Category: Articles

Diabetic Amputations May Be Rising in the United States

Lower-limb amputations may be rising in the United States after decades of decline, according to data published in Diabetes Care, the official journal of the American Diabetes Association.

 

The study, which evaluated hospitalization rates for nontraumatic lower extremity amputation in the years 2000 to 2015 using data from the National Health Interview Survey, evaluated estimates for populations with and without diabetes.

 

Poorly controlled blood sugar that occurs in diabetes can limit blood flow to the lower legs and toes, causing nerve damage that people with the disease may not sense until problems have already developed. People with advanced diabetes may develop wounds or sores that do not heal and eventually result in loss of the damaged toe or portion of the foot or leg … read more

Researchers Coax Leftover Pancreatic Cells to Morph Into Insulin-Producing Cells

Using a growth factor produced naturally by the human body—and used in spinal-fusion surgeries—scientists from the Diabetes Research Institute (DRI) at the University of Miami Miller School of Medicine have coaxed “leftover” cells from the pancreas to morph into insulin-producing islet cells. In a study set for publication in the December issue of the journal Diabetes, the reprogrammed cells churned out about as much insulin as healthy human islet cells.

islet insulin producing cellsUsing BMP-7, the research team induced islet-like clusters from the exocrine cells as shown by several markers, including insulin expression (green, top left) and C-peptide (red, top right). C-peptide is a by-product of insulin expression by the cells and is used to demonstrate the production of natural insulin as opposed to the possibility that cells are simply absorbing insulin from the culture medium. Additionally, the reprogrammed cells show the expression of PDX1, a key marker of beta cell function (red, bottom right).Transplanted into lab mice and rats, the new islets released their blood sugar-lowering hormone in response to increases in blood glucose levels—just like the real thing. “That’s the hallmark of functioning islet cells, the ability to sense and respond to blood glucose levels,” notes the study’s co-lead investigator Juan Dominguez-Bendala, Ph.D., director of stem cell development for translational research at the DRI … read more

A photonic band aid using the healing power of blue light

A smart dressing that uses blue-light therapy for wound healing and which can also monitor and treat infections has been developed by an EU-funded consortium … Blue light is already known for its anti-bacterial and anti-inflammatory effects, but now the EU-funded MEDILIGHT consortium has harnessed it to aid the healing of chronic wounds such as those suffered by patients with diabetes … “The aim is to have a non-chemical solution for chronic wounds,” says project coordinator Dionysios Manessis of the System Integration and Interconnection Technologies Department, Technical University Berlin. “We found that blue light originally thought to be good for disinfection also produces good results for proliferation of keratinocytes and fibroblasts—the types of skin cells needed for wound closure.” … With EUR 3 million of EU funding for just over three years, the research team was able to produce a smart wearable device from scratch. The prototype consists of a soft, flexible foil with blue LEDs (light emitting diodes) and sensors. This is inserted into a transparent pocket over the wound dressing … read more

HMP Announces Launch of Post-Acute Care Symposium for Nurses

HMP, a leader in healthcare events and education, today announced the launch of the Post-Acute Care Symposium (PACS). The meeting will take place May 9–10, 2019, and will be co-located with the Symposium on Advanced Wound Care (SAWC) Spring/Wound Healing Society meeting in San Antonio, Texas.

 

PACS is uniquely designed to provide nurses with the important tools they need through a curriculum that focuses on practical, evidence-based strategies for implementing clinical practice guidelines, protocols, and care pathways for wound and incontinence interventions. The PACS Steering Committee is comprised of many of the same experts who guide the programming for the established SAWC Spring and Fall meetings.

 

“With the post-acute care setting now central to our healthcare delivery system, the time has come to provide a practical conference for nursing professionals that focuses on the day-to-day realities of patients with wound and incontinence issues,” said Catherine T. Milne, MSN, APRN, CWOCN-AP, Advanced Practice Nurse and Co-Chair for the meeting.

 

The two-day event, expected to draw approximately 250 nursing professionals, will provide a unique experience for attendees. The meeting will include a curriculum based on the nursing process method, interactive panel and case-based discussion, and “Rapid-Fire” and “Ask the Experts” sessions led by a diverse faculty that includes post-acute care educators with broad experience and practical insight. Attendees will have the opportunity to earn up to 10 CNE credits.

 

By co-locating the meeting with SAWC Spring, PACS attendees will also gain access to the world’s largest wound care exhibit hall and networking receptions as part of their registration.

 

“HMP saw an unmet need in the marketplace,” said Peter Norris, Executive Vice President, HMP. “The idea for PACS came in light of statistics showing the majority of wounds in the U.S. are being treated within the post-acute care setting by skilled nursing facility (SNF), home health (HH), and hospice providers. The educational agenda aims to provide post-acute care nursing professionals with real-world tools and strategies fit for the setting in which they care for patients on a daily basis.”

To learn more about the meeting, visit pacsymposium.com.

 

About HMP
HMP is the force behind Healthcare Made Practical—and is a multichannel leader in healthcare events and education, with a mission to improve patient care. The company produces accredited medical education events and clinically relevant, evidence-based content for the global healthcare community across a range of therapeutic areas. Its brands include Consultant360, the year-round, award-winning platform relied upon by healthcare providers across 21 specialties; Psych Congress, the largest independent mental health meeting in the U.S.; EMS World Expo, the world’s largest EMS-dedicated event; and the Symposium on Advanced Wound Care (SAWC), the largest wound care meeting in the world. For more information, visit hmpglobal.com.

originally posted in PR WEB

‘Magic powder’ heals wounds nothing else can

FORT LAUDERDALE, Fla. (Ivanhoe Newswire) – More than 5.7 million Americans suffer from chronic wounds that won’t heal. Now, a new, easy to use treatment some are calling a “magic powder” is helping patients heal much faster.

Plastic surgeon Tracey Stokes, MD, FACS, Board Certified Plastic Surgeon is used to being in the operating room, but not as a patient.

“I underwent bilateral mastectomy and reconstruction,” said Dr. Stokes.

Dr. Stokes made the decision after she and her mother tested positive for the gene that causes breast cancer. Unfortunately, she developed a wound on her left breast that would not heal.

“I think in today’s day and age wound care and wound care problems have almost become an epidemic,” said Laura Sudarsky, MD, FACS, Board Certified Plastic Surgeon & Wound Care Specialist at Esse Plastic Surgery … read more

Meet The First Wound-Care Certified LPN aka “WOuNDER Woman”

By Portia Wofford

 

Have you ever been the first to achieve a great feat? Do you remember all the naysayers and those “encouraging” you to pursue other avenues? The self-doubt, that nagging lump at the bottom of your throat, the second-guessing you plagued yourself with? Despite it all, you kept swimming and here you are, a badass!

 

I thought of these things when I met Cheryl Carver or as her friends and colleagues call her- ‘WOuNder WOMAN!’ Cheryl is a nationally renowned wound care specialist and expert, published writer, educator, and LPN!

 

Life Doesn’t Always Go As Planned

 

Cheryl’s nursing career began when she served in the Army, while stationed in Germany. She received a life-changing phone call that her mother had a stroke. She rushed home to be her mother’s caregiver. After a year, her mother died in Cheryl’s arms due to complications of diabetes and pressure ulcers/osteomyelitis/sepsis … read more

Healogics Wound Science Initiative Addresses Social Determinants of Health

The World Health Organization (WHO) defines social determinants of health as the conditions in which people are born, grow, live, work and age, that shape health. These factors include characteristics such as socioeconomic status, education, neighborhood and physical environment, employment and social support networks. Surprisingly, these social and environmental conditions account for 80 percent of health outcomes while only 20 percent are the result of care delivery.

 

“Over the next year, we will release a series of findings based on surveys of clinicians, interviews with patients and secondary data analysis,” said Hanna Gordon, PhD, Healogics Executive Director, Research and Informatics. “Our goal is to ensure that all patients can access high quality care and heal their chronic ulcers. We will begin our series with an introduction to the social determinants and how they impact health outcomes, followed by the findings of a survey on clinician perspectives on social barriers to care, and original research on the sociogeographic patterning of chronic wounds.”

 

Chronic wound patients face a number of challenges to their health and well-being. The presence of ulcers is an indication of broader physical systems failures. However, with education, many wounds could be prevented or treated when they are less severe resulting in improved outcomes. The association between chronic conditions such as diabetes, cardiovascular disease and social conditions is well established, yet none of the previous studies have addressed chronic ulcers. Healogics Wound Science Initiative is partnering with hospitals … read more

Multiphoton Microscopy Monitors Chronic Wound Healing

Chronic skin wounds such as diabetic foot ulcers, pressure wounds and other chronic skin wounds affect more than 6 million people in the U.S. alone, with the cost of treatments mounting to $25 billion each year. The current standard of care requires removing a small piece of the wound tissue for laboratory analysis under a microscope, but disturbing tissue around the wound can be disruptive to the healing process.

 

Recognizing a lack of non-invasive diagnostic biomarkers to monitor such wounds, University of Arkansas Optical redox ratio of the wound edge changes over time. In vivo redox ratio maps of FAD/(NADH+FAD) were generated from the normalized fluorescence intensities. Source: University of ArkansasOptical redox ratio of the wound edge changes over time. In vivo redox ratio maps of FAD/(NADH+FAD) were generated from the normalized fluorescence intensities. Source: University of Arkansasresearchers have identified a biomarker to track changes in cellular metabolism as wounds transition through the healing process. The group applied multiphoton microscopy to acquire a 3D image of wound structure and its metabolism … read more

Diabetic foot care providers’ perspectives on barriers and facilitators

     to delivering patient-focused foot care services: A qualitative descriptive study.

 

A qualitative descriptive study design was used (Sandelowski, 2000). Participants were health-care professionals providing foot care, foot wear, and wound care services in a Canadian province. Professionals voluntarily completed 48 open-ended surveys. Survey data was thematically analyzed to identify meaning and leading themes (nVivo10). The lead researcher kept field notes to support auditability and trustworthiness. Ethical approval was from the Research Ethics Board at St. Lawrence College, Cornwall, Ontario. Informed participant consent was obtained. Workshop attendees did not have to participate, and they did not have to return the survey if they did not choose to do so … read more

PolarityTE to Present SkinTE Clinical Outcomes

    at Innovations in Wound Healing Conference

 

SALT LAKE CITYDec. 4, 2018 /PRNewswire/ — PolarityTE, Inc. (Nasdaq: PTE), a commercial stage biotechnology company focused on transforming the lives of patients by discovering, designing and developing a range of regenerative tissue products and biomaterials for the fields of medicine, biomedical engineering and material sciences, announced today that it will present SkinTE™ clinical outcomes at the Innovations in Wound Healing Conference held in Key West, FL December 6-9, 2018.

 

During a presentation entitled, Regeneration of Functional Skin, Stephen Milner, MD, DDS, DSc, FRCSE, FACS and Chief Clinical Officer of PolarityTE, who practiced medicine for more than 20 years and served as former Professor of Plastic and Reconstructive Surgery at the Johns Hopkins University School of Medicine and former Director of Johns Hopkins Burn Center, will discuss SkinTE clinical outcomes data. Dr. Milner will highlight utilization of the autologous SkinTE cell-tissue product in chronic, burn and acute traumatic wounds. The presentation is scheduled during Scientific Session 8 on Sunday, December 9, 2018.

 

This unique conference is led by a group of experienced educators, scientists and clinicians interested in communicating new approaches to the repair of tissues throughout the human body. The program will focus on the science of tissue repair, the implementation of new findings and the exchange of the latest advances and thinking in the field. Participants, who include clinicians, developers, students and scientists from government, academia and industry, all share an interest in innovative ideas and novel therapies of tissue regeneration and the treatment of chronic wounds. Attendees come from the country’s foremost academic institutions and high-volume medical centers and include notable individuals from the wound care field like leaders from the nation’s largest provider of advanced wound healing services … read more

Outcomes of an Esterified Hyaluronic Acid Matrix in the Treatment

     of Chronic Lower Extremity Wounds: A Case Series

 

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. Outcomes evaluated included time to complete wound closure and proportion of patients achieving wound closure in 20 weeks. Results. In total, 85.7% of wounds measuring a mean of 2.32 cm2healed in the 20-week evaluation period … read more

Ask the wound care expert about … arterial ulcers

They’re less frequent than diabetic ulcers, but how concerned should we be about arterial ulcers (ischemic ulcers)?… Atherosclerosis is the major cause of peripheral arterial disease. This reduces the arterial blood flow to the lower extremities. The lumen of the arteries become occluded and the extremity becomes ischemic. Most ulcers develop due to a traumatic event to the ischemic leg or foot. However, skin breakdown can occur spontaneously … Risk factors for arterial ulcers include hyperlipidemia, smoking, hypertension, diabetes, advanced age and post trauma to the foot or leg … Arterial ulcers are usually located on the top of the toes, over the phalangeal heads … read more

Diabetic Foot Ulcers Heal Quickly with Nitric Oxide Technology

Editors Note: This article starts by claiming that “15% of 425 million people in the U.S. living with diabetes develop foot ulcers”. So ….

 

15% of the 425 million people in the U.S. living with diabetes develop foot ulcers. This is called diabetic foot ulcers, and it is said to increase the risk of death on a person by up to 2.5 times. Treating the ulcer with current means takes around 120 days … Now, with a nitric oxide-releasing technology, a team of biometric engineers say they can reduce the healing time of this diabetic foot ulcer by 99 days – that is from 120 to only 21 days … In the quest to lower these expenses, experts from Michigan Technological University have created what they call a nitric oxide-laden bandage that monitors, adjusts and releases the chemical, based on the need or depending on the state of the cells … To arrive at that, they first investigated what goes inside the skin cells when nitric oxide was introduced. In this case, the focus was on dermal fibroblast cells, which they analyzed on both normal and diabetic human cells … read more

NIBIB-funded researchers use non-invasive imaging technique

     to diagnose, monitor chronic wounds

 

A team of NIH-funded researchers at the University of Arkansas have demonstrated the novel use of multiphoton microscopy to monitor wound healing in live animals. The scientists measured metabolic changes that occur during healing at the wounds’ surface using autofluorescence imaging. In the future, doctors could use the images to non-invasively diagnose the type of chronic wound and determine the best treatment strategy.

 

Chronic skin wounds such as diabetic foot ulcers and pressure wounds affect more than 6 million people in the United States, with the cost of treatments mounting to $25 billion each year … read more

TWC Video Series: Reimbursement Tips for Success

In this new video series, TWC editorial advisory board member Kathleen D. Schaum, MS, shares eight poignant reimbursement tips for today’s outpatient wound care clinics.

Tip No. 1: Research
Tip No. 2: Learn Payment Systems
Tip No. 3: Itemizing 
Tip No. 4: Identify Pertinent Codes
Tip No. 5: Establish Appropriate Charges
Tip No. 6: NCDs, LCDs, Payer Contracts & Medical Policies
Tip No. 7: Insurance Benefits & Coverage Verification 
Tip No. 8: Auditing Claims

It’s not a shock: Better bandage promotes powerful healing

A new, low-cost wound dressing developed by University of Wisconsin-Madison engineers could dramatically speed up healing in a surprising way … The method leverages energy generated from a patient’s own body motions to apply gentle electrical pulses at the site of an injury … In rodent tests, the dressings reduced healing times to a mere three days compared to nearly two weeks for the normal healing process …”We were surprised to see such a fast recovery rate,” says Xudong Wang, a professor of materials science and engineering at UW-Madison … “We suspected that the devices would produce some effect, but the magnitude was much more than we expected” … Wang and collaborators described their wound dressing method today (Nov … 29, 2018) in the journal ACS Nano … read more

Organogenesis Supports ADA Scientific Compendium

     Highlighting Latest Treatments for Diabetic Foot Ulcers

 

CANTON, Mass.Nov. 29, 2018 /PRNewswire/ — Organogenesis Inc., a leading regenerative medicine company committed to empowering healing, is proud to support the American Diabetes Association (ADA)’s publication of a new scientific compendium reviewing the latest methods for diagnosing and treating diabetic foot complications.

 

“We are proud to support the production of the compendium, which will be an invaluable resource for both clinicians and patients,” said Shabnam Vaezzadeh, Vice President of Global Medical & Clinical Affairs for Organogenesis. “Diabetic foot ulcers represent a significant and ongoing public health challenge and we applaud the ADA for this rigorous, independent and timely review of evidence-based interventions.”

 

The ADA compendium, Diagnosis and Management of Diabetic Foot Complications, is a comprehensive review of the latest scientific evidence related to the treatment of DFUs, including best practices for early screening and diagnosis, prevention strategies, and wound care and treatment options. The content for the compendium was developed by a respected team of independent researchers and clinicians and is solely the responsibility of the ADA and ADA leadership.

DFUs are the leading cause of diabetes-related amputations in the United States. Nearly 100,000 non-traumatic amputations are performed each year, a number which includes 1 in 6 patients with a DFU, according to the ADA. Proper foot care and access to advanced wound care treatment options are critical to prevent amputation or premature death due to diabetic foot ulcers.

 

from Cision PR Newswire

Amputation-free survival in 17,353 people at high risk for foot ulceration in diabetes

     a national observational study

 

Diabetic foot ulcers and amputations are devastating and much feared complications of diabetes. Between 15% and 34% of people with diabetes develop a foot ulcer during their lifetime, with more than half acquiring infections that may result in lower extremity amputations causing disability, extensive periods of hospitalisation, and premature mortality. The incidence of major amputation ranges from 0·2 to 2·0 per 1000 people in those with diabetes [4, 5]. Major or minor amputation also increases the risk of additional subsequent amputations [6]. Foot ulcers are the costliest microvascular complication of diabetes …Amputations in people with diabetes have a significant impact on ambulation, body care, movement and mobility, resulting in an inability to perform daily tasks and often a loss of employment [6] impacting on the wider family. Clinical epidemiology studies suggest that foot ulcers precede around 85% of non-traumatic lower extremity amputations in individuals with diabetes and hence ulcer prevention is important. Previous studies have reported that apart from severity of ulcer … read more

Shoe Insole May be a Help for Patients with Diabetic Foot Ulcers

Diabetic ulcers commonly result from high blood sugar damaging nerves, which takes away feeling from the toes or feet … Without the ability to feel pain, hits and bumps tend to go unnoticed and skin tissue breaks down, forming ulcers … A lot of sugar in the bloodstream, along with dried skin as a consequence of diabetes, further slow the ulcer healing process … Recently, Purdue researchers developed a shoe insole that could help make the healing process more portable for the 15% of Americans who develop ulcers as a result of diabetes … The researchers used lasers to shape silicone-based rubber into insoles, and then create reservoirs that release oxygen only at the part of the foot where the ulcer is located … read more

 

Choosing compression to heal venous leg ulceration

There is a robust evidence base to support the use of compression therapy for healing venous leg ulceration and for preventing ulcer recurrence. The most recent version of the Cochrane Review on the effectiveness of compression and the relative effectiveness of different compression systems on venous leg ulcer healing included 48 randomised controlled trials (RCTs) reporting 59 comparisons. Although the methodological quality of the evidence is variable, there is overwhelming evidence that multi-layer high compression systems greatly increase the chances of healing compared to no compression. A more recent review and update of the evidence came to the same conclusion. Similarly, although there is very little evidence on the use of compression to prevent recurrence of venous ulcers, the overwhelming evidence of effectiveness for healing makes it highly likely that compression is also highly effective at preventing recurrence … read more

How Israel is transforming diabetes worldwide

Israeli companies are tackling medical issues that are impacting people across the world, and diabetes is one of the key areas that these companies are tackling. Improved approaches, treatments and management are helping these companies transform diabetes across the world … A chronic disease of the pancreas, diabetes occurs when a person cannot make enough insulin to regulate their blood sugar … Betalin Therapeutics, a startup, is leading the way for diabetic treatment advancement. The company, still a relatively young company, has been able to cure type-1 diabetes in mice. And while the transition from mice to humans is drastically different, the company hopes that they’ll be able to one day cure humans of diabetes … read more

Researchers develop portable 3-D skin printer to repair deep wounds

University of Toronto researchers have developed a handheld 3-D skin printer that deposits even layers of skin tissue to cover and heal deep wounds. The team believes it to be the first device that forms tissue in situ, depositing and setting in place, within two minutes or less … The research, led by Ph.D. student Navid Hakimi under the supervision of Associate Professor Axel Guenther of the Faculty of Applied Science & Engineering, and in collaboration with Dr. Marc Jeschke, director of the Ross Tilley Burn Centre at Sunnybrook Hospital and professor of immunology at the Faculty of Medicine, was recently published in the journal Lab on a Chip … read more

Moldable Hyaluronan Hydrogel Enabled by Dynamic Metal–Bisphosphonate

     Coordination Chemistry for Wound Healing

 

Biomaterial‐based regenerative approaches would allow for cost‐effective off‐the‐shelf solution for the treatment of wounds. Hyaluronan (HA)‐based hydrogel is one attractive biomaterial candidate because it is involved in natural healing processes, including inflammation, granulation, and reepithelialization. Herein, dynamic metal–ligand coordination bonds are used to fabricate moldable supramolecular HA hydrogels with self‐healing properties. To achieve reversible crosslinking of HA chains, the biopolymer is modified with pendant bisphosphonate (BP) ligands using carbodiimide coupling and chemoselective “click” reactions. Hydrogel is formed immediately after simple addition of silver (Ag+) ions to the solution of HA containing BP groups (HA‐BP). Compared with previous HA‐based wound healing hydrogels, the HA‐BP·Ag+ hydrogel is highly suitable for clinical use as it can fill irregularly shaped wound defects without the need for premolding. The HA‐BP·Ag+ hydrogel shows antimicrobial properties to both Gram‐positive and Gram‐negative bacterial strains, enabling prevention of infections in wound care. In vivo evaluation using a rat full‐thickness skin wound model shows significantly lower wound remaining rate and a thicker layer of regenerated epidermis as compared with the group left without treatment. The presented moldable and self‐healing supramolecular HA hydrogel with “ready‐to‐use” properties possesses a great potential for regenerative wound treatment … read more

Nexodyn Wound Care Solution Launched in the U.S.

The new Nexodyn AOS wound care solution, cleared for sale by the FDA, is now starting to be available in the USA, promoted and commercialized by the Italian pharmaceutical company Angelini, as a result of an exclusive partnership with the Swiss company APR Applied Pharma Research, the owner and developer of the proprietary, patented technology TEHCLO, for the production of acidic super-oxidizing solutions … Nexodyn helps cleanse and moisten the wound environment by removing dirt, debris and foreign material by flushing across the wound … Nexodyn is intended for use, under the supervision of healthcare professionals, to treat acute and chronic dermal lesions (such as leg ulcers, post-surgical wounds or 1st and 2nd degree burns) and minor cuts, burns, skin irritations and superficial abrasions … The solution, characterized by an acidic pH between 2 … 5 and 3 … 0, has cell viability preservation features, so as not to negatively interfere with the natural physiological healing process and epthelialization … Its antimicrobial preservative effectiveness has been demonstrated by in vitro testing … read more

The Effect of Foot Exercises on Wound Healing in Type 2

     Diabetic Patients With a Foot Ulcer

 

The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer … Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis … Subjects were followed up between February 2014 and June 2015 … Subjects were recruited by the researchers in the clinics where they received treatment … Subjects were randomly allocated to either the control or intervention group … Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log … Patients in the intervention group received standard wound care and performed daily foot exercises for 12 weeks; the control group received standard wound care but no exercises … The ulcers of the patients in both the intervention and control groups were examined and measured at the 4th, 8th, and 12th weeks … The groups were compared in terms of the ulcer size and depth … To analyze and compare the data, frequency distribution, mean (standard deviation), variance analysis, and the independent samples t test and the χ test were used … read more

New healing hydrogel is full of holes

Although we’ve already heard about hydrogels that help to heal chronic wounds, the University of New Hampshire’s Asst … Prof … Kyung Jae Jeong states that most of them have a shortcoming – they’re not porous enough … An inexpensive micro-hole-filled gel made by his team, however, is claimed to perform much better … The idea behind most hydrogels is that they get applied to “difficult” wounds such as diabetic foot ulcers, either being injected into them or put on as a dressing … The gels then create a form-fitting matrix across the surface of those injuries, promoting healing by keeping the wounds moist, preventing bacteria from entering them, and in some cases releasing medication … According to Jeong, though, cells from adjacent tissue often have difficulty growing through these relatively non-porous hydrogels and into the wound, resulting in a slow healing process … read more

Non-invasive Ozone Therapy Shows Effectiveness in Treating Digital Ulcers

Non-invasive, local treatment of digital ulcers with ozone for 20 days showed clinical effectiveness in systemic sclerosis patients, according to a new study …The study, “Non-invasive Oxygen-Ozone Therapy in Treating Digital Ulcers of Patients with Systemic Sclerosis,” was published in the journal Acta Reumatológica Portuguesa, and was conducted by researchers at Asyut University and Suez Canal University, in Egypt …Systemic sclerosis (SSc), or systemic scleroderma, is a chronic autoimmune disease that affects connective tissue (the tissue that supports and holds other tissues or organs together), and is characterized by excessive production of collagen protein, leading to fibrosis of the skin and internal organs …Excessive collagen deposition can also narrow small blood vessels in the fingers and toes, resulting in Raynaud’s phenomenon … read more

A guide to wound care

In this table, we cover the basics of wound care, such as reducing bioburden, reducing edema and maintaining a moist wound environment. This information was gathered from a 2014 article from the journal, Plastic Surgical Nursing, in which Marcia Spear, DNP, ACNP-BC, CWS, CPSN, addressed the “Principles of Wound Care – Back to Basics.” … view pdf

Researchers Develop New Method to Diagnose, Monitor Chronic Wounds

Researchers at the University of Arkansas have developed a new approach to diagnosing and monitoring chronic skin wounds, such as diabetic foot ulcers and pressure wounds … Chronic skin wounds affect more than 150 million people worldwide and cost approximately $25 billion in health care annually in the United States alone. These non-healing wounds are characterized by inflamed tissue, poor blood circulation, callus formation or infection … Current clinical approaches for diagnosing and monitoring these wounds do not provide critical diagnostic information about how they develop or why they do not heal … read more

Wound healing in psoriasis, multiple sclerosis

Wound healing is impaired in both psoriasis and multiple sclerosis, raising the prospect that a better understanding of the process could improve our understanding of the pathophysiology of these two chronic conditions and generate targets for treating them … The two conditions share a number of characteristics … For example, both diseases demonstrate slight itching, symmetry of the lesions, exacerbation after stopping corticosteroid treatment, and the Koebner phenomenon – provocation of the condition by stress … The Koebner phenomenon (isomorphic response) was first described in 1876 by the German dermatologist Heinrich Koebner who noted that patients developed psoriasis at sites of excoriations, horse bites, and tattoos … Koebner famously saw a psoriatic plaque develop on the skin of a farmer where his horse … read more

What can be revealed when you listen to your patients

You may wonder, “What in the world does this man know about type 2 diabetes (T2D) and toe injuries?” Well, I have had a very lengthy and lived experience with T2D. I was diagnosed 19 years ago, and I was very likely one of the worst patients with T2D ever.

 

How did I get here? How did it come to this? What is this? This is a problem with my feet that I will battle with for the rest of my life. This is an ongoing wound on my left large toe that a dear friend and I caused nearly 9 years ago that has never completely healed and now causes me to visit the diabetic foot clinic at the local hospital every 2–3 months.

 

Nearly 8.5 years ago, I did not know that this clinic even existed. I learned this fact, literally, by accident. Actually, it wasn’t an accident; I learned through what some might consider performing a really stupid act … read more

Considering Function When Evaluating Threatened Limbs

At the Southwestern Academic Limb Salvage Alliance (SALSA), we have long nicknamed our program “Toe and Flow,” highlighting the central nature of podiatric and vascular surgery to the interdisciplinary team. However, this may be inadequate to describe what we actually do. “Toe, Flow and Go” might better describe what we are doing in clinic, on the hospital wards, and on our research team … As we get more and more adept at technique and technology for limb preservation and limb salvage, what we’re faced with often is a much more fundamental question, which is just because we can do something to preserve a limb, should we? I know people have discussed and talked about this over the years but we are really doing our best to live at it SALSA and USC … read more

Victory on E/M Codes: Medicare Physician Fee Schedule Final Rule Released

APMA celebrated another major advocacy win today as CMS released the 2019 Medicare Physician Fee Schedule final rule. The final rule did not include the originally proposed podiatry-specific E/M codes, which would have reimbursed at a significantly lower rate than codes for the same care provided by other physicians … APMA extends its sincere gratitude to the thousands of members, colleagues, patients, family, and friends who joined APMA’s grassroots campaign and submitted comments to CMS about this punitive proposal. We also thank our allies at other medical societies and in the halls of Congress, who strongly opposed the proposed rule.“Today we saw proof that when APMA members work together … toward a common goal, we can do great things,” said APMA President Dennis R. Frisch, DPM …. read more

Diabetes Mellitus ‘Fifth Leading Cause Of Death’ In The Bahamas

DIABETES mellitus is the fifth leading cause of death in The Bahamas, according to Health Minister Dr Duane Sands …The Bahamas Podiatric Medical Association underscored the devastating impact of diabetes on feet during a conference at the University of the Bahamas yesterday …“Foot complications are the source of major patient suffering, high emotion and financial costs to the individual and health care system,” Dr Sands told the conference …“We have seen the prevalence of diabetes increase from 6.7% to 9.2% in 2005 now to epidemic proportions of 13.6% in 2017. 37.9 deaths per 100,000 persons are due to diabetes …Dr Sands continued: “Foot ulcers are the most prevalent problem, with a yearly incidence of around 2 – 4% and a lifetime incidence between 15 and 25%. The most important factors underlying the development of foot ulcers are peripheral sensory neuropathy, foot deformities related to motor neuropathy, minor foot trauma, and peripheral artery disease … “Once the skin is ulcerated, it is susceptible to becoming infected, an urgent medical problem that can result in amputation or even death … read more

Some Diabetes Drugs, Higher Amputation Risk Linked

A specific class of diabetes medication appears to double the risk of losing a leg or foot to amputation, a new study reports … People on sodium-glucose cotransporter2 (SGLT2) inhibitors were twice as likely to require a lower limb amputation as people taking another type of diabetes medication, Scandinavian researchers found … Patients also had a doubled risk of diabetic ketoacidosis, a life-threatening complication in which acids called ketones build up in the bloodstream … “Patients at high risk of amputation, for example those with peripheral artery disease or foot ulcers, might be monitored more closely if SGLT2 inhibitors are used, and the risk of this adverse event may be considered when deciding on which drugs to use,” said lead researcher Dr. Peter Ueda, a postdoctoral researcher with Karolinska University Hospital in Stockholm, Sweden … read more

Oxygen-dispensing insole designed to treat diabetic ulcers

Developed at Indiana’s Purdue University, the prototype two-layered insole is made of polydimethylsiloxane, which is a type of silicone. Its bottom layer is actually a chamber that contains oxygen gas, while the top layer is laser-ablated to be particularly oxygen-permeable right at the point where the ulcer is located … The idea is that as the wearer walks throughout the day, placing pressure upon the insole, oxygen is continuously forced out of the bottom layer, up through the top layer and into the oxygen-deprived tissue of the ulcer – there, it helps accelerate healing. Even when they’re sitting, the patient’s foot will still exert enough pressure to deliver some oxygen to the wound … read more

Wound Fluid in Diabetic Foot Ulceration

Valid and reproducible sampling techniques as well as processing protocols are required for the assessment of biomarkers and mediators contained in wound exudate. Moreover, the ideal technique should be easy to use even in daily clinical routine. This is challenging since wound fluid represents an inhomogeneous mixture of different exogenous and endogenous sources. Analyzing wound fluid, however, may facilitate clinical decision making. Many techniques for obtaining wound fluid have been described. There is very little validation data, and the array of different techniques appears confusing. Structuring and new standards are needed to avoid wound fluid sampling yielding an “undefined soup.” A lot of wound fluid parameters have been analyzed, although none of them have made its way into clinical practice. Nevertheless, basic principles of wound healing have been established from wound fluid analysis. With adequate techniques suitable for daily practice, basic research might foster our clinical understanding of wound healing with implications for new therapies. So far, research has mainly concentrated on analyzing available sample material with respect to … read more

Role of protease targets in wound healing uncertain

Protease modulating therapies are used to assist in venous leg ulcer closure. However, a recent systematic review of the evidencesuggests a need to question the biomarker’s importance and further role in the future of targeted chronic wound healing therapies … Earlier research reported in the literature has suggested that reducing protease levels can improve venous leg ulcer healing beyond the use of first-line treatments, such as compression, according to Maggie Westby, Ph.D., research fellow in the School of Health Sciences at the University
of Manchester, UK … read more

Diabetic foot ulcers heal quickly with nitric oxide technology

Diabetic foot ulcers can take up to 150 days to heal. A biomedical engineering team wants to reduce it to 21 days … They’re planning to drop the healing time by amplifying what the body already does naturally: build layers of new tissue pumped up by nitric oxide. In patients with diabetes, impaired nitric oxide production lessens the healing power of skin cells and the Centers for Disease Control reports that 15 percent of Americans living with type II diabetes struggle with hard-to-heal foot ulcers. However, simply pumping up nitric oxide is not necessarily better. The long-term plan of Michigan Technological University …. read more

Leg ulcers that require punch biopsies

Leg ulcers can be caused by vasculitis, pressure sores, inflammatory diseases, traumatic injuries and cutaneous neoplasms―which are often misdiagnosed as skin ulcers, write Lidia Sacchelli and colleagues in the September 19 online issue of the Journal Dermatopathology … “We believe that clinicians should be aware of the importance of an early and correct diagnosis of cutaneous neoplasms underlying chronic leg ulcers. This could avoid diagnostic delay and guarantee the best therapeutic approach to each patient,” they wrote … Lesions that grow, spread or are pigmented may require a biopsy and histologic study … read more

An Aussie Researcher Insists Maggots Are the Best Way to Heal Wounds

“Maggots are fantastic,” he says. “They eat all the dead and decaying tissue in the wound… [and] remove bacteria by eating them and digesting them, and through their excretions and secretions that they place into the wound.” … Frank explains that these “anti-microbial” properties of the humble maggot keep the infection under control and allow the body to properly heal the wound. The process is known as “debridement”: the removal of dead or infected tissue that in turn improves the healing potential of the healthy tissue. The maggot then disinfects the wound by secreting anti-bacterial substances, and stimulates the production of new, fresh capillaries over the top … read more

Bayer VP Alan Westwood to lead antimicrobial firm Matoke Pharma

Former Bayer VP Alan Westwood has taken the reins of British antimicrobial biotech Matoke Pharma … Westwood spent 35 years at Bayer Health Care, becoming its VP of global strategic marketing for anti-infectives. As managing director of Matoke Pharma, he will oversee development of its lead candidate, RO-101, based on the company’s “reactive oxygen” platform …The platform uses naturally occurring compounds and molecules, such as hydrogen peroxide, to kill bacteria by physically disrupting their cell structures and membranes. Such oxygen-containing compounds are also used in the body’s normal wound-healing processes … read more

Amputation-free survival in 17,353 people at high risk for foot ulceration

     in diabetes: A national observational study

 

Diabetic foot ulcers and amputations are devastating and much feared complications of diabetes. Between 15% and 34% of people with diabetes develop a foot ulcer during their lifetime, with more than half acquiring infections that may result in lower extremity amputations causing disability, extensive periods of hospitalisation, and premature mortality. The incidence of major amputation ranges from 0·2 to 2·0 per 1000 people in those with diabetes. Major or minor amputation also increases the risk of additional subsequent amputations. Foot ulcers are the costliest microvascular complication of diabetes … Amputations in people with diabetes have a significant impact on ambulation, body care, movement and mobility, resulting in an inability to perform daily tasks and often a loss of employment impacting on the wider family. Clinical epidemiology studies suggest that foot ulcers precede around 85% of non-traumatic lower extremity amputations in individuals with diabetes [8] and hence ulcer prevention is important. Previous studies have reported that apart from severity of ulcer, age [9], low socioeconomic status, smoking, sex, renal impairment, ischaemic heart disease, diabetic neuropathy, glucose levels and peripheral arterial disease are some of the important factors associated with the risk of amputation. Identifying a person’s risk of foot ulceration helps in directing scarce resources to those most at need. Assessment of individual risk factors … read more

London-developed tool zeros in on diabetic foot ulcers

A new screening tool developed by St. Joseph’s Health Care London could reduce the number of diabetes-related amputations across the region … The primary care diabetes support program (PCDSP) at St. Joseph’s partnered with the South West Local Health Integration Network (LHIN) to come up with a standardized screening, assessment and referral tool for family doctors. The tool helps to identify red flags in patients that could lead to devastating foot ulcers … “The end game is early identification and effective intervention of those at risk of diabetes-related foot ulcers,” said Betty Harvey, a nurse practitioner and clinical nurse specialist with the PCDSP. “Once a person has a foot ulcer … read more

Evaluation of fluorescence biomodulation in the real-life management

     of chronic wounds: the EUREKA trial

 

Fluorescence biomodulation (FB), a form of photobiomodulation (PBM) that is also known as low energy level light (LELL), has become an increasingly used clinical tool to induce wound healing in wounds that remain recalcitrant to treatment. In a real-life clinical setting, the aim of the EUREKA (EvalUation of Real-lifE use of Klox biophotonic system in chronic wound mAnagement) study was to confirm the efficacy and safety of LumiHeal, a system based on FB, in the treatment of chronic wounds such as venous leg ulcers (VLUs), diabetic foot ulcers (DFUs) and pressure ulcers (PUs). The effects of this FB system on the modulation of wound healing in chronic ulcers through FB induction were previously examined in an interim analysis of this study … read more

Healogics Unveils Patient Engagement Program

Healogics®, the nation’s leading provider of advanced chronic wound care services, today unveiled their Patient Engagement program. Through this program, patients will receive text message reminders for their appointments as well as links to educational videos, relevant articles and instructions related to wound and ostomy care … “Wound care as a specialty relies heavily on patients’ willingness and ability to adhere to their prescribed plan of care,” says Dr. William Ennis, DO, MBA, MMM, Healogics Chief Medical Officer. “By engaging patients where they are, and encouraging appointment attendance, the Patient Engagement program has reduced appointment cancellations supporting care plan adherence.” … The new program has two-way engagement, meaning Healogics team members can see patients’ responses in real time. If a patient has to cancel, a team member will proactively call the patient to reschedule the appointment to avoid any delays in care. During the program’s pilot, Healogics saw an eight percent reduction in appointment cancellations, which means eight percent more people received the life-changing care … read more

Silverlon’s New Wound Care Website Gives Surgeons

    Healthcare Professionals Searchable Access to Clinical Studies and Silverlon Products by Specialty

 

Argentum Medical, LLC and Cura Surgical launched its new website for its Silverlon® antimicrobial wound care technology (https://www.silverlon.com). The robust website gives surgeons and other healthcare professionals — both in civilian and in military settings — convenient access to the science and clinical research supporting the most evidence-based silver-based dressings available today.

 

Users of the new Silverlon website can quickly find Silverlon wound care products by specialty, including surgical, wound care, burn, catheter and negative pressure contact dressings. The site includes educational videos to explain the antimicrobial advantage of silver ions as well as instructional videos on the proper use of Silverlon dressings in a number of clinical settings.

 

The website also features a searchable index of independent, peer-reviewed, clinical studies that demonstrate the effectiveness of Silverlon technology across multiple specialties including surgical, venous catheter, wound and burn care. Recent clinical studies include research conducted by the Harvard Combined Orthopaedic Residency Program published in the Journal of the American Academy of Orthopaedic Surgeons and the University of South Florida/Tampa General Hospital’s central line catheter-related infection (CLABSI) study published in the Journal of Intensive Care Medicine.

“Our new website is designed to give surgeons and other medical professionals an efficient resource to explore the science and robust body of clinical research supporting the advantages of Silverlon dressings as part of a comprehensive infection prevention bundle,” said Raul Brizuela, president and CEO of Cura Surgical and Argentum Medical … read more

Amputation-free survival in 17,353 people at high risk for foot ulceration

     in diabetes: a national observational study

 

Using data from the Scottish Care Information-Diabetes register (N=247,278), researchers analyzed 17,353 individuals with diabetes and at high risk for foot ulceration (“high-risk foot”) from January 2008 to December 2011 to determine amputation-free survival and to compare different subcategories of high-risk foot. According to findings, for those with diabetes and at high risk for foot ulceration, the risk of death was up to nine times the risk of amputation. In addition, those with diabetes who had healed ulcers displayed higher death rates than those with active ulcers. However, the highest risk of amputation was noted for people with active ulcers.

 

Read the full article on Diabetologia – Clinical and Experimental Diabetes and Metabolism

LeucoPatch system for the management of hard-to-heal diabetic foot ulcers

     in the UK, Denmark, and Sweden: An observer-masked, randomised controlled trial

 

The LeucoPatch device uses bedside centrifugation without additional reagents to generate a disc comprising autologous leucocytes, platelets, and fibrin, which is applied to the surface of the wound. We aimed to test the effectiveness of LeucoPatch on the healing of hard-to-heal foot ulcers in people with diabetes … This was a multicentre, international, observer-masked, randomised controlled trial of people with diabetes and a hard-to-heal foot ulcer done in 32 specialist diabetic foot clinics in three countries (UK, Denmark, and Sweden). After a 4-week run-in period, those with a reduction in ulcer area of less than 50% were randomly allocated (1:1) by computer-generated, web-based randomisation … read more

 

Read the full article on The Lancet Diabetes & Endocrinology

MiMedx To Present Clinical And Scientific Studies At Desert Foot Conference

MARIETTA, Ga. /PRNewswire/ —MiMedx (NASDAQ: MDXG), a leading developer and marketer of regenerative and therapeutic biologics, today announced that five poster abstracts reporting on the Company’s EpiFix® dehydrated Human Amnion/Chorion Membrane (dHACM) allograft and EpiCord® dehydrated human umbilical cord (dHUC) allograft will be presented at the Desert Foot 15th Annual Multi-Disciplinary Limb Salvage Conference in Phoenix, Arizona. The conference begins Wednesday, November 7, 2018, and concludes on Saturday, November 10, 2018.

 

MiMedx will sponsor a symposium entitled, “Clinical Efficacy of EpiFix and AmnioFix dehydrated human amnion/chorion membrane allografts in Surgical and Wound Care Applications” on Wednesday, November 7th in the Phoenix Ballroom main lecture hall. The symposium faculty and presenters include Ray Ortega, MD, MiMedx Medical Director, and Jeremy Lim, PhD, Senior R&D Engineer at MiMedx.

 

Dr. Ortega, a former Army Special Forces Officer (Green Beret) and Medical Corps plastic surgeon, will review two recent EpiFix and EpiCord multicenter DFU randomized control trial (RCTs) studies … read more

Ending Avoidable Amputations Within A Generation

Diabetic Foot Australia (DFA) was established in 2015 with the goal of ending avoidable amputations within a generation in Australia. As a key initiative of the Wound Management Innovation CRC, we engaged the expertise of multiple partner organisations across Australia to create a national diabetes-related foot disease (DFD) body for Australia. On the 1st July 2018, Diabetic Foot Australia joined the Australian Diabetes Society’s (ADS) stable of national diabetes clinical and research programs …. download Australian Diabetes-Related Foot Disease Strategy (PDF)

MTF Biologics and Academy Medical Partner to Advance Care for Veterans

EDISON, N.J.Nov. 1, 2018 /PRNewswire/ — MTF Biologics, the world’s largest tissue bank, and Academy Medical, a certified Service-Disabled, Veteran-Owned Small Business (SDVOSB) that specializes in providing medical products, tissues and devices to government agencies, have joined forces to bring advanced human allograft tissues to the Department of Veteran’s Affairs (VA) medical centers across the country. MTF Biologics has joined Academy Medical’s supplier network, ensuring that MTF Biologics’ portfolio of tissue innovations, used to treat a variety of acute and chronic wounds, orthopedic conditions, and plastic and reconstructive surgery needs, are available to healthcare providers serving veterans at VA facilities.

 

As a result of this partnership with Academy Medical, MTF Biologics tissues have been added to Academy Medical’s Strategic Acquisition Center (SAC) Biologics and Biological Implants Contract and their National Acquisition Center (NAC) Federal Supply Schedule (FSS) contract for the Department of Veterans Affairs. Together, Academy Medical and MTF Biologics now offer the broadest portfolio of bone, dermis, placenta and other tissues to address the needs of our veterans and military personnel.

 

“Academy Medical has a great track record of connecting government healthcare providers with medical innovations,” said Thomas Shaffer, Executive Vice President of Global Sales and Marketing at MTF Biologics.  “We are excited to partner with the Academy Medical team to bring innovations in tissue transplantation to our nation’s veterans. Our organizations share a commitment to ensuring that physicians have access to the medical advances, tools and technologies they need to meet the needs of their patients. This partnership achieves this commitment while also furthering MTF Biologics’ Mission of saving and healing lives.” … read more

Mӧlnlycke® to Launch Latest Innovation, Mepilex® Border Flex, at Fall SAWC Conference

Mӧlnlycke® will launch Mepilex® Border Flex at the Symposium on Advanced Wound Care Fall meeting (SAWC Fall) 2-4 November in Las Vegas. The new Mepilex® Border Flex dressing was specifically engineered to support fewer dressing changes, reducing dressing costs and waste, while creating an optimal healing environment.

 

We believe that the Mepilex Border Flex dressing may change the way wound care experts practice because its features effectively support undisturbed wound healing,’ says Randy Schwartz, Vice President of Marketing. ‘Less frequent dressing changes benefit the patient, caregiver and the wound healing process. The product’s unique structure enhances conformability and its exudate management properties and allows it to remain in place for longer wear times. These features will positively impact cost.

 

Mӧlnlycke will feature the dressing in its booth and is sponsoring a complimentary breakfast symposium at the Fall SAWC conference, ‘Novel Technology for Advanced Wound Dressings: Early Clinical Experience.’ The session will examine the role of dressing conformability and exudate management in supporting undisturbed healing of acute and chronic wounds. The presenters will also share their experience with the new dressing and examine its impact on clinical outcomes, patient satisfaction and cost savings.

 

Renowned wound care expert Robert Kirsner, MD, PhD will lead the symposium which features Oscar Alvarez, PhD and Deborah Nelson RN, BSN, CWOCN who will discuss their clinical experience with the product. The symposium will take place on Sunday, 4 November at 7:30 AM – 9:00 AM … read more

Organogenesis Celebrates Launch of Advancing Healing Education

     Resource Center and Highlights Latest Wound Care Research at SAWC Fall 2018

 

CANTON, Mass. and LAS VEGASNov. 1, 2018 /PRNewswire/ — Organogenesis Inc., a leading regenerative medicine company committed to empowering healing, will celebrate the launch of the Advancing Healing Education Resource Center, a continuing medical education microsite covering the latest clinical and practical developments in wound healing, as well as showcase the company’s latest product research during the Symposium on Advanced Wound Care (SAWC) Fall 2018 meeting held this week in Las Vegas.

 

Made possible through an educational grant from Organogenesis to the North American Center for Continuing Medical Education (NACCME), the Advancing Healing Education Resource Center will feature accredited educational activities designed to improve the care of patients with repair and regenerative needs across the continuum of care. Topics will include healing of musculoskeletal injuries, including degenerative conditions, and the treatment of chronic and acute wounds … read more

Harbor MedTech Presents the Latest Findings on its Advanced Wound-Healing

     Technology at the Symposium on Advanced Wound Care and Wound Healing Society Spring Conference

 

Harbor MedTech, a commercial-stage regenerative medicine company delivering innovative biologic wound-healing products, presented a Poster on Architect®, its advanced wound-healing product, and BriDGE®, its unique technology.

 

The scientific poster, “Stabilized Collagen Matrix Dressing Improves Macrophage Recruitment and Wound Epithelialization” was presented at the Symposium on Advanced Wound Care and Wound Healing Society Spring Conference, April 5 – April 9, 2017, in San Diego, California and was selected for the WHS Industrial Research & Development Poster Award Competition.

 

The poster was a presentation of ongoing research, led by Dr. Chandan K. Sen, Executive Director of Ohio State University’s Comprehensive Wound Center. Dr. Sen’s work involves a variety of in vitro and animal studies that initially describe the mechanism of action of Architect, a stabilized collagen matrix, for the treatment of a variety of wound types. These studies suggest that Architect may serve as a scaffold for cells within the wound microenvironment and may provide effective defenses against bacterial colonization and wound infection. In vivo, application of Architect stimulated … read more

MiMedx to Present Clinical and Scientific Studies at SAWC Fall Meeting

MARIETTA, Ga.Oct. 31, 2018 /PRNewswire/ — MiMedx Group, Inc. (NASDAQ: MDXG), a leading developer and marketer of regenerative and therapeutic biologics, today announced that five poster abstracts highlighting studies on the Company’s EpiFix® dehydrated Human Amnion/Chorion Membrane (dHACM) allograft and EpiCord® dehydrated human umbilical cord (dHUC) allograft will be presented at the 2018 Symposium on Advanced Wound Care Fall (SAWC Fall) at Caesars Palace in Las Vegas, Nevada. The SAWC, now in its 31st year, is the official meeting for members of The Association for the Advancement of Wound Care and the leading national wound healing conference.

 

The conference begins Friday, November 2nd and concludes on Sunday, November 4th. MiMedx will be exhibiting in booth #207 during all booth times throughout the three-day meeting.

 

MiMedx will also sponsor a Breakfast Symposium entitled, PURION® Processed Placental Based Allografts – The Use of Bioactive Tissue Matrices in the Treatment of Wounds,” on Friday, November 2nd, from 7:30 a.m. to 9:00 a.m. The presenters during the breakfast symposium will include:

 

  • Michelle Massee, Manager of Biomedical Research, MiMedx
  • William Tettelbach, MD, Associate Chief Medical Officer, MiMedx
  • James Stavosky, DPM

read more

Wound Care Advantage Partners With Tissue Analytics

     Combining 17 Years of Clinical Data With AI and 3D Imaging to Improve Patient Outcomes

 

BALTIMORE, Oct. 29, 2018 /PRNewswire/ — Wound Care Advantage, a leading provider of management and consulting services for outpatient wound care and hyperbaric medicine programs, today announced a partnership with Tissue Analytics, the world’s leading mobile imaging and artificial intelligence (AI) platform for wound management. The partnership allows for WCA to leverage its clinical expertise and 17 years of clinical data with Tissue Analytics’ imaging and AI to improve the accuracy of measurement during wound assessments and provide better insights into the efficacy of wound treatments to improve patient outcomes and reduce costs … Chronic wounds affect about 6.5 million people in the U.S., many stemming from diabetes and/or vascular insufficiency. These wounds have a slow healing process and require frequent monitoring and measurement of progress by a specialized wound care team. Research has shown that automatic smartphone measurements help to eliminate the high degree of interrater and intrarater reliability often encountered when using a traditional ruler … read more

Corstrata Shares Post-Acute Wound Care Challenges Survey Results

Corstrata, a provider of digital healthcare IT solutions and services for wound prevention and care management, announced today the results of the recently completed, Post-Acute Wound Care Challenge Survey. The survey was directed to U.S.-based home health agencies (HHAs) and hospice organizations and sought to gather industry-wide input on the state of the current challenges HHAs and hospice organizations face in providing value-based care for the growing wound patient population.

 

Like other areas of healthcare, HHAs and hospice organizations have also historically had difficulties with hiring and retaining board-certified wound cares nurses. While nearly 80% of the 124 survey respondents believe their organization is properly staffed to handle wound care patients, 46% of CNOs/VPs Nursing/Directors of Nursing indicate their organizations do not have access to a board-certified wound care nurse. Collectively, 32% of all respondents indicate they do not have access to a board-certified wound care nurse with another 12% of respondents indicating they only have access to a part-time/contract board-certified wound care nurse.

 

In addition, when HHA and hospice representatives were asked to describe how their current wound care staffing model impacts their business, 9% indicate they are missing out on patients due to lack of adequate wound care staff or wound knowledge; 37% say their in-home nursing visits are high with wound patients, and 29% have low or no financial margins on wound care patients.

 

However, another key finding is indicative of a growing desire to change how HHAs and hospice organizations address the needs of its wound care patients. 55% of HHAs and hospice organizations believe they would benefit from increased access to board-certified wound care nurses using virtual visit technologies …. read more

Healogics to take part in campaign highlighting link between diabetes

     and chronic wounds

 

Healogics®, the nation’s wound healing expert, is proud to participate in a national diabetes awareness campaign October 29 through November 2. This campaign will highlight the important connection between diabetes and chronic wounds and their recurrence. Throughout this week, Wound Care Centers® from across the country will dedicate their time to visiting local physician offices to provide education on the treatment of potential or existing chronic wounds for people also living with diabetes … An estimated 30.3 million people in the United States have diabetes, and the percentage of adults with diabetes increases with age, reaching a high of 25.2 percent among those aged 65 years or older. In addition to age, risk factors for diabetes also include diet, activity level, obesity and heredity. Approximately one in four people living with diabetes will develop a foot ulcer. Even more alarmingly, people with healed a diabetic foot ulcer have a recurrence rate of nearly 40 percent within the first year … read more

Cuba aims to boost exports at China’s import expo (Heberprot-P)

Cuba plans to put on a big show at the upcoming China International Import Expo (CIIE) in a bid to expand its export market, Vice President of Cuba’s Chamber of Commerce Ruben Ramos told Xinhua in a recent interview … While Cuba plans to tout its traditional strengths at the expo, it also intends to introduce its ground-breaking biotechnology products such as CIMAvax-EGF, a therapeutic vaccine against lung cancer and Heberprot-P, a unique treatment for diabetic foot ulcers.

Frank Bures: Diabetic foot ulcers: A story, and a lesson

Here’s a story about a foot ulcer and it’s tragic result in a diabetic with several other health problems. This is an attempt to inform people with diabetes about the vital necessity of foot inspection and care. It goes like this … Someone familiar, who will be Uncle Al for this yarn, had his left foot and lower leg amputated because of a diabetic foot ulcer he didn’t even know he had, because he never looked. Uncle Al has been a very happy fellow throughout his life. He had known he has diabetes for quite a while. He also has had a heart attack, and more lately congestive heart failure of controllable nature — if he watches it … read more

Transcutaneous oxygen – not abi or toe pressure – is a predictor for

     short-term survival in people with diabetic foot ulcers (study)

 

Ankle-brachial index (ABI) is the most commonly used test when diagnosing peripheral vascular disease and is considered a marker for cardiovascular risk. Transcutaneous oxygen pressure (TcPO2), a test associated with microvascular function, has in several studies shown better correlation with diabetic foot ulcer (DFU) healing. Whether a low TcPO2 could be a marker for mortality in the high-risk population of DFU patients has not been evaluated before. The aim of this study was to evaluate the predictive value of TcPO2 in comparison with ABI and toe blood pressure (TBP) on 1-year mortality in type 2 diabetes patients with DFU …. read more

Financial burden of diabetic foot ulcers to world: a progressive topic to discuss always

Diabetic foot complications are the most common occurring problems throughout the globe, resulting in devastating economic crises for the patients, families and society. Diabetic foot ulcers (DFUs) have a neuropathic origin with a progressive prevalence rate in developing countries compared with developed countries among diabetes mellitus patients. Diabetic patients that are of greatest risk of ulcers may easily be diagnosed with foot examination. Economic burden may be carefully examined. The budget costing must include both the clinical and social impact of the patients … Diabetes mellitus (DM) is a chronic metabolic disorder imparting loss in health and economic burden on patients and healthcare machinery around the globe. As the present world is facing an epidemic of both type 1 and type 2 DM, the International Diabetes Federation (IDF) has focused on the micro and macrovascular complications associated with DM. In 2005, the IDF committed to execute the management approach for diabetic foot diseases. The risk for developing foot ulcers is 25% high in patients with diabetes and it is also reported that every 30 seconds, one lower limb amputation in diabetes patients occurred around the world. The IDF has now become proactive and declared in its mandate that now is the time to increase awareness about the foot complications associated with DM in scenarios of social, personal, clinical and economic costs … read more

Novel combination therapy promotes wound healing

October 25, 2018–(BRONX, NY)–By incorporating a gene-suppressing drug into an over-the-counter gel, researchers at Albert Einstein College of Medicine and their colleagues cut healing time by half and significantly improved healing outcomes compared to control treatments. Results from the combination therapy, which was tested in mice, were published online today in Advances in Wound Care …”Not only did wound healing occur more rapidly and completely, but actual regeneration occurred, with hair follicles and the skin’s supportive collagen network restored in wounded skin–clinically important improvements that are unprecedented in wound care,” says senior author David J. Sharp, Ph.D, professor of physiology & biophysics at Einstein. “We foresee this therapy having broad application for all sorts of wounds … read more

Efficacy of negative pressure wound therapy using vacuum-assisted

     closure combined with photon therapy for management of diabetic foot ulcers

 

Background: Diabetes mellitus, one of the most prevalent chronic metabolic diseases, causes many complications. Among the complications, one of the most common chronic complications is diabetic foot ulcers (DFUs).
Objective: This study was conducted to investigate the efficacy of negative pressure wound therapy using vacuum-assisted closure (VAC) combined with photon therapy for the management of DFUs … Patients and methods: The study included a total of 69 patients with DFUs during the period from January 2014 to December 2015. All patients were diagnosed with DFUs with Wagner’s stage 2 or 3 and were divided into two groups – the VAC group in which patients received only VAC and the combined group in which patients received both VAC and photon therapy. Data on duration of the treatment, pre- and postoperative wound surface areas, dressing changing times, pain conditions assessed using visual analog scale scores, recurrence rate and amputation rate were collected … Results: Among all patients, 35 patients were divided into the VAC group and 34 patients into the  …. read more

New Clinical Research Program Takes Steps to Predict

     and Prevent Diabetic Foot Ulcers

 

More than 100 million adults in the United States live with diabetes or prediabetes, according to the Centers for Disease Control and Prevention. Most people know that common complications of the disease include increased thirst, weight loss and fatigue … But fewer may know about another side effect: diabetic foot ulcers, which affect nearly 25 percent of individuals and are one of the disease’s most prevalent complications. Patients with ulcers can’t put weight on the affected area in order to facilitate healing (and avoid infection) … Still, those ulcers are responsible for about 80,000 nontraumatic amputations nationwide each year — surgery that comes with a five-year mortality rate of up to 40 percent … read more

Podiatry Billing Firm Announces Partnership with iRemedy

     to Dispense Wound Care Supplies

 

Hippocratic Solutions, an outsourced podiatry billing firm, has announced a partnership with iRemedy, a leading ecommerce medical supplies provider. The partnership will allow podiatrists to prescribe, bill for, and dispense advanced wound care supplies through their DME license … iRemedy, an industry leader in ecommerce medical supplies and medical business consulting, has recently partnered with Hippocratic Solutions … “Integrating iRemedy with Hippocratic Solutions is a real breakthrough that is going to take our Advanced Wound Care Program to the next level,” said Tony Paquin, CEO of iRemedy Healthcare. “We’re excited to work with Peter Koukounasand the Hippocratic Solutions team.” … Alongside outsourced podiatry billing services, Hippocratic Solutions clients will now have instant online access to iRemedy’s online platform with the ability to submit and manage prescriptions for their patients with chronic wounds. Podiatrists will be able to file and bill for wound care prescriptions directly through iRemedy, who will audit the prescription for the podiatrist and handle insurance preauthorization and any insurance denials …”Most podiatrists don’t think they can dispense and profit from wound care supplies through their license, but this just isn’t true,” said Peter Koukounas, CEO of Hippocratic Solutions. “By partnering with iRemedy, we’re helping podiatrists earn greater profits while drastically improving patient outcomes.”

read more

Arizona-based biotech startup BioLab Sciences announces patent

     for regenerative tissue therapy, MyOwn Skin™

 

SCOTTSDALE, Ariz., Oct. 24, 2018 /PRNewswire/ — BioLab Sciences, an innovator in regenerative medicine technologies, today announced its exclusively licensed technology for MyOwn SkinTM, a painless, non-surgical procedure, which leverages a patient’s own skin to produce full-thickness skin grafts in 5-7 days.

 

MyOwn SkinTM is a revolutionary approach that uses a patient’s own skin to accelerate healing of chronic wounds, burns, diabetic foot ulcers and other difficult-to-heal wounds. By utilizing a small skin sample, this regenerative approach allows the body to heal itself and is less likely to face infection or rejection.

 

“In the United States alone, chronic wounds affect 6.5 million patients,” said Bob Maguire, BioLab Sciences CEO. “Our advanced, tissue-biomanufacturing approach offers a viable, effective solution for skin regeneration and repair. This innovative strategy has shown to accelerate the healing of damaged soft tissue and improve wound-care outcomes.”

 

This autologous strategy to wound care is non-invasive, improves recovery time, and eliminates potential rejection. BioLab’s impressive portfolio of regenerative products includes its amnion-derived fluid products, Fluid FlowTM and Amnio RestoreTM and its amniotic allograft membrane product Membrane PatchTM, an amnion membrane allograft …

 

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Smoking e-cigarettes could significantly slow healing of wounds

Researchers have found that smoking electronic cigarettes could slow the healing of skin wounds as much as regular cigarettes, according to a new study on rats – but admit that further studies are warranted … Smoking electronic cigarettes could slow the healing of skin wounds as much as regular cigarettes, according to a new study on rats … “Based on our findings, e-cigarettes are not a safe alternative to traditional cigarettes as it relates to timely wound healing,” said study corresponding author Dr Jeffrey Spiegel. He’s chief of facial plastic surgery at Boston Medical Center … It’s long been known that smoking regular cigarettes impairs wound healing, and surgery patients are advised to avoid smoking for several months before an elective operation … read more

Study: Antiobitics, probiotics together eradicate bacteria that infect wounds

By combining antibiotics and probiotics, researchers have developed a one-two punch to eradicate two strains of drug-resistant bacteria that often infect wounds, according to a preclinical study … MIT researchers encapsulated probiotic bacteria in a protective shell of alginate, which is a biocompatible material that prevents the probiotics from being killed by the antibiotic. The findings were published Wednesday in the journal Advanced Materials … Probiotics, which are good live bacteria and yeasts, help send food through the digestive system by affecting nerves that control gut movement. Probiotics come from supplements, as well as foods that are prepared by bacterial fermentation, including yogurt, kefir, sauerkraut, tempeh and kimchi … read more

related: Probiotics and antibiotics create a killer combination

Acelity Acquires Crawford Healthcare to Create the World’s

    Most Expansive Wound Care Portfolio

 

Acelity L.P. Inc., the world’s largest wound care company, and Crawford Healthcare, a rapidly growing UK-based advanced wound care and dermatology company, today announced an agreement for Acelity to acquire Crawford and all of its assets. Terms of the agreement were not disclosed.

With the acquisition of Crawford, Acelity expands its portfolio of advanced wound dressings (AWD), further strengthening its position as the global leader in advanced wound healing.

Crawford Healthcare is a recognized leader in developing and commercializing innovative treatments for the care and repair of skin. Crawford’s wound dressing portfolio includes the market-leading superabsorbent KerraMax Care® range and KerraFoam and KerraCel in the foam and antimicrobial gelling fiber AWD categories, respectively.

Crawford’s advanced wound dressing lines complement Acelity’s existing AWD portfolio, which includes the market-leading collagen dressing PROMOGRAN PRISMA™ Matrix, as well as the TIELLE™ Dressing Family and ADAPTIC™ Dressings. This expanded line of advanced wound dressings combined with Acelity’s industry-leading negative pressure wound therapy platforms forms the world’s most expansive wound care portfolio. In addition to its commercial products, Acelity will acquire Crawford’s innovative R&D capabilities and manufacturing operations based in Cheshire, UK … read more

Healogics Provides Unrestricted Educational Grant to Support an American Diabetes

     Association Compendium: Diagnosis and Management of Diabetic Foot Complications

JACKSONVILLE, Fla., Oct. 17, 2018 /PRNewswire/ — Healogics Inc., the nation’s largest provider of advanced wound care services, today announced their support of the American Diabetes Association (ADA) Compendium Diagnosis and Management of Diabetic Foot Ulcer Complications through an unrestricted educational grant1. More than 30 million people across the U.S. are living with diabetes, and foot problems including foot ulcers are common complications that, without proper treatment, can lead to hospital admissions and even amputations. The ADA Compendium was compiled by a panel of contributing authors and distributed this month to health care professionals who subscribe to the ADA’s peer-reviewed journals Diabetes Care and Diabetes. Healogics is passionate about providing wound care for the 25 percent of diabetics who will experience a foot ulcer at some point in their life2 … “We are proud to support the ADA in their efforts to better understand the latest evidence for treating diabetic foot ulcers,” said David Bassin, Healogics Chief Executive Officer. “We are thrilled that through our unrestricted grant to the ADA, the Compendium was published with a focus on diabetic foot complications.” … read more

Developing a foot ulcer risk model

     what is needed to do this in a real‐world primary care setting?

 

To determine how routinely collected data can inform a risk model to predict de novofoot ulcer presentation in the primary care setting … Data were available on 15 727 individuals without foot ulcers and 1125 individuals with new foot ulcers over a 12‐year follow‐up in UK primary care. We examined known risk factors and added putative risk factors in our logistic model … read more

Arizona-based biotech startup BioLab Sciences

     announces patent for regenerative tissue therapy, MyOwn Skin™

 

SCOTTSDALE, Ariz., Oct. 24, 2018 /PRNewswire/ — BioLab Sciences, an innovator in regenerative medicine technologies, today announced its exclusively licensed technology for MyOwn SkinTM, a painless, non-surgical procedure, which leverages a patient’s own skin to produce full-thickness skin grafts in 5-7 days.

MyOwn SkinTM is a revolutionary approach that uses a patient’s own skin to accelerate healing of chronic wounds, burns, diabetic foot ulcers and other difficult-to-heal wounds. By utilizing a small skin sample, this regenerative approach allows the body to heal itself and is less likely to face infection or rejection.

“In the United States alone, chronic wounds affect 6.5 million patients,” said Bob Maguire, BioLab Sciences CEO. “Our advanced, tissue-biomanufacturing approach offers a viable, effective solution for skin regeneration and repair. This innovative strategy has shown to accelerate the healing of damaged soft tissue and improve wound-care outcomes.”

This autologous strategy to wound care is non-invasive, improves recovery time, and eliminates potential rejection. BioLab’s impressive portfolio of regenerative products includes its amnion-derived fluid products, Fluid FlowTM and Amnio RestoreTM and its amniotic allograft membrane product Membrane PatchTM, an amnion membrane allograft composed of a connective tissue matrix that regenerates soft tissue while inhibiting inflammation and scarring. BioLab Sciences also offers a comprehensive wound care kit that provides physicians with the necessary tools to help patients recover quickly from diabetic ulcers, burns and other traumatic external wounds, as well as its Amnio Breathe Nebulizer bundled package designed to deliver a topical treatment directly onto a patient’s respiratory system …

View original content to download multimedia: http://www.prnewswire.com/news-releases/arizona-based-biotech-startup-biolab-sciences-announces-patent-for-regenerative-tissue-therapy-myown-skin-300736690.html

Change in Circulating Monocyte Profile with Foot Ulcer Healing in Diabetic Patients

Poor wound healing in diabetes is associated with increased chronic inflammation and alterations in macrophage accumulation. Chronic inflammation can alter the phenotype of macrophage precursors, monocytes but whether their phenotype is changed in association with wound healing is not known. Blood was obtained from 21 patients (14 male: 7 female) attending the High Risk Foot Clinic at RPA Hospital at their initial visit (V1), week 4 (V2) and week 8 (V3). Wound area was measured and wound type was assessed by a podiatrist. Monocyte number (CD14+), phenotype as classical (CD16), non-classical (CD16++), and intermediate (CD16+), anti-inflammatory (CD163+) subset and expression of receptors CCR2, CCR5 and TLR2, TLR4 were determined by flow cytometry. The MMPs and TIMP-1 were measured in plasma by zymography and ELISA. Over the 8 weeks, 6 ulcers healed (H) and 15 failed to heal (NH). The age, duration of diabetes, HbA1c, wound size and duration at V1 were not different between the groups but the % CD16++ monocytes was higher in H vs. NH at V1 (23.5 vs. 8.3) and V3 (17.4 vs. 7.2) and monocyte CCR2+ was lower in H at V3  … read more

Bioelectrical impedance assessment of wound healing

Objective assessment of wound healing is fundamental to evaluate therapeutic and nutritional interventions and to identify complications. Despite availability of many techniques to monitor wounds, there is a need for a safe, practical, accurate, and effective method. A new method is localized bioelectrical impedance analysis (BIA) that noninvasively provides information describing cellular changes that occur during healing and signal complications to wound healing. This article describes the theory and application of localized BIA and provides examples of its use among patients with lower leg wounds. This promising method may afford clinicians a novel technique for routine monitoring of interventions and surveillance of wounds … read more

Legal Perils and Pitfalls of Wound Care

     How to Keep Yourself out of Court: Part 1

 

No matter the setting in which we practice, as health care providers we constantly are under the threat of a malpractice lawsuit. In nursing homes the top targets for litigation are pressure ulcers, malnutrition, and dehydration. Up to 20% of all U.S. legal medical claims and more than 10% of settlements are wound related,1 and there are more than 17,000 pressure ulcer-related lawsuits filed annually in the United States … So, it behooves us to take the necessary measures to avoid being sued! What are the perils and pitfalls of wound care that we may encounter in our practice, and how can we best avoid them? This blog explores the various elements that can make or break a case … read more

TWO2 Randomized Controlled Trial Chosen

     as One of the Best Abstracts Presented at the Leading Diabetic Foot Global Conference

 

The number of biotech companies completing an IPO has swelled this year and Adynxx aims to join their ranks—but through an alternate path. The pain drug developer has agreed to combine operations with publicly traded Alliqua Biomedical … Under the merger agreement announced Friday, shares of Adynxx will convert into Alliqua (NASDAQ: ALQA) stock, leaving former Adynxx shareholders owning approximately 86 percent of the combined company. That company will have the Adynxx name and will be led by the current Adynnx management team. It will be headquartered in San Francisco, where Adynxx is currently based … read more

Be ‘Smart’ With New Technology for Diabetic Foot Monitoring

Diabetic foot ulcers are a major health and economic global burden, but ultimately, at least in theory, they’re preventable. The re-ulceration rate is as high as 65% within 5 years, and among persons who initially present with a diabetic foot ulcer, up to 25% may require amputation … One of the most important risk factors for diabetic foot ulceration is diabetic peripheral neuropathy. This involves loss of sensory perception, haptic feedback, and pain perception, so patients can’t self-regulate their foot pressures. It’s thought that these high foot pressures over time cumulatively contribute to the development of diabetic foot ulcers … read more

Common Inadequacies in Wound Management

Throughout my career I have been lucky enough to be part of several nursing branches: home health, long-term care, acute care, long-term acute care hospital, hospice, and even a tuberculosis hospital; wounds have no limitations on where they will appear. As a passionate clinician, teaching, coaching, and mentoring have become a huge part of what I do, as is true for most clinicians. We are teachers, coaches, and mentors driven by passion and wanting to help and put in our “two clinical cents” or “stamp” on the industry … I frequently converse with clinicians in my area, all part of SWAT (skin and wound assessment team), and talk about how it takes a village. I especially enjoy talking with my good friend and mentor Jesse Cantu, RN, BSN, CWS, FACCWS, who is a passionate clinician with a fire that gets you all excited—those who know him know what I am talking about. We share stories of what we do, we give each other constructive criticism, and we often share with each other some of the most common inadequacies we see out there. We always get after each other, in a good way: are we doing enough? and how can we help educate, empower, increase awareness … read more

Tissue Analytics Launches 3D Wound Imaging for Smartphones

Digital health company delivers mobile depth imaging with submillimeter resolution and no need for specialty hardware. The product will be showcased at Cerner Health Conference, October 8-11, Kansas City, Missouri … “Tissue Analytics uses sophisticated algorithms that allow clinicians to generate and securely transfer clinical data from Android or iOS devices into the electronic medical record (EMR). Now, for the first time ever, I’m very excited and honored to present our 3D measurement feature that requires no external device attachments,” announced Joshua Budman, CTO. “From a very simple five-second video, we can now generate a true 3D rendering of any wound, to provide clients with volume and depth measurements at a submillimeter resolution.” … read more

AmpliPhi Biosciences Announces Presentation of Positive Clinical

Data From its Expanded Access Program for Serious S. aureus Infections at IDWeek 2018 Conference

AmpliPhi Biosciences Corporation (NYSE American:APHB), a clinical-stage biotechnology company focused on precisely targeted bacteriophage therapeutics for antibiotic-resistant infections, today announced the presentation of clinical case series data from the company’s ongoing expanded access program for its investigational bacteriophage therapeutic, AB-SA01 targeting Staphylococcus aureus (S. aureus), at the IDWeek 2018 conference in San Francisco … Prof. Jonathan Iredell, Senior Staff Infectious Diseases Physician at the Westmead Hospital in Sydney, Director of Centre for Infectious Diseases and Microbiology at the Westmead Institute of Medical Research and Professor of Medicine and Microbiology at the University of Sydney, gave a presentation “Adjunctive bacteriophage therapy for severe Staphylococcal sepsis,” including data on 13 patients suffering from severe S. aureus infections, who were treated with AB-SA01 as an adjunct to antibiotics at the Westmead Hospital in 2017-2018. The potential treatment of S. aureus bacteremia with AB-SA01 was also the subject of the Company’s recent Type B meeting with the FDA. The treatment was conducted under emergency protocols per the Australian Therapeutic Goods Administration’s (TGA) Special Access Scheme (SAS) … read more

Researcher Looks To Curb Rate Of Diabetic Amputations In NL

A local researcher is hoping to change the alarming rate of amputation due to diabetes in the province … Newfoundland and Labrador has the highest rate of diabetes in the country, and the highest rate of lower limb amputation due to diabetes … Kathleen Stevens is a Registered Nurse and PhD candidate at Memorial University’s School of Nursing … read more

Windsor’s Scapa completes acquisition

Windsor skin care products provider Scapa Healthcare says it has completed its acquisition of an England-based maker of wound care products … Scapa is adding Systagenix and its 335,000-square-foot manufacturing facility in Gargrave, England to its wound care footprint. Financial terms were not disclosed … read more

Malnutrition in type 2 diabetic patients does not affect healing of foot ulcers

Protein–energy malnutrition is known to be involved in wound healing. While wound healing in patients with diabetic foot ulcers (DFU) is a complex and multifactorial process, the role of malnutrition in this case has rarely been explored. The objective of this study was to determine whether the nutritional status of diabetic patients influences the healing of DFU … 48 patients were included in this prospective, single-center study. All patients with comorbidities or factors involving malnutrition or influencing biological measurements were excluded. Patients were followed up for 24 weeks … read more at Acta Diabetologica (purchase required)

Increasing SBP variability is associated with an increased risk of

     developing incident diabetic foot ulcers

 

Researchers assessed the link between increased SBP variability and incident diabetic foot ulceration risk in 51,111 cases and 129,247 controls. Cases were patients diagnosed with diabetes and treated by the US Department of Veterans Affairs Healthcare system for development of a diabetic foot ulcer (event) between 2006 and 2010; on the basis of age, sex, race/ethnicity, and calendar time, each case was randomly matched to up to five controls. Higher adjusted odds ratios for diabetic foot ulcer development were observed in patients in quartiles 2-4 vs those in quartile 1 (lowest variability). In adjusted subgroup analyses, reduced risks of ulceration were observed in association with calcium channel blockers for those without peripheral vascular disease or neuropathy. Overall, a graded link between SBP variability and diabetic foot ulceration risk was shown.

Read the full article on Journal of Hypertension (subscription required)

‘Smart’ Insoles Reduce Diabetic Foot Ulcer Recurrence

BERLIN — Wearing pressure-sensing smart insoles (SurroSense Rx, Orpyx Medical Technologies) reduced diabetic foot ulcer recurrence by up to 86% in compliant patients in a randomized single-blinded trial in high-risk individuals with type 1 and 2 diabetes … Neil Reeves, PhD, professor of musculoskeletal biomechanics, Manchester Metropolitan University, UK, presented the results here today at the European Association for the Study of Diabetes (EASD) 2018 Annual Meeting …“By using a plantar pressure-sensing smart insole device, the feedback of pressure information in the intervention arm reduces ulcer recurrence by 71%, and furthermore in the compliant patients, this further increased benefit, with an 86% reduction in ulcer recurrence [compared with controls],” he reported … read more

Bioactive Glass Implants and Wound Care

Bioactive glass implants are commonly used in orthopedics and dentistry as they can form strong and direct bonds with bone. The capability of bioactive glass to stimulate the growth of new blood vessels also makes them ideal for wound healing …Bioactive glasses are a group of surface-reactive glass-ceramic biomaterials. The first bioactive glass was developed in 1969 by Larry L. Hench at the University of Florida … This material was formed using silicate glass in order to enhance the mechanical and bioactive properties needed for applications in bone regeneration … read more

 

MTF Biologics Adds New Recovery Partner: Regenerative Biologics, Inc.

MTF Biologics today announced that it has formed a new tissue recovery relationship with Regenerative Biologics, Inc. (RBI). Together, the organizations will seek to provide expanded birth tissue donation opportunities for expectant mothers and their families and enhance patients’ access to high-quality placental tissues for wound care applications … Joe Yaccarino, President and CEO of MTF Biologics added, “MTF Biologics is pleased to partner with RBI again as it combines the key strengths of each of our organizations and expands donation opportunities. We’ve known many of the senior staff at RBI for years and are excited to be collaborating with them again.” … read more

 

As obesity rate rises, ‘double diabetes’ looms large

An October report from the CDC’s National Center for Health Statistics revealed a startling increase in the prevalence of obesity in the U.S., with rates now approaching 20% in children and 40% in adults for 2015-2016 … The growing epidemic has not spared those with type 1 diabetes. Today, obesity prevalence is as high or higher among patients with type 1 diabetes as in the general population. According to 2015 data from the T1D Exchange Clinic Registry, nearly 40% of children and adolescents with the disease also have overweight or obesity, putting them at increased risk for insulin resistance, hypertension and dyslipidemia — all the hallmarks of not type 1, but type 2 diabetes … read more

Osiris Therapeutics, Inc. Announces Peer-Reviewed Publication

Demonstrating That Lyopreservation Method Developed for Living Tissues is an Alternative to Cryopreservation with the Convenience of Ambient Storage

 

COLUMBIA, Md., Oct. 02, 2018 (GLOBE NEWSWIRE) — Osiris Therapeutics, Inc. (NASDAQ: OSIR), a regenerative medicine company focused on developing and marketing products for wound care, orthopedics, and sports medicine, announced today that a new peer-reviewed manuscript entitled “Properties of Viable Lyopreserved Amnion Are Equivalent to Viable Cryopreserved Amnion with the Convenience of Ambient Storage” has been published in PLOS ONE and is available online https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204060 … In the published study the structural, molecular, and wound relevant properties of a lyopreserved human amniotic membrane were compared with the properties of a cryopreserved human amniotic membrane. Results showed that the structure, growth factors, and cell viability of the lyopreserved amnion are comparable to that of cryopreserved and fresh amnions. Properties of lyopreserved and cryopreserved amniotic membranes were tested in vivo in a diabetic mouse chronic wound model, which mimics impaired wound healing reported in diabetic patients. Both lyopreserved and cryopreserved amnion weekly applications resulted in wound closure by day 35 whereas in the saline gel control group of animals wounds became larger … read more

Thermal imaging improves diabetes-related foot ulcer assessment

Thermal imaging can better predict a diabetes related foot ulcer’s size and the healing trajectory than conventional methods, Melbourne-led research has found. It could also possibly save money through better targeted treatment … The study, which was the first of its kind, was a collaboration between RMIT University, the University of Melbourne and Austin Health. It used thermal imaging to quantify the size and predict the healing status of recently developed ulcers … based on their work, the RMIT researchers want to see thermal imaging, which is suitable for most clinical settings, used as an inexpensive and real-time option to identify wounds that may have delayed healing … read more

Calcipotriol Ointment Seen to Improve Wound Healing in RDEB Patient, Study Finds

A low dose of calcipotriol, which is already approved for the treatment of psoriasis, may improve healing and prevent wound infections in patients with recessive dystrophic epidermolysis bullosa (RDEB), a study showed … treatment with calcipotriol ointment helped close a chronic wound in one patient and eliminated harmful bacteria growing inside it. The compound was also able to enhance skin cells’ defenses against microbial growth and reduce cancer proliferation in skin cells of RDEB patients … read more

Surgical Wounds 101

The Centers for Disease Control and Prevention (CDC) estimate approximately 30 million surgical procedures are performed annually in the United States.1 Advances in technology have afforded patients options such as minimally invasive surgery, commonly known as laparoscopic or arthroscopic surgery, which tend to result in much smaller (1cm–2cm) incisions … However, some procedures necessitate larger incisions of varying size, potentially 10cm–20cm or greater, depending on type of procedure, body habitus, and anatomic area involved. These longer incisions create larger surgical wounds with greater potential for chronicity and complications … read more

Aquacel Extra dressing in practice: Quick Guide

This Quick Guide outlines how using a partnership of tried and tested AQUACEL dressings can provide effective wound management. The focus is on AQUACEL Extra dressing, which is designed to lock in harmful bacteria, micro-contour to the wound bed to maintain optimal moisture balance and reduce ‘dead space’ where bacteria can grow, and respond to wound conditions by forming a cohesive gel when in contact with exudate … read more

Intraoperative oxygen monitoring predicts wound healing

     in critical limb ischaemia patients after endovascular intervention

 

Preliminary findings from an initial study with 25 patients have shown that measuring the changes in oxygen concentration at baseline, during, and after endovascular revascularisation, can predict wound healing and functional improvement in critical limb ischaemia patients … Marianne Brodmann, Medical University Graz, Austria, presented the initial OMNIA study results that used the Lumee oxygen platform (Profusa) as a unique tool to assess and clinical management of critical limb ischaemia patients at the Leipzig Interventional Course (LINC; 30 January–2 February 2018, Leipzig, Germany). The platform is designed to provide immediate feedback on the quality of revascularisation and along the entire course of the patient’s recovery. It uses hydrogel sensors that are injected into the skin of the patient that measure the oxygen concentration in the tissue … read more

The use of topical analgesics in the management of diabetic neuropathy

Painful diabetic neuropathy (PDN) affects up to half of patients with diabetes and is a major cause of functional impairment and increased mortality. Its clinical manifestations include sensations such as burning, stabbing and tingling and/or loss of sensation, and it increases the risk for injuries and foot ulceration. Oral pharmacological therapy is the standard approach to management. It is effective in some patients, but its use is limited due to unfavourable side-effect profiles, limited response rates and drug interactions. Increasing evidence of the localized, non-systemic treatment approach of topical analgesics aims to overcome these obstacles and provide valuable, efficacious and safe management of PDN. This article reviews the rapidly expanding field of topical analgesia in managing PDN … read more

Clean vs. Sterile Dressing Techniques for Management of Chronic Wounds

This document originated in 2001 as a joint position statement from a collaborative effort of the Wound, Ostomy and Continence Nurses Society and the Association for Professionals in Infection Control and Epidemiology, Inc.1,2 Its purpose was to review the evidence about clean vs. sterile technique and present approaches for chronic wound care management. Then as now, areas of controversy exist due to a lack of agreement on the definitions of “clean” and “sterile” technique, lack of consensus as to when each is indicated in the management of chronic wounds, and lack of research to serve as a guide. Wound care practices are extremely variable and are frequently based on rituals and traditions as opposed to a scientific foundation … read more

Joint EPUAP & EWMA Pressure Ulcer prevention & patient safety

     advocacy project

 

The European Pressure Ulcer Advisory Panel (EPUAP) and EWMA are collaborating on a joint engagement in the PU prevention and patient safety agendas at the European level as well as at the national level in selected European countries.

Five articles by the joint EPUAP-EWMA initiative have now been published. The articles are available for download here:

The role of pressure ulcer prevention in the fight against antimicrobial resistance

EWMA & EPUAP added-value to OECD efforts

Diabetic Control & Pressure Ulcers: fighting fatal complications and
improving quality of life

Patient safety across Europe: the perspective of pressure ulcers.

The time to invest in patient safety and pressure ulcer prevention is now!

 

Patient safety has for some years been high on the European Commission health care agenda. At the EU level as well as at national levels of many European nations, considerable investments have been made by health care authorities to establish organisations and programmes addressing the patient safety agenda.

 

Looking at the patient safety agenda from a wound care perspective, the topic of Pressure Ulcer (PU) prevention has always been central due to the fact that most PU’s are preventable if the patient is managed correctly by health care staff … read more

‘Amputated limb every two hours’: Experts warn Aussies against health risk

For a health issue that has cost the Australian health care system $1.6 billion every year and has a mortality rate worse than many cancers, diabetic foot disease is one of the country’s least known major health problems … The condition typically develops from trauma caused by peripheral neuropathy or peripheral arterial disease, which is complicated by infection. Neuropathy is a nerve condition that can lead to pain, numbness and tingling and is one of the major factors in diabetic foot disease … read more

Effect of Polyhexamethylene Biguanide Solution on Bacterial

     Load and Biofilm in Venous Leg Ulcers: A Randomized Controlled Trial

 

The purpose of this study was to investigate the effect of polyhexamethylene biguanide (PHMB) solution as a wound cleanser on bacterial load and bacterial biofilm in venous leg ulcers … The target population was adults attending the dermatology outpatient clinic of the Clinical Hospital of the Federal University of Minas Gerais, Brazil. The sample comprised 44 patients with venous leg ulcers recruited over a 6-month period … read more

Liraglutide Lowers Risk for Amputation in Patients with Type 2 Diabetes and CV Risk

Liraglutide lowers risk for amputation: investigators find patients treated with GLP-1 drug had significantly lower number of amputations compared to placebo group.

 

The word may still be out on whether certain oral diabetes medications puts patients at risk for lower limb complications, but a new study has shown that liraglutide is not one of them. A post hoc review analysis of the LEADER trial published in Diabetes Care examined the effects of Liraglutide on rates of foot ulceration and amputation in patients at high risk for cardiovascular (CV) events.

 

Liraglutide, a GLP-1 agonist, is an injectable glucose-lowering medication used in patients with type 2 diabetes. GLP-1 agonists act by mimicking the effects of the hormone GLP-1, which increases insulin secretion and lowers glucagon release. This, in effect, causes increased satiety and slowed gastric emptying, with one of the main benefits of GLP-1 agonists being weight loss in patients with diabetes … read more

Advanced Wound Care Technologies to Manage Wound Infections

BOSTONSept. 26, 2018 /PRNewswire/ — Recently, research undertaken by the UK’s House of Commons library at the request of the UK’s Labour Party revealed that diabetic foot and toe amputations performed by the UK’s National Health Service (NHS) has risen by 26 percent. Between April 2010 and March 2013, minor amputations due to diabetes numbered 15,075. This has risen to 19,073 in the same 3-year period of 2014 – 2017. Though the Department of Health and Social Care acknowledge that the rate of minor amputations has increased, it is also important to note that they state that the number of major amputations (above the ankle) has decreased. Regardless, diabetic foot amputations are estimated to cost the NHS over £44 million just in the year 2016.

 

Patients typically arrive at the point of requiring a lower limb amputation due to tissue necrosis resulting from an infected diabetic foot ulcer (DFU). DFUs are hard to heal wounds that remain open for extended time. Thus, extra care is required in keeping the wound clean and in preventing infection. DFUs are formed in the first place due to ischemia and neuropathy, two side effects of poor blood glucose management.

 

Clearly, the best intervention is to prevent the formation of DFUs in the first place. This may begin in good management of blood glucose to prevent ischemia and neuropathy, though sensor technologies can also be used for the express purpose of preventing DFUs. Once the wound is formed, preventing and treating any wound infection is critical. However, there are many factors that healthcare providers have to contend with during the treatment of DFUs … read more

Following the Evidence for Total Contact Casting

     as First-Line Treatment of DFUs in the Wound Clinic

 

Diabetic foot ulcers (DFUs) are a major concern in the outpatient wound clinic due to the growing diabetes epidemic, the significant morbidity and mortality associated with DFUs, and the economic burden on the healthcare system. Despite a well-established standard of care for DFUs, which includes effective offloading as a cornerstone, there are gaps in practice with regard to clinical implementation of appropriate offloading. This article will provide a discussion of the evidence supporting the use of offloading as a standard of care for DFUs with a focus on total contact casting (TCC). In addition, we will discuss barriers to using TCC in clinical practice followed by an example of how one heavily trafficked wound clinic located in Texas has successfully implemented TCC and has experienced a positive impact on wound healing rates as well as clinic efficiency … read more

Support Surfaces Do Not Replace the Need for Good Pressure Ulcer Care

Support surfaces alone neither prevent nor heal pressure ulcers. They are to be used as part of a total program of prevention and treatment. When pressure ulcers deteriorate or fail to heal, the professional should consider replacing the existing support surface with one that will improve pressure redistribution and microclimate (heat and moisture control) for the individual. Changing the support surface is only one of several strategies to consider. The individual and his or her pressure ulcer should be re-evaluated. Preventive interventions and local wound care should also be intensified as needed. A significant increase in risk status may also prompt such re-evaluation of the individual and the support surface … read more

Factors associated with acute and chronic wound complications

     in patients with soft tissue sarcoma with long-term follow-up

 

In a cohort of patients treated for soft tissue sarcoma (STS) with modern radiotherapy (RT) and surgical techniques, experts assessed the rates of acute and chronic wound complications and related factors. They identified all adult nonmetastatic patients treated for STS at a single institution between 2006 and 2015 with a minimum 1-year follow-up. In these patients, the rate of acute wound complications was 22.1%. In STS patients, numerous factors linked to acute and chronic wound complications, including the timing of RT, tumor site, and reconstruction use, were found. Results demonstrated the probable correlation between development of acute wound complications with a higher risk of chronic wound complications … read more

Corstrata to Launch Next Gen Virtual Wound Clinic Powered by Citus Health

Corstrata, a provider of digital healthcare IT solutions and services for wound prevention and care management, announced today a partnership with Citus Health, a digital health solutions provider for the post-acute care industry, to power its next-generation virtual clinic. Corstrata will leverage Citus Health’s state-of-the-art patient and provider engagement platform to enable enhanced remote access to wound and ostomy care experts for wound and ostomy patients everywhere … Corstrata will utilize the Citus Health platform to serve its wound and ostomy customers, provider customers, and Diabetic Foot Ulcer Prevention members. Citus provides a versatile, leading-edge, patient and provider engagement architecture for enhanced care coordination and communication to improve clinical and financial outcomes. The Corstrata branded app powered by Citus Health will integrate key technologies, including wound image capture, video, patient engagement, and with the flexibility of the platform, streamline the capability to add third-party IoT data sources in the future … read more

Advanced Wound Care Technologies to Manage Wound Infections

BOSTONSept. 26, 2018 /PRNewswire/ — Recently, research undertaken by the UK’s House of Commons library at the request of the UK’s Labour Party revealed that diabetic foot and toe amputations performed by the UK’s National Health Service (NHS) has risen by 26 percent. Between April 2010 and March 2013, minor amputations due to diabetes numbered 15,075. This has risen to 19,073 in the same 3-year period of 2014 – 2017. Though the Department of Health and Social Care acknowledge that the rate of minor amputations has increased, it is also important to note that they state that the number of major amputations (above the ankle) has decreased. Regardless, diabetic foot amputations are estimated to cost the NHS over £44 million just in the year 2016 … read more

LeucoPatch helps heal diabetic foot ulcers faster

A new system that uses a multilayer patch made with a patient’s own leukocytes, platelets, and fibrin can speed the healing of diabetic foot ulcers, according to new findings … “The use of LeucoPatch is associated with significant enhancement of healing of hard-to-heal foot ulcers in people with diabetes,” Dr. Frances Game of Derby Teaching Hospitals NHS Foundation Trust in the UK and colleagues conclude in The Lancet Diabetes & Endocrinology online September 19 report … read more

New study reveals potential therapeutic approach to enhance keratinocyte

Researchers have identified a new mechanism involving ginsenoside Rb1, which has the ability to stimulate keratinocyte migration and promote cutaneous wound healing. They report the results of a study showing that Rb1 enhances keratinocyte migration in an article published in Journal of Medicinal Food, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The researchers demonstrated that Rb1 significantly increases the production of sphingosine-1-phosphate (S1P), which is a signaling factor in keratinocytes known to stimulate wound repair through greater keratinocyte migration … read more

Preventive Care: Reducing the Recurrence of Diabetic Foot Ulcers

Comprehensive treatment of diabetic foot ulcers (DFUs) includes moist local or topical wound care, serial sharp debridement, treatment of infection, mechanical offloading, glycemic control, nutritional management, and overall chronic disease management. These facets of therapy are best addressed by an interdisciplinary approach.

 

If we understand the principles of healing, what can we do to prevent the pathologic process of DFUs? Instituting measures to prevent development of DFUs can decrease morbidity and mortality. There are several organizations with guidelines for prevention of DFU and subsequent complications including amputation, infection, and loss of independence. This article will review the highlights of some of the most recent guidelines for DFU prevention … read more

Healogics Joins the Epic App Orchard

JACKSONVILLE, Fla.–(BUSINESS WIRE)–Healogics Inc., the nation’s largest provider of advanced wound care services, today announced they have joined the App Orchard to begin working on an integration to improve interoperability within their nationwide network of Wound Care Centers®. Currently, this integration is set to deploy in the fall of 2019.

 

This integration will allow discrete data flow between systems with a goal to reduce errors for hospital compliance and audits, eliminate redundant double entry work for Wound Care Centers and foster better partnerships with hospital systems. Additionally, these updates will allow for integration with Healogics applications, and Epic creating a more streamlined user experience.

 

“This integration is a major step forward for Healogics’ hospital partners that are looking to use Epic in their Wound Care Center,” said Ty Smith, Chief Information Officer at Healogics. “This level of integration will bring the best of Healogics applications into the Epic ecosystem and supports our Centers with the best technology available. We are looking forward to all the ways in which these updates will improve the patient experience and save time for clinicians and physicians, all while increasing the quality and consistency of patient care.” … read more

MiMedx up 6% premarket on positive data on dHUC in diabetic foot ulcers

MiMedx Group (NASDAQ:MDXG) is up 6% premarket on light volume on the heels of the publication of a study evaluating its dehydrated human umbilical cord (dHUC) for the treatment of chronic diabetic foot ulcers in the International Wound Journal … In the intent-to-treat group, 70% of patients receiving weekly dHUC allograft achieved complete healing by week 12 compared to 48% of those receiving standard-of-care (SOC) treatment for 12 weeks (p=0.0089) … read more

Decompression nerve surgery for diabetic neuropathy

     a structured review of published clinical trials

 

MEDLINE, PubMed, and related registries were searched through December 2017 to identify randomized, quasi-randomized or observational trials that evaluated the efficacy of lower extremity DNS on pain relief (primary outcome) or other secondary outcomes. Observational studies were included, given investigators’ reluctance to use sham surgery controls. Outcome effect size was estimated, and a weighted average was calculated.
Results: Eight of 23 studies evaluated pain relief, including a double-blind randomized controlled trial (with a sham surgery leg), an unblinded trial with a nonsurgical control leg, and 6 observational studies. All reported substantial pain relief post-DNS with average effect sizes between two and five. Unexpectedly, the double-blind trial showed improvement in the sham leg comparable to the DNS leg … read more

Principles of Clean Dressing Technique Versus Asepsis

Having read a recent article on clean versus sterile dressing technique, commenting again on this issue seems highly appropriate. The conclusion of the paper essentially is that a clean technique for acute wound care does not affect the incidence of infection.1 There is insufficient evidence in the literature relating to chronic wound care. I particularly appreciated the comment that nurses need to decide which approach to have by using critical thinking skills. I was reminded of a visit to a patient to utilize a fancy new dressing that I had never used before …  read more

NuVasive launches expanded biologics in US

NuVasive (NSDQ:NUVA) said today it launched three new products as part of its biologics portfolio, including its Traditional Bone Allograft, Amniotic Membrate DS and Propel DBM …The San Diego-based company’s Traditional Bone Allograft includes cancellous chips, demineralized cancellous chips, cortical cancellous chips and cancellous crushed, which the company claims the has osteoconductive properties intended to provide a scaffold for bone growth … The newly launched Amniotic Membrane DS is a dual-sided layer of human amniotic membrane intended to act as a biologic barrier to prevent adhesions and reduce scar tissue formation near adjacent muscle, nerve and fascia layer tissues … read more

Key Considerations With Dressing Selection In Wound Care

With the plethora of wound dressings available, how can you choose the right dressing for your patients? Assessing the merits and drawbacks of current and emerging dressings, these authors share their experience with multi-layer dressings, wound cleansers, dressings that facilitate wound debridement and others … In our wound care practice, we diagnose and treat various etiologies of lower extremity wounds including diabetic foot ulcers, venous leg ulcers, pressure ulcers and other wounds. As there are hundreds of wound dressings and topical treatments available in the United States today … read more

Peripheral arterial disease and the diabetic foot

Peripheral arterial disease (PAD) is a term used to describe atherosclerotic vessels in the periphery, mostly affecting the lower extremities. The blocked vessels impair blood and oxygen perfusion to the lower limbs and may lead to increased risk of ulceration, wounds and amputations. PAD is also associated with increased risk of coronary and cerebrovascular incidents. More than 50% of people living with PAD may not have any clinical symptoms, posing a challenge to diagnosis and management. This article will discuss the aetiology, presentation, risk factors, and management of PAD as related to the lower extremities … read more

Why Do Promising Wound Therapies Fail?

Is a histologically hostile environment causing promising treatments for chronic wounds to fail? My coauthor and I tackle this question in a recent review for Nature Reviews Endocrinology.

 

As we say in the review, “As with so many other areas in medicine, the field of tissue repair and wound healing is littered with early-stage promise in preclinical models followed by late-stage disappointment in human trials.”1 If we understand that the wound environment is histologically hostile, many of the types of treatments we have endeavored to use in this area come into question … read more

UK nurses carry out 180 wound dressing changes a year

     on each chronic wound patient

 

New research finds UK nurses carry out 180 wound dressing changes a year – on each chronic wound patient
  • Chronic wounds, such as diabetic foot ulcers, pressure ulcers and venous leg ulcers, take more than 8 months to heal for the average patient and some will be affected for decades1
  • Despite advancements in wound care, patients report dressings are changed on average 5 times a week1
  • This poses a huge burden on UK nurses and impacts the quality of life for nearly all (90%) of patients1
August 2018, Milton Keynes, UK. A survey of more than 200 people living with chronic wounds, conducted by Mölnlycke, a provider of wound care solutions, reveals that living with an open wound for almost a year has become the ‘new normal’ in the UK.1 The situation is challenging for UK nurses and has a devastating impact on quality of life for those affected … read more

Higher proportion of limb salvage and lower amputation rates

     The impact of a wound centre on a vascular surgery practice

 

The opening of an outpatient wound centre has been associated with a significant increase in peripheral vascular practice and a significant decrease in amputation rate. Venita Chandra and colleagues Alyssa M Flores, Matthew W Mell and Ronald L Dalman (Stanford University, Stanford, USA) believe that such centres result in synergistic systems that promote more aggressive and effective limb salvage strategies. Chandra presented the findings of a recent study analysing the clinical impact of a wound care centre on a vascular surgery practice, at the Society for Vascular Surgery’s Vascular Annual Meeting (VAM; 20–23 June, Boston, USA) … read more

Reduction of 50% in Diabetic Foot Ulcers With Stem Cells

MUNICH — Local injection of mesenchymal stem cells derived from autologous bone marrow shows promise in healing recalcitrant neuropathic diabetic foot ulcers, a novel study from Egypt shows.

 

Presenting the results at the European Association for the Study of Diabetes (EASD) 2016 Annual Meeting, Ahmed Albehairy, MD, from Mansoura University, Egypt, said: “In patients who received the mesenchymal stem cells, ulcer reduction was found to be significantly higher compared with patients on conventional treatment after both 6 weeks and 12 weeks of follow-up. This is despite the fact that initial ulcer size was larger in the stem-cell–treated group.”

 

After 6 weeks, median ulcer reductions were 49.9% and 7.67% (P = .001) in stem-cell–treated and control groups, respectively, and after 12 weeks, median ulcer reductions were 68.24% and 5.27% (P = .0001). Complete healing was achieved in one case in the mesenchymal stem cell–treated group.

 

“The healing mechanism may be due to the pure effect of injected mesenchymal stem cells … read more

The Rise Of The Bio-Inks: 3D Skin Printing

May Solve Problems For Patients With Chronic Wounds

 

Bio-inks are becoming an increasingly common feature of next-generation medicine. These inks consist of living cells from donor tissues that may be suspended in bio-compatible solutions or polymers. The bio-inks are laid down or deposited using techniques much like medical-grade 3D printing … A recent project that incorporates bio-inks is intended to address deep skin wounds and the issues that affect their treatment and ultimate healing. The scientists behind it hope that their innovative solution can improve outcomes for these patients while overcoming the problems they face as a result of current medical practice … read more

An Observational, Prospective Cohort Pilot Study to Compare the Use of …

     Subepidermal Moisture Measurements Versus Ultrasound and Visual Skin Assessments for Early Detection of Pressure Injury

 

Pressure ulcers (PUs) are detected by visual skin assessment (VSA). Evidence suggests ultrasound (US) and subepidermal moisture (SEM) scanner technology can measure tissue damage before it is visible … A pilot study was conducted to evaluate consistency between SEM and US examinations of suspected deep tissue injury (sDTI) … Using an observational, prospective cohort study design, patients >55 years of age were recruited. VSA, SEM, and US assessments were performed daily for a minimum of 3 and maximum of 10 consecutive days following enrollment. US results were considered indicative of sDTI if hypoechoic lesions were present. SEM readings were considered abnormal when ∆ ≥0.6 was noted for at least 2 consecutive days. Boolean analysis was utilized to systematically determine consistency between US and SEM where sDTI was the clinical judgment … read more

Effective Wound Bed Preparation Using Maggot Debridement Therapy

     for Patients with Critical Limb Ischemia

 

An important factor in wound healing is adequate blood flow; thus patients with critical limb ischemia (CLI) and complex wounds are poor healers. Primary treatment for CLI is revascularization. Wound healing can be prolonged as a consequence of cyclical protease production by necrotic tissue during the inflammatory phase of healing. Debridement of necrotic tissue is therefore necessary to reduce inflammation and progress the healing cycle, as well as to promote epithelialization and reduce risk of infection. Conventional debridement therapy can be difficult in patients with CLI because of limitations in visualizing wound margins and time effectiveness. Maggot debridement therapy (MDT) is a traditional debridement therapy using live, sterilized fly larvae. This study investigated MDT in patients with CLI after midfoot amputation following revascularization by endovascular therapy. The outcomes of wound bed preparation were compared with the outcomes in patients receiving conventional therapy … read more

LeucoPatch system for the management of hard-to-heal diabetic foot ulcers in

     the UK, Denmark, and Sweden: an observer-masked, randomised controlled trial

 

The LeucoPatch device uses bedside centrifugation without additional reagents to generate a disc comprising autologous leucocytes, platelets, and fibrin, which is applied to the surface of the wound. We aimed to test the effectiveness of LeucoPatch on the healing of hard-to-heal foot ulcers in people with diabetes … Methods … This was a multicentre, international, observer-masked, randomised controlled trial of people with diabetes and a hard-to-heal foot ulcer done in 32 specialist diabetic foot clinics in three countries (UK, Denmark, and Sweden). After a 4-week run-in period, those with a reduction in ulcer area of less than 50% were randomly allocated … read more

R&D Remains the “Heartbeat” of 3M

While 3M is 116 years old, the company continues to churn out new products like a young startup. Research and development remains the heartbeat of 3M with the company spending $1.9 billion or 6% of sales in 2017 on research and development to drive organic growth and new products … Top priorities for growth today include automotive electrification, advanced wound care, connected safety, data centers, structural adhesives, filtration, air quality and population health … read more

OnCourse Learning to be acquired for reported $500 million

Brookfield-based professional training webinar provider OnCourse Learning is set to be acquired by German company Bertelsmann for a reported $500 million. The transaction is expected to close this fall, pending regulatory approval … OnCourse was sold by New York private equity firm CIP Capital, which acquired the company in 2014 from Cleveland private equity firm The Riverside Co. The transaction was described by Bertelsmann as “in the mid-nine-digit euro range.” Reuters pegged the deal at around $500 million … The company, which was founded in 2007, has grown steadily via acquisition. In January, it announced the acquisition of Lake Geneva-based Wound Care Education Institute Inc., … read more

3D Printing Advances are Changing Medicine and Military Safety

3D–printed objects are no longer a novelty and are paving the way for incredible scientific innovation. For example, a large 3D–printed engine part was successfully tested and could be used in the next generation SLS rocket that will send humans to the moon and Mars, NASA reported … The road to recovery for any individual with deep skin wounds, which affect all three layers of the skin, can be as painful and traumatic as the incident itself … Researchers at the University of Toronto have developed a handheld 3D printer filled with “bio ink” — essentially an ink cartridge containing biological materials. The bio ink contains strips of biomaterial that include the proteins collagen and fibrin, which are used to promote wound healing … read more

Wounds Asia: Current issue: Vol 1, No 2

  • Wound care management in Indonesia: issues and challenges in diabetic foot ulceration
    There are 415 million people aged 20–79 years with diabetes worldwide, almost 153 million of them live in the Western Pacific region (Ogurtsova et al, 2017). The number of people with diabetes is predicted to rise to 642 million worldwide by 2040 (Ogurtsova et al, 2017). Indonesia has approximately 258 million citizens, making it the world’s fourth most populated country. It is one of 21 countries and territories in the International Diabetes Federation Western Pacific region. According to the International Diabetes Federation (2017), about 10.3 million Indonesians have diabetes
  • Optimising quality of life for people with non-healing wounds
    Some wounds persist for months or years (Krasner et al, 2014). Non-healing wounds may be a result of host factors, such as inadequate vasculature, medications that interfere with the healing process, immunocompromised status or critically-ill status with non-modifiable risk factors (terminal disease, end-stage organ failure and other life-threatening health conditions). Among patients who are dying, receiving hospice or palliative care, non-healing or palliative wounds can be associated with complications
  • Reconstruction of a soft tissue defect of the big toe by pedicled perforator flap
    Treatment of soft tissue defect on the distal of the big toe is challenging due to the lack of reliable options that can be used to create a local flap to cover the injured area. Following injury, soft tissue defects expose the structures, joints, tendons and bone. Even a small defect will become problematic if it is not managed appropriately
  • Natrox® — Let the topical oxygen flow for healing complex wounds
    The presence of a wound increases the body’s requirement for oxygen by 20% for a patient with a clean wound and by 50% for an infected wound (Dernling, 2009). Oxygen is critical to many of the processes required in wound healing including the production of energy to fuel cell function and metabolism, angiogenesis, collagen synthesis and cross-linking

AmpliPhi receives positive feedback from FDA for its …

     AB-PA01 product targeting P.aeruginosa infections

 

AmpliPhi Biosciences Corporation, a clinical-stage biotechnology company focused on precisely targeted bacteriophage therapeutics for antibiotic-resistant infections, today announced that the company has received positive feedback, via written response, from the U.S. Food and Drug Administration (FDA) regarding its development plans for AB-PA01, without the need for a Type B Pre-IND meeting … “We are delighted with the FDA’s response to our development plans for AB-PA01, AmpliPhi’s bacteriophage product candidate targeting Pseudomonas aeruginosa infections, and the FDA’s concurrence on the proposed design of two randomized controlled clinical trials, in hospital-acquired and ventilator-associated pneumonia and P. aeruginosabacteremia,” said Paul C. Grint, M.D., CEO … read more

Beverly Hospital Hosts Amputation Prevention Summit

Beverly Hospital will be hosting its first Amputation Prevention Summit on Saturday, September 29, 2018 on the hospital campus at 309 West Beverly Boulevard, Montebello, California, drawing clinicians from the greater Los Angeles area.

 

This educational event will highlight the urgent nature of the diabetes epidemic— diabetes being among one of the top ten leading causes of death in California and the leading cause of non-traumatic lower extremity amputation. Guest speakers will share important data, current trends in limb salvage and best-practices in the battle against diabetes-related complications. They will also discuss ways healthcare professionals can improve their practices in order to reduce lower extremity amputations.

 

A person with diabetes has a risk of leg amputation that is 15-40 times greater than a person without diabetes. Within two to four years of unilateral limb loss, one-third of all patients lose the other leg. Only about 50% survive more than five years following a leg amputation. With the future incidence of diabetes projected to rise to 550 million people worldwide by the year 2030, limb salvage is becoming a viable alternative, often producing better outcomes than amputation … read more

Negative pressure wound therapy in the treatment of diabetic foot ulcers

     may be mediated through differential gene expression

 

Negative pressure wound therapy (NPWT) has been successfully used as a treatment for diabetic foot ulceration (DFU). Its mechanism of action on the molecular level, however, is not fully understood. We assessed the effect of NPWT on gene expression in patients with type 2 diabetes (T2DM) and DFU … The final cohort encompassed 21 patients treated with NPWT and 8 with standard therapy. The groups were similar in terms of age (69.0 versus 67.5 years) and duration of T2DM (14.5 versus 14.4 years). We identified four genes differentially expressed between the two study arms post-treatment, but not pre-treatment: GFRA2 (GDNF family receptor alpha-2), C1QBP (complement C1q binding protein), RAB35 (member of RAS oncogene family) and SYNJ1 (synaptic inositol 1,4,5-trisphosphate 5-phosphatase 1) … read more

One Call Announces New Wound Resource Program with Broadspire®

One Call, the nation’s leading provider of workers’ compensation care management services, and Broadspire®, a subsidiary of Crawford & Company® and a leading global third-party administrator, today announced a partnership to develop a customized patient-centric wound resource program to improve wound healing of injured workers.

 

The primary goal of wound care is to provide optimal conditions for the natural reparative processes to take place on their own. One Call’s new wound resource program, in partnership with Broadspire, utilizes evidence-based protocols to proactively identify injured workers who either have a non-healing wound or may be at risk for developing wounds.

Wounds that have continued for more than 30 days are 36-69 percent less likely to heal. Chronic wounds affect 5.7 million people in the U.S. at an annual cost of $20 billion.[1] Pressure ulcers are among the most common chronic wounds. According to the Agency for Healthcare Research and Quality (AHRQ), pressure ulcers account for more than 17,000 lawsuits annually and are the second most common claim after wrongful death. Sadly, about 60,000 patients die as a direct result of a pressure ulcer each year.

 

“Pressure ulcers and other chronic wounds have an enormously detrimental impact on function and overall healing,” said Dr. Marcos Iglesias, chief medical officer at Broadspire … read more

Osiris Therapeutics, Inc. Announces GrafixPL PRIME™

Launches October 1, 2018

 

COLUMBIA, Md., Sept. 17, 2018 (GLOBE NEWSWIRE) — Osiris Therapeutics, Inc.(NASDAQ: OSIR), a regenerative medicine company focused on developing and marketing products for wound care, orthopedics, and sports medicine, announces that GrafixPL PRIME™, a human placental membrane that can be stored at ambient temperatures, launches for sale on October 1, 2018.  The structural matrix, growth factors, and cell viability of GrafixPL PRIME is equivalent to those of Grafix®, a cryopreserved placental membrane, but without the constraints of ultra-low temperature storage.

 

GrafixPL PRIME is processed using Prestige LyotechnologySM, which is Osiris’s preservation technique for ambient storage of living tissues.  GrafixPL PRIME is flexible and conforming and designed as a wound cover/barrier for application directly to hard-to-treat acute and chronic wounds, including but not limited to diabetic foot ulcers, venous leg ulcers and thermal burns.

 

Jason Keefer, Interim President and CEO said: “I am pleased to announce that our ambient temperature stable GrafixPL PRIME product will be available in all settings of care, in addition to our cryopreserved Grafix products … read more

The role of bacteria and biofilms in non-healing wounds

Broadcast times available: 8:00 AM (UK), 11:00 AM (UK), 15:00 PM (UK)

 

Evidence has proven the positive effects of topical oxygen therapy on chronic, hard-to-heal wounds. It is becoming widely accepted that hard-to-heal wounds contain biofilm and that the presence of biofilm delays and/or prevents healing. This webcast will inform practitioners about the issue of biofilm and how it affects wound chronicity, as well as how topical oxygen therapy may help to kickstart stalled healing. The NATROX study has shown that topical oxygen therapy has a positive effect on biofilm in chronic wounds, and this webcast will provide practical guidance so this can be applied in practice to improve healing outcomes ….. read more

Solsys Medical’s TheraSkin Regenerative Wound Healing

     Product Chosen to be a Part of Healogics New iSupply(SM) Program

 

NEWPORT NEWS, Va.Sept. 10, 2018 /PRNewswire/ — Solsys Medical, LLC (“Solsys”) (formerly known and doing business as Soluble Systems, LLC) (“Solsys Medical”), which markets TheraSkin®, a cellular and tissue-based product for regenerative wound healing, announced today that it has partnered with Healogics, the nations largest provider of advanced chronic wound care services, to be a part of the new Healogics iSupply program, offering TheraSkin to Healogics facilities. Through the partnership with Healogics, Solsys furthers its mission to improve quality outcomes while reducing the total cost of care.  TheraSkin is a living human split-thickness skin allograft that is cryopreserved to preserve living cells and growth factors while maintaining a mature native human dermal architecture.  The versatility in applications and sizes of TheraSkin reduces product waste and helps to drive operational efficiencies in the wound care center to better manage total cost of care and quality outcomes related to wound care.

 

“We are very excited to be working with Healogics and have TheraSkin included in its iSupply initiative,” stated Allan Staley, CEO of Solsys Medical. “The iSupply program enables Healogics’ hospital partners improved access to TheraSkin in order to improve wound healing outcomes at a lower cost.” … read more

Supporting Closure: Therapeutic Interventions for Diabetic Foot Ulcers

Diabetic foot ulcers (DFUs) are arguably among the most difficult types of wounds to manage; the etiology of these wounds poses some of the greatest clinical challenges for healing, considering the multifaceted nature of diabetes mellitus (DM). Multiple patient-related factors must be addressed and controlled through faithful adherence to the prescribed plan of care, which is developed by both the patient and clinicians to ensure success … Treatment of DFUs requires multidisciplinary provider involvement (podiatry, vascular, infectious disease, internal medicine or family practice, endocrinology, cardiology, nephrology, and physical therapy). The standard of care for patients with DFUs includes medical management of chronic disease, including nutrition and glucose control, routine wound assessments with ulcer grading and risk stratification, topical wound management with attention to serial debridements and moist wound healing … read more

The Diabetic Foot in Remission: Strategies to Make Prevention Pay

September 25, 2018 1:00 pm to 2:00 pm EDT
Presented by: Dr. David G. Armstrong, DPM, MD, PhD

Because neuroischemic complications are associated with a high rate of recurrence, this presentation proposes a slight shift in how health care providers counsel and communicate risk to their patients. If the epidemiology of this problem is comparable with that of cancer, and recurrences are common, then perhaps language commensurate with such risks should follow.

 

After initial healing of an index wound, patients are referred to not as being cured but rather as being “in remission.” This concept is easy for the patient and the rest of the team to understand, and it powerfully connotes the necessity for frequent follow-up and rapid intervention for inevitable minor and sometimes major complications.

This program will review tried-and-true as well as up-to-the-minute advances in biologics, consumer electronics, mechanics, medicine, and surgery that are “pushing the envelope” in extending ulcer-free, hospital-free, and activity-rich days in efforts to make prevention pay.

 

Registrants will learn how to:

  • Identify risk factors for ulceration
  • Identify risk factors for amputation
  • Understand the impact of diabetes on the health care system
  • Understand the impact of diabetic foot complications on the health care system

Diabetic Foot Ulcer Classification and Assessment

Classification of Diabetic Foot Ulcers

Historically, classification and subsequent treatment of DFUs do not adequately include management of concomitant ischemia of peripheral arterial disease (PAD). The Wagner Diabetic Foot Ulcer Grade Classification System, which has been in use since its inception in the 1970s, did not have the capacity to describe ischemic components of DFU. The University of Texas Diabetic Foot Ulcer Classification System, PEDIS (perfusion, extent, depth, infection, and sensation), WIfI Threatened Limb (Wound/Ischemia/Foot Infection), and SINBAD (Site, Ischemia, Neuropathy, Bacterial infection, And Depth) are classification systems that utilize degrees of ischemia as a contributing factor.

 

At present, subclassification of DFUs can be divided into three categories: neuropathic, ischemic, and neuroischemic. The most prevalent of the three is the neuroischemic DFU, which comprises approximately 50% of such ulcerations. Organization and reproducibility of the assessment process are crucial to success. Workups should include identification of intrinsic and extrinsic factors, both modifiable and non-modifiable. We will review appropriate assessments by using a typical history and physical examination format … read more

Scientists Trial An Unexpected Source To Help Heal Hard-To-Treat Injuries

Scientists have revealed how proteins in menstrual blood can be used to stimulate skin repair, including wounds that otherwise recover poorly. Today, tens of billions of dollars are spent on chronic skin injuries, and increasing rates of diabetes are adding to this demand, so utilizing the womb’s incredible ability to repair itself quickly could be the way forward … “The lining of the uterus, the endometrium, is an amazing tissue which undergoes ‘self-destruction’ each month at menstruation, followed by repair and regeneration of the tissue in preparation for pregnancy. This occurs, on average, 450 times in each woman’s reproductive life,” said Dr Jemma Evans of Melbourne’s Hudson Institute of Medical Research in a statement … read more

Treating Diabetes with GLP-1 Reduces Heart Disease, Fewer Foot Ulcers

Two analyses from the LEADER Trial show reduced risks of deaths and better outcomes in both heart health and diabetes-related foot ulcers and associated complications in patients with type 2 diabetes who are at increased risk for cardiovascular disease … GLP-1 Proves Effective in Lessening Risks of 2 Common Diabetes-Related Risks … Patients with type 2 diabetes who were at heightened risk of cardiovascular disease (CVD) and received liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1) saw a reduction in CVD events and cardiovascular death … read more

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Car crashes and chronic wounds

     The health epidemic no one is talking about

 

Chronic wounds impact the lives of millions of Americans, yet the stories of those suffering are rarely told. As a result, chronic wounds have turned into a silent epidemic that remains largely invisible to the general public. Twenty-five years ago, Kevin Fontenot was one of those people, living his life generally unaware of this horrible condition, which is often caused by other diseases such as renal failure, diabetes, circulatory problems or malnutrition. That is, until he himself fell victim to it … read more

Natural product-based nanomedicines for wound healing purposes:

     therapeutic targets and drug delivery systems

 

Wound healing process is an intricate sequence of well-orchestrated biochemical and cellular phenomena to restore the integrity of the skin and subcutaneous tissue. Several plant extracts and their phytoconstituents are known as a promising alternative for wound healing agents due to the presence of diverse active components, ease of access, and their limited side effects. The development of nanotechnological methods can help to improve the efficacy of different therapeutics as well as herbal-based products. Here, we present a review of the efficacy of the plant based-nanomaterials in the management of wounds and discuss the involved therapeutic targets. For this purpose, a profound search has been conducted on in vitro, in vivo, and/or clinical evidences evaluating the efficacy and pharmacological mechanisms of natural product-based nanostructures on different types of wounds … read more

Using AutoCAD software to measure venous leg ulcers:

     a reproducibility assessment study

 

To assess the reproducibility of using AutoCAD software to measure the area of venous leg ulcers (VLUs) … Data from patients with VLUs were collected between March and July 2015, using data collection forms and photographing the different ulcers. A researcher and five nurses collected the data. The wounds were measured using AutoCAD software. Data were analysed using intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and Bland-Altman analysis … read more (login required)

US military explores microbiology of combat wounds

To help improve the care of troops injured in combat, the United States military has been exploring the complex microbiology of combat wounds … The goal of the initiative “is to expand the understanding of the complex microbiology inherent within combat-related extremity wounds,” according to Katrin Mende, PhD … Biofilm formation in 376 Enterococcus wound isolates was found to be generally weak — 8.8% in the presence of human plasma and 1.9% in the absence of human plasma, Mende and colleagues reported … read more

Electrical Stimulation for Pressure Injuries: A Health Technology Assessment

Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries … We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non–randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries. We assessed the quality of evidence through Grading of Recommendations Assessment, Development, and Evaluation (GRADE). In addition, we conducted an economic literature review and a budget impact analysis to assess the cost-effectiveness and affordability of electrical stimulation for treatment of pressure ulcers in Ontario. Given uncertainties in clinical evidence and resource use, we did not conduct … read more

Transitioning wound care patients to post-acute care

When discharging patients from acute care facilities, consider cognitive and functional status; the home environment; family or caregiver support; access to services, medications, and transportation; and follow-up care.
Depending on the patient’s situation, the three goals of wound care are healing, maintenance, and comfort.
After discharge from an acute-care facility, patient medication management, diet, and lifestyle can help support wound healing … read more

Greater concentration on wound care will save NHS millions

     argues prof of vascular surgery

 

Former Head of Vascular Surgery at Bradford’s Royal Infirmary Professor Peter Vowden gave the opening address at the 3rd International Skin Integrity and Tissue Viability Conference which explored advances in and the management of all aspects wound care.

 

IT is estimated that annually the NHS treats over two million wounds at a cost of £5.3 billion and with tougher financial constraints being announced every year, there needs to be ongoing research to ensure the lack of finances doesn’t affect the quality of wound care available.

This was the topic of the opening lecture at the 3rd International Skin Integrity and Tissue Viability Conference hosted by the University of Huddersfield’s Institute of Skin Integrity and Infection Prevention (ISIaIP), in conjunction with the Journal of Wound Care … read more

Scientists Create a Surgical Sealant for Closing Major Wounds

Closing a wound usually requires a needle going through your skin, or staples. Just imagine having to sit there watching staples sticking into your flesh, not a pretty sight, right? Well, researchers have found an easier way to get things done.

 

One of the primary reasons the ways as mentioned above to close wounds are not perfect is the fact that they do not completely seal the entrance area. OK then, maybe doctors should use sealants to get the job done, but you know what? None of the ones available today meet the requirements of being a useful surgical tool … read more

BEST PRACTICE RECOMMENDATIONS FOR THE Prevention and

     Management of Diabetic Foot Ulcers

 

The best practice recommendation articles are special publications of Wound Care Canada. Together they form the Foundations of Best Practice for Skin and Wound Management, an online resource available for free download from the Wounds Canada website (woundscanada.ca). These 2017 updates build on the work of previous author teams and incorporate the latest research and expert opinion. We would like to thank everyone involved in the production of past and present versions of these articles for their hard work, diligence and rigour in researching, writing and producing these valuable resources … read more

Hemoglobin A1c levels not tied to wound outcomes

There does not appear to be a clinically meaningful association between baseline or prospective hemoglobin A1c (A1C) and wound healing in patients with diabetic foot ulcers (DFUs), according to a study published online April 16 in Diabetes Care.

 

The researchers found that baseline A1C was not associated with wound healing in univariate or in fully adjusted models. In the participants with baseline A1C <7.5 percent (hazard ratio [HR], 2.07; 95 percent CI, 1.08 to 4.00), no association with wound healing was seen with the mean A1C change from baseline. A nadir A1C change of 0.09 to 2.4 (tertile 3) was positively associated with long-term wound healing versus those with a nadir A1C … read more

Nexodyn Wound Care Solution Launched in the U.S.

Angelini and APR Applied Pharma Research strengthen their partnership in wound care with the launch of Nexodyn in the USA.

 

The new Nexodyn AOS wound care solution, cleared for sale by the FDA, is now starting to be available in the USA, promoted and commercialized by the Italian pharmaceutical company Angelini, as a result of an exclusive partnership with the Swiss company APR Applied Pharma Research, the owner and developer of the proprietary, patented technology TEHCLO, for the production of acidic super-oxidizing solutions.

 

Nexodyn helps cleanse and moisten the wound environment by removing dirt, debris and foreign material by flushing across the wound. Nexodyn is intended for use, under the supervision of healthcare … read more

Researchers invent ‘smart’ thread that collects diagnostic data

     when sutured into tissue

 

For the first time, researchers led by Tufts University engineers have integrated nano-scale sensors, electronics and microfluidics into threads – ranging from simple cotton to sophisticated synthetics – that can be sutured through multiple layers of tissue to gather diagnostic data wirelessly in real time, according to a paper published online July 18 in Microsystems & Nanoengineering. The research suggests that the thread-based diagnostic platform could be an effective substrate for a new generation of implantable diagnostic devices and smart wearable systems … read more

International Conference on Wound Care, Tissue Repair and Regenerative Medicine

With Immense pleasure, Wound Care 2018 along with the Organizing Committee Members invites all the participants from all across the globe to attend “International Conference on Wound Care, Tissue Repair and Regenerative Medicine” which is slated on October 29-30, 2018 at Amsterdam, Netherlands with the theme Advanced wound healing techniques for the cure and care of wounded patients. This year Wound Care Conferences anticipated as two days interactive, stimulating discussion with 10+ keynote lectures, 50+ plenary lectures, 10+ Young Research Forum Lectures, 20 + Poster Sessions. Besides, there will be 3+ workshops and 2+ Symposiums. We also expect to provide technical demonstrations and numerous opportunities for informal networking.

 

Mission, Vision and Values:

Wound Care conferences mission is to provide the exclusive research topics where all the participants can be up to date with the Latest developments in the wound care. Conference on Wound Care ultimate vision is to be the Premier and Exclusive healthcare conference in the worldwide regions. The values of Wound Care 2018 are Innovation, Quality, Integrity, Knowledge and Patient care.

 

Why Amsterdam?

Amsterdam is the capital of the Netherlands. These days the city has a population of just over 790.000 inhabitants and is the largest city in the country. Amsterdam is located in the province ‘Noord-Holland’, situated in the west. It is one of the most popular destinations in Europe, receiving more than 4.5 million tourists annually … read more

A new platform for gaining insight and knowledge in managing wounds

Wounds can cover diabetic foot ulcers, pressure injury, vascular ulcers or wounds, immunopathic wounds and traumatic wounds. Chronic, hard-to-heal wounds also have an adverse effect on health-related quality of life. Wounds are a global problem, with increasing incidence due in part to the increase in diabetes mellitus. In Asia, there are more than 4 billion people, and this is where diabetes and its complications, namely diabetic foot, are increasing at an alarming rate … read more

Moldable Hyaluronan Hydrogel Enabled by Dynamic

     Metal–Bisphosphonate Coordination Chemistry for Wound Healing

 

Biomaterial‐based regenerative approaches would allow for cost‐effective off‐the‐shelf solution for the treatment of wounds. Hyaluronan (HA)‐based hydrogel is one attractive biomaterial candidate because it is involved in natural healing processes, including inflammation, granulation, and reepithelialization. Herein, dynamic metal–ligand coordination bonds are used to fabricate moldable supramolecular HA hydrogels with self‐healing properties. To achieve reversible crosslinking of HA chains, the biopolymer is modified with pendant bisphosphonate (BP) ligands using carbodiimide coupling and chemoselective “click” reactions. Hydrogel is formed immediately after simple addition of silver (Ag+) ions to the solution of HA containing BP groups (HA‐BP). Compared with previous HA‐based wound healing hydrogels, the HA‐BP·Ag+ hydrogel is highly suitable … read more

Oxygen therapies for wound healing: EWMA findings and recommendations

For wounds to heal, it is essential that macro- and microcirculation is restored in the surrounding tissue (Niinikoski et al, 1991; Gottrup, 2004a). One of the most urgent requirements is oxygen, as it is critically important for the reconstruction of new vessels and connective tissue, and also enables resistance to infection … View PDF

Diabetes causes more than 120 foot and toe amputations a WEEK in England

More than 120 foot and toe amputations are carried out every week in England as a result of diabetes.

 

Shocking figures reveal the number of amputations linked to the disease have risen by over a quarter since 2013.

 

Type 2 diabetes’ prevalence has more than doubled over the past decade due to rising rates of obesity, inactivity and unhealthy eating.

 

The disease can lead to amputations if it causes nerve damage that lead to infected wounds that do not heal. These infections can then spread to a person’s bones and even result in gangrene … read more

Windsor’s Scapa to expand wound care footprint with acquisition

Windsor skin care products provider Scapa Healthcare said Thursday it has agreed to acquire an England-based maker of wound care products.

 

Scapa said acquiring Systagenix, and its 335,000-square-foot manufacturing facility, will “significantly” add to the Windsor company’s wound care footprint. Financial terms were not disclosed for the deal expected to be completed in October …. read more

Methodological considerations of investigating adherence

     to using offloading devices among people with diabetes

 

Foot ulcers are a diabetic complication associated with significant morbidity, mortality, and amputation risk. Offloading devices prevent and heal foot ulcers, but adherence to using these devices is low. The reasons for nonadherence are unclear, and study results are difficult to compare due to methodological heterogeneity. This paper explores aspects of investigating adherence to using offloading devices among people with diabetes and provides recommendations for future studies, focusing on study designs, definitions of adherence, measurement methods, and conceptual frameworks. Most studies use a cross-sectional observational study design, limiting the potential to establish the temporal sequence between predictors and adherence, rule out confounding factors, and establish causality. Studies defining adherence as the length of time the device is worn have often used self-report to measure adherence, which may be unreliable. Studies using activity monitors to … read more

SMARTPORE Technology Made Easy

Selecting the appropriate dressing for the individual is essential in promoting optimum healing, symptom management, comfort and overall quality of life for the patient. This Made Easy describes SMARTPORE Technology®, utilised in the BETAplast® dressing range (Mundipharma). SMARTPORE Technology® provides high absorption and retention of exudate, along with an optimal moisture vapour transmission rate (MVTR), creating an ideal option for wound healing.

 


Download:

SMARTPORE TECHNOLOGY MADE EASY

Cell reprogramming converts open wounds into healthy skin

The work focuses on a type of wound known as cutaneous ulcers, which are long-lasting lesions commonly found on sufferers of severe burns, bedsores and diabetes. These complex wounds run deep, through several layers of skin, which often means that they need to be treated surgically by taking grafts of existing skin and layering them over the top.

 

With expertise in plastic surgery, Salk scientists Izpisua Belmonte and Masakazu Kurita started to explore advanced regenerative techniques that could avoid the need for these procedures. Key to their mission were cells called basal keratinocytes, which resemble stem cells in that they serve as a precursor to various types of skin cells … read more

UIC to lead study of negative pressure wound

     therapy in obese and diabetic patients

 

Surgical site infections are a significant complication that can prevent proper wound healing, require expensive treatment and may even lead to death in severe cases. Patients with higher body mass indices and with diabetes have an increased risk of developing incision infections.

 

With a $1.7 million, two-year grant from the Centers for Disease Control and Prevention, researchers in the University of Illinois at Chicago Epicenter for Prevention of Healthcare Associated Infections — one of six such centers funded by the CDC — will determine whether negative pressure wound therapy can help reduce the incidents of surgical site infections in obese and diabetic patients.

 

“Obese patients are more prone to develop surgical site infections because incisions tend to be larger and need to be deeper to allow surgeons to access the areas they need to work,” said Dr. Susan Bleasdale, associate professor of clinical medicine in the UIC College of Medicine and principal investigator on the grant … read more

Wilmington-based company creates smartphone app for wound care

A smartphone application called MyWoundDoctor can help people needing wound care get quick access and treatment from a certified healthcare provider.

 

Here’s a simple version of how it can work: You snap a picture of the wound, select where on your body it’s located, and share a few more details about your condition. Then 30 minutes to four hours later, you’ll receive a doctor’s assessment, treatment instructions, and personalized supplies mailed to your home in a few days.

 

“It’s sort of a self-serve model,” said Dan Heneghan, the CEO of MyWoundDoctor, LLC which is based in Wilmington.

 

MyWoundDoctor was founded in 2015 by Heneghan and Dr. Nick Sieveking, a board-certified plastic surgeon.

 

Heneghan said he was talking with Sieveking, who said his patients had been sending pictures of wounds to him through his smartphone … read more

Scientists find way of treating skin wounds without surgery

Researchers trick wound cells in mice into becoming healing surface skin cells

 

Scientists have discovered a new way of treating skin wounds in mice by tricking the cells in the wound into becoming healing surface skin cells.

 

The findings raise the prospect of being able to develop simple, non-surgical treatments for human wounds in the future.

 

Large skin wounds and ulcers are painful and occasionally life-threatening. When the surface of the skin is ruptured, epithelial cells, which make up the outer layer of the skin, migrate towards the wound in an effort to seal up the injury. But this healing process becomes more difficult in larger wounds and is impaired in older people, making the need for simple, effective treatments all the greater … read more

Chitosan-polyvinyl alcohol nanoscale liquid film-forming system

     facilitates MRSA-infected wound healing by enhancing antibacterial and antibiofilm properties

 

Sha Yang,* Yun Yang,* Sixin Cui, Ziqi Feng, Yuzhi Du, Zhen Song, Yanan Tong, Liuyang Yang, Zelin Wang, Hao Zeng, Quanming Zou, Hongwu Sun

 

National Engineering Research Center of Immunological Products & Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University of Chinese PLA, Chongqing, 400038, People’s Republic of China

 

*These authors contributed equally to this work

 

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most predominant and fatal pathogens at wound infection sites. MRSA is difficult to treat because of its antibiotic resistance and ability to form biofilms at the wound site.

 

Methods: In this study, a novel nanoscale liquid film-forming system (LFFS) loaded with benzalkonium bromide was produced based on polyvinyl alcohol and chitosan.

 

Results: This LFFS showed a faster and more potent effect against MRSA252 than benzalkonium bromide aqueous solution both in vitro and in vivo. Additionally, the LFFS had a stronger ability to destroy biofilms (5 mg/mL) and inhibit their formation (1.33 µg/mL). The LFFS inflicted obvious damage to the structure and integrity of MRSA cell membranes and caused increases in the release of alkaline phosphate and lactate dehydrogenase in the relative electrical conductivity and in K+ and Mg2+ concentrations due to changes in the MRSA cell membrane permeability.

 

Conclusion: The novel LFFS is promising as an effective system for disinfectant delivery and for application in the treatment of MRSA wound infections.

Download Article (pdf)

Antibiotic Resistance Influence on Wound Care

Antibiotic resistance is one of the factors which causes delay in wound healing and a corresponding spike in medical and healthcare expenses.

 

The primary reason for the emergence of resistance is the inappropriate use of antimicrobials. To use antibiotics wisely, it is necessary to understand the principles of diagnosing wound infection, what organisms are likely to be responsible, and to what antimicrobial agents they respond.

 

This knowledge will help to ensure that antibiotics are used only when essential, and in a manner that does not cause more resistance to be generated … read more

Role of oxygen in wound healing (webcast)

13 Sep 2018
Broadcast times available: 8:30 AM (UK), 12:30 PM (UK), 16:30 PM (UK)
This Wounds International webcast focuses on the role of oxygen in wound healing and how topical oxygen therapy can improve oxygenation and, therefore, healing.

 

In the first presentation, Breda Cullen, Research and Development Director, UK, outlines the vital role that oxygen plays throughout the healing process and the impact that lack of oxygen (hypoxia) can have on the wound. Breda explores the factors that can cause compromised healing and how these can be addressed.

 

In the next presentation, Hanna Kaufman, Orthopaedic Surgeon, Israel, looks in depth at the clinical evidence and how this can be applied to practice. Hanna identifies the wounds that are suitable for topical oxygen therapy and shares tips for use in practice, drawing on clinical evidence and experience.

 

In the final presentation, Tjun Tang, Vascular Surgeon, Singapore, looks at the role of topical oxygen therapy in limb salvage.

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Complex Wound Management: Diabetic Foot Ulcers

Background and Prevalence of Diabetic Foot Ulcers
Diabetes-related foot complications, including diabetic foot ulcers (DFUs), are leading causes of non-traumatic lower extremity amputation. Of the approximately 420 million adults in the United States with diabetes mellitus, one fourth will develop at least one DFU. DFUs are preceded by a compendium of risk factors, including the presence of neuropathy, external trauma, infection, effects of ischemia from concomitant peripheral arterial disease, malnutrition, and poor hygiene or self-care, among others. In 80% of patients, DFU is a precursor to some degree of lower extremity amputation. And, for these patients who have undergone amputation, their risk for further amputation becomes double that of a patient without diabetes. The mortality rate following a diagnosis of diabetic foot ulceration is 5% in the first year. The five-year mortality rate is 50% and rises to 70% after amputation. Once healed, 40% of DFUs will recur within 12 months, nearly 70% at three years, and nearly 75% at five years … read more

Wound Management Tech spins CellerateRX collagen asset into JV with Catalyst Group

Wound Management Technologies (OTC:WNDM), operating under WNDM Medical, said last week it inked a deal to spin out its CellerateRX activated collagen assets into a new joint venture with The Catalyst Group.

 

Fort Worth, Texas-based Wound Management Tech will maintain a 50% ownership interest in the new joint venture, with The Catalyst Group taking up the other half, according to an SEC filing.

 

The newly formed Cellerate JV will maintain an exclusive sublicense to distribute the CellerateRX activated collagen adjuvant into the wound care markets in the US, Canada and Mexico, according to an SEC filing.

 

As part of the agreement, Wound Management Tech issued a 30-month promissory note to The Catalyst Group’s newly formed CellerateRX subsidiary in the princpal amount of $1.5 million with a 5% interest rate, convertible into shares of WNDM Medical at a conversion price of 9¢ per share, according to an SEC filing … read more

Turning wound cells into skin cells may help doctors heal ulcers

Sept. 6 (UPI) — Scientists have developed a technique to convert cells in open wounds into skin cells as an alternative to plastic surgery for treatment of large cutaneous ulcers.

 

The method involves reprogramming the cells into a stem-cell-like state for healing skin damage, including severe burns, bedsores or chronic diseases such as diabetes. The researchers at the Salk Institute also see this process as a way to counter the effects of aging and better understanding skin cancer.

Their findings were published Wednesday in the journal Nature.

“This knowledge might not only be useful for enhancing skin repair but could also serve to guide in vivo regenerative strategies in other human pathological situations, as well as during aging, in which tissue repair is impaired,” senior author Dr. Juan Carlos Izpisua Belmonte, a professor at he Salk Institute, said in a press release … read more

Telehealth technology utilized at Signature HealthCARE

GLASGOW — Residents at Signature HealthCARE of Glasgow can avoid trips to a doctor’s office or to the hospital for treatment of some medical conditions thanks to telehealth technology through YourDoc2U.

 

With telehealth technology, health care providers can talk face-to-face with residents, as well as the staff at the nursing facility via computer screen that sits atop a cart enabling it to be moved from location to location as needed.

 

Psychiatric and wound care evaluations are the medical services available to the nursing facility residents through telehealth technology.

 

“If we identify a need with any of our elders, we call the primary physician and ask for a consult with telewound,” said Kim Poynter, director of nursing at Signature HealthCare of Glasgow. “It’s all online. They have nurse practitioners and physicians available. If it’s an emergency situation, like if we have an elder who is having a crisis and needs psych services, we either call in or get online and make an appointment. They are available 24/7.” read more

Wound Care Patient Outcomes: Establishing Trust to

     Improve Wound Healing Results

 

Last spring, I encountered that specific type of patient we sometimes meet, the one who has been through the chronic wound care revolving door so many times that he or she sets out on his or her own path and refuses any byways diverting from it.

 

Ms. A had stage 3 lymphedema after a left knee replacement opened the hidden trap door of undiagnosed lymphedema several years before her admission to our inpatient rehab facility. Her reason for admission was debility from urinary tract infection (UTI). Comorbidities of obesity, severe arthritis of the right knee, diabetes, and chronic lymphedema wounds on both legs were exacerbating factors making discharge home difficult from the acute hospital … read more

Intravenous Ketamine as an adjunct to procedural sedation

     during burn wound care and dressing changes

 

Little has been published regarding intravenous (IV) ketamine for burn wound care in adult patients. Ketamine may serve as a safe alternative to provide conscious sedation and limit opioid administration to patients. The purpose of this study was to characterize IV ketamine use during burn wound care and establish its potential role as a safe adjunct to opioid and benzodiazepine medications. This is a retrospective review of adult patients admitted to a regional burn center who received IV ketamine for burn wound care. Patient demographics, medications, and ketamine-related side effects including hypertension and dysphoric reactions were recorded. Cardiopulmonary complications were also tracked. Thirty-six patients met inclusion criteria; 50 total cases were performed. The median patient age was 37 [IQR 28 – 55] years with a median burn size of 9.5 [IQR 4.0 – 52] %TBSA. The median ketamine dose administered was 1.2 [IQR 0.8 – 2.1] mg/kg. IV midazolam was administered in almost all cases (98%) at a median dose of 3.0 [IQR 2.0 – 5.0] mg. Opioids were administered in 13 of 50 cases (26%) at a median morphine … read more

The Diabetic Foot in Remission: Strategies to Make Prevention Pay

Tuesday, September 25, 2018

 

Because neuroischemic complications are associated with a high rate of recurrence, this presentation proposes a slight shift in how health care providers counsel and communicate risk to their patients. If the epidemiology of this problem is comparable with that of cancer, and recurrences are common, then perhaps language commensurate with such risks should follow.

 

After initial healing of an index wound, patients are referred to not as being cured but rather as being “in remission.” This concept is easy for the patient and the rest of the team to understand, and it powerfully connotes the necessity for frequent follow-up and rapid intervention for inevitable minor and sometimes major complications.

 

This program will review tried-and-true as well as up-to-the-minute advances in biologics, consumer electronics, mechanics, medicine, and surgery that are “pushing the envelope” in extending ulcer-free, hospital-free, and activity-rich days in efforts to make prevention pay.

 

Dr. David G. Armstrong
DPM, MD, PhD
University of Southern California

Phase 2 Clinical Trial for Venous Leg Ulcers Nears Completion

BRISBANE, Australia, Sept. 05, 2018 (GLOBE NEWSWIRE) — Factor Therapeutics Limited (ASX: FTT, the “Company”), an Australian biomedical company developing therapeutics for advanced wound care, is pleased to announce that the Company’s Phase 2 clinical trial VF00102, for the treatment of venous leg ulcers (VLU), is approaching the end of its treatment phase.

 

“Since finalising recruitment in July, the study has progressed to schedule and there are now only eight patients left to complete treatment. We expect the last patient to have their final treatment visit in the first week of October, a key milestone for the study as it then triggers a final round of data cleaning and quality checks before top-line results can be analysed in November,” said Dr Ros Wilson, CEO of Factor Therapeutics … read more

Know-how: Canadian hospital first to сure patients with virtual reality

A Calgary hospital has become the first in Canada to treat patients with virtual reality technology. It has seen patients experience a 75-percent reduction in discomfort by escaping their surroundings during painful procedures.

Graydon Cuthbertson, a patient at Rockyview General Hospital, nearly lost his legs from compartment syndrome. Following multiple surgeries on his calf muscle, the 47-year old experienced pain ranging from discomfort to excruciating during wound-dressing changes.

 

Cuthbertson found that utilizing the VR technology helped him to escape his grim hospital surroundings and take in a calming virtual lakeside campground, a prehistoric landscape with dinosaurs, or a tranquil ocean to swim with dolphins.

 

It’s a godsend,” he said. “Even with painkillers, the first time I had wound care after my surgery, the pain was excruciating. But with virtual reality, I got through the next treatment with flying colors. I was focused on what I was seeing and hearing, and not thinking at all about how painful it might be. All of the sudden, one-and-a-half hours go by and it’s all over. It was awesome.” read more

When and When Not to Use An SGLT-2

After reviewing evidence, a tool to evaluate benefit and risk has been developed showing when and when not to use an SGLT-2 inhibitor.

 

The management of type 2 diabetes has significantly diversified over recent years, producing a data-rich environment. SGLT2 inhibitors are a more recent agent that work by reabsorbing glucose in the kidney and cause an increase in glucose excretion in the urine. There have been misconceptions concerning the efficacy, safety and appropriate use of SGLT2 inhibitors in diabetes management. In order to address these concerns, the UK created The Improving Diabetes Steering Committee, consisting of diabetes specialists.

 

The Improving Diabetes Steering Committee used multiple trials to developed a quick reference guide that aims to clarify common areas in type 2 diabetes management, with a focus on SGLT2 inhibitors … read more

Is it a Pressure Injury?

     Factors to Consider When Determining Wound Etiology

 

As specialists in wound, continence and ostomy care, we are forever in a role of wearing many hats. We are educators to patients, staff, and providers… we are patient advocates and supporters of our bedside nurses… we are liaisons in many aspects of care and help to coordinate care and services for our patient population. We are often referred to as the specialist and are called upon when there is a patient with a wound, skin, ostomy, or continence concern. Our peers trust us, and it is important that we possess the knowledge and skills to share with others when determining etiology and treatment of wounds and skin issues.

 

Determining Wound Etiology
An issue we are often faced with as skin specialists is determining the etiology of wounds and skin concerns. When determining the etiology of wounds, it is important to look at the entire picture…and, when doing so, understand that many variables can and do make wounds better or worse, but there is usually an isolated variable that caused the wound.

 

Medical Device-Related Pressure Injuries
Some things to keep in mind: Pressure injuries are usually round, can appear punched out, may be partial- or full-thickness, may have slough or necrotic tissue, and are usually over a bony prominence. In terms of shape, pressure injuries related to devices usually take the shape of that device (think of a linear, fluid-filled blister from Foley catheter tubing on the thigh… a stage 2 medical device-related pressure injury, or a purple or discolored, non-blanchable area on the lip from an endotracheal tube… a mucosal pressure injury). Other devices that may be responsible for pressure injuries are prosthetic devices … read more

Cold Atmospheric Plasmas Used In Wound Healing and Cancer Treatment

Cold atmospheric plasmas (CAPs) are investigated for several medical applications; major research effort is devoted to the promotion of wound healing in of chronic wounds. These wounds, typically associated with diabetes, are a major health concern due to their high occurrence in the population, long healing time, and associated high costs. Cell culture studies and clinical trials show promising results towards wound reduction or closure using relatively short plasma treatment times between 45 s and 2 min. Another growing application of CAPs is the inactivation of cancer cells. While short treatment times associated with wound healing seem to induce no permanent damage, cancer treatments are performed at significantly higher plasma exposure times.

 

Due to the complex nature of both wound healing and cancer, investigating the effect of plasma is challenging. One system that seems highly interesting in both wound healing and cancer is the epidermal growth factor receptor (EGFR) and one of its ligands, the epidermal growth factor (EGF). EGFR is known to be involved in several cancer types, because an overproduction or overstimulation of EGFR has a severe impact on the cell cycle by inducing proliferation … read more

The skill behind skilled

So many times, we get questions about how to “skill” a resident. Is she skilled if she’s getting IVs? Is he skilled because he’s getting wound care? What about the resident whose trach is capped? Is she skilled? When the rehab patient reaches the almighty “plateau”, and isn’t getting better, is he still skilled?

 

We need to remember what the S-word means (no, not that one.) “Skilled” in our arena is defined by the services that we are delivering to the client, not by what the client is or isn’t doing … read more

Higher proportion of limb salvage and lower amputation rates

     The impact of a wound centre on a vascular surgery practice

 

The opening of an outpatient wound centre has been associated with a significant increase in peripheral vascular practice and a significant decrease in amputation rate. Venita Chandra and colleagues Alyssa M Flores, Matthew W Mell and Ronald L Dalman (Stanford University, Stanford, USA) believe that such centres result in synergistic systems that promote more aggressive and effective limb salvage strategies. Chandra presented the findings of a recent study analysing the clinical impact of a wound care centre on a vascular surgery practice, at the Society for Vascular Surgery’s Vascular Annual Meeting (VAM; 20–23 June, Boston, USA).

 

According to Chandra, chronic wounds remain a growing problem, not only in the USA but worldwide—with many patients at risk of limb loss presenting as particularly challenging. This cohort requires complex and resource-intensive medical care, reported Chandra.

 

World experts and leaders in this specialty have developed and described programs to attempt to improve the care of these complex patients and decrease the risk of amputation … read more

Healogics® Announces New Program Aimed at Improving Continuity of Care

JACKSONVILLE, Fla.–(BUSINESS WIRE)–Aug 30, 2018–Healogics®, the wound healing experts, today announced the launch of their newest program: Healogics Specialty Physicians Care Continuum (HSP Care Continuum). The Program is designed to support the patient experience by improving continuity of care, cost-effectiveness, patient outcomes, value and satisfaction for people with chronic wounds who are transitioning from an inpatient to an outpatient setting.

 

 

Healogics Announces New Program Aimed at Improving Continuity of Care

 

The HSP Care Continuum Program provides skilled wound care physicians in the hospital inpatient setting who have specialized training in the management of complex wounds. These physicians will work collaboratively with Certified Wound and Ostomy Nurses and referring specialists needing a specialty consult. Also, Healogics clinical teams educate discharge planners on post-acute options so patients with wounds receive care for this critical co-morbid condition while they are also receiving post-acute care for their primary diagnosis. Healogics has a vast library of educational content that will be made available for patients who can care for their wounds between follow up post-acute visits.

 

“The average hospital stay is 2.4 days longer for patients living with a chronic wound. With better inpatient consults, we believe we can have an impact on care continuity and, in turn, reducing the overall cost of care. We are excited for the launch of this new program, and the positive implications it will have on the overall patient experience,” said David Bassin, Healogics Chief Executive Officer.

 

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20180830005777/en/

NeuroMetrix to Exhibit and Sponsor Symposium on the

Early Diagnosis of Diabetic Peripheral Neuropathy at the Annual Meeting of NEURODIAB

 

WALTHAM, Mass., Aug. 29, 2018 (GLOBE NEWSWIRE) — NeuroMetrix, Inc. (Nasdaq:NURO) today reported that it will be both exhibiting and sponsoring a diabetic neuropathy symposium at the 28th Annual Meeting of NEURODIAB held in Rome, Italy September 4-7.

 

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, affecting over half of people with diabetes. It causes significant morbidity including pain, increased risk of falling in the elderly, and is the primary trigger for diabetic foot ulcers which may require lower extremity amputations. Early detection of neuropathy allows for earlier clinical intervention to help mitigate the effects of neuropathy on both patient quality of life and cost of care.

 

NEURODIAB is the annual meeting of the Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (EASD) where thought leaders share ideas and scientific findings on diabetic neuropathy. NEURODIAB is considered the most important annual event in the field of diabetic neuropathy … read more

Caring for the diabetic foot

Patients with psoriasis have a higher risk of developing new onset diabetes mellitus. It’s a risk that’s been described as statistically significant. So, in this article, we examine dermatologic care for diabetic foot infections.

 

Patients with psoriasis have a higher risk of developing new onset diabetes mellitus. The increased incidence of psoriasis and diabetes mellitus was documented in a 2013 study by Usman Khalid, et al. published in Diabetes Care in which authors described the correlation as “statistically significant.” So, in this article, we examine dermatologic care for diabetic foot infections.

Dermatologists must be able to diagnose and manage mild-to-moderate infections in diabetic foot ulcers (DFUs), said Warren S. Joseph, D.P.M., FIDSA, in a presentation at DERMfoot 2018 in Baltimore … read more

True multidisciplinary approach essential for limb preservation

CHICAGO — To prevent amputation, physicians must assemble a comprehensive multidisciplinary team to care for patients at risk for losing their limbs, Ramon Varcoe, MD, MBBS, MS, FRACS, PhD, said at AMP: The Amputation Prevention Symposium.

 

A multidisciplinary approach to limb preservation begins with recognizing the major drivers of amputation. The global public health threat posed by the “tsunami of diabetes,” for instance, is a significant problem, he said.

 

If a patient develops diabetes, his or her risk for amputation is 15 times as high as someone who does not, according to Varcoe.

 

“The impact is more than amputation itself, though; it’s a reduction in life expectancy as well,” he said, noting that studies have linked amputation to an increased risk for death and 5-year rates of death exceeding that of some cancers … read more

New smart bandages could monitor and treat chronic wounds

Researchers in the United States present their findings on research into new smart bandages capable of real-time monitoring and treating chronic wounds.

Chronic wounds develop when a wound fails to heal within the expected time, which might be a couple of weeks or up to several months. They are often caused by diabetic wounds, pressure ulcers, leg ulcers, arterial ulcers, and malignant wounds. Chronic wounds may lead to severe pain, affecting an individual’s quality of life.

 

Chronic wounds affect millions
Currently, chronic wounds are a major health concern in the United States as they are affecting over 25 million people. This number will likely increase owing to the aging population and the continuous increase in the number of diabetes and obesity cases. According to the American Professional Wound Care Association, chronic wounds have caused the nation over 30 billion dollars each year … read more

Liraglutide May Lower Risk for Foot Amputation in Type 2 Diabetes

Patients with type 2 diabetes who took liraglutide were at a lower risk for foot amputation, according to a study recently published in Diabetes Care.

Researchers completed a post hoc analysis on data collected during the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial to determine the effect of liraglutide on rates of diabetes-related foot ulcers in patients who were also at high risk for cardiovascular events. Patients in the LEADER study were randomly assigned to either an intervention arm (n=4668), receiving 1.8 mg of liraglutide a day, or a control arm (n=4672), receiving a placebo. The study continued for 5 years with an average follow-up time of 3.8 years. A diabetes-related foot ulcer was … read more

Deferoxamine Can Prevent Pressure Ulcers and Accelerate Healing in Aged Mice

Chronic wounds are a significant medical and economic problem worldwide. Individuals over the age of 65 are particularly vulnerable to pressure ulcers and impaired wound healing. With this demographic growing rapidly there is a need for effective treatments. We have previously shown that defective hypoxia signaling through destabilization of the master hypoxia‐inducible factor 1α (HIF‐1α) underlies impairments in both aging and diabetic wound healing. To stabilize HIF‐1α, we developed a transdermal delivery system of the FDA‐approved small molecule deferoxamine (DFO) and found that transdermal DFO could both prevent and treat ulcers in diabetic mice. Here, we show that transdermal DFO can similarly prevent pressure ulcers and normalize aged wound healing. Enhanced wound healing by DFO is brought about by stabilization of HIF‐1α and improvements in neovascularization. Transdermal DFO can be rapidly translated into the clinic and may represent a new approach to prevent and treat pressure ulcers in aged patients … read more

Liraglutide May Lower Risk for Foot Amputation in Type 2 Diabetes

Patients with type 2 diabetes who took liraglutide were at a lower risk for foot amputation, according to a study recently published in Diabetes Care.

 

Researchers completed a post hoc analysis on data collected during the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial to determine the effect of liraglutide on rates of diabetes-related foot ulcers in patients who were also at high risk for cardiovascular events. Patients in the LEADER study were randomly assigned to either an intervention arm (n=4668), receiving 1.8 mg of liraglutide a day, or a control arm (n=4672), receiving a placebo. The study continued for 5 years with an average follow-up time of 3.8 years. A diabetes-related foot ulcer was specified as a medical event of special interest, and all complications related to the ulcer were documented.

read more

Texas A&M partnership developing biomedical ‘bandage’ for wounds

University research focusing on building stimuli-responsive material that could release, absorb antibiotics

 

Researchers at Texas A&M University and the Stevens Institute of Technology are working on the next generation of biomedical materials used to treat chronic wounds, including ulcers and wounds caused by diabetes.

 

Svetlana Sukhishvili, A&M professor and director of the soft matter facility, and her research partner at Stevens, Hongjun Wang, have conducted experiments alongside their respective teams and combined them to form one study.

 

“If you have diabetes, for example, your ability to heal wounds may be compromised, and ulcers may occur. What we’re trying to do is give you this bandage-like material that will be able to transform into skin that will help your body overcome the wound and to heal,” said Victoria Albright, a fourth-year doctoral student and lead researcher in the A&M Department of Materials Science and Engineering … read more

Man Bitten By Shark Develops Flesh-Eating Bacteria

A man bitten on the leg by a 7-foot shark quickly gets treatment for his wounds. A week later, he suffers from excruciating pain brought about by flesh-eating bacteria.

 

In early August, Blaine Shelton from Texas was swimming at Crystal Beach in Houston when he spotted a fin, which he immediately knew was not from a friendly porpoise. He was reportedly about 200 yards from the shore, so he began swimming to get away from the shark. It was then that he was bitten on the thigh, just above his knee. Shelton was able to swim ashore after the bite and was immediately taken to the hospital to be treated for his wounds. He later learns that the shark attack was likely from a 7-foot bull shark … read more

MiMedx Announces Statistically Significant Results

     In New Multicenter Clinical Study Of Healing Of Diabetic Foot Ulcers Using EpiFix®

 

MARIETTA, Ga., Aug. 24, 2018 /PRNewswire/ — MiMedx Group, Inc. (NASDAQ : MDXG ), a leading developer and marketer of regenerative and therapeutic biologics, today announced that a new study regarding the use of EpiFix® in the treatment of diabetic foot ulcers (DFUs) has been published in the peer-reviewed journal, International Wound Journal.

 

The paper is entitled “A Confirmatory Study on the Efficacy of Dehydrated Human Amnion/Chorion Membrane dHACM Allograft in the Management of Diabetic Foot Ulcers: A Prospective, Multicenter, Randomized, Controlled Study of 110 Patients from 14 Wound Clinics.” The paper was authored by: William Tettelbach, MD; Shawn Cazzell, DPM; Alexander M. Reyzelman, DPM; Felix Sigal, DPM; Joseph M Caporusso, DPM; and Patrick S. Agnew, DPM. The electronic publication of the article in International Wound Journal can be found at https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.12976.

 

This multi-center randomized and controlled trial was led by William Tettelbach, MD, principal investigator and former Executive System Medical Director of Wound Care and Hyperbaric Medicine Services for InterMountain Healthcare. Dr. Tettelbach is now Associate Chief Medical Officer for MiMedx, a position that postdated the completion of the study.

 

Clinical Study Design and Results

The objective of the study was to determine the safety and effectiveness of EpiFix as compared to standard of care (SOC) therapy for the treatment of non-healing DFUs. The primary efficacy endpoint was the incidence of complete wound closure over a 12-week period. Data from 110 patients meeting study inclusion and exclusion criteria were analyzed in the Intent-to-Treat (ITT) cohort. A total of 98 patients completed the study Per Protocol (Per-Protocol cohort).

 

ITT analysis requires patients to be included even if they did not fully adhere to the protocol. In comparison, in a Per-Protocol analysis, only patients who completed the entire clinical trial according to the protocol are counted towards the final results.

 

In the current study on an ITT basis, 70% of patients who received weekly EpiFix had complete healing by 12 weeks versus 50% of patients only receiving weekly SOC (EpiFix 70% vs. SOC 50%, p=0.0338) … read more

Epidermolysis bullosa: a case report

Epidermolysis bullosa (EB), often referred to as the butterfly disease, is a group of rare genetic conditions characterized by skin that is delicate and fragile as butterfly wings. The skin blisters in response to friction, minor injury, or trauma. In certain types of EB, other organs, such as the esophagus, can also be affected, and secondary complications may require multiple interventions. While there has been significant progress in classifying the disease – identifying genes and proteins involved – there have been few advances in the treatment of the disease. The care of the EB patient focuses on management of symptoms, protecting the skin, and preventing complications. In this case report, the use of a multivalent wound-healing ointment (Terrasil®) was evaluated in a 60-year-old patient with a history of junctional EB. A polymerase chain reaction-based culturing was utilized to quantitatively test for bacteria and fungi at baseline and follow-up visits. Pain assessment and wound area were also documented at each visit. Following the application of the wound care ointment, there was a reduction in wound surface area on central (96%) and distal mid-back (92%) by treatment visit three, and there was a 96% reduction on the left shoulder blade ulcer by treatment visit four. Moreover, there was a noticeable drop in the percentage of bacteria detected by polymerase chain reaction. The wound care ointment was also effective in eliminating the fungal species and reducing pain, itching, blistering, and cracking around the wound … read more

The industry’s BEST TCC Kit is Now Available on Amazon. M-Med provides the most versatile total contact cast on the market with the TCC-Mobility Series. 60% more padding for patient comfort and safety. Click here for more information on TCC-Mobility Series.

 

You can order as many or as few kits based on your need- there’s no minimum order quantity. And, we have the Best Price in the marketplace allowing your practice to maximize value per procedure. M-Med’s TCC kits are fully customizable.

 

Sample Request Form


Dr. Michael Miller

As an advanced wound care specialist for almost 20 years full time, I am a relentless devotee of best practices and the wound care literature. While there are many wound care practices that allow some personal latitude, there are one or two “definites”. The literature has recently become very vociferous in the use of Total Contact Casting as the “Gold Standard” for offloading plantar based Diabetic Neuropathic Foot ulcers. As a non-hospital affiliated wound care specialist, I have no deep pocket entity to support me as I trial device after device searching for ease of use, facilitated patient compliance, and more, best pricing.

 

I found your devices in a search for an equally efficacious TCC that had better pricing than the many on the market. Since no two patients are alike, the many components in your kit allowed me to configure the final product, controlling the height, thickness, weight and even the configuration/position of the walking gasket. More, the pricing for needed large orders made this a less painful expenditure for me. Of course, the rapid shipping came in handy when my staff opened a closet door to discover two casts and four patients on the schedule in 48 hours.

 

I wanted to take the time to let you know how much I appreciate the products you have available for those of us who strive to provide best care using the best products, at what I have found to be best service and pricing.

 

Respectfully yours

 

Michael S. Miller DO, FACOS, WCC
CEO and Medical Director – The Miller Care Group
Indianapolis, IN

Clay fights MRSA, other ‘superbugs’ in wounds

The use of mud or wet clay as a topical skin treatment, or poultice, is a common practice in many cultures. In fact, the concept of using mud as medicine goes back to the earliest times.

 

Now, Arizona State University (ASU) and Mayo Clinic researchers have found that one type of clay, Oregon blue clay, may help fight disease-causing bacteria in wounds, including treatment-resistant bacteria. Their findings appear in the International Journal of Antimicrobial Agents.

 

“The study is an important advance in understanding how clays, specifically blue clay from Oregon, have shown medicinal properties by attaching to pathogenic bacteria,” says Enriqueta Barrera, a program director in the National Science Foundation’s (NSF) Division of Earth Sciences, which funded the research.

 

The scientists identified certain clays that kill bacteria, including many drug-resistant pathogens.

 

“Working with Mayo Clinic, we showed that these clays also diminish populations of bacterial biofilms, as well as bacteria common in wounds that are more resistant to drugs,” says biogeochemist Lynda Williams of ASU, a co-author of the study. “The results support our efforts to design new antibacterial drugs using natural clays.” … read more

Innovation in Wound Care

An interview with Prof. Harding, CBE, and Dr Dixon, PhD, conducted by Alina Shrourou, BSC

 

What is a hard-to-heal wound?

There are many definitions of hard-to-heal. More conventionally, it’s based on underlying etiology of the wound, but in practice it’s any wound that has not healed within a timely fashion. This is often due to a lack of coordinated care. Many of those patients receive multiple courses of antibiotics and antimicrobial therapy, because clinicians aren’t sure what they’re looking at.

 

Not all wounds are necessarily hard-to-heal from the beginning, but because of the need for improvements and coordination of care, many of those patients that are seen in clinical practice become hard-to-heal … read more

MiMedx Announces Statistically Significant Results In New

     Multicenter Clinical Study Of Healing Of Diabetic Foot Ulcers Using EpiFix®

 

– Study Published in International Wound Journal Reported Statistically Significant Evidence of Healing Compared to Control Group

– Intent-To-Treat EpiFix Treated Patients = 70% vs Control 50%, p=0.0338
– Per-Protocol EpiFix Treated Patients = 81% vs Control 55%, p=0.0093

MARIETTA, Ga., Aug. 24, 2018 /PRNewswire/ — MiMedx Group, Inc. (NASDAQ: MDXG), a leading developer and marketer of regenerative and therapeutic biologics, today announced that a new study regarding the use of EpiFix® in the treatment of diabetic foot ulcers (DFUs) has been published in the peer-reviewed journal, International Wound Journal.

 

The paper is entitled “A Confirmatory Study on the Efficacy of Dehydrated Human Amnion/Chorion Membrane dHACM Allograft in the Management of Diabetic Foot Ulcers: A Prospective, Multicenter, Randomized, Controlled Study of 110 Patients from 14 Wound Clinics.” The paper was authored by: William Tettelbach, MD; Shawn Cazzell, DPM; Alexander M. Reyzelman, DPM; Felix Sigal, DPM; Joseph M Caporusso, DPM; and Patrick S. Agnew, DPM. The electronic publication of the article in International Wound Journal can be found at https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.12976.

 

This multi-center randomized and controlled trial was led by William Tettelbach, MD, principal investigator and former Executive System Medical Director of Wound Care and Hyperbaric Medicine Services for InterMountain Healthcare. Dr. Tettelbach is now Associate Chief Medical Officer for MiMedx, a position that postdated the completion of the study.

read more

Type 2 diabetes: Poor sleep slows wound healing

Researchers uncovered a connection between poor sleep and wound healing in type 2 diabetes that could pave the way for new treatments.

 

Diabetes is one of the leading causes of death in the United States.

 

Type 2 diabetes is the most common form of diabetes, and it impacts the ability of the body to produce insulin, the hormone that regulates blood sugar levels.

 

One serious complication of diabetes are ulcers that can form from wounds. Feet are one of the most common places of injury. Small wounds that develop on feet can eventually become ulcers … read more

SGLT2 inhibitor therapies may raise risk for amputation

     diabetic ketoacidosis in diabetes with CVD

 

Adults with type 2 diabetes and established CVD prescribed SGLT2 inhibitor therapy have a twofold increased risk for lower-limb amputation and diabetic ketoacidosis compared with patients prescribed a GLP-1 receptor agonist, according to study findings presented at the European Society of Cardiology Congress.

 

“Sodium glucose cotransporter 2 inhibitors are playing an increasingly prominent role in the treatment of diabetes, following the reduced risk of major adverse cardiovascular events and heart failure outcomes seen in the EMPA-REG Outcome trial with empagliflozin [Jardiance, Boehringer Ingelheim] and in the CANVAS study with canagliflozin [Invokana, Janssen],” Peter Ueda, MD, PhD, from the department of medicine at the Karolinska Institute in Solna, Sweden, said during a presentation here. “Concerns exist regarding the safety of the drugs, with signals of serious adverse events emerging from clinical trials, case reports and observational studies.” … read more

Wound healing work presented at the RCP Innovation in

     Medicine Conference 2018 by Neem Biotech

 

Neem Biotech, a South Wales based R&D pharmaceutical biotech working in the field of novel antimicrobial drug development, and the Welsh Wound Innovation Centre recently attended the Royal College of Physicians’ Innovation in Medicine Conference 2018 where Neem presented their data around wound-relevant biofilms.

 

The promising laboratory data presented reinforces the role of quorum sensing inhibition in virulence factor regulation and biofilm disruption, with implications for management of antimicrobial resistance.

 

Dr Graham Dixon, Neem’s CEO and Prof Keith Harding … read more

Jipmer to treat wounds with marine resource

Doctors at JIPMER have begun using a marine resource sourced from shrimps for wound management. Marine resources are used to help patients with chronic wounds such as burns, diabetic foot ulcers, bed sores, infections, trauma and even surgery-related injury.

 

Jipmer Director, Dr. S Vivekanandam, said the protocol was initiated by the Department of Plastic Surgery. As a forerunner, a Continuing Medical Education (CME) was recently organised on ‘Wound Update-2018’ by the Department of Plastic Surgery to sensitise and to make aware of this technology in wound management.

 

According to the Director … read more

Wound Management Technologies, Inc. (WNDM) Reports

Publication of Clinical Trial Data from CellerateRX(R) Surgical Activated Collagen(R) Peptides

 

WNDM Medical Inc. (: WNDM) today announced the publication of a journal article in Orthopedics: ”The Effects of Platelet-Rich Plasma and Activated Collagen on Wound Healing in Primary Total Joint Arthroplasty” by David Evans, BA and Bruce Evans, MD. This study examined whether two wound additives, platelet-rich plasma (PRP) and activated collagen (CellerateRX Surgical), would improve postoperative wound healing and reduce complications after total knee or hip replacement surgery.

 

Based in Fort Worth, Texas, WNDM Medical Inc. (WNDM) has a management team in place with significant healthcare industry experience that is committed to sales growth by providing efficacious products to improve patient outcomes.

 

Key Points from the Publication

 

• This was an unsponsored, institutional review board (IRB)-approved, prospective, randomized, single-blinded, controlled study with three cohorts of 30 patients each … read more

Bedside Advanced Wound Care in Nursing Homes

As it stands now, we have 1.6 million nursing home residents in the United States; that number is expected to double by the year 2030. Bringing advanced wound care to the long-term care arena is becoming more common throughout the country. Physician-based wound groups can bring their expertise to the patient’s bedside, thereby saving the patient pain during transport to the wound center and lowering costs. However, certain procedures—such as total contact casting and bioengineered skin substitutes—cannot be performed at the bedside because of billing and reimbursement guidelines.

 

Physician-Based Wound Care Groups: Rationale and Challenges in the Long-Term Care Setting

Utilizing a wound care physician-based group has many advantages in long-term care. Residents build a trusting relationship with their providers who come weekly to assess and treat their wounds. Wound rounds are also the perfect opportunity for the physician and nurse to collaborate. However, providers tend to have somewhat of a learning curve, as well as culture shock stepping into the long-term care arena for the first time. Being competent in wound care is not sufficient to work as a provider in this setting. The long-term care arena is surprisingly different from the hospital. The best way to describe it is, you are on their turf. Nursing homes are under a microscope, and federal regulations must be followed accordingly or facilities are at risk for fines and penalties. Providers must be compliant with the state survey process and associated wound care federal tags … read more

Medicare update: new electronic clinical quality measure

The Centers for Medicare and Medicaid Services (CMS) recently released an announcement seeking input from stakeholders on a new electronic clinical quality measure under development titled, “Hospital Harm – Hospital-Acquired Pressure Injury.”

 

This measure assesses the proportion of hospitalized patients 18 years and older who develop a new stage 2-4 pressure ulcer, deep tissue injury, unstageable pressure ulcer, or experience worsening of any of the above during their hospitalization.

 

We read the full description of the measure and provided the following feedback on behalf of APWCA membership … read more

Skin Conditions Frequently Found in Obese Patient Populations

The Centers for Disease Control and Prevention state that in the United States, “…thirty eight percent of adults, and that seventeen percent of children and teens are obese.” It is imperative that the term obesity be differentiated from overweight. Obesity refers to higher than normal body fat, whereas overweight is in reference to an individual weighing more than the standard for height and weight. Although both terms mean that a person’s weight is greater than what is considered healthy for his or her height, obesity has higher negative health-related consequences.

 

Health care professionals are challenged to manage increasingly complex health issues related to obesity, including complex skin conditions. The increase in stored fat associated with obesity can contribute to a variety of changes in skin physiology and is implicated in a range of dermatologic conditions.2 The skin’s ability to manage transepidermal water loss is altered in the obese population. With increased fat stores the transepidermal water loss is increased, resulting in dryness and delayed skin repair. Additionally, sebaceous channels are blocked, leading to an increase in oils and resulting in acne.2 The thick layers of subcutaneous fat in obese individuals may contribute to profuse sweating (hyperhidrosis) when overheated or with activities. Hyperhidrosis can set the stage for profuse skin damage. Moisture trapped in skin folds coupled with friction as body folds rub together … read more

Predictors of lower extremity amputation among

     patients with diabetic foot ulcer in a tertiary health facility in north central Nigeria

 

INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers.

METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined.

RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation.

CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.

… read more

Application of Viable Cryopreserved Human Placental Membrane

Grafts in the Treatment of Wounds of Diverse Etiologies

There is evidence in the literature that viable cryopreserved human placental membrane (vCHPM) grafts are effective in treating diabetic foot ulcers and venous leg ulcers.

 

Objective. This case series presents 3 cases of chronic ulcerations — 1 arterial ulcer (AU), 1 pressure ulcer (PU), and 1 recurrence of a pyoderma gangrenosum ulcer (PGU) — that had failed previous courses of standard wound care and were subsequently treated with vCHPM to determine if the treatment is an effective modality for treating wounds of these etiologies.

 

Materials and Methods. This retrospective review describes 3 cases in which patients with chronic wounds that had failed standard of care treatments for more than 4 weeks were subsequently treated with weekly applications of vCHPM. Each wound area was recorded and photographed on a weekly basis and wound area reduction also was charted weekly.

 

Results. The PU and AU both reached full closure in 4 and 5 weeks, respectively, without complication. The patient with the PGU achieved 64% closure after 9 applications of vCHPM … read more

Inlow’s 60-Second Diabetic Foot Screen Gets a New Look!

Dr. Shane Inlow wrote a two-page article, published in 2004, to help guide clinicians in assessing and planning care for patients with or at risk for diabetic foot ulcers.1 A few years later, clinicians in Northern Canada indicated that one of their problems was communicating effectively with experts in larger centres about their patients’ foot problems. The article by Dr. Inlow came to mind, and Inlow’s 60-Second Diabetic Foot Screen was created to give clinicians a common language and process to perform such an assessment.2 This tool then underwent a validation study that included interrater and intrarater reliability and predictive validity to determine consistency of risk recognition for development of ulceration independent of specific assessor and practice setting.1,3 Four years later, a growing body of work by the International Working Group on the Diabetic Foot (IWGDF) resulted in a risk-classification tool … read more

Ants care for wounded comrades by licking their wounds clean

A species of ant has become the first known non-human animal to tend the wounds of its fellows. “Nurse” ants lick the wounds of fallen comrades, and this helps them survive.

 

Matabele ants (Megaponera analis) live dangerous lives. Several times a day, parties of 200-600 soldier ants set out to hunt termites, dragging them from their nests and carrying them home. The termites fight back, and their powerful jaws can administer lethal bites, so Matabele ants frequently lose one or more limbs.

 

In 2017, Erik Frank, then at the University of Würzburg, Germany reported that Matabele ants routinely carry their wounded back to the nest. This is odd, as social insects usually treat each other as expendable … read more

Novel tissue engineering scaffolds fabricated via controlled

     ice crystallization

 

A large number of people around the world suffer from chronic skin wounds each year. Often, chronic wounds such as skin ulcers are seen in older people suffering from circulation disorders and diabetic patients whose skin tissue has a poor capacity of regeneration. Currently, many treatment approaches focus primarily on managing the wounds.

 

Researchers have now taken a nanotechnology-based tissue engineering approach to accelerate the regeneration and repair of damaged tissues at the wound site by directing cells and tissues to grow towards the target site. Their hope is that this leads to the development of affordable and functional biodegradable wound dressings for accelerated healing of chronic skin wounds by promoting regeneration of local tissues.

 

“We show that 3D scaffolds with both aligned nanofibers and aligned interconnected macrochannels can be created with various biomacromolecules, including silk fibroin, using a facile guided ice-crystal growth and nanofiber assembly strategy,” Dr. Linpeng Fan, first author of a paper on this work (ACS Nano, “Creating Biomimetic Anisotropic Architectures with Co-Aligned Nanofibers and Macrochannels by Manipulating Ice Crystallization”), tells Nanowerk … read more

Role of oxygen in wound healing Webcast

13 Sep 2018

 

This Wounds International webcast focuses on the role of oxygen in wound healing and how topical oxygen therapy can improve oxygenation and, therefore, healing.

 

In the first presentation, Breda Cullen, Research and Development Director, UK, outlines the vital role that oxygen plays throughout the healing process and the impact that lack of oxygen (hypoxia) can have on the wound. Breda explores the factors that can cause compromised healing and how these can be addressed.
In the next presentation, Hanna Kaufman, Orthopaedic Surgeon, Israel, looks in depth at the clinical evidence and how this can be applied to practice. Hanna identifies the wounds that are suitable for topical oxygen therapy and shares tips for use in practice, drawing on clinical evidence and experience … read more

‘Really Good’ New Guidelines for T2 Diabetes

The diabetes guidelines discussed below are a draft version of a consensus statement to be issued in October at the annual meeting of the European Association for the Study of Diabetes in Berlin, Germany.

 

Hi. I am Dr Anne Peters, and today I’m going to talk about the new ADA/EASD treatment guidelines for managing patients with type 2 diabetes. First off, my “headline” is that I think these are really good guidelines. Although guiding people is difficult, these guidelines actually begin to guide us in the treatment of our patients with type 2 diabetes …. read more

Agony of Britons hit by chronic wounds lasting more than three months

The devastating impact of chronic wounds has been laid bare as research reveals that hundreds of thousands of patients suffer with pain and immobility for more than a year.

 

One in ten sufferers is even taking antidepressants to cope, with many more unable to work or leave the house.

 

About a million patients are undergoing five dressing changes a week, with 90 per cent of those claiming their quality of life is severely affected.

 

More than 2.8 million Britons are living with a chronic wound, defined as one that does not heal within three months.

But the ‘new normal’ is that patients are affected for eight months … read more

Wounds Australia’s Five Point Plan to Reduce the Burden of Chronic Wounds

The burden of chronic wounds for the individual, the health system and the whole community is familiar to the readers of this journal. Improving lives and saving money through better wound care is a common theme across this issue, and in the broader wound care activities.

 

Wounds Australia recognises that to achieve our vision of Quality wound care and prevention for all requires us to inform and engage with a broad audience. During Wound Awareness Week from 15 to 21 July 2018 Wounds Australia will launch our Five Point Plan to Reduce the Burden of Chronic Wounds. Our plan outlines 5 key initiatives to drive the change for best practice wound care for all Australians and reduce the suffering as a result of chronic wounds.

 

1. Medicare funding for treatment of chronic wounds in primary health care. A dedicated MBS item for treatment of chronic wounds to enable GPs, nurses and allied health professionals to deliver the best practice.

2. Subsidised wound products (dressings and related products) for people experiencing long term wound care. Advanced Wound management products often attract a premium cost. Selecting low cost, modest outcome products is a false economy. Research has shown that the use of less expensive dressings actually increases costs of treating a wound … read more

The accuracy of venous leg ulcer prognostic models in a wound care system

Venous leg ulcers are among the most common chronic wounds. Treatment is commonly with a limb compression bandage. Previous small, often single‐center, studies have shown that it is possible to predict which wounds are likely to respond to compression therapy. We designed this cohort study using a dataset of over 20,000 individuals with a venous leg ulcer to investigate the accuracy of several prognostic models. Creating complex models using logistic regression, as well as simply counting prognostic factors, we show that initial measures of wound size and duration accurately predict, as measured by area under the receiver operator curve and Brier score, who will heal by the 24th week of care. For example, a wound that is less than 10 cm2 and less than 12 months old at the first visit has a 29 percent chance of not healing by the 24th week of care, while a wound greater than 10 cm2 …. read more

Oxidized Regenerated Cellulose/Collagen Dressings

     Review of Evidence and Recommendations

 

Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds.

 

Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Chronic wounds affect more than 6.5 million people in the United States. This trend has also been observed in other developed countries, such as Denmark (affecting an estimated 1% of the population), Sweden (prevalence: 2.4 per 1000 people), and the United Kingdom (prevalence: 3.55–3.7 per 1000 people). As populations increase and age, the incidence of chronic wounds is also forecasted to increase, further stressing healthcare systems and providers.

 

Wound healing and tissue regeneration are a complicated series of biochemical processes that create an orderly healing cascade with 4 key phases: hemostasis, inflammation, proliferation, and remodeling. If this process becomes unbalanced, healing stalls and results in chronic, nonhealing wounds. Acute wounds progress through healing in a predictable time frame, culminating in an epithelialized wound. Chronic wounds start out as acute wounds and, unless their chronic causes are removed, either fail to progress through the wound healing process and (most often) stall in the inflammatory phase, or proceed through the repair process without establishing a sustained anatomic and functional result … read more

Molecular study of wound healing after using biosynthesized

     BNC/Fe3O4 nanocomposites assisted with a bioinformatics approach

 

Department of Bioprocess Technology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Young Researcher and Elite Club, Sabzevar Branch, Islamic Azad University, Sabzevar, Iran; Department of Cell and Molecular Biology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Department of Microbiology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Institute of Tropical Forestry and Forest Products, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 6Young Research and Elite Club, Parand Branch, Islamic Azad University, Parand, Iran; Department of Medical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran; Muthayammal Centre for Advanced Research, Muthayammal College of Arts and Science, Rasipuram, Tamilnadu, India … read more

New Products & Practices for Wound Care

Apps, HydroClean and Honey?

According to PR Newswire, the wound care biologics market is expected to earn 1.42 billion US dollars in 2018. That number is expected to skyrocket by the year 2023, when the market is expected to increase to 2.26 billion US dollars.

 

That is a jaw-dropping amount of money that we’re spending on wound care. What’s going on?

 

There are several factors that are driving up the those wound care dollars – primarily diabetic foot ulcers, the aging geriatric population, and a general increase in burn injuries globally.

 

With the ever-increasing number of wounds requiring advanced wound care, there is new products and practices. Here’s a quick update … read more

Elevated obstructive sleep apnoea risk score is associated

     with poor healing of diabetic foot ulcers: A prospective cohort study

 

We studied 94 consecutive people (69% men) with diabetic foot ulcers (Type 2 diabetes,n=66, Type 1 diabetes, n=28) attending a university hospital foot unit. All participants were screened for obstructive sleep apnoea using the STOP‐BANG questionnaire, with a score ≥4 identifying high risk of obstructive sleep apnoea. The primary outcome was poor diabetic foot ulcer healing, defined as diabetic foot ulcer recurrence (diabetic foot ulcers which healed and re‐ulcerated in same anatomical position) and diabetic foot ulcer persistence (no evidence of healing on clinical examination). All participants were evaluated at 12 months … read more

Evaluation of skin perfusion pressure to assess refractory foot ulcers

The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection … read more

Mobile diet and exercise apps for adolescent weight loss

Innovative approaches can encourage healthy eating and activity in adolescents.

 

Takeaways:

  • Nurses can help their adolescent patients with obesity by encouraging a healthy diet and greater activity
  • Smartphone apps for diet and exercise tracking may be an effective tool to help adolescents with obesity lose weight.
  • Recommend apps that are inexpensive and have high user ratings for ease of use and dependability.

By Julie Ludwig, MSN, RN, NP-C, and Christine Galluzzi, MSN, RN, APC-BC

 

Many teens with obesity go on to have obesity as adults. The ramifications of obesity are both physical and psychological, including metabolic conditions, sleep disorders, bullying, anxiety, depression, and low self-esteem. In addition, adolescents with obesity may experience increased school absenteeism and decreased scholastic performance. The result can be lower quality of life and limited life expectancy.

 

You can help your adolescent patients with obesity by encouraging a healthy diet and greater activity. (See Help young patients lose weight.) Engaging your patients in this effort may require some innovative interventions, including the use of technology … read more

What Are Biofilms?

Identifying and managing biofilms have become two of the most important aspects of wound care. Biofilms can have a significant impact on wound healing, by contributing to bacterial infection, inflammation, and delayed wound healing. These issues make reducing biofilm presence a critical component of effective wound care. Although over 60% of chronic wounds contain a biofilm, many health care professionals are not able to identify biofilm formation in their patients. To manage this challenge effectively, health care professionals must understand what biofilms are, how to identify them, and how to take steps to reduce their impact on wound healing … read more

This ‘skin printer’ is like a magic wand for healing wounds

Imagine a version of the kind of duct tape dispenser you can buy from your local home Home Depot or white-out tape used for correcting a writing error — only instead of rolling out pieces of tape or white-out material it can produce a sheet of skin tissue to cover a wound. That may sound a couple of phasers away from being a Star Trek gadget, but it’s a very real piece of research coming out of the University of Toronto. Engineers there have developed a 3D skin printer that can apparently, “[form] tissue in situ, depositing and setting in place, within two minutes or less.”

 

According to its creators, the device could serve as a future alternative to regular skin grafts. However, instead of first requiring that a patient has healthy skin removed to be grafted elsewhere, this device can roll out a new layer of “bio ink”-based, 3D-printed skin tissue onto the areas that are required … read more

Breakthrough Evidence on Vomaris Bioelectric Technology’s

     Impact on Wound Biofilm Infection

 

TEMPE, Ariz.Dec. 5, 2017 /PRNewswire/ — Vomaris Innovations, Inc. announced today breakthrough results of the first controlled, preclinical in vivo evidence on the anti-biofilm impact of the Company’s bioelectric antimicrobial technology. The study found that the technology can prevent and disrupt biofilm infection and restore functional wound healing. The manuscript, “Electric Field Based Dressing Disrupts Mixed-Species Bacterial Biofilm Infection and Restores Functional Wound Healing,” was published online in the Annals of Surgery. The research was led by Chandan Sen, Ph.D., Professor of Surgery and Director of the Comprehensive Wound Center at The Ohio State University’s Wexner Medical Center.

 

Bacteria use electrical interactions to communicate with each other in a process called quorum sensing (QS), signaling them to adhere to a wound, multiply, and encase themselves within a protective structural substance known as a biofilm. This protective biofilm barrier impedes the body’s immune defense system and renders the bacteria highly resistant to antibiotics, making biofilm infections extremely difficult to treat.

 

Approximately 80% of infections in chronic and surgical wounds are thought to be caused by bacteria within biofilm.1,2Chronic wounds affect an estimated 6.5 million patients a year and over $25 billion is estimated to be spent annually on their treatment.3 Surgical site infections (SSIs) occur in 2% to 5% of all patients undergoing inpatient surgery and affect up to 300,000 patients a year in the U.S. alone. Annual costs of managing SSIs range from $3.5 billion to $10 billion … full press release

Vomaris Innovations, Inc. website

Wearable Devices For Diabetics At Risk Of Diabetic Foot Ulcers

A US-Qatar joint research project, involving different studies carried out by the Hamad Medical Corporation (HMC), the Qatar Foundation, and several institutions and companies across the US, developed innovative and useful wearable devices for diabetics, which can help the patients either prevent and manage or even treat diabetic foot ulcers.

 

By gathering the data from all the studies, the research project earned the Best Research Project Award at Qatar Foundation’s Annual Research Conference, held earlier in 2018.

 

Research of significant importance for the world
The project, of a considerable importance for Qatar, as the International Diabetes Federations assessed that about 23% of the country’s population has diabetes, while the diabetic foot ulcers are the primary reason for hospitalization, is also massively important for the world, as the nowadays unhealthy dietary habits increase the risks of diabetes development, worldwide … read more

New treatment may dispense old ideas about wound care

Imagine rolling a tape dispenser over a wound, leaving behind a strip of cells that will generate new skin.

 

Researchers at the University of Toronto and Sunnybrook Hospital are getting close. They have designed a handheld machine that can create tissue and deposit in about two minutes, with material similar to human skin … read more

Researchers develop wearable technology for diabetics

A collaborative research project bringing together four separate studies by researchers at Hamad Medical Corporation (HMC), in partnership with Qatar Foundation and several institutions in the US, has led to the development of innovative, wearable devices that could enhance the prevention, management and treatment of diabetic foot ulcers.
The studies, completed over a 10-year period, won the Best Research Project Award at Qatar Foundation’s Annual Research Conference earlier this year, HMC said in a statement yesterday.

HMC’s podiatry clinics treat thousands of patients with diabetes each year, with nearly 15,000 diabetes-related appointments in 2017 alone. The International Diabetes Federation estimates that around 23% of Qatar’s population has diabetes, with diabetic foot ulcers being the main reason for hospitalisation for people with diabetes.
“Between 10% and 20% of people with diabetes will develop a foot ulcer at some point in their life,” explained Dr Talal Khader Talal, head of Podiatric Services at HMC and a lead author of the studies … read more

A super-elastic surgical glue that sticks and seals in vivo

     even when tissues are moving

 

To repair ruptured or pierced organs and tissues, surgeons commonly use staples, sutures and wires to bring and hold the wound edges together so that they can heal. However, these procedures can be difficult to perform in hard-to-reach areas of the body and wounds are often not completely sealed immediately. They also come with the risk that tissues are further damaged and infected. A particular challenge is posed by wounds in fragile or elastic tissues that continuously expand or contract and relax, like the breathing lung, the beating heart and pulsing arteries.

 

To remedy some of these problems, biomedical engineers have developed a range of surgical sealants that can bond tissues to stop leakages. Yet, “currently available sealants are not suitable for most surgical applications and they do not work alone without the need for suturing or stapling because they lack an optimal combination of elasticity, tissue adhesion and strength. Using our expertise in creating materials for regenerative medicine, we aimed to create an actual fix for this problem in a multi-disciplinary effort with clinicians and bioengineers,”

full article

The TIME Model of Wound Bed Preparation: Frequently Asked Questions

On July 24, 2018, I presented a webinar on the topic of the TIME (tissue management, infection or inflammation, moisture balance, and edge of wound) model of wound bed preparation as part of WoundSource’s Practice Accelerator series on wound bed preparation. Preparing a wound for healing is key to ensure that chronic wounds convert to healing wounds. The TIME mnemonic for wound bed preparation assists clinicians and bedside nurses to think critically when making decisions on treatment options. During the image-driven presentation, I discussed such topics as:

  • Use of the TIME mnemonic to evaluate various wound challenges
  • A review of terms related to the TIME wound bed preparation model
  • Visual guidance on different wound types and wound descriptors to determine appropriate next steps for wound healing

read full article

 

Water for wound cleansing

Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and does not interfere with the normal healing process. Tap water is commonly used in the community for cleansing wounds because it is easily accessible, efficient and cost effective; however, there is an unresolved debate about its use. The objective of this review was to assess the effects of water compared with other solutions for wound cleansing … read more

Identifying and treating foot ulcers in patients with diabetes

     saving feet, legs and lives

 

There has been a great deal of debate around diabetic foot ulcers (DFUs) and pressure ulcers (PUs) on the feet of patients with diabetes, in terms of how to define, detect, assess and treat them. The confusion and lack of evidence in differentiating between these two types of foot ulcers, particularly on the heel, can lead to misdiagnosis, which can increase both financial and patient-related costs.

 

To address and tackle those inconsistencies, the Journal of Wound Care (JWC) has published its first international consensus document, Identifying and treating foot ulcers in patients with diabetes: saving feet, legs and lives. The main objectives of this project were to:

  • Provide information on the differences between a DFU and a PU in patients with diabetes

  • Help reduce misdiagnosis by providing and discussing assessment guidelines

  • Make a difference in practice through improved patient outcomes.

 

With this in mind, an international panel of ten key opinion leaders from Australia, England, Republic of Ireland, Malaysia, Poland, Portugal, Spain, United Arab Emirates and US met on 1 and 2 March 2018 in London. They discussed the definitions of a DFU and a PU, and concluded that one way to distinguish between them is knowing whether the patient is mobile (usually associated with DFUs) or immobile (normally related to PUs), although this should be considered along with simple assessments for ischaemia and neuropathy. To this end, and given the importance of an early and correct assessment, the mnemonic ‘VIPS’ was suggested:

  • V: vascular (ischaemia)

  • I: infection (local signs, odour, exudate, slough, inflammation, etc.)

  • P: pressure (causes mobility or immobility)

  • S: sensation (neuropathy).

read more

Lumicell Launches Wound Care Infection and Perfusion Division

WELLESLEY, Mass.–(BUSINESS WIRE)–Lumicell, Inc., a leader in the field of image-guided cancer surgery, today announced that it has created a new division to drive the expansion of its pioneering technologies to include wound care, infection and perfusion.

 

According to a recent study in the Journal of The International Society for Pharmacoeconomics and Outcomes Research, each year in the U.S. there are about 8.2 million patients being treated under Medicare for chronic wounds with an estimated cost between $31.7 to $96.8 billion per year1. With the rising prevalence of obesity-related diseases, such as diabetes, and an aging population – there continues to be a growth in the number of patients suffering from chronic wounds. And with healthcare professionals making care decisions based on the limited, evidence-based knowledge of wounds and requiring patients to make weekly visits to track progress, this upward trend is predicted to continue.

 

“Chronic wounds have a dramatic impact on affected individuals, their families and the U.S. Health Care System, leading to reduced quality of life, limb loss and loss of life at a significant financial cost,” said Robert S. Kirsner, M.D., PhD, FAAD, Director, University of Miami Hospital and Clinics Wound Center. “Unfortunately, wound care is often a largely overlooked medical need compared to other medical challenges like cancer, despite similar effects on loss of life. There is a need for new technologies to assess the state of a wound, integrate this with clinical data, and support the best treatment, for the right patient, at the right time.”

 

“We created our new wound care, infection and perfusion division for the same reason we launched our pioneering cancer technology — we identified a patient population in desperate need and decided to apply our technology and leverage our world-class team to help people suffering from chronic wounds,” said W. David Lee, CSO of Lumicell. “We believe the biggest healthcare engineering breakthroughs happen outside of the biology lab. As such, Lumicell’s new division will use concurrent engineering – the convergence of engineering and biological research – to accelerate the pace of biological discoveries and create new applications to diagnose and treat patients.”

 

“While it will require significant research and development, it will be well worth the effort,” Lee said. “Lumicell has already established the foundational technology for this forward-thinking approach and assembled a small group of advisors to guide the team through the first stages of development. Our goal is to better understand wound healing and on a molecular level and to create an unbiased, holistic protocol that blends Lumicell’s care-leading technology, artificial intelligence and informed care options.”

 

Lumicell also hopes to create a community of wound care experts, including doctors, nurses, researchers and insurance company executives who are interested in providing expertise, evidence, opinions and guidance. This community will curate the statistics, biology and science needed to ensure the infection and profusion detecting technologies and accompanying standard of care protocols are accessible and adopted across disciplines.

 

Samuel R. Nussbaum MD, Marissa J. Carter PhD MA, Caroline E. Fife MD, Joan DaVanzo PhD MSW, Randall Haught, Marcia Nusgart RPh, Donna Cartwright MPA. An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds. Journal of The International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Value in Health 21 (2018) 27-32

 

About Lumicell, Inc.
Lumicell is a technology leader in the field of image-guided cancer surgery. The company is developing a novel system that enables real-time detection of tumor tissue in patients so that no cancer cells are left behind during surgery. The company’s LUM System has unprecedented ability to see and remove cancer cells remaining in the surgical cavity – beyond the margin of the specimen – and has the potential to significantly improve surgical outcomes and reduce healthcare costs by eliminating the need for repeat surgeries. Lumicell is investigating the LUM System in patients undergoing surgery for breast cancer, prostate cancer, colorectal, esophageal and pancreatic cancers. Additional future indications are planned to include surgeries for lung, ovarian, and brain cancers. For more information, please visit www.lumicell.com.

Contacts

For Lumicell
Ali Buckneberg, 612-334-5960
ali.buckneberg@wordsatwork.com

press release from BusinessWire

Both Wound Care and Decoration Achieved with 3D-Printed Materials

Cellulose nanofibrils have properties that can improve the characteristics of bio-based 3D-printing pastes. VTT Technical Research Centre of Finland is developing a 3D wound care product for monitoring wound condition in hospital care. However, the first commercial nanocellulose applications will be seen in indoor decoration elements, textiles, and the production of mock-ups.

 

3D printing has proven to be an efficient manufacturing method for complex, customized, and light structures. In addition to thermoplastics, 3D printing materials include metals, ceramics and foodstuffs. The range of biomaterials in 3D paste printing is still fairly limited, since pastes pose unique challenges: their structure must not collapse during printing and the objects manufactured must remain sufficiently strong, rigid or flexible after drying. In 3D biomaterial filaments, however, commercial products already exist … read more

Expert Insight: Technology to Help Tackle Diabetic Foot Problems

As I’m sure you all know diabetic foot problems in this country and most western countries represent the commonest cause for patients with diabetes being admitted to hospital. And I think there is much we can do about this, and I really think that ulceration, as it’s so common and recurrence is so common, we should really redesign what we say when the patient is healed. Healing gives the impression that it’s gone away and will never come back. Thus in a recent review article[1] with my good friend David Armstrong, from the USA, and Sicco Bus from the Netherlands, we brought out the term remission rather than heal, because foot ulcers recur up to 40% in the first year and up to 60% after several more years. So we should be talking about the foot being in remission because it may recur.

 

Now what can we do about the foot in remission to prevent recurrence? And I think there’s a lot of exciting data coming through recently. First of all, not recently, it was Dr Paul Brand[2] who worked in leprosy, who observed that the insensitive foot in leprosy, and also in diabetes, tends to heat up before it breaks down. Therefore, the foot warms up because it becomes inflamed … read more

Diabetic Foot and the Bedside Bone Biopsy

This is an edited, translated transcript of a conversation taped on June 24, 2018, during the 78th Scientific Sessions of the American Diabetes Association (ADA) in Orlando, Florida. Prof Ronan Roussel, endocrinologist and diabetologist in Paris, France, spoke with diabetologist Florine Féron and cardiologist Jean-Philippe Kevorkian, both from Hôpital Lariboisière, Paris, about diabetic foot ulcers, amputations, and bedside bone biopsy.

 

Hello, and welcome to Medscape’s set at the 2018 ADA conference in Orlando. Today our webcast is devoted to diabetic foot. It’s not the most often reported complication of diabetes in abstracts or oral presentations at conferences, but there have been some interesting data at this year’s ADA conference. Joining me to talk about a study they presented during an oral session on diabetic foot are diabetologist Florine Féron and cardiologist Jean-Philippe Kevorkian, both from the Department of Diabetology at Hôpital Lariboisière. … read more

Minimizing Scars of Every Type

Under ideal circumstances, a break in the skin would stimulate the skin’s own repair processes to seal up the wound and restore normal skin. Clotting factors in the blood would stop the bleeding by forming a scab. The second deepest layer of the skin (the dermis) would produce new cells called fibroblasts. Those fibroblasts would produce collagen and other proteins to seal up the wound and produce a seamless layer of new skin. In some cases, evidence of the wound skin completely disappears in about a week, leaving no scar at all.

 

For the skin to heal without leaving a scar, healing processes have to occur at exactly the right time in precisely the right degree. However, the body puts a premium on fast healing rather than accurate healing.1 Prehistoric man had a better chance at survival if a wound healed quickly than if it had healed perfectly. The skin had to close quickly to prevent excessive blood loss and infection. When the skin heals quickly, the skin that covers the wound is structurally different from normal skin. The wound heals, but the scar tissue that remains is usually permanent.

read more

Researchers develop portable 3-D skin printer to repair deep wounds

University of Toronto researchers have developed a handheld 3-D skin printer that deposits even layers of skin tissue to cover and heal deep wounds. The team believes it to be the first device that forms tissue in situ, depositing and setting in place, within two minutes or less.

 

The research, led by Ph.D. student Navid Hakimi under the supervision of Associate Professor Axel Guenther of the Faculty of Applied Science & Engineering, and in collaboration with Dr. Marc Jeschke, director of the Ross Tilley Burn Centre at Sunnybrook Hospital and professor of immunology at the Faculty of Medicine, was recently published in the journal Lab on a Chip … read more

Best practice recommendations for the Prevention and

     Management of Diabetic Foot Ulcers

 

Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia that
leads to microvascular, macrovascular and neuropathic complications. In 2016, there
were 11 million Canadians living with type 1, type 2 or pre-diabetes, and every three
minutes another Canadian is diagnosed. Certain populations are at higher risk for
developing type 2 DM, including those of Asian, African, Hispanic and Indigenous decent.
The rates of DM are three to five times higher in Indigenous populations, an issue
compounded by unique barriers to care including, but not limited to, a lack of cultural
competency among health-care providers, jurisdictional confusion, limited access to
care, geographical location and language barriers.

 

Foot health should be a major consideration for people with diabetes and for those
who care for them. Foot complications in this high-risk population can lead to a cascade
of negative complications, potentially resulting in loss of limb and life.
The lifetime risk for foot ulceration in people with diabetes is 15 to 25%. According to
the International Diabetes Federation, persons with diabetes are 15 to 40 times more
likely to require lower-leg amputation compared to the general population. Approximately
85% of amputations are preceded by the development of a neuropathic foot
ulcer.

 

Following a lower-limb amputation, people with diabetes not only suffer the
clinical and psychological consequences of limb loss, but also have a five-year mortality
rate of 50%. This is a higher mortality rate than is seen in breast cancer in females,
prostate cancer in males or lymphoma … read more

Hydrogel could totally change treatment of diabetic wounds

A hydrogel that can help the body heal may also be particularly good at treating wounds related to diabetes, new research suggests.

 

Tests on diabetic animal models show that the injectable hydrogel significantly accelerates wound healing compared with another hydrogel often used in clinics.

 

The multidomain peptide (MDP) hydrogel known by its amino acid sequence—K2(SL)6K2—has in a recent study proven useful for the timed release of immunotherapy drugs. It has also been shown to encourage healing all by itself.

 

That quality may be useful for people with diabetes mellitus who often develop chronic wounds in their lower extremities that take longer to heal than normal wounds do … read more

Material could offer ‘smarter’ wound healing

A new study takes a step toward the development of smarter skin grafts that facilitate healing while minimizing infection for chronic skin wounds.

 

“Our group has expertise in developing new polymers and functional surface assemblies for biomedical applications,” says Svetlana Sukhishvili, professor and director of the soft matter facility at Texas A&M University.

 

“At Texas A&M we investigated how to build a stimuli-responsive polymeric material that could absorb and release antibiotics when prompted by a physiologically relevant stimuli,” explains lead researcher Victoria Albright, a graduate student materials science and engineering department … read more

Negative pressure wound therapy no better than standard care for open

     traumatic wounds

 

For open traumatic wounds involving fracture or soft tissue, there is “no clear difference” between standard care and negative pressure wound therapy (NPWT), and the latter is unlikely to be cost-effective, according to a recent Cochrane Review.

 

“All (of our) research led us to conclude there is no clear difference in the rate of healing of open fracture wounds treated with NPWT and those treated with standard care,” she said, “and also that NPWT is likely not a cost-effective treatment for (these) wounds,” Dr. Joanne Dumville of the University of Manchester, UK, told Reuters Health by email on behalf of her colleagues.

 

Dr. Dumville and colleagues searched the literature and various registries and reports through June 2018 for published and unpublished randomized controlled trials using NPWT for open traumatic wounds involving either fractures or soft tissue.

read more

AcryMed’s Oxygenesys for Wound O2 Delivery

AcryMed is touting their latest innovation in wound healing: Dissolved oxygen delivery, via their Oxygenesys system:

 

Our research shows that these new devices deliver significant amounts of dissolved oxygen, which is the biologically relevant form” said Dr. Bruce Gibbins, Founder and Chief Technical Officer at AcryMed. “We conducted studies on human donor skin to show for the first time that through Oxygenesys TDO, sufficient oxygen penetrates deep into tissues to make up for the oxygen deficiency … read more

Silk-based biomaterials in biomedical textiles and fiber-based implants

Biomedical textiles and fiber-based implants (BTFIs) have been in routine clinical use to facilitate healing for nearly five decades. Amongst the variety of biomaterials used, silk-based biomaterials (SBBs) have been widely used clinically viz. sutures for centuries and are being increasingly recognized as a prospective material for biomedical textiles. The ease of processing, controllable degradability, remarkable mechanical properties and biocompatibility have prompted the use of SBBs for various BTFIs for extracorporeal implants, soft tissue repair, healthcare/hygiene products and related needs. The present review focuses on BTFIs from the perspective of types and physical and biological properties, and this discussion is followed with an examination of the advantages and limitations of BTFIs from SBBs. The review covers progress in surface coatings, physical and chemical modifications of SBBs for BTFIs and identifies future needs and opportunities for the further development for BTFIs using SBBs … read more

Keys To Coding When You Are Seeing Patients In Nursing Facilities

The CPT codes 99304–99306 cover initial nursing facility care. Yes, podiatrists can absolutely submit initial nursing facility evaluation and management (E/M) codes for Medicare patients.

 

Medicare does not recognize consultation codes. When Medicare stopped recognizing consultation codes on January 1, 2010, it then instructed specialists, including podiatrists, to use the initial nursing facility codes when seeing a nursing facility patient for the first time during that patient’s admission. Podiatrists should use initial nursing facility codes if that encounter qualified for what the facility would consider a “consult” and even if the specialist was not the admitting/primary doctor. Since there are now multiple doctors using those initial encounter codes, the admitting/primary doctor must use an “AI” modifier on the initial E/M encounter.

 

This change did not alter the fact that in order to submit any E/M code, one must meet the thresholds of complexity for that code. Complexity refers to the key elements of E/M coding (history, exam, decision making) in what you performed, what you documented and what was medically necessary … read more

Inherent variations in the cellular events at the site of amputation orchestrate scar‐free

      wound healing in the tail and scarred wound healing in the limb of lizard Hemidactylus flaviviridis

 

Lizards are unique in having both – regeneration competent (tail) as well as non‐regenerating appendages (limbs) in adults. They therefore present an appropriate model for comparing processes underlying regenerative repair and non‐regenerative healing after amputation. In the current study, we use northern house gecko Hemidactylus flaviviridis to compare major cellular and molecular events following amputation of the limb and of the tail. Although the early response to injury in both cases comprises apoptosis, proliferation and angiogenesis, the temporal distribution of these processes in each remained obscure. In this regard, observations were made on the anatomy and gene expression levels of key regulators of these processes during the healing phase of the tail and limb separately. It was revealed that cell proliferation markers like FGFs were upregulated early in the healing tail, coinciding with the growing epithelium. The amputated limb, in contrast, showed weak expression of proliferation markers, limited only to fibroblasts in the later stage of healing. Additionally, apoptotic activity in the tail was limited to the very early phase of healing, as opposed to that in the limb, wherein … read more

DC Durable Medical Equipment Company Owner Pleads Guilty To Defrauding Medicaid

This week, it was announced that the owner of a company that provided durable medical equipment had pleaded guilty to a federal charge of health care fraud. The defendant carried out a scheme to fraudulently obtain more than $9.4 million in District of Columbia Medicaid payments. 72-year-old Waveney Blackman of Bowie, Maryland pleaded guilty. She is now scheduled to be sentenced on October 18, 2018.

 

The defendant was the sole owner and CEO of WaveCare Health Services LLC, which was also known as WaveCare Healthcare Services LLC. The company provided durable medical equipment, such as wound care and incontinence supplies to Medicaid beneficiaries and others. The company became a Medicaid provider in 2008. Plea documents show that Blackman devised and carried out a scheme to submit false and fraudulent claims to Medicaid for durable medical equipment .. read more

Healing lamp lights the way for improved treatment of chronic ulcers

Chronic skin ulcers such as those associated with diabetes are notoriously difficult to treat. As a result, we’ve seen experimental approaches such as spray-on skin, ultrasound band-aids, and silver-laced dressings. Now, scientists are getting very good results using a high-tech lamp.

 

Developed by a team from Britain’s University of Manchester and Salford Royal NHS Trust, the device has a total of 32 bulbs which emit a combination of infrared, red and ultraviolet light.

 

Led by Dr. Michael Hughes, the researchers tested it on eight patients suffering from systemic sclerosis, a condition in which the immune system attacks the fingers and toes. Each person received two 15-minute treatments per week, for a period of three weeks … read more

Till We Get the Healing Done

It is estimated that in the United States alone, diabetes affects 29 million people. Patients who suffer from this illness are susceptible to chronic leg and foot ulcers. These diabetic wounds are particularly likely to lead to amputations, due to a disruption in the healing process caused by the illness. In this context, finding aids to artificially accelerate the healing process for diabetic wounds is crucial.

 

One presently used technique for accelerating the healing process, is the direct injection of stem cells into the wound. This has been shown to significantly increase the rate of wound healing. However, the injection protocol reduces the lifespan of the cells though mechanical damage. Once the cells have been injected, there is no cell matrix present, further limiting their viability … read more

Trinity University students researching a new diabetic wound care treatment

At Trinity University’s Department of Engineering Science, students aren’t just taking the summer off. Many are doing important research about diabetes that they hope will eventually save limbs and lives.

 

“Everyone is very excited to hear about the work we are doing, and it’s nice to hear that it’s going to impact lives around me,” junior Abbie Jones said.

 

Abbie and her research partner Adil have been working on a way to help common diabetic wounds heal faster using something called a “hydro-gel wound dressing,” which helps heal from the inside out.

 

“With a hydro-gel, you can lay more inside and on top of the wound, instead of a Band-Aid, to help with the wound healing process,” said Jones, adding that research like this is needed because the number of diabetics is skyrocketing. “There are a large number of Type 2 diabetics in the U.S. currently, and many of them have the foot ulcers that are common occurrence with diabetes.”

read more

Diabetes doubles risk for hospital-acquired foot ulcers

Patients with diabetes have at least double the risk for developing hospital-acquired foot ulcers vs. those without diabetes, according to a study published in BMJ Open Diabetes Research & Care.

 

In a prospective, multilevel regression analysis, Frances Wensley, PhD, MBBS,formerly of the Royal Free Hospitals NHS Foundation Trust in London, and colleagues analyzed data from 18,946 patients with 28,642 admissions of at least 2 days to the Ipswich Hospital NHS Trust between October 2008 and September 2010, including 3,076 individuals with diabetes with 5,043 admissions. Patients included in the analysis were aged at least 50 years and developed a hospital-acquired foot ulcer at least 48 hours after hospital admission. For all admissions, the analyses included data on diabetes, heel ulcer, length of stay and other covariates. The researchers compared patients with vs. without diabetes … read more

CMS ends hyperbaric oxygen treatment experiment despite savings

The CMS will not continue an experiment that saved Medicare millions of dollars by reducing the use of non-emergency hyperbaric oxygen therapy.

 

The treatment uses pressurized oxygen to help expedite wound healing, particularly for diabetic wound care. Since the CMS launched the experiment in 2015, its spending per beneficiary per quarter dropped by $60, according to a report released Monday by the CMS. Federal data shows the experiment saved the government $17.6 million by 2017.

 

Only Illinois, Michigan and New Jersey participated in the prior authorization experiment for non-emergency hyperbaric oxygen therapy. Those states were chosen because of their high utilization and improper payment rates.

 

The demonstration ended in February 2018, and the savings it generated didn’t harm quality of care, according to the report … read more

Use of negative pressure wound therapy in a chronic leg wound with

     coexisting rheumatoid arthritis: a case study

 

We present a case of a 69-year-old woman with rheumatoid arthritis. The patient’s condition was managed with steroid therapy for more than 12 years. She had a coexisting infected chronic ulceration in the left leg, which was treated with negative pressure wound therapy for 52 days. Use of this therapy within the wound reduced exudate and the bacterial count, which dramatically accelerated the process of wound healing.

 

The introduction of negative pressure wound therapy (NPWT) in the early 1990s resulted in a change in the concept of care and treatment of wounds of various aetiologies in the hospital and outpatient care settings. NPWT is increasingly being used in primary and home health care because of its non-invasiveness, high efficacy, shortening the time of wound healing, and improving wound healing, thereby greatly reducing the need for hospital treatment.13 NPWT requires specialized equipment with manual control of negative pressure. Negative pressure is maintained in the wound bed with ready-made sterile sets (sponge, proper dressing, adapter, polyurethane foil). Negative pressure causes wound shrinkage and reduction of the bacterial count by evacuating the effusion into a disposable canister placed on the device.4,5 Although the potential of NPWT … read more

Decision Memo for Hyperbaric Oxygen (HBO) Therapy

     (Section C, Topical Oxygen) (CAG-00060R)

 

The Centers for Medicare & Medicaid Services (CMS) received a reconsideration request to remove the coverage exclusion of Continuous Diffusion of Oxygen Therapy (CDO) from NCD Manual 20.29, Section C. This section of the NCD (Topical Application of Oxygen) considers treatment known as CDO as the application of topical oxygen and nationally non-covers this treatment.

 

After examining the evidence, CMS has decided that no National Coverage Determination is appropriate at this time concerning the use of topical oxygen for the treatment of chronic wounds. We will amend NCD 20.29 by removing Section C, Topical Application of Oxygen and Medicare coverage of topical oxygen for the treatment of chronic wounds will be determined by the local contractors.

Summary:

Chronic wounds are prevalent in the Medicare population and cause a disproportionate burden on beneficiaries and their families and caretakers. CMS recognizes the need for new therapies that will heal wounds and the standardization of wound care in general. Overall, since the evidence on chronic wound healing from topical oxygen therapies has increased over the past few years, CMS believes a national non-coverage decision is no longer appropriate.  CMS received 17 public comments and most of the commenters support this position.  However, given the inability to identify the characteristics of chronic wounds that best respond to topical oxygen therapy and the type of patients’ best suited to use this therapy, we are not able to define a patient population that would benefit from topical oxygen therapy in a national coverage determination at the present time.  Ongoing research in the US and Europe and pending publications may provide additional evidence that may support a national determination in the future.  CMS realizes that double blinded RCTs cannot always be used in order to answer questions regarding the outcomes of exposure to various treatment regimens in the wound care space. However we acknowledge that various investigative groups have, and are currently, studying the treatment of chronic wounds by TOT through randomized controlled trials.  CMS reviewed a number of articles from commenters, considered all additional information and has determined to finalize the proposed decision.

 

Conclusion

The Centers for Medicare & Medicaid Services (CMS) received a reconsideration request to remove the coverage exclusion of Continuous Diffusion of Oxygen Therapy (CDO) from NCD Manual 20.29, Section C. This section of the NCD (Topical Application of Oxygen) considers treatment known as CDO as the application of topical oxygen and nationally non-covers this treatment.

 

After examining the evidence, CMS has decided that no National Coverage Determination is appropriate at this time concerning the use of topical oxygen for the treatment of chronic wounds. We will amend NCD 20.29 by removing Section C, Topical Application of Oxygen and Medicare coverage of topical oxygen for the treatment of chronic wounds will be determined by the local contractors.

read more

 

OxyGenesys Dissolved Oxygen Dressing at Northwestern University

Twelve acute wounds (6 on either side of the umbilicus) will be surgically created in the lower abdominal area. One side of the umbilicus will be randomized to Oxygenesys treatment arm and the other side will be receiving a standard Tegaderm treatment arm. Time to wound healing will be observed over 14 days.

 

At least 12 study visits will occur over a 3 month timeframe. Twelve acute wounds (6 on either side of the umbilicus) will be surgically created in the lower abdominal area. One side of the umbilicus will be randomized to Oxygenesys treatment arm and the other side will be receiving a standard Tegaderm treatment arm. Time to wound healing will be observed over 14 days (follow up assessments include wound photography, pain scores, wound biopsies, exudate collection, gene expression and proteomic analysis, scar assessment and adverse event collections. Study visits will occur at:

Prescreening Visit; Day of wounding; Day 2; Day 7; Day 8-14 (until all wounds have healed); Day 28; Day 42; Abdominoplasty Surgery. An abdominoplasty will occur after day 42.

read more

What would our health care system look like if doctors spoke the same

     language as engineers?

 

Medical school students today are trained to diagnose complicated diseases, but they are rarely trained to engineer the solutions themselves. To change that, soon Texas A&M University will start training doctors and nurses to also be engineers.

 

“Our technology [is] is a bandage that generates oxygen from the chemical decomposition of hydrogen peroxide,” Frey said. A chemical reaction between the layers of the bandage creates a concentrated oxygen gas which Frey said helps a wound heal. MedNoxa is seeking FDA clearance to sell the bandages by prescription and over the counter … read more

related: Purdue startup developing restorative oxygenation wound dressings receives $30,000 investment

Not all foams redistribute pressure equally

Recent research demonstrates the effectiveness of various foam dressings for pressure redistribution. Jeffrey Niezgoda, MD (APWCA Vice-President) recently published his findings in a poster presentation (SAWC 2018).  His results demonstrated that all foams are not equivalent in the ability to provide pressure relief in patients at risk for developing pressure ulcers.  OxyBand Rescue out performed all other foam dressings currently on the market, providing superior reduction in average pressures and peak pressures, while at the same time maximizing contact area.  The NPUAP has recently published recommendations advocating the use of foam dressings to provide pressure redistribution in an attempt to reduce the risk of pressure ulcer formation in at risk patients.  A copy of the Poster is provided.

From the The American Professional Wound Care Association® (APWCA) 

Patients With Infected Diabetic Foot Ulcers Need Quick Referral

Patients with an infected diabetic foot ulcer have a far worse prognosis than previously thought, with 15% of patients dying within a year, less than half of the ulcers healing in the same time period, and one in seven individuals having all or part of their foot amputated, results from a new UK study reveal.

 

The analysis of almost 300 patients with infected diabetic foot ulcers also showed that, even if the ulcer healed, nearly 10% experienced a recurrence within 12 months and more than 25% of patients underwent some kind of procedure.

 

It’s therefore crucial that such patients are reviewed quickly and referred for specialist care if required, say Mwidimi Ndosi, PhD, of the University of West Bristol, United Kingdom, and colleagues in their paper published online November 20 in Diabetic Medicine … read more (registration required)

Smart Textiles Offer Development Opportunities In Medical

The medical field benefits from textile innovations, and the rapid development of sensor technology brings new products to the healthcare and wellness market.

 

The textile news has presented a number of stories centered in and around the medical industry in recent months. Whether the news relates to implantables and grafts, coatings and additives for wellness and bacteria protection, or innovative uniform fabrics, the textile industry is playing a role in medical progress. One particular area of note is sensor technology. Rapid development is taking place in the sensor market, and many companies are developing smart textile products for medical and health-related applications.

 

Making Socks Smart
Recently, San Francisco-based health technology company Siren introduced Neurofabric™, a Diabetic Sock and Foot Monitoring System that features microsensors embedded directly into the fabric. Six sensors — three across the ball of the foot, one in the arch and one on the heel — continuously monitor foot temperature looking for variation  … read more

Acute and Impaired Wound Healing: Pathophysiology and Current Methods for

     Drug Delivery, Part 1: Normal and Chronic Wounds: Biology, Causes, and Approaches to Care

 

This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians’ understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that initiate cellular and tissue responses after injury, which may be impeded during chronic wound healing.

 

Acute and chronic wounds affect millions of people in the United States and around the world. In recent decades, clinicians have gained a better understanding of the mechanisms of normal wound repair process and causes of delays in healing. This progress has led to significant improvement in the quality of life of affected patients. This article reviews the latest insights and opportunities for wound repair science and innovations in wound care … read more

 

 

Medscape Residents Salary & Debt Report 2018

How much are residents earning in 2018, and are they satisfied with their earnings? How much debt do they have? More than 1900 residents in 29-plus specialties told us how much they earn, as well as the hours they work, how much scut work they have, and what their relationships with attendings, nurses, and PAs are like. All participants were enrolled in US medical resident programs. Average resident salary appears to be trending upward. Over the past 3 years, the average salary has increased by about 7%. The average salary for residents overall is $59,300 … read more

 

 

Efficacy of Honeydew Honey and Blossom Honey

    on Full-thickness Wound Healing in Mice

 

The wound healing properties of honey, including blossom honey, are well known; however, the effects of honeydew honey during the wound healing process have not yet been investigated and thus remain unclear.Objective. This study compares the effects of honeydew honey with those of blossom honey. Materials and Methods. A total of 140 mice were divided into 2 control groups, which received either a hydrocolloid dressing (HCD; n = 22) or gauze (n = 22), and 4 experimental groups: honeydew honey (n = 23), Acacia honey (n = 23), Manuka honey (n = 22), and Japanese Pharmacopoeia honey (n = 28). Two circular full-thickness wounds were made and measured for 14 days. Each wound in the experimental groups was treated with 0.1 mL of honey and covered with gauze. Dressings in the control and experimental groups were changed daily. Results. The wounds in all of the honey groups and the HCD group were moist by day 14, while those in the gauze group were dry. The ratio of wound area to initial wound area and the number of inflammatory cells decreased during the inflammatory phase in all honey groups. However, the honey groups exhibited reepithelialization rates of < 40%, numerous neutrophils, weak wound contraction, and impaired collagen deposition in wounds after day … read more

Spider silk could be used to create artificial skin to help heal wounds

Unless your name is Peter Parker, you may not be aware of quite how versatile spider silk is as a material. In fact, aside from spinning webs, spider silk can also be used for a plethora of applications — from improving the quality of microphones in hearing aids to forming incredibly strong-yet-lightweight shields to forming microcapsules for delivering anti-cancer vaccines.

 

Now researchers from Sweden and India have come up with yet another novel use for spider silk’s unusual mix of strength and elasticity: Creating artificial skin and wound dressings for helping heal wounds.

 

“We have developed two types of silk-based constructs: Nanofibrous matrices which serve as bioactive wound dressings, and microporous sponges cultured with human skin cells to serve as artificial skin,” Biman Mandal, an associate professor in the Department of Biosciences … full article in Digital Trends

Healogics Inc. agrees to $22.51 million settlement

Jacksonville-based hyperbaric oxygen therapy company billed Medicare for unnecessary and unreasonable treatments.

 

Hyperbaric oxygen therapy provider Healogics Inc. agreed to pay up to $22.51 million to settle allegations that it violated the federal False Claims Act by knowingly causing wound care centers to bill Medicare for unnecessary and unreasonable treatments.

 

The company, based in Jacksonville, manages more than 700 hospital-based wound care centers in the U.S., including at Baptist Medical Center … read more

Phase 3 CREDENCE Renal Outcomes Trial of INVOKANA® is Being Stopped

     Early for Positive Efficacy Findings

 

– INVOKANA® has the potential to be the first new therapy in more than 15 years for slowing the progression of chronic kidney disease in patients with type 2 diabetes

 

– Worldwide, 160 million patients with type 2 diabetes are at risk for developing chronic kidney disease

 

– CREDENCE assessed INVOKANA® for renal protection by evaluating the risk reduction of the composite endpoint of time to dialysis or kidney transplantation, doubling of serum creatinine, and renal or cardiovascular death, when used in addition to standard of care

 

RARITAN, N.J.July 16, 2018 /PRNewswire/ — The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that the Phase 3 CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) clinical trial, evaluating the efficacy and safety of INVOKANA® (canagliflozin) versus placebo when used in addition to standard of care for patients with chronic kidney disease (CKD) and type 2 diabetes (T2D), is being stopped early based on the achievement of pre-specified efficacy criteria.

 

The decision is based on a recommendation from the study’s Independent Data Monitoring Committee (IDMC) that met to review the data during a planned interim analysis. This recommendation was based on demonstration of efficacy, as the trial had achieved pre-specified criteria for the primary composite endpoint of end-stage kidney disease (time to dialysis or kidney transplantation), doubling of serum creatinine, and renal or cardiovascular (CV) death, when used in addition to standard of care … read more

Prevention and Management of Diabetic Foot Ulcers

BEST PRACTICE RECOMMENDATIONS FOR THE Prevention and Management of Diabetic Foot Ulcers

 

Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia that leads to microvascular, macrovascular and neuropathic complications. In 2016, there were 11 million Canadians living with type 1, type 2 or pre-diabetes, and every three minutes another Canadian is diagnosed. Certain populations are at higher risk for developing type 2 DM, including those of Asian, African, Hispanic and Indigenous decent. The rates of DM are three to five times higher in Indigenous populations, an issue compounded by unique barriers to care including, but not limited to, a lack of cultural competency among health-care providers, jurisdictional confusion, limited access to care, geographical location and language barriers.1,2 Foot health should be a major consideration for people with diabetes and for those who care for them. Foot complications in this high-risk population can lead to a cascade of negative complications, potentially resulting in loss of limb and life. The lifetime risk for foot ulceration in people with diabetes is 15 to 25%. According to the International Diabetes Federation … read more (PDF)

Differences in Joint Mobility and Foot Pressures Between

     Black and White Diabetic Patients

 

Limited joint mobility is common in diabetes and is related to high foot pressures and foot ulceration. We have examined the differences in joint mobility and foot pressures in four groups matched for age, sex, and duration of diabetes: 31 white diabetic, 33 white non‐diabetic, 24 black diabetic, and 22 non‐diabetic black subjects. Joint mobility was assessed using a goniometer at the fifth metacarpal, first metatarsal, and subtalar joints. In‐shoe and without shoes foot pressures were measured using an F‐Scan system. Neuropathy was evaluated using clinical symptoms (Neuropathy Symptom Score), signs (Neuropathy Disability Score), and Vibration Perception Threshold. There was no difference between white and black diabetic patients in Neuropathy Symptom Score, Neuropathy Disability Score, and Vibration Perception Threshold. Subtalar joint mobility was significantly reduced in white diabetic patients (22 ± 7°) compared to white controls (26 ± 4°, black diabetic patients (25 ± 5°), and black controls (29 ± 7°), and increased in black controls compared to white controls and black diabetic patients … read more

Study: Diabetic Foot Complications Among The Top 10 Causes Of Disability

David G. Armstrong DPM MD PhD

 

Diabetes-related lower extremity complications are a major cause of global disability, according to a recent study in Diabetic Medicine.

 

The study notes that of the 435 million people worldwide estimated to have diabetes, about 19 to 34 percent will experience a foot ulcer during their lifetimes.1 My coauthors and I note that diabetic foot complications are a leading cause of infection, hospitalization and amputation throughout the world although evidence-based care can prevent these outcomes … read more

Nutrition Management of Individuals with Diabetes and Pressure Injuries

by Dr. Nancy Munoz, DCN, MHA, RDN, FAND

 

The presence of diabetes can have a negative impact on wound healing rates. Increased glucose levels can stiffen the arteries and contribute to narrowing of the blood vessels. This can influence pressure injury development and is a risk factor for impaired wound healing.

 

Overview of Diabetes Mellitus
Diabetes is an illness in which the individual’s blood glucose level is above the established range. Glucose is present in the foods we eat. Most foods contain a blend of carbohydrates, proteins, and fats. The amount of each of these nutrients in the foods we consume determines how quickly the body transforms food into glucose. For instance, consuming carbohydrates affects blood glucose levels one to two hours after the meal. Ingesting protein has very little influence on blood glucose levels, and the glucose from the fat in foods is slowly absorbed and does not contribute to increased glucose levels … read more

CAN WE WOUND BIOFILMS?

These complex 3D structures of bacteria explain many of the challenges clinicians face with wound care, infection and healing. Scientists are fighting back.

 

Antonie van Leeuwenhoek (1632-1723) was the first person to delve into the field of microbiology and document initial observations of bacteria. After this preliminary discovery, microbiology was not actively studied again until the 1800s, when it began to gain a foothold in contemporary medicine. Fast-forward to today’s labs, where clinicians are becoming more knowledgeable in the bacteriology of wound healing, and researchers are identifying new ways to overcome long-standing challenges in wound healing, such as biofilms.

 

Biofilm is a term used to describe a colony of microorganisms, such as bacteria, fungi or yeast, encased by an extracellular polymeric substance (EPS). The EPS forms a shield, often causing the bacteria to be  … read more

KCI Expands Offering of Next Generation

     Negative Pressure Wound Therapy Dressing

 

SAN ANTONIO–(BUSINESS WIRE)– KCI, an Acelity Company, today announced the launch of the V.A.C. VERAFLO CLEANSE CHOICE™ Large Dressing designed for use with V.A.C. VERAFLO™ Therapy to cleanse larger wounds with thick, fibrous exudate and infectious material such as slough, and may be used on patients when surgical debridement must be delayed or is not possible or appropriate. With a unique, three-layer foam design with an array of holes, V.A.C. VERAFLO CLEANSE CHOICE™ Dressing allows for selective wound cleansing beyond traditional negative pressure wound therapy (NPWT) dressings, and provides flexibility in treating wounds of various depths.

 

“As an industry leader, we understand that wound care is incredibly complex and clinicians need more options – the combination of our core V.A.C.® Therapy technology with these new dressings shows remarkable potential for upending the traditional wound care approach, as illustrated by a growing body of clinical data,” said R. Andrew Eckert, President and CEO of Acelity. “Since launching V.A.C. VERAFLO CLEANSE CHOICE™ Dressing last year, we have seen tremendous response from clinicians with rapid adoption of the platform. Innovating for patients and customers is a driving force for our company, and we continue striving to revolutionize wound healing.”

read more

Therapy can accelerate wound healing

Using microcurrent therapy along with traditional wound care approaches significantly reduces wound size and lessens pain, according to a study in the Journal of Wound Care.

 

Harikrishna K.R. Nair, M.D., head of the wound care unit at Malaysia’s Hospital Kuala Lumpur, studied the effect of microcurrents on 100 chronic wound patients over four months in 2016. Their diagnoses included diabetic foot ulcers, venous leg ulcers and pressure ulcers … read more

Doctors who focus on the foot and brain team up on a smart insole

Professors David Armstrong and Charles Liu at first seemed to be an unlikely pair.

But the podiatric surgeon and neurosurgeon clicked on a personal level and promptly realized they had a lot to offer each other as Keck School of Medicine of USC collaborators.

 

Both were already studying how much information a person takes in through the nerves of the feet, how to preserve, repair or replace that information system, and how nerve damage can affect a patient’s mobility.

 

Armstrong is interested in metabolic health, mobility and neuropathy—the loss of nerve sensitivity that can occur in patients with diabetes, Liu noted.

 

“As a neurosurgeon, I’m interested in lower-extremity function and metabolic health, too,” he said. “In my work, I think about how to restore mobility to patients who can’t feel their legs. It’s a similar problem to diabetic foot ulcers.”

read more

A Total Offloading Foot Brace for Treatment of Diabetic Foot Ulcers

     Results From a Halted Randomized Controlled Trial

 

Introduction. Foot offloading is the mainstay treatment for plantar diabetic foot ulcers (DFUs). Objective. This multicenter, single-blinded, randomized controlled trial evaluates the efficacy of a total offloading foot brace for healing plantar DFUs. Materials and Methods. Seventeen patients were randomized to standard therapy (ie, reducing stress and pressure via mechanical offloading) or offloading foot brace. Comparison of plantar pressures was performed using digital pressure sensing films. The ulcers were assessed by physical inspection and digital planimetry of photographs. Results. Reductions in peak plantar pressures ranged from 67.3% to 89.4% (P = .09). Healing at weeks 12 to 15 had minimal differences (brace vs. control: 71.7% vs. 80.3%, respectively). Although not significant, earlier periods of the brace versus the control demonstrated faster wound healing in weeks 2 to 5 (36.0% vs. 6.8%, respectively) and weeks 6 to 9 (50.7% vs. 17.0%, respectively). Conclusions. The total offloading foot brace minimizes plantar pressure, allowing for early healing of DFUs, and optimizations in brace design may enhance healing of plantar DFUs … read more

Controlling Bacterial Burden in Chronic Wounds

Bioburden in chronic wounds can be a principal contributor to inflammation, clinical wound infection, and further delayed wound healing. Clinically diagnosing infection in chronic wounds can be problematic because most individuals susceptible to developing chronic wounds are subject to physiological states that often blunt typical infectious responses in various ways.1 These responses include pain, erythema, febrile state, leukocytosis, edema and increased wound exudate, wound odor, etc. For example, a patient with a neuropathic ulcer and diabetes mellitus may not report pain or fever or present with leukocytosis but will have increased edema and wound exudate. A patient with an ischemic ulcer of peripheral arterial disease may report pain, erythema, fever, and leukocytosis but not have perfusion sufficient to produce edema or increased wound exudate.1 It is imperative to understand how to concurrently manage factors that can contribute to infection, as well as assess for symptoms and implement interventions to prevent infection … read more

Corstrata Announces Availability of New Tech Empowered

     Diabetic Foot Ulcer & Amputation Prevention Solution

 

CORSTRATA, a provider of digital healthcare IT solutions and services for wound management, announced today the availability of the company’s new Diabetic Foot Ulcer & Amputation Prevention Solution. The Solution is designed to prevent costly and complicated wounds from developing and is the first comprehensive program that leverages state-of-the-art technology and a team of top-tier Board Certified Wound Clinicians for the early detection of ulcers that often lead to hard-to-heal wounds and amputations among the growing U.S. diabetic population.

 

Diabetic foot ulcers (DFUs) are a common, limb-threatening and expensive complication of Type 1 and Type 2 diabetes. Today, more than 30M people in the U.S. have diabetes and more than 1.7M suffer from new DFUs per year with a 40% reulceration rate. 80K of these diabetics ultimately require an amputation and the risk of death at 5 years for DFU patients is 2.5 times as high as the risk for a patient with diabetes without a foot ulcer.

 

“The Corstrata Diabetic Foot Ulcer and Amputation Solution offers an important advancement in both the detection and prevention of one of the most costly and complex types of wounds to heal,” said Katherine Piette, Chief Executive Officer and Founder, Corstrata. “The mobile and remote monitoring technology combined with our deep clinical expertise in diabetic foot ulcer prevention and wound management, enable us to help payers and value-based care organizations significantly reduce their risk and costs associated with ulcerations in diabetic members.”

 

The Corstrata program is a comprehensive end-to-end technology-enabled solution that uses the HIPAA compliant, Corstrata Intervention & Engagement mobile app and the industry’s only FDA approved smart thermometric mat. The Solution is designed to help value-based care organizations and payers with the following:

  •     High-Risk Patient Identification
  •     Program Enrollment
  •     Daily Remote Patient Monitoring
  •     Member Engagement & Education
  •     Timely Evidenced-Based Intervention for Prevention of DFU
  •     Empowering Members for Self-Management

 

“Research indicates that the use of early detection technology, coupled with evidence-based interventions, can prevent 75% of foot ulcers in this high-risk population,” said Joseph Ebberwein, Chief Financial Officer and Founder, Corstrata. Lower extremity amputation studies and clinical trials have shown that Diabetic Foot Ulcer and Amputation prevention solutions can greatly reduce costly hospital visits and procedures associated with ulcerations and amputations, including:

  •     Reduction in Hospitalizations
  •     Decreased Hospital Days
  •     Reduction in Amputations
  •     Decreased Emergency Room Visits
  •     Decreased Foot Ulcer Recurrence

 

Corstrata was also recently named a semifinalist in the T1D Exchange 2018 Diabetes Innovation Challenge. A poster depicting the Corstrata DFU solution was showcased at the public event on May 21, 2018, at the Royal Sonesto Boston in Cambridge, MA.

 

Learn more about the Corstrata Diabetic Foot Ulcer and Amputation Prevention Solution at http://www.corstrata.com/Diabetic-Foot-Ulcer-Prevention.

 

About Corstrata
Corstrata was founded in 2015 by two passionate healthcare experts with the goal of improving access to technology enabled, evidence-based care for patients with chronic wounds, which currently costs the U.S. $33B annually. Home health agencies, hospices, self-funded employers, clinically integrated networks of doctors and related practitioners (CINs), and third-party payers (Medicare Advantage, Medicaid MCOs) can benefit from Corstrata’s unique combination of professional expertise, digital technologies and telemedicine to treat wound patients and support practitioners anywhere, any time. The company delivers a Comprehensive Wound Care Management Program, Wound Patient Consultations, and specific services such as wound program assessment, formulary design, treatment guidelines assessment, wound documentation review, and practitioner education. Wound program development is available for Pressure Injury (Ulcer) Prevention and Management, Diabetic Foot Ulcer Prevention and Management, Ostomy Care and Management, and Palliative Wound Management. For more information about Corstrata, visit http://www.corstrata.com.

From PRWeb

Smart Bandages Give Better Treatment to Chronic Wounds

Engineers from Tufts University have developed a new prototype bandage that actively monitors the condition of chronic wounds and delivers the appropriate drug treatments to improve the chances of healing.

 

Chronic skin wounds from burns, diabetes and other medical conditions can overwhelm the regenerative capabilities of the skin and can lead to persistent infections and amputations.

 

However, the researchers designed the bandages with healing elements and thermoresposive drug carries that deliver tailored treatments in response to embedded pH, and temperature sensors that track infection and inflammation … read more

A smart bandage placed on an arm. Temperature and pH sensors in the bandage (right) are read by a microprocessor (left), which may trigger release of drug from the bandage by sending a current through heating elements. Credit: Tufts University

Low-cost prosthetic foot mimics natural walking

Prosthetic limb technology has advanced by leaps and bounds, giving amputees a range of bionic options, including artificial knees controlled by microchips, sensor-laden feet driven by artificial intelligence, and robotic hands that a user can manipulate with her mind. But such high-tech designs can cost tens of thousands of dollars, making them unattainable for many amputees, particularly in developing countries.

Now MIT engineers have developed a simple, low-cost, passive prosthetic foot that they can tailor to an individual. Given a user’s body weight and size, the researchers can tune the shape and stiffness of the prosthetic foot, such that the user’s walk is similar to an able-bodied gait. They estimate that the foot, if manufactured on a wide scale, could cost an order of magnitude less than existing products … read more

How to apply silver nitrate

Topical application of silver nitrate is often used in wound care to help remove and debride hypergranulation tissue or calloused rolled edges in wounds or ulcerations. It’s also an effective agent to cauterize bleeding in wounds. Silver nitrate is a highly caustic material, so it must be used with caution to prevent damage to healthy tissues.

 

Application method
Silver nitrate applicators are firm wooden sticks with 75% silver nitrate and 25% potassium nitrate embedded on the tip. Moistening the tip sparks a chemical reaction that burns organic matter (skin), coagulates tissue, and destroys bacteria.

read more

Retired surgeon leads local diabetes study

SHERIDAN — After working as an orthopedic surgeon for 20 years, Dr. Scott Nickerson was forced into an early retirement by diabetes.

 

After graduating from the Johns Hopkins University School of Medicine, Nickerson moved to Sheridan in 1977 to work as an orthopedic surgeon at Sheridan Orthopaedics, which was a small three-doctor practice at the time.

 

One of the many complications of diabetes is neuropathy, nerve damage that can lead to pain, weakness and loss of sensation in the extremities.

 

Nickerson said after living with diabetes for about 10 years, he began to notice his hands were getting clumsy.

 

“I would drop tools a little bit or just not have quite the sensation you would depend on to do the work,” Nickerson said. “Plus it would hurt me a lot to be on my feet.”

 

Nickerson decided to retire so the effects of his neuropathy would not affect his work as a surgeon … read more

Electrically charged bandages help to heal burn wounds

     combat antibiotic resistance

 

Researchers from the Ohio State University Wexner Medical Center have developed special electrically charged bandages that can prevent infections, combat antibiotic resistance and enable healing in burn wounds. This type of dressing turns electrically active when it comes in contact with bodily fluids. According to Dr. Chandan Sen, director of Ohio State’s Center for Regenerative Medicine and Cell Based Therapies, who led the study with colleagues at the Medical Center’s Comprehensive Wound Center and Center for Microbial Interface Technology, “Drug resistance in bacteria is a major threat, and antibiotic-resistant biofilm infections are estimated to account for at least 75 percent of bacterial infections in the United States. This is the first pre-clinical long-term porcine study to recognize the potential of ‘electroceuticals’ as an effective platform technology to combat wound biofilm infection.”

Read more at: https://gineersnow.com/industries/medical/electrically-charged-bandages-can-fight-infections

Medilight develops light system to heal wounds

European project makes bandage that bathes wound in blue light to speed recovery.

 

With the objective of using light to improve wound healing and within the framework of the European project MEDILIGHT, Swiss company CSEM and six partners have developed a new solution for treating chronic wounds. This portable device delivers blue light to improve and accelerate the healing process. The prototype was first presented this week at the project wrap-up event on July 2nd, at the URGO Laboratories in Dijon, France.

Chronic wounds are often difficult to treat, because they do not follow the typical injury healing process or time-frame. The resulting burden is significant, affecting over 40 million patients worldwide and costing healthcare systems an estimated €40 billion annually.

Blue light is known for its anti-microbial and anti-inflammatory effects in the initial stages of the healing process; it does not damage tissue, unlike the hazardous UV light. However, clear evidence of the beneficial effects of blue-light irradiation in the later stages of wound healing was still missing, thus hindering the development of effective solutions for complete therapy … read more

Heberprot-P to Deliver Effective Treatment Against Amino Acid

Metabolism Disorders; Nestle Health Sciences and Codex Collaboration to Enhance CodeEvolver Enzyme Platform

 

Metabolism is essentially a process that the human body uses to gain energy from food intake. In case of a metabolic disorder, improper food digestion takes place. Amino acids are referred to as building blocks. In case of metabolism disorders, breaking of amino acids becomes difficult that can lead to difficulty in getting them in cells. These complications can lead to generation of harmful substances in the body that can ultimately lead to life threatening or serious health problems. Such disorders are typically inherited, which makes their early diagnosis followed by effective treatment imperative. New-born babies are screened for such disorders via blood tests. According to analysis of Future Market Insights, the global market for amino acid metabolism disorders treatment is expected to grow at a high CAGR during the forecast period, 2017-2026 … read more

 

 

Superbug-Resistant Bandages

A staple of the news headlines in the UK over the past couple of years has been the periodic outbreak of so-called ‘Superbug’ infections in hospitals, when antibiotic-resistant strains of bacteria cause a high proportion of secondary infections in patients. Although the majority of such infections are relatively mild, they can develop into potentially fatal conditions including sepsis, toxic shock syndrome and necrotizing pneumonia. To keep things in context, the Superbug (or methicillin-resistant Staphylococcus aureus (MRSA)), for all its virulence, is simply the latest and most advanced version of a problem that spans human history – how to effectively combat bacterial infections that develop in wounds or injuries. Such infections were nearly always fatal before the development and wide-scale use of antibiotics; for example, in a military context, secondary infection and disease accounted for a far greater number of casualties than outright combat (at higher than a 2:1 ratio in the US Civil War) in the nineteenth century. In the ongoing medical arms race between diseases and treatment, then, MRSA is the next evolution on the side of the diseases, and a challenge that scientists and medics are working to meet … read more

Restoring the Wound Base: The Role of Tissue Management

Successful utilization of the TIME model for wound bed preparation requires a working knowledge of chronic wound tissue types. In addition, building on this foundational knowledge is the development of accurate wound assessment skills. These components combined will assist the clinician in implementing the appropriate interventions for each wound.

 

Viable Chronic Wound Tissue Types
The term “viable” describes vascular tissue with dynamic biological activity.

 

Epithelium: This should be dry to touch and can appear white or light pink; it is composed of restratified keratinocytes arising from the basement membrane of the dermis.

 

Granulation: This appears light pink to red and should be moist with a bumpy texture. Capillaries give granulation tissue its characteristic color, and collagen made from fibroblasts provides structural support. If granulation tissue is pale (poor perfusion), dark red or ruddy (vascular congestion or stasis), or “bubbly” or friable (bleeds with very gentle contact), it is technically considered non-viable because it will not support migrating epithelial cells … read more

Wound care and leg ulcer advances feature at conference

IT is estimated that annually the NHS treats over two million wounds at a cost of £5.3 billion and with tougher financial constraints being announced every year, there needs to be ongoing research to ensure the lack of finances doesn’t affect the quality of wound care available.

 

This was the topic of the opening lecture at the 3rd International Skin Integrity and Tissue Viability Conference hosted by the University of Huddersfield’s Institute of Skin Integrity and Infection Prevention (ISIaIP), in conjunction with the Journal of Wound Care.

 

The conference attracted 110 delegates from around the world and they listened to the former Head of Vascular Surgery at Bradford’s Royal Infirmary Professor Peter Vowden, as he gave the opening lecture entitled The Burden of Wound Care.

 

The recently retired wound care expert explained how wounds impose substantial health economic burden on the UK’s NHS.

 

He argued that it was comparable to that of managing obesity, which in 2012/2013 was valued at £5 billion. “Clinical and economic benefits would accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients and the NHS”, said Professor Vowden … read more

Expert explains how wounds impose health economic burden on the UK’s NHS

Former Head of Vascular Surgery at Bradford’s Royal Infirmary Professor Peter Vowden gave the opening address at the 3rd International Skin Integrity and Tissue Viability Conference which explored advances in and the management of all aspects wound care.

 

It is estimated that annually the NHS treats over two million wounds at a cost of £5.3 billion and with tougher financial constraints being announced every year, there needs to be ongoing research to ensure the lack of finances doesn’t affect the quality of wound care available.

 

This was the topic of the opening lecture at the 3rd International Skin Integrity and Tissue Viability Conference hosted by the University of Huddersfield’s Institute of Skin Integrity and Infection Prevention (ISIaIP), in conjunction with the Journal of Wound Care.

The conference attracted 110 delegates from around the world and they listened to the former Head of Vascular Surgery at Bradford’s Royal Infirmary Professor Peter Vowden, as he gave the opening lecture entitled The Burden of Wound Care … read more

Paulsen takes another run at repealing the medical device tax

Rep. Erik Paulsen (R-Minn.), facing a tough re-election campaign, is taking yet another run at repealing the medical device tax.

 

Althought the 2.3% levy on prescribed medical devices was enacted as part of the Affordable Care Act in 2010, it didn’t go into effect until 2012 and was mothballed two years later; that moratorium, extended earlier this year, is slated to end in 2020.

 

Paulsen, who filed his first bill to repeal the tax back in 2010, introduced his latest repeal bid in January 2017. The bill, H.R. 184, or the “Protect Medical Innovation Act of 2017,” aims to “amend the Internal Revenue Code of 1986 to repeal the excise tax on medical devices.” The bill has 269 co-sponsors, including 43 Democrats.

Citing “sources familiar with the plan,” The Hill reported yesterday that the U.S. House of Representatives could vote on the Paulsen bill as early as this month … read more

Moldable Hyaluronan Hydrogel Enabled by Dynamic

     Metal–Bisphosphonate Coordination Chemistry for Wound Healing

 

Biomaterial‐based regenerative approaches would allow for cost‐effective off‐the‐shelf solution for the treatment of wounds. Hyaluronan (HA)‐based hydrogel is one attractive biomaterial candidate because it is involved in natural healing processes, including inflammation, granulation, and reepithelialization. Herein, dynamic metal–ligand coordination bonds are used to fabricate moldable supramolecular HA hydrogels with self‐healing properties. To achieve reversible crosslinking of HA chains, the biopolymer is modified with pendant bisphosphonate (BP) ligands using carbodiimide coupling and chemoselective “click” reactions. Hydrogel is formed immediately after simple addition of silver (Ag+) ions to the solution of HA containing BP groups (HA‐BP). Compared with previous HA‐based wound healing hydrogels, the HA‐BP·Ag+ hydrogel is highly suitable for clinical use as it can fill irregularly shaped wound defects without the need for premolding. The HA‐BP·Ag+ hydrogel shows antimicrobial properties to both Gram‐positive and Gram‐negative bacterial strains, enabling prevention of infections in wound care. In vivo evaluation using a rat full‐thickness skin wound model shows significantly lower wound remaining rate and a thicker layer of regenerated epidermis as compared with the group left without treatment. The presented moldable and self‐healing supramolecular HA hydrogel with “ready‐to‐use” properties possesses a great potential for regenerative wound treatment … read more

Patient Assessment and Wound Dressing Considerations

As wound care clinicians, we need to take into consideration many different factors in deciding on a treatment plan for our wound patients. Our patients should be evaluated on an individual basis. If we look at our patient’s socioeconomic status, we will find it varies from patient to patient. Socioeconomic status clearly affects morbidity and mortality rates related to wounds: wound management tends to be lower in quality and follow-up visits tend to be fewer in number when compared with patients with better economic status.

Socioeconomic Factors Affecting Wound Management

Socioeconomic factors can be big stressors for patients. Patients want their wounds to heal but feel helpless. We, as compassionate health care clinicians, feel the frustration for our patients. Patients miss follow-up appointments because they lack gas money, access to transportation, or caregiver support to assist with transportation. What can we do to help? There are some hospitals throughout the country that have free shuttle services to and from the wound center. This helps relieve the burden for the patient and provides more consistent wound management. Most recently, there are companies that are similar to Uber, but for health care needs. The following list provides examples of barriers to wound management … read more

Kent Imaging Inc. and SerenaGroup announce Partnership in wound care

CALGARY, June 27, 2018 /PRNewswire/ – Kent Imaging Inc. and SerenaGroup® today announced a Strategic Partnership to jointly improve tissue assessment in wounds with the use of Near Infrared Imaging technology using Kent’s KD203 device.

 

Oxygenation is widely accepted as the best biomarker of tissue health and healing. Kent’s device is intended for use by healthcare professionals as a non-invasive tissue oxygenation measurement system that reports oxygen saturation (StO2), relative oxyhemoglobin level (HbO2), and relative deoxyhemoglobin (Hb) level in superficial tissue. Kent’s multispectral imaging technology displays two-dimensional color-coded images providing critical information to help clinicians determine at risk tissue and guide treatments to optimize patient outcomes in wound care, plastic surgery, and various other reconstructive applications.

 

This is a great partnership between one of the leaders in building wound care teams and an innovative tissue assessment technology that is easy to use, convenient, and cost effective. SerenaGroup® will adopt Kent Imaging’s technology as the standard of care for assessing wound oxygenation thus wound health. Kent will be integrated into each of the SerenaGroup® managed facilities, included in Hyperbaric training courses curriculum, as well as included in future clinical and preclinical research.

 

“We are pleased to introduce Kent’s imaging system into the wound care protocol at our clinics. One of the most troublesome and elusive criteria in treating wounds is the timely and accurate assessment of viable tissue.” said Dr. Serena MD FACS FACHM MAPWCA, Founder and Medical Director of The SerenaGroup®. “Kent’s device will propel us a long way down the healing path with a technology that has been lacking across the board in the Wound Care space. ”

read more

Healogics Releases Software to Improve Chronic Wound Care Experience

JACKSONVILLE, Fla.–(BUSINESS WIRE)–Healogics®, the wound healing experts, today announced the launch of two new applications that support efforts to improve the patient experience and save time for clinicians and physicians, all while increasing the quality and consistency of patient care. Clinical OptimizationSM and Decision SupportSM, applications on Healogics’WoundSuiteSM platform, enable the critical connection between people living with chronic wounds and their multi-disciplinary healthcare team for collaborative, evidence-based, patient-centered care.

 

“Over the past year, Healogics has been working tirelessly to ensure that the care teams at our Wound Care Centers® have access to the best software available to help more people heal. We are excited about the launch of these new applications, and their ability to support more in-depth documentation, accurate wound measurements and, most importantly, better patient outcomes,” said David Bassin, Healogics CEO.

 

Healogics Clinical Optimization provides clinicians and physicians with patient-focused insights starting with the daily team huddle. Additionally, this application supports them throughout the Healogics Patient Care ProcessSM, a six-sigma lean productivity process used in each Wound Care Center. Clinical Optimization provides a one-click patient summary that eliminates all of the arduous and time-consuming paper processes built around EMRs. By concisely presenting the essential patient information, physicians can now go through medical surveillance, a process designed to monitor patient healing, with case managers before ever walking into a patient’s room. This allows more time for meaningful patient interaction.

read more

Molecular Diagnosis of SSTIs May Yield Better Clinical Outcomes

Molecular diagnostics such as polymerase chain reaction (PCR)–based tests provide faster, more complete results than traditional culture-based tests, and their use may improve outcomes for patients with chronic wounds and skin and soft tissue infections (SSTIs), according to new findings presented at the 21st Annual MAD-ID Meeting held May 9 to 12 in Orlando, Florida.

About 6.5 million individuals were afflicted with chronic wounds and SSTIs in the United States in 2009.1 The costs of treating associated complications reached upward of $25 billion at that time. A more recent study estimated that annual Medicare spending for all wound types ranged from $28.1 billion to a whopping $96.8 billion in 2014.2

“These costs could potentially be mitigated with the use of rapid diagnostics that have the capability to better identify wound pathogens and thus allow clinicians to provide better clinical care through targeted antimicrobial therapy,” said Tanya Moreno, PhD, vice president of research and development at Millennium Health, citing a Mayo Clinic Proceedings article on the hospitalists’ view of treating SSTIs … read more

Skin hydration of the heel with fissure in patients with diabetes:

     a cross-sectional observational study

 

Purpose: Foot fissure should be prevented in patients with diabetes due to the likelihood of subsequent diabetic ulcer. The purpose of this study was to investigate a cutoff point for skin hydration with fissure and the factors associated with low skin hydration in patients with diabetes.

 

Subjects and methods: Subjects were patients with diabetes who visited the diabetic foot clinic and were evaluated for skin hydration on the heel between April 2008 and March 2015. Information about fissure, skin hydration, age, sex, autonomic neuropathy, angiopathy, and tinea pedis were collected from the medical charts. Skin hydration on the heel was measured using a moisture checker. Skin hydration was compared between heels with and without fissure, and a cutoff for skin hydration with fissure was determined using receiver operating characteristic analysis. Based on the determined cutoff, factors associated with lower skin hydration were analyzed using logistic regression analysis.

 

Results: Participants comprised 693 patients. Mean±SD age was 66.8±10.8 years, and 57.0% of subjects were male. The frequency of fissures on the heels was 10.4%. Area under the receiver operating characteristic curve for skin hydration in the presence of fissure was 0.717. Twenty percent was selected as the cutoff point, offering sensitivity of 0.478 and specificity of 0.819. Logistic regression analysis showed correlations between three factors (male sex, tinea pedis, and room temperature) and skin hydration <20.0% (odds ratio [OR] 1.587, 95% CI 1.157–2.178, p=0.004; OR 1.548, 95% CI 1.122–2.135, p=0.005; and OR 0.900, 95% CI 0.823–0.0985, p=0.021, respectively).

 

Conclusion: To prevent heel fissures, moisturizing care should aim at achieving skin hydration of 20%. If skin hydration is <20%, prevention of fissures may warrant not only specialized moisturizing care but also consideration of treatment for tinea pedis.

read more

Eggshell membrane waste beneficial for wound healing

EU research has brought the benefits of eggshell membrane (ESM) protection from the chick to ‘hard-to-heal’ open wounds.

 

Delayed chronic wound healing is the so-called ‘vicious cycle’ of many illnesses. Chronic inflammation, excess protease, a key risk factor in healing, and tissue degradation are the hallmarks of this condition that can lead to further debilitation for the patient including a deterioration in psychological health. What’s more, already high healthcare costs are set to escalate the longer the wound goes unchecked.

 

ESM: Material mastermind behind wound healing

 

ESM is a low-cost alternative to currently used collagen-derived dressings that are often too expensive to use. Based on a novel biomaterial derived from ESM, it is extracted from waste eggshells. Protecting the egg and its chick during development, ESM is a thin, structural protein-rich lining that performs similar key functions in wound healing to the extracellular membrane in skin … read more

Wound Care Clinical Trials: Setting the Record Straight

A recent article by Kaiser Health News misquoted me as saying that we enroll only “healthy” patients in our clinical trials. At moments like this, one feels that something has been overlooked. One of my research coordinators, recalling the serious adverse events (SAEs) of the previous week said, “The only patients sicker than ours are underground.”

 

Anyone who has ever spent more than ten minutes in a wound clinic knows that our patients are anything but healthy. Our acuity levels mirror the dialysis and transplant units. We check the obituaries when our patients miss appointments.

The Chronic Wound Epidemic

Although it should be, this is not just a minor annoyance. A procession of anecdotal observations on the failing health of the wound care space—in a time of flux and disarray—is neither enlightening nor supportive. The article itself focuses on the use of expensive products in wound care. In comparison to other medical specialties, such as oncology or cardiology, our products are inexpensive and cost effective. Chronic wounds are an unacknowledged epidemic. The huge increase in spending has less to do with the cost of wound care products than it does to the staggering number of patients who need them. Why is wound care research so poorly funded? The National Institutes of Health (NIH) does not even have a wound care division … read more

MediWound Completes Enrollment in NexoBrid®

U.S. Phase 3 DETECT Study

YAVNE, Israel, June 11, 2018 (GLOBE NEWSWIRE) — MediWound Ltd. (Nasdaq:MDWD), a fully-integrated biopharmaceutical company bringing innovative therapies to address unmet needs in severe burn and wound management, today announced it has completed enrollment in NexoBrid®U.S. Phase 3 DETECT study. Top-line acute data are currently expected around year end 2018.

 

“We are happy to achieve this important milestone of completing the enrollment in NexoBrid Phase 3 study, which is one of the most comprehensive randomized controlled studies ever conducted in burn care, and we believe it will support our Biological License Application (BLA) submission to the FDA,” said Gal Cohen, president and chief executive officer of MediWound. “Prior studies of NexoBrid have shown positive results and we eagerly await our top-line acute data. Subject to a successful study outcome, we plan to meet with the FDA to discuss the BLA submission plan. We warmly thank our Principal Investigators, their teams and everyone involved in the study for their commitment and dedication in an effort to advance burn care.”

read more

What is a deep tissue injury?

A deep tissue injury is a unique form of pressure ulcer. The National Pressure Ulcer Advisory Panel defines a deep tissue injury as “A pressure-related injury to subcutaneous tissues under intact skin. Initially, these lesions have the appearance of a deep bruise. These lesions may herald the subsequent development of a Stage III-IV pressure ulcer even with optimal treatment.”(NPAUP, 2005). Why is it important to have yet another stage for pressure ulcers? The answer lies in the fact that, even with proper treatment, deep tissue injuries can deteriorate quickly into your worst nightmare.

 

The Problem With Deep Tissue Injuries

The problem with deep tissue injuries is that they are not readily apparent. A patient who has fallen at home and lain on the floor for a day may be admitted to the hospital and have every inch of skin examined upon admission, and then develop the tell-tale area of purplish discoloration several days after admission. In many cases, hospitals and other care facilities are being blamed (and payment is being withheld) when patients end up with a gaping hole in their sacrum that takes several months (and several trips to the OR) to heal, if they don’t succumb to their injury … read more

Wound healing is complex, almost miraculous process

Without the ability to heal wounds every scratch, nick, scrape and cut would remain open, a permanent and painful reminder of the body’s frailty.

 

Yet this basic process of life goes largely unrecognized because it works so effectively.

 

Wound healing requires the activation of over 10,000 genes, a precise, sequential release of hundreds of chemicals and the growth, division and migration of millions of different types of cells. It is usually only when wound healing fails, leaving us with a chronic wound, that we ever are aware of the process.

 

Normal wound healing involves four distinct phases: the clotting of blood, inflammation, proliferation and remodeling. Chemicals released from the cells of the damaged capillaries, the work of platelets and formation of the blood clot initiate the healing process …. full article

Healogics settles False Claims allegations

     agrees to pay up to $22 million

 

Healogics has agreed to pay up to $22 million to settle allegations that it knowingly billed Medicare for medically unnecessary therapies, the Justice Department announced Wednesday.

 

The Jacksonville-based company manages the hyperbaric oxygen therapy centers at more than 700 hospital-based wound care facilities across the country and is one of the largest in the nation. The company has several centers in Central Florida.

 

According to the Justice Department, between 2010 and 2015 Healogics knowingly caused wound care centers to bill Medicare for hyperbaric oxygen therapies that were medically unnecessary and unreasonable.

 

The allegations stem from two whistleblower lawsuits, one filed by a former director for research and quality at Healogics and another filed by several doctors and employees at Healogics-affiliated wound care centers.

 

“Medicare beneficiaries are entitled to care based on their clinical needs and not the financial goals of healthcare providers,” said Chad Readler, the Justice Department’s … read full article

Healogics to Host Scientific Symposium on Diabetic Wound Healing Innovations

The Healogics symposium will include an overview of diabetic wound identification, prevention and care, and a discussion on leveraging data to improve wound care.

 

JACKSONVILLE, Fla., June 19, 2018 /PRNewswire/ — Healogics, Inc., the foremost advanced wound care services provider for hospitals, is honored to be hosting a scientific symposium entitled Innovations in Diabetic Wound Healing at the American Diabetes Association 78th Scientific Sessions. The symposium will be taking place on Saturday, June 23 in Orlando, Florida.

 

The symposium will be led by Healogics Chief Medical Officer, Dr. William Ennis and Organogenesis Vice President of Global and Medical Affairs, Dr. Shabnam Vaezzadeh. There will be presentations from Healogics Medical Director, Dr. Jaime Wise, the Founder and President of the “Save A Leg, Save A Life” Foundation, Dr. Desmond Bell and the Medical Director of the Acute Care Orthopedic Program at Genesis Hospital, Dr. Amy Tucker. The symposium will include an overview of diabetic wound identification, prevention and care, and a discussion on leveraging data to improve wound care. Data will also be shared on wound healing outcomes of more than half a million wounds treated in Healogics outpatient clinics. The use of machine learning and predictive analytics in diabetic wound care will also be discussed … read more

New Products & Practices for Wound Care

Apps, HydroClean and Honey?

According to PR Newswire, the wound care biologics market is expected to earn 1.42 billion US dollars in 2018. That number is expected to skyrocket by the year 2023, when the market is expected to increase to 2.26 billion US dollars.

 

That is a jaw-dropping amount of money that we’re spending on wound care. What’s going on?

 

There are several factors that are driving up the those wound care dollars – primarily diabetic foot ulcers, the aging geriatric population, and a general increase in burn injuries globally.

 

With the ever-increasing number of wounds requiring advanced wound care, there is new products and practices. Here’s a quick update … read more

Wound management in a case of an open amniotic band

     syndrome in a 31-week-old preterm baby

 

This is a case study of a 31-week-old preterm baby presented with severe amniotic band syndrome of the left leg at birth. Circumferential band with skin defect, exposing the subcutaneous tissue and periosteum of the left tibia was visible on the distal third of the left leg. The left dorsalis pedis artery and posterior tibialis artery pulsations were not palpable, but detectable with handheld Doppler ultrasound device. The capillary refilling time of the toes was good. While waiting for stabilisation of patient’s condition due to the poor lung function, wound management played a role in this case to protect the exposed left tibia from dehydration and necrosis as well as prevention of infection via the skin defect. Wound closure of the left leg was successfully achieved in 18 days … read more

Wound Care Challenges: When The Lymphatic System Doesn’t Work

Due to difficulty defining lymphatic markers, difficulty visualizing vessels with traditional methods, and emphasis on the vascular system, research into the development of the lymphatics is still in its infancy–with many theories still to be proven. Without a doubt, it starts development in week 5, perhaps from the veins or the mesenchyme. Then, in weeks 6-9, sacs are formed in the neck, groin, posterior abdominal wall, and in the gut. Ducts grow and connect the different sacs while lymphatic vessels grow peripherally to the head, neck, arms, gut, and legs. The sacs become the lymph nodes, except for the upper portion of the gut sac: the cisterna chyli. Mesenchymal cells infiltrate the nodes and develop channels, capsule, and node framework. Lymphocytes appear just before birth in the nodes from the thymus. Lymph organs form from mesenchymal cells and clumping of lymph nodules.

 

So, from week 5 to the final week of gestation, the lymphatic system is developing. A spontaneous mutation at any point, injury to the fetus, a hereditary malformation, or a preterm delivery can all affect the lymphatic system of a child. This deficit can be apparent at birth, or latently appear at any time in their life, depending on where the deficit is … read more

Dressing Selection: Which Dressing to Choose?

Dressing selections can be overwhelming for clinicians and providers in health care. There are now well over 6,000 wound care products on the market. Ideally, there would be a multifunctional smart dressing that could “do it all” readily available in all settings. Unfortunately, we as health care providers know, that definitely isn’t the case.

 

Dressing category education plays a vital role in wound management. Knowing the functionality and appropriateness of the dressing is key in enhancing the wound healing process. As wound care clinicians, we want to be in a mindset of looking at our whole patient. However, let’s not forget the Wound Care Basics 101: wound bed preparation, monitoring, patient compliance, appropriateness of dressing, and addressing underlying factors or causes.

 

Biofilm formation is also a culprit for impeding wound healing. Most, if not all, ulcers develop a biofilm over time. It is reported 60% to 90% of chronic wounds contain a biofilm. Therefore, selecting the appropriate dressing for effectiveness is imperative … read more

Micelle‐Coated, Hierarchically Structured Nanofibers with Dual‐Release

     Capability for Accelerated Wound Healing and Infection Control

 

Tailoring nanofibrous matrices—a material with much promise for wound healing applications—to simultaneously mitigate bacterial colonization and stimulate wound closure of infected wounds is highly desirable. To that end, a dual‐releasing, multiscale system of biodegradable electrospun nanofibers coated with biocompatible micellar nanocarriers is reported. For wound healing, transforming growth factor‐β1 is incorporated into polycaprolactone/collagen (PCL/Coll) nanofibers via electrospinning and the myofibroblastic differentiation of human dermal fibroblasts is locally stimulated. To prevent infection, biocompatible nanocarriers of polypeptide‐based block copolymer micelles are deposited onto the surfaces of PCL/Coll nanofibers using tannic acid as a binding partner. Micelle‐modified fibrous scaffolds are favorable for wound healing, not only supporting the attachment and spreading of fibroblasts comparable to those on noncoated nanofibers … read more

Molecular Diagnosis of SSTIs May Yield Better Clinical Outcomes

Molecular diagnostics such as polymerase chain reaction (PCR)–based tests provide faster, more complete results than traditional culture-based tests, and their use may improve outcomes for patients with chronic wounds and skin and soft tissue infections (SSTIs), according to new findings presented at the 21st Annual MAD-ID Meeting held May 9 to 12 in Orlando, Florida.

About 6.5 million individuals were afflicted with chronic wounds and SSTIs in the United States in 2009.1 The costs of treating associated complications reached upward of $25 billion at that time. A more recent study estimated that annual Medicare spending for all wound types ranged from $28.1 billion to a whopping $96.8 billion in 2014 … read more

Treatment of Diabetic Foot Ulcers

Diabetic wound is the most common cause of non-traumatic
lower extremity amputation, and response to traditional
interventions is poor in many patients. The lifetime risk of
developing an ulcer among diabetics is 25%, and recurrent
wounds are common after healing. Stigmatization, social
isolation, unemployment, and depression are some of the
negative consequence of Diabetic Foot Ulcer (DFU) on the
quality of life of diabetics. DFU adds a substantial economic
burden to afflicted patients and health systems, primarily
attributable to frequent hospitalization, medication, surgical
procedures, amputation, prosthesis, rehabilitation, and loss of
productivity … read more

Negative-Pressure Therapy No Better for Open Fractures

Negative-pressure therapy does not improve 12 month outcomes compared with standard wound dressings in adults with severe open fractures of the lower limb, according to a study published online June 12 in JAMA.

 

The study is the largest randomized controlled trial (RCT) to compare negative-pressure therapy to standard wound care in this setting.

 

“The findings do not support this treatment for severe open fractures,” write Matthew Costa, PhD, from the University of Warwick, Coventry, United Kingdom, and colleagues with the UK Wound management of Open Lower Limb Fractures (WOLLF) Collaboration … read more

Dressing Selection: Which Dressing to Choose?

Dressing selections can be overwhelming for clinicians and providers in health care. There are now well over 6,000 wound care products on the market. Ideally, there would be a multifunctional smart dressing that could “do it all” readily available in all settings. Unfortunately, we as health care providers know, that definitely isn’t the case.

 

Dressing category education plays a vital role in wound management. Knowing the functionality and appropriateness of the dressing is key in enhancing the wound healing process. As wound care clinicians, we want to be in a mindset of looking at our whole patient. However, let’s not forget the Wound Care Basics 101: wound bed preparation, monitoring, patient compliance, appropriateness of dressing, and addressing underlying factors or causes … read more