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Wounds: a Compendium of Clinical Research and Practice

Chi-Yu Wang, Chien-Ju Wu, Yu-Jen Shih, Tzi-Shiang Chu, Hung-Hui Liu, Chun-Yu Chen, Kuo-Feng Hsu, Shyi-Gen Chen, Yuan-Sheng Tzeng
INTRODUCTION: Ischial pressure ulcers are considered the most difficult type of pressure ulcers (PUs) to treat. OBJECTIVE: The authors report the use of a pedicled anterolateral thigh (pALT) myocutaneous flap as an alternative for covering an ischial PU. MATERIALS AND METHODS: The authors retrospectively collected the data of 21 patients with an indurated recurrent ischial ulcer or a fresh ischial ulcer. A pALT myocutaneous flap was harvested without intramuscular dissection and skeletonization of the perforators for the ischial defect reconstruction...
January 31, 2019: Wounds: a Compendium of Clinical Research and Practice
Radhakrishnan Raju, Sunil Naik Kethavath, Satyanarayana Murthy Sangavarapu, Praveen Kanjarla
INTRODUCTION: Due to being hard to heal, chronic ulcers account for high morbidity. OBJECTIVE: This study compares the safety and efficacy of 2 formulations of cadexomer iodine and standard care for the treatment of chronic ulcers. MATERIALS AND METHODS: This prospective, randomized, open-label clinical trial was conducted at 8 cities across 15 institutions in India from March 2016 to March 2017. After screening a total of 145 patients with chronic, recalcitrant ulcers, 124 were randomized to 1 of 3 treatments: 0...
January 31, 2019: Wounds: a Compendium of Clinical Research and Practice
Shawn Cazzell
INTRODUCTION: Venous leg ulcers (VLUs) are often chronic and difficult to treat, which makes alternative options to conventional care necessary to improve ulcer healing rates. While human acellular dermal matrices (ADMs) have shown promise in treating diabetic foot ulcers, no comparative studies have been published regarding VLU treatment. Decellularized ADMs (D-ADMs) have been used successfully in the treatment of a wide variety of wound repairs and may be effective in treating VLUs...
January 31, 2019: Wounds: a Compendium of Clinical Research and Practice
Simona Gabriele, Beth Buchanan, Azoy Kundu, Heather C Dwyer, Joseph P Gabriele, Perry Mayer, David Charles Baranowski
INTRODUCTION: Tetracycline molecules comprise a group of broad-spectrum antibiotics whose primary mechanism of action is the inhibition of protein synthesis through the binding of the bacterial ribosome. In addition, tetracyclines inhibit matrix metalloproteases (MMPs), a family of zinc-dependent proteases that contribute to tissue remodeling, inflammation, and angiogenesis and are overexpressed in certain pathophysiologies such as diabetic foot ulcers (DFUs). OBJECTIVE: This study aims to develop a liquid chromatography and mass spectrometry (LC-MS/MS) doxycycline quantification methodology to facilitate the development of a stable topical doxycycline hyclate (DOXY) formulation as well as evaluate the topical DOXY formulation for the efficacy in MMP-9 inhibition in vitro and in a clinical application of diabetic lower extremity wounds...
December 26, 2018: Wounds: a Compendium of Clinical Research and Practice
William Tettelbach, Jonathan Arnold, Alberto Aviles, Christopher Barrett, Animesh Bhatia, Michael Desvigne, Lisa J Gould, Marcus S Speyrer, Mark Suski, Colin J Traynor, Lucian Vlad
Use of ultra-portable, mechanically powered disposable negative pressure wound therapy (dNPWT) has grown as an adjunctive modality to manage wounds in outpatient care and to expedite transition of inpatients to an outpatient setting. This technology has demonstrated similar efficacy and usability for mobile outpatients when compared with electrically powered negative pressure wound therapy devices. It was designed for patients with smaller, low to moderately exudating wounds and does not require batteries or a power source...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Luis Angel Suarez Gonzalez, Pablo Del Canto Peruyera, Javier Cerviño Alvarez, Luis Javier Alvarez Fernandez
INTRODUCTION: Acral lentiginous melanoma (ALM) is a rare variety of melanoma typically located on distal areas of the body. Due to its presentation, it can be confused with a vascular ulcer. CASE REPORT: The authors present the case of a 68-year-old man who smokes with a history of hypertension, diabetes, and dyslipidemia, who was referred to the vascular clinic with complaints of intermittent claudication and a developing ulcer on his heel. After formulating an accurate wound care plan and performing revascularization surgery, the ulcer did not heal...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Leah Griffin, Mikaela M Sifuentes
INTRODUCTION: Patient nonadherence to home care treatment poses an obstacle to wound healing that can lead to additional costs and prolong care. OBJECTIVE: This retrospective pilot study examines the potential time and cost savings associated with a remote therapy monitoring (RTM) program designed to improve negative pressure wound therapy (NPWT) adherence in the home care setting. MATERIALS AND METHODS: Payor claims data of patients receiving NPWT with (n = 199) or without (n = 232) RTM between January 1 and June 30, 2017 were analyzed...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Laura Bolton
The calf muscles have been called the body's "second heart," improving blood circulation when exercised, usually by walking. Structured exercise training (SET) increases calf muscle pump function, lower limb circulation, and walking capacity for those with limited ambulation due to peripheral arterial disease (PAD)1 or venous insufficiency.2 This resulted in the Centers for Medicare and Medicaid Services (CMS) decision to reimburse up to thirty-six 30- to 60-minute, properly supervised hospital outpatient or office-based SET sessions over 12 weeks to treat intermittent claudication for patients with PAD...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Harry P Schneider, Adam Landsman
INTRODUCTION: Esterified hyaluronic acid is part of a unique dressing that can be used for the treatment of difficult, nonprogressive wounds, including venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). OBJECTIVE: The data presented herein represent a small retrospective sample of the authors' clinical experience with this unique material. MATERIALS AND METHODS: Data were collected from 6 patients with DFUs and 3 patients with VLUs...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Jennifer Bayron, Kathy Gallagher, Luis Cardenas
INTRODUCTION: Modern wound management continues to present new challenges. Many patients elect to forego operative debridement secondary to high risk, fear, cost concerns, and personal ideologies on healing. Although operative debridement has long been a tenet of proper wound care, alternative innovative approaches to wound management must be considered. OBJECTIVE: This case series describes the successful outcomes of 12 patients with dissimilar wounds who were managed with medical-grade honey (active Leptospermum honey [ALH]) as an alternative to surgery...
February 2019: Wounds: a Compendium of Clinical Research and Practice
Oleg Teleten, Holly Kirkland-Kyhn, Tim Paine, Reynaldo J Ballesteros
A pressure ulcer/injury (PU/I) is caused by multiple factors with sustained pressure being the major contributor to its development. This pressure may be measured by a health care provider using a pressure mapping device in order to assess pressure distribution properties of surfaces used. This educational article describes a general overview, the value, how to perform, and how to incorporate pressure mapping into clinical practice. Also included is an exemplar of a nurse and a physical therapist using pressure mapping to identify the best surface and position for a wheelchair-bound patient in order to minimize PU/I risk...
January 2019: Wounds: a Compendium of Clinical Research and Practice
Luis Fernández, Cynthia Ellman, Patricia Jackson
INTRODUCTION: Negative pressure wound therapy with instillation and dwell time (NPWTi-d) cleanses wounds with cyclic delivery, dwell, and removal of topical solutions to solubilize infectious materials and wound debris. OBJECTIVE: In this 2-patient case study, the authors report their experiences using NPWTi-d on 2 critically ill patients requiring management of large, complex wounds. MATERIALS AND METHODS: In both cases, normal saline was instilled with 10- to 20-minute dwell times, followed by 2 hours of negative pressure wound therapy (NPWT) at -125 mm Hg...
January 2019: Wounds: a Compendium of Clinical Research and Practice
Dinakar Golla, Dorothy H Kurtz Phelan
INTRODUCTION: Surgical closure of late-stage pressure ulcers (PUs) poses challenges in the immobilized population due to the high rate of complications, including infection, dehiscence, and recurrence. Muscle flap closure is the standard treatment for chronic, late-stage (stage 4) PUs, characterized by the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel as full-thickness tissue loss with exposure of bone, tendon, or muscle. OBJECTIVE: The aim of this study is to evaluate the outcomes associated with the use of a cryopreserved placental membrane containing viable cells (vCPM) graft for the augmentation of surgical flap closure in nonhealing perineal ulcers...
January 2019: Wounds: a Compendium of Clinical Research and Practice
Karishma Kaushik, Snehal Kadam
The authors of this Letter to the Editor suggest an alternative approach than to either abandon or administer antibiotics in response to an article published in the November 2018 issue of Wounds.
January 2019: Wounds: a Compendium of Clinical Research and Practice
Harika Boinpally, Raelina S Howell, Bebu Ram, Virginia Donovan, Michael Castellano, John S Woods, Scott Gorenstein
INTRODUCTION: Necrotizing myositis (NM) is an extremely rare necrotizing soft tissue infection involving muscle. Unlike similar infections (eg, necrotizing fasciitis, clostridial myonecrosis) that can be more readily diagnosed, NM can have a benign presentation then rapidly progress into a life-threatening condition with a mortality rate of 100% without surgical intervention. CASE REPORT: A 74-year-old man with a history of prostate cancer with radiation therapy, seed implants, and 2 transurethral resection procedures presented to the emergency department after a fall...
December 2018: Wounds: a Compendium of Clinical Research and Practice
Ronald Arlen Sherman, Robyn Bjork
No abstract text is available yet for this article.
December 2018: Wounds: a Compendium of Clinical Research and Practice
Laura Bolton
Diabetic foot ulcers (DFUs) remain a challenge for clinicians despite decades of study. Clinicians now realize that healing strategies should focus on the patient as well as the ulcer. The search continues for interventions that affected individuals and their care providers can count on to heal and manage these challenging wounds, stopping the dreaded progression to amputation and death. The path to healing a patient's DFU often requires multidisciplinary care, including consistent offloading of insensate areas, endocrinologic and metabolic control, and improved circulation...
December 2018: Wounds: a Compendium of Clinical Research and Practice
Sara Javanmardi, Amaneh Ghojoghi, Baharak Divband, Javad Ashrafi
INTRODUCTION: Over the past few decades, the application of nanotechnology has gained progressive interest for the regeneration of injured and burned tissues. OBJECTIVE: This study evaluates the effects of titanium dioxide (TiO₂) nanoparticle (NP)/gelatin on burn wound healing in mice. MATERIALS AND METHODS: Sixty healthy male BALB/c mice with a full-thickness burn wound were randomized into 4 experimental groups of 15 animals each: (1) control group was treated with normal saline; (2) gelatin group was treated with gelatin-based ointment; (3) silver sulfadiazine group was treated with silver sulfadiazine 1% ointment; and (4) TiO₂ NP/gelatin group (TNG) received TiO₂ NP/gelatin...
December 2018: Wounds: a Compendium of Clinical Research and Practice
Timothy Cheung, Zachary Laidley, Jacob Jones, Stephanie Wu
OBJECTIVE: This case series evaluates the outcomes of persons with chronic lower extremity wounds treated with an esterified hyaluronic acid matrix (EHAM). MATERIALS AND METHODS: Data were abstracted from 12 consecutive patients with a total of 14 evaluated chronic wounds (12 [100%] men, mean age 58.72 years) presenting for care at a multidisciplinary wound care center. Nine of the 12 patients had diabetes. The mean wound duration was 39.2 weeks. All patients received surgical wound debridement and were started on therapy consisting of weekly to biweekly applications of the EHAM with a nonadherent, moisture-retentive dressing until complete epithelialization was achieved...
December 2018: Wounds: a Compendium of Clinical Research and Practice
Lindsey Blalock
INTRODUCTION: Current wound treatment options for complex wounds include advanced wound therapies. One such treatment, negative pressure wound therapy (NPWT), has evolved to include automated instillation of topical wound solutions with a user-specified dwell time (NPWTi-d). A novel reticulated open-cell foam dressing with through holes (ROCF-CC) was developed to assist wound cleansing by removing thick wound exudate and infectious material. OBJECTIVE: The author's experience using NPWTi-d with ROCF-CC on complex wounds is presented...
November 22, 2018: Wounds: a Compendium of Clinical Research and Practice
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