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Natarajan J, Joseph MA, Al Alawi R, Al Bulushi T, Al Alawi I, Al Junaibi SM, Thanka AN, Al Balushi LD, Al Ismaili IS, Shummo M, Al Nabhani SST. A domain specific health-related quality of life of omani patients living with chronic wounds. J Tissue Viability 2024; 33:393-398. [PMID: 38762367 DOI: 10.1016/j.jtv.2024.05.004] [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] [Received: 11/13/2023] [Revised: 02/12/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
AIM Chronic wounds, defined as wounds that do not heal in a logical set of stages, impact patients' quality of life by disrupting their self-esteem, sleep, social interaction, work capacity, and psychological well-being. Chronic wounds are a prevalent problem in Oman due to the high number of patients with diabetes, sickle cell disease, road traffic accidents, and decubitus ulcer. Therefore, it is paramount to analyse the health-related quality of life (HRQOL) of these patients with chronic wounds. MATERIAL AND METHODS An observational, cross-sectional, descriptive study with a quantitative approach was conducted among 275 adult patients with chronic wounds in three tertiary hospitals of Muscat from June to December 2021 using a self-reported Cardiff life wound impact questionnaire and the Bates-Jensen wound assessment tool. Data were analysed with IBM SPSS version 23 using inferential statistics and chi-square test. RESULTS We found that the majority of participants were men (178; 64.7 %), aged between 41 and 60 years (107; 38.9 %), predominantly with diabetic wounds (80; 29.1 %). Respondents reported poor HRQOL across all domains: well-being (63.24 ± 18.092), physical (53.24 ± 18.387), and social (59.54 ± 19.025). Statistically significant poorer HRQOL was observed among the elderly above 60 years, illiterates, those with traumatic wounds, and those receiving medication and dressing as treatment. CONCLUSIONS Our findings indicate that Omani patients with chronic wounds experience low HRQOL. It is imperative for healthcare providers to offer comprehensive care to these patients. To enhance their quality of life and alleviate suffering, evaluating both the wounds and HRQOL is essential. Such assessments will enable the optimisation of treatment and coping strategies for patients.
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Affiliation(s)
- Jansirani Natarajan
- School of Health in Social Science, The University of Edinburgh, Scotland, United Kingdom
| | - Mickael Antoine Joseph
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman.
| | - Rashid Al Alawi
- Surgery Department, Royal Hospital, Muscat, Sultanate of Oman
| | - Taimoor Al Bulushi
- Department of Plastic and Reconstructive Surgery, Khoula Hospital, Muscat, Sultanate of Oman
| | | | - Suad Moosa Al Junaibi
- Adult Health Nursing Department, Oman College of Health Sciences, Muscat, Sultanate of Oman
| | - Anitha Nesa Thanka
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | | | | | - Moath Shummo
- Department of Plastic and Reconstructive Surgery, Khoula Hospital, Muscat, Sultanate of Oman
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2
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Abiakam NS, Jayabal H, Filingeri D, Bader DL, Worsley PR. Spatial and temporal changes in biophysical skin parameters over a category I pressure ulcer. Int Wound J 2023; 20:3164-3176. [PMID: 37060199 PMCID: PMC10502241 DOI: 10.1111/iwj.14194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/16/2023] Open
Abstract
In acute care facilities, the detection of pressure ulcers (PUs) relies on visual and manual examination of the patient's skin, which has been reported to be inconsistent and may lead to misdiagnosis. In skin and wound research, various biophysical parameters have been extensively employed to monitor changes in skin health. Nonetheless, the transition of these measures into care settings as part of a routine clinical assessment has been limited. This study was designed to examine the spatial and temporal changes in skin biophysical parameters over the site of a category I PU, in a cohort of hospitalised patients. Thirty patients, each presenting with a category I PU, were enrolled in the study. Skin integrity was assessed at the PU-compromised site and two adjacent areas (5 and 10 cm away). Data was collected over three sessions to examine both temporal differences and longitudinal changes. Skin integrity was assessed using two biophysical parameters, namely, transepidermal water loss (TEWL) and stratum corneum (SC) hydration. In addition, the influence of intrinsic factors, namely, incontinence and mobility status, on the parameters was evaluated. TEWL values at the sites compromised by PU were statistically significantly greater (P < .001) than corresponding values at the adjacent control sites at 5 and 10 cm, which were consistent with a normative range (<20 g/h/m2 ). By contrast, SC hydration values did not reveal clear distinctions between the three sites, with high inter-patient variation detected at the sites. Nevertheless, individual profiles were consistent across the three sessions, and the PU site was observed to be either abnormally dry or overhydrated in different individuals. No consistent temporal trend in either parameter was evident. However, intrinsic factors were shown to influence the parameters, with females, bedridden and incontinent patients presenting significantly higher TEWL and SC hydration values (P < .05). TEWL was able to identify differences in skin responses at skin sites compromised with a category I PU when compared to healthy adjacent skin sites. Accordingly, this parameter could be included in the clinical assessment for the identification of PU risk. Further studies are required to elucidate the role of hydration and skin barrier function in the development of PUs and their ability to monitor temporal changes in skin integrity.
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Affiliation(s)
- Nkemjika S. Abiakam
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Hemalatha Jayabal
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Davide Filingeri
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Dan L. Bader
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Peter R. Worsley
- Faculty of Environmental and Life Sciences, School of Health SciencesUniversity of SouthamptonSouthamptonUK
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3
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Savadkoohi H, Barasteh S, Ebadi A, Ashrafizadeh H, Akbarzadeh Amirdehi M, Safdari A, Mollahadi M, Oghli SH. Psychometric properties of Persian version of wound-QOL questionnaire among older adults suffering from chronic wounds. Front Psychol 2023; 13:1041754. [PMID: 36778173 PMCID: PMC9909697 DOI: 10.3389/fpsyg.2022.1041754] [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: 09/13/2022] [Accepted: 11/10/2022] [Indexed: 01/28/2023] Open
Abstract
Background Patients with chronic wounds experience various biopsychosocial problems which severely affects their quality of life (QoL). Thus, a Persian instrument to assess the QoL of these patients is required. This study aimed to determine the psychometric properties of the Persian version of the wound-QOL questionnaire. Methods This methodological study was performed on Iranian patients during 2021-2022. The translation was carried out via forward-backward method. Face validity was addressed with 10 patients and content validity with 12 wound specialists. Construct validity was also assessed by performing exploratory factor analysis (EFA) (n = 100) and convergent validation with EQ-5D-3L plus Pain VAS Score and known-groups validity. The reliability was assessed by internal consistency using Cronbach's alpha coefficient and test-retest. Results A total of 100 patients with chronic wounds were included in the study. Two factors with cumulative variance of 65.39% were extracted during EFA. The results revealed a significant and high correlation between the total scores of wound-QOL questionnaire, the Persian version of EQ-5D-3L (p = 0.000, r = 0.502), and Pain score (0-10; p = 0.000, r = 0.627). The Cronbach's alpha was 0.743 and stability of the questionnaire (α = 0.872) was confirmed. In confirming the known-groups validity, the results showed that this tool can differentiate the QOL of patients with different wounds. Conclusion The Persian version of the wound-QOL questionnaire is a valid and reliable questionnaire which can measure the QoL of patients with chronic wounds. This instrument can be used in clinical evaluation as well as research purposes across the Iranian population.
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Affiliation(s)
- Hamed Savadkoohi
- Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Salman Barasteh
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran,Salman Barasteh, ✉
| | - Abbas Ebadi
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran,Behavioral Sciences Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizadeh
- Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran
| | - Mahdi Akbarzadeh Amirdehi
- The Head of Wound and Ostomy Department, Baqiyatallah Hospital (IIWCC-EWMA-ICW-WOC-ET Nurse), Tehran, Iran
| | - Ali Safdari
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Mollahadi
- Exercise Physiology Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Saeid Hossein Oghli
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran,*Correspondence: Saeid Hossein Oghli, ✉
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4
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Guillen MRS, Borges EL, Amorim GL, Vieira PC, Guedes ACM, Barcelos LS. The use of occlusive dressings: influence on excisional wound healing in animal model. Acta Cir Bras 2023; 37:e371206. [PMID: 36651431 PMCID: PMC9839187 DOI: 10.1590/acb371206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/14/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To analyze the influence of occlusive dressing on the healing of excisional skin wounds in mice. METHODS Pre-clinical, comparative, and translational study. Mice were divided into three experimental groups: wounds occluded with hydrocolloid (HD) dressings, transparent polyurethane film (TF) dressings, and without occlusion (WO), monitored at three, six and 14 days, with eight animals each. Closure rate, infiltration of neutrophils and macrophages, measurement of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) and, histologically, angiogenesis were evaluated. RESULTS Wound closure was accelerated in the occlusive groups. There was a decrease in TNF-α levels in the HD group when compared to the WO and TF groups. Neutrophils accumulation decreased in the HD group. Increased dosages of macrophages were evidenced in the HD group, compared to the WO and TF groups. Levels of VEGF were increased in the TF and HD groups. CONCLUSIONS It is suggested that the occlusion of wounds modulates the inflammatory response.
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Affiliation(s)
- Mariana Raquel Soares Guillen
- MSc. Universidade Federal de Minas Gerais – School of Nursing – Department of Basic Nursing – Belo Horizonte (MG), Brazil.,Corresponding author:
- (55 31) 32489853
| | - Eline Lima Borges
- PhD. Universidade Federal de Minas Gerais – School of Nursing – Department of Basic Nursing – Belo Horizonte (MG), Brazil
| | - Gilmara Lopes Amorim
- MSc. Universidade Federal de Minas Gerais – School of Nursing – Department of Basic Nursing – Belo Horizonte (MG), Brazil
| | - Puebla Cassini Vieira
- PhD. Universidade Federal Rural de Pernambuco – Department of Animal Morphology and Physiology – Pernambuco (PE), Brazil
| | - Antônio Carlos Martins Guedes
- PhD. Universidade Federal de Minas Gerais – School of Medicine – Medical Clinic Department – Belo Horizonte (MG), Brazil
| | - Luciola Silva Barcelos
- PhD. Universidade Federal de Minas Gerais – Institute of Biological Sciences – Department of Physiology and Biophysics – Belo Horizonte (MG), Brazil
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Diban F, Di Lodovico S, Di Fermo P, D’Ercole S, D’Arcangelo S, Di Giulio M, Cellini L. Biofilms in Chronic Wound Infections: Innovative Antimicrobial Approaches Using the In Vitro Lubbock Chronic Wound Biofilm Model. Int J Mol Sci 2023; 24:1004. [PMID: 36674518 PMCID: PMC9862456 DOI: 10.3390/ijms24021004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
Chronic wounds have harmful effects on both patients and healthcare systems. Wound chronicity is attributed to an impaired healing process due to several host and local factors that affect healing pathways. The resulting ulcers contain a wide variety of microorganisms that are mostly resistant to antimicrobials and possess the ability to form mono/poly-microbial biofilms. The search for new, effective and safe compounds to handle chronic wounds has come a long way throughout the history of medicine, which has included several studies and trials of conventional treatments. Treatments focus on fighting the microbial colonization that develops in the wound by multidrug resistant pathogens. The development of molecular medicine, especially in antibacterial agents, needs an in vitro model similar to the in vivo chronic wound environment to evaluate the efficacy of antimicrobial agents. The Lubbock chronic wound biofilm (LCWB) model is an in vitro model developed to mimic the pathogen colonization and the biofilm formation of a real chronic wound, and it is suitable to screen the antibacterial activity of innovative compounds. In this review, we focused on the characteristics of chronic wound biofilms and the contribution of the LCWB model both to the study of wound poly-microbial biofilms and as a model for novel treatment strategies.
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Affiliation(s)
- Firas Diban
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Silvia Di Lodovico
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Paola Di Fermo
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Simonetta D’Ercole
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Sara D’Arcangelo
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Mara Di Giulio
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Luigina Cellini
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
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6
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Soares Dantas J, Silva CCM, Nogueira WP, de Oliveira e Silva AC, de Araújo EMNF, da Silva Araújo P, Freire MEM. Health-related quality of life predictors in people with chronic wounds. J Tissue Viability 2022; 31:741-745. [DOI: 10.1016/j.jtv.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
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de Almeida EF, Goulart J, Moraes JT, Lanza FM, Cortez DN. Calidad de vida asociada con polifarmacia en personas con lesiones cutáneas crónicas. J Wound Care 2022; 31:34-40. [PMID: 36787947 DOI: 10.12968/jowc.2022.31.latam_sup_6a.34] [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: 02/16/2023]
Abstract
Objetivo: Analizar la asociación entre el uso de polifarmacia y la calidad de vida de personas con lesiones cutáneas crónicas. Método: Estudio transversal con una muestra conformada por 146 personas afectadas por lesiones cutáneas crónicas, vinculadas con la atención primaria de salud. La recolección de datos se realizó entre julio de 2017 y febrero de 2018. La información se recopiló mediante un cuestionario sociodemográfico y el cuestionario Cardiff Wound Impact Schedule (CWIS). Resultados: Hubo predominio de hipertensión arterial sistémica en 86 personas (58,9%) y de diabetes mellitus en 50 (34,2%). La etiología de la lesión cutánea predominante fue vasculogénica (38,4%), y se identificó polifarmacia en el 46,7% de los pacientes. En el cuestionario CWIS, el dominio con el puntaje promedio más bajo fue el bienestar (promedio de 46,2±17,9). Hubo asociación estadísticamente significativa (p<0.05) entre polifarmacia y las siguientes variables: dominio de “síntomas físicos/vida diaria", dominio de “vida social” y “autosatisfacción con la calidad de vida". Conclusión: La polifarmacia está asociada con un detrimento en la calidad de vida de personas con lesiones cutáneas crónicas. Por lo tanto, los profesionales de la salud que trabajan en la atención primaria deberían considerar la terapia farmacológica en sus planes de atención, coordinar con asistencia médica y farmacéutica la elaboración de estrategias de monitoreo de los riesgos que involucran la polifarmacia, y evaluar sus impactos en la calidad de vida. Conflicto de interés: Ninguno.
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Affiliation(s)
| | - Jéssica Goulart
- Universidade Federal de São João del-Rei/Campus Centro Oeste, Minas Gerais, Brasil
| | | | - Fernanda Moura Lanza
- Universidade Federal de São João del-Rei/Campus Centro Oeste, Minas Gerais, Brasil
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8
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de Almeida EF, Goulart J, Moraes JT, Lanza FM, Cortez DN. Calidad de vida asociada con polifarmacia en personas con lesiones cutáneas crónicas. J Wound Care 2022; 31:34-40. [PMID: 36789904 DOI: 10.12968/jowc.2022.31.latam_sup_6.34] [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: 02/16/2023]
Abstract
Objetivo: Analizar la asociación entre el uso de polifarmacia y la calidad de vida de personas con lesiones cutáneas crónicas. Método: Estudio transversal con una muestra conformada por 146 personas afectadas por lesiones cutáneas crónicas, vinculadas con la atención primaria de salud. La recolección de datos se realizó entre julio de 2017 y febrero de 2018. La información se recopiló mediante un cuestionario sociodemográfico y el cuestionario Cardiff Wound Impact Schedule (CWIS). Resultados: Hubo predominio de hipertensión arterial sistémica en 86 personas (58,9%) y de diabetes mellitus en 50 (34,2%). La etiología de la lesión cutánea predominante fue vasculogénica (38,4%), y se identificó polifarmacia en el 46,7% de los pacientes. En el cuestionario CWIS, el dominio con el puntaje promedio más bajo fue el bienestar (promedio de 46,2±17,9). Hubo asociación estadísticamente significativa (p<0.05) entre polifarmacia y las siguientes variables: dominio de “síntomas físicos/vida diaria", dominio de “vida social” y “autosatisfacción con la calidad de vida". Conclusión: La polifarmacia está asociada con un detrimento en la calidad de vida de personas con lesiones cutáneas crónicas. Por lo tanto, los profesionales de la salud que trabajan en la atención primaria deberían considerar la terapia farmacológica en sus planes de atención, coordinar con asistencia médica y farmacéutica la elaboración de estrategias de monitoreo de los riesgos que involucran la polifarmacia, y evaluar sus impactos en la calidad de vida. Conflicto de interés: Ninguno.
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Affiliation(s)
| | - Jéssica Goulart
- Universidade Federal de São João del-Rei/Campus Centro Oeste, Minas Gerais, Brasil
| | | | - Fernanda Moura Lanza
- Universidade Federal de São João del-Rei/Campus Centro Oeste, Minas Gerais, Brasil
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Zhu X, Olsson MM, Bajpai R, Järbrink K, Tang WE, Car J. Health-related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross-sectional study in Singapore. Int Wound J 2021; 19:1121-1132. [PMID: 34854234 PMCID: PMC9284657 DOI: 10.1111/iwj.13708] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age (β = 0.008, P < .001), non‐Chinese ethnicity (β = 0.25, P = .001), mixed ulcers (β = −0.41, P = .022), atypical hard‐to‐heal wounds (β = −0.38, P = .021), wounds with low (β = 0.24, P = .044) to moderate (β = 0.29, P = .018) exudate level, and a wound duration ≥6 months (β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.
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Affiliation(s)
- Xiaoli Zhu
- Nursing Services, National Healthcare Group Polyclinics, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Maja Magdalena Olsson
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ram Bajpai
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,School of Medicine, Keele University, Staffordshire, UK
| | - Krister Järbrink
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wern Ee Tang
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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10
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Garcia TDF, Silva PGA, Barcelos BJ, Miranda MDGRD, Alonso CDS, Abreu MNS, Borges EL. Criteria to evaluate the quality of alginate wound dressings. Rev Bras Enferm 2021; 74:e20201091. [PMID: 34287561 DOI: 10.1590/0034-7167-2020-1091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/18/2021] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVES to validate an instrument with criteria to evaluate the quality of calcium alginate wound dressings to treat skin injuries. METHODS methodological study, developed in two stages: the elaboration of criteria to evaluate the quality of the alginate wound dressing based on literature; validation of these criteria by a group of evaluators in two moments. Data was analyzed using descriptive statistics, central tendency measures and the Content Validity Index. RESULTS seven articles were selected, leading to the elaboration of 7 criteria and 11 expected results. The Content Validity Index was 0.98 in stage 1 and 0.93 in stage 2. After adjustments, 8 criteria were validated, and 13 results were expected. FINAL CONSIDERATIONS the study allowed the validation of criteria to evaluate the quality of calcium alginate wound dressings, helping the nurses to choose with more autonomy and assertiveness.
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Affiliation(s)
| | | | | | | | | | | | - Eline Lima Borges
- Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
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11
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Mehl AA, Damião AO, Viana SD, Andretta CP. Hard-to-heal wounds: a randomised trial of an oral proline-containing supplement to aid repair. J Wound Care 2021; 30:26-31. [PMID: 33439085 DOI: 10.12968/jowc.2021.30.1.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We evaluated the effects of a specialised oral nutritional supplement (ONS) containing arginine and proline, with high vitamin A, C and E, zinc and selenium content, on the repair of hard-to-heal wounds. METHOD Patients with hard-to-heal wounds were evaluated at five timepoints (S0-S4) over four consecutive weeks. At S0 patients were randomised to the specialised ONS (n=15; 25 wounds) or control (n=15; 25 wounds) groups. Posology was 200ml twice daily over the research period. Wound surface area and perimeter were monitored. In addition to the metric data, it was also possible to calculate the rate of wound contraction and the linear growth of the wound edges, looking for wound-healing predictive factors. RESULTS A total of 30 patients took part in the study. Mean age was 65 years and 50% of patients had diabetes. Of the total evaluated wounds, 78% were <50cm2, 14% were 50-150cm2 and 8% were >250cm2. In 96% of cases, the wounds were in the lower limbs. A statistically significant reduction (p=0.004) in surface area of the wounds due to the specialised ONS, with a performance peak between S1 and S2, was observed. This specialised ONS did not induce changes in blood pressure, blood glucose level or renal function. A mean weekly wound edge growth of 1.85mm in patients with diabetes and 3.0mm in those without diabetes was observed. These results were 2.9 and 4.6 times, respectively, higher than expected, according to the literature. CONCLUSION Specialised ONS can be a therapeutic option for hard-to-heal wounds.
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Affiliation(s)
| | | | - Sâmela Ddo Viana
- Nutritionist Specialising in Clinical and Hospital Nutrition; Grupo de Apoio de Nutrição Enteral e Parenteral, Brazil
| | - Camila P Andretta
- Nutritionist Specialising in Clinical Nutrition; Faculdade Evangélica do Paraná, Brazil
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12
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Robles-Romero JM, Romero-Martín M, Conde-Guillén G, Cruces-Romero D, Gómez-Salgado J, Ponce-Blandón JA. The Physics of Fluid Dynamics Applied to Vascular Ulcers and Its Impact on Nursing Care. Healthcare (Basel) 2020; 8:healthcare8020147. [PMID: 32481597 PMCID: PMC7349071 DOI: 10.3390/healthcare8020147] [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: 05/10/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 11/16/2022] Open
Abstract
The high incidence of vascular ulcers and the difficulties encountered in their healing process require the understanding of their multiple etiologies to develop effective strategies focused on providing different treatment options. This work provides a description of the principles of the physics of fluid dynamics related to vascular ulcers. The morphological characteristics of the cardiovascular system promote blood flow. The contraction force of the left ventricle is enhanced by its ability to reduce its radius of curvature and by increasing the thickness of the ventricular wall (Laplace’s Law). Arterial flow must overcome vascular resistance (Ohm’s equation). The elastic nature of the artery and the ability to reduce its diameter as flow rate progresses facilitate blood conduction at high speed up to arteriolar level, and this can be determined by the second equation of continuity. As it is a viscous fluid, we must discuss laminar flow, calculated by the Reynolds number, which favors proper conduction while aiming at the correct net filtration pressure. Any endothelial harmful process that affects the muscle wall of the vessel increases the flow speed, causing a decrease in capillary hydrostatic pressure, thus reducing the exchange of nutrients at the interstitial level. With regard to the return system, the flow direction is anti-gravity and requires endogenous aid to establish the Starling’s equilibrium. Knowledge on the physics of vascular fluid dynamics makes it easier to understand the processes of formation of these ulcers so as to choosing the optimal healing and prevention techniques for these chronic wounds.
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Affiliation(s)
- José Miguel Robles-Romero
- Faculty of Nursing, Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.M.R.-R.); (M.R.-M.)
| | - Macarena Romero-Martín
- Faculty of Nursing, Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.M.R.-R.); (M.R.-M.)
- Cruz Roja University Nursing School, University of Seville, 41009 Seville, Spain;
| | - Gloria Conde-Guillén
- Ministry of Education, Government of Spain, Delegation of Huelva, 21002 Huelva, Spain;
| | | | - Juan Gómez-Salgado
- Faculty of Labour Sciences, Department of Sociology, Social Work and Public Health, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
- Correspondence: ; Tel.: +34-959-219-700
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Kapp S, Santamaria N. The effect of self-treatment of wounds on quality of life: a qualitative study. J Wound Care 2020; 29:260-268. [PMID: 32421484 DOI: 10.12968/jowc.2020.29.5.260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Skin wounds, such as leg ulcers and pressure ulcers (PUs), can have a negative effect on quality of life (QoL). This effect has been confirmed among self-treaters of wounds, specifically. The aim of the study was to investigate the effect of self-treatment of wounds on the physical, emotional, lifestyle and financial domains of QoL. The findings of the study may be used to optimise the wellbeing of people who have wounds. METHOD A qualitative study was conducted with people who were 18 years of age or older; lived in Victoria, Australia; spoke English; and had a wound that they had self-treated. Participants were interviewed and the data thematically analysed to identify themes that represented the effect of self-treatment on the physical, emotional, lifestyle and financial domains of QoL. RESULTS The participants (n=25) averaged 71 years of age and the majority (n=20) had leg wounds. Participants described mostly positive effects on QoL that were attributable to self-treatment. Self-treatment improved physical wellbeing because it resulted in better pain management and wound healing; however, it was a physical challenge for some. Self-treatment enhanced emotional wellbeing because it helped to manage worry about infection and resolve dissatisfaction with professional care. Self-treatment lessened the social consequences of the wound by enabling participants to create an acceptable appearance, maintain their lifestyle and minimise time receiving professional care. Self-treatment reduced the financial cost of wound dressings and the expense associated with receiving professional care. CONCLUSION As an approach to care, self-treatment of wounds may offer QoL gains that might otherwise be unachievable. The importance of engaging patients in their own management, and the increasing accountability of healthcare providers to report consumer-focused outcomes, are further reasons to consider self-treatment of wounds as an approach to care in the community setting.
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Affiliation(s)
- Suzanne Kapp
- The University of Melbourne, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, Department of Nursing, Victoria, Australia
| | - Nick Santamaria
- The University of Melbourne, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, Department of Nursing, Victoria, Australia
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