayed wound healing. Pre-existing conditions could also be exacerbated by the wound.
Collapse
Affiliation(s)
- A M Stewart
- University of Technology, Sydney, New South Wales, Australia.
| | | | | |
Collapse
|
49
|
Upton D, Solowiej K, Woo KY. A multinational health professional perspective of the prevalence of mood disorders in patients with acute and chronic wounds. Int Wound J 2013; 11:627-35. [PMID: 23289905 DOI: 10.1111/iwj.12018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 06/21/2012] [Accepted: 06/21/2012] [Indexed: 11/27/2022] Open
Abstract
Recent research has started to identify mood disorders and problems associated with acute and chronic wounds, which have been shown to contribute to delayed healing, poor patient well-being and a reduced quality of life. Furthermore, mood disorders have been shown to have a negative impact on financial costs for service providers and the wider society in terms of treatment and sickness absence. This study aimed to survey a multinational sample of health professionals to explore their perspective and awareness of mood disorders amongst acute and chronic wound patients. Responses were received from n = 908 health professionals working in Asia, Africa, Australia, Europe, North America and South America. A strong awareness of the prevalence of mood disorders appeared to be widespread among the health professionals across the world, in addition to a view on the potential factors contributing to these problems with mood. Despite this, it was thought that few patients were actually receiving treatment for their mood disorders. Implications for clinical practice include the need for health professionals to engage actively with their patients to enable them to learn from their experiences. Studies that explore the benefits of treatments and techniques appropriate for minimising mood disorders in patients with wounds would provide empirical evidence for health professionals to make recommendations for patients with acute and chronic wounds.
Collapse
Affiliation(s)
- Dominic Upton
- Psychological Sciences, University of Worcester, Henwick Grove, Worcester, WR2 6AJ, UK
| | | | | |
Collapse
|
50
|
Upton D, Stephens D, Andrews A. Patients' experiences of negative pressure wound therapy for the treatment of wounds: a review. J Wound Care 2013; 22:34-9. [PMID: 23299356 DOI: 10.12968/jowc.2013.22.1.34] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- D. Upton
- University of Worcester, Henwick Grove, St Johns, Worcester, UK.
| | - D. Stephens
- University of Worcester, Henwick Grove, St Johns, Worcester, UK.
| | - A. Andrews
- University of Worcester, Henwick Grove, St Johns, Worcester, UK.
| |
Collapse
|