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

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

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

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.

read more

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

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

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

     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

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

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

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

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

     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

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

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

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

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

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

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

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

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

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

     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

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

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

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

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

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

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

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

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

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

     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

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

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

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

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

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

     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).3 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.6 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

From Today’s Wound Clinic offers an informative clinical guide to review and pass along to their patients for purposes of assisting in their education.  Login required to download PDF version

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

     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

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

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

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

     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

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

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

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.

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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

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

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

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

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.”

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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

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

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

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

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.”

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     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

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

     Preservation Method Allowing Ambient Storage of Living Tissues

COLUMBIA, Md., June 04, 2018 (GLOBE NEWSWIRE) — Osiris Therapeutics, Inc.(OTC Pink:OSIR), a regenerative medicine company focused on developing and marketing products for wound care, orthopedics, and sports medicine, announced today the implementation of Prestige Lyotechnology for manufacturing of commercial products.

In 2017, Osiris announced the development of Prestige Lyotechnology, a preservation technique for ambient storage of living tissues (see http://www.osiris.com/wp-content/uploads/2017/03/2017-03-30-Prestige-Lyo-Nature-article-PR-FINAL.pdf). In April 2018, studies describing properties of viable lyopreserved tissues were presented at scientific conferences including the Annual Symposium on Advanced Wound Care (SAWC) and Wound Healing Society (WHS) (see http://www.osiris.com/wp-content/uploads/2018/04/2018-04-24-Osiris-to-Present-at-SAWC-Spring-2018-FINAL.pdf).

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MELBOURNE, Australia, June 01, 2018 (GLOBE NEWSWIRE) — Australian stem cell and regenerative medicine company Cynata Therapeutics Limited (ASX:CYP) is pleased to announce that it has received positive data demonstrating the efficacy of its Cymerus™ mesenchymal stem cells (MSCs) in a preclinical model of diabetic wounds (also known as diabetic ulcers). The studies were conducted independently by the Cooperative Research Centre for Cell Therapy Manufacturing (CTM CRC) and were designed to compare cells from various sources.

Key Highlights:

• Cymerus MSCs resulted in significantly faster wound healing than bone marrow-derived MSCs
• Discussions between Cynata and CTM CRC are underway regarding progressing Cymerus MSCs and CTM CRC’s wound-dressing technology into a clinical trial in human patients with diabetic foot ulcers
• Diabetic wounds are prevalent among the 400m+ diabetics globally and a significant opportunity exists to improve existing treatments and meet a growing unmet medical need

CTM CRC, based in Adelaide, South Australia, is developing an active wound care dressing for the treatment of diabetic wounds. This novel dressing, for which a patent is pending, consists of a polymer-coated silicone dressing seeded with MSCs or similar cells … read more

Eleven leaders in tech — from high school students to large companies — were honored Thursday night during the Charlottesville Business Innovation Council’s annual awards gala.

The CBIC, a nonprofit council of technology-related businesses, organizes the gala every year to celebrate the area’s achievements in innovation.

“There’s so many things happening in Charlottesville, but it’s nowhere in one place,” said 2018 CBIC Student Entrepreneur of the Year Ashwinraj Karthikeyan. “Here, you can talk to all sorts of people doing really cool things in the entrepreneurial community.”

A recent graduate of the University of Virginia, Karthikeyan founded the chronic wound care company InMEDBio as a student. His award included a $1,000 grant.

More than 400 people attended the event at the Paramount Theater, which included a showcase of early-stage startups and an optional dance party.

“Two years ago, when I came to my first one of these, that’s where I met the person who helped make our first prototype,” said gala attendee Arjun Dirghangi while manning a table for his medical startup, Scanoptix … read more

The signing of the Bipartisan Budget Act of 2018 that took place Feb. 9 received much in the way of national media coverage because it ended the United States’ governmental shutdown. However, the act also provided the wound care industry some “wins” that were not well publicized. This article will focus on the major “wins” that pertain to wound care professionals who work in outpatient provider-based departments (PBDs) as well as various other sites of care and payment models.

REMOVED “DIRECT SUPERVISION” IN CRITICAL ACCESS PBDs

Hospital-based outpatient wound care PBDs are required to have direct physician supervision when Medicare beneficiaries are receiving therapeutic services. However, these same departments that are housed in critical access hospitals (CAHs) were exempt from the direct supervision requirement until 2014, when the Centers for Medicare & Medicaid Services (CMS) announced that it was going to enforce the direct-supervision requirement for CAHs. At that time, Congress stepped in and prevented CMS from enforcing the direct-supervision requirements for 2014, 2015, and 2016. However, Congress did allow CMS to enforce direct supervision in CAHs effective Jan. 1, 2017. That new requirement surprised many and caught staff members in the CAH space off guard, especially among those who did not have the availability of physicians or other qualified healthcare professionals who could be immediately available when patients were receiving care in the PBDs … read more

     and decorative elements

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, customised 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

MALAT1 Promote Human Dermal Fibroblast Migration and Ischemic Wound Healing

Using Pressure-Sensing Shoe Insoles

The SurroSense Rx system is a set of pressure-sensing shoe insoles that connect wirelessly to a proprietary smartwatch and is intended for people with diabetes who have mild to moderate sensory loss associated with diabetic peripheral neuropathy, or nerve damage. By providing real-time alerts about plantar pressure distributions, or the area of pressure between the foot and the surface supporting it, users of the SurroSense Rx system can alter their activities in order to relieve unsafe pressures. The SurroSense Rx system is used in addition to current standard-of-care treatment for the prevention of plantar ulcers in diabetic patients. There is currently no available evidence that using the SurroSense Rx system prevents plantar ulcers. However, there are ongoing clinical trials that may identify patient populations that will benefit from its use.

Over time, high blood sugar in people living with diabetes causes damage to the peripheral nerves — the nerves that serve the arms, hands, legs, and feet. This damage, called diabetic peripheral neuropathy, includes symptoms such as painful tingling or burning sensations in the hands and feet, and the loss of protective sensations such as feeling pain or temperature changes.¹ When pain sensation is lost, there is an increased risk of developing open sores caused by prolonged pressure or other injuries … read more

     a paradigm shift in wound care

Chronic ulcers continue to pose a significant clinical and economic burden for both patients and wound care practitioners. Despite good standard of care (SOC), many wounds fail to heal. Wound healing requires a complex cascade of physiologic and immunologic processes as well as proper nutrition. An adequate balance of macro- and micronutrients is important to support the cellular activities that are necessary for repairing and remodeling of tissue. Despite being well documented in a number of clinical studies there continues to be a gap in recognizing nutritional deficits as well as appropriate clinical interventions in patients with chronic wounds. Effective management of malnutrition in patients with chronic wounds requires collaboration among multiple clinical disciplines. A holistic nutritional management approach may yield both clinical and economic benefits … read more

As advancements in connectivity and miniaturization of electronics are made, smart sensors are beginning to find traction within the wound care pathway. IDTechEx has published a report titled Advanced Wound Care Technologies 2018 – 2028 and have previously reported on why disruption is needed in wound care in the next 10 years. Here, we explore a few connected devices that can contribute to the prevention of chronic wounds of pressure ulcers (PUs) and diabetic foot ulcers (DFUs).

Sensors for the Prevention of Pressure Ulcers MedicusTek have created the Sensable Care system which relies on a connected sensor pad or sensor mattress for detection of patient positioning to prevent pressure ulcer formation. By tracking patient position over time, the Sensable Care system can determine which areas of the patient are being exposed to prolonged pressure and notify caregivers accordingly for repositioning. The system resets if the patient successfully repositions themselves, thus decreasing the burden on caregivers where possible. Moreover, caregivers can receive immediate feedback as to whether their repositioning efforts were adequate in reliving the excessive pressure.

Read more at: https://www.wearabletechnologyinsights.com/articles/14270/connected-sensors-for-the-prevention-of-chronic-ulcers

Pancreatic cell transplants have the potential to be a permanent treatment for Type 1 diabetes. Problem is, the cells have trouble forming the blood vessel networks they need to thrive and provide insulin to patients. So scientists in the U.S. and Japan devised a new tissue engineering method to tackle this blood-supply problem in pancreatic cell transplantation. Using the method, they created pancreatic islets that cured severe Type 1 diabetes when they were transplanted into mice.

Human pancreatic islets tend to lose their blood vessels while being prepped for transplant, and attempts to combat this—including creating new islets from stem cells—have been largely unsuccessful, the researchers, from Cincinnati Children’s Hospital and Yokohama City University (YCU), wrote in their study. So to speed up vascularization in transplanted tissues, the researchers, led by Takanori Takebe of Cincinnati Children’s and Hideki Taniguchi of YCU, created a technique called self-condensation cell culture … read more

The first step towards ending avoidable amputations within a generation

Diabetic Foot Australia September 2017

Introduction
On any given day in Australia, the national burden of diabetes-related foot disease (DFD) is
significant:
• 300,000 people are at-risk of developing DFD
• 50,000 people are living with DFD
• 12,500 people are living with a diabetes-related amputation
• 1,000 people are in hospital because of DFD
• 12 people will undergo a diabetes-related amputation
• 4 people will die because of DFD
• $4 million will be spent managing DFD
To reduce this large national burden, the following three priorities should be addressed for people
with, or at-risk of, DFD:
A. Access to affordable and effective care
B. Provision of safe quality care
C. Research and development to improve patient outcomes

download pdf

for the Prevention of Chronic Ulcers

As advancements in connectivity and miniaturization of electronics are made, smart sensors are beginning to find traction within the wound care pathway. IDTechEx Research has published a report titled Advanced Wound Care Technologies 2018–2028 and have previously reported on why disruption is needed in wound care in the next 10 years. Here, IDTechEx explores a few connected devices that can contribute to the prevention of chronic wounds of pressure ulcers (PUs) and diabetic foot ulcers (DFUs).

Sensors for the Prevention of Pressure Ulcers

MedicusTek have created the Sensable Care system which relies on a connected sensor pad or sensor mattress for detection of patient positioning to prevent pressure ulcer formation. By tracking patient position over time, the Sensable Care system can determine which areas of the patient are being exposed to prolonged pressure and notify caregivers accordingly for repositioning. The system resets if the patient successfully repositions themselves, thus decreasing the burden on caregivers where possible. Moreover, caregivers can receive immediate feedback as to whether their repositioning efforts were adequate in reliving the excessive pressure … read more

by Margaret Heale RN, MSc, CWOCN

The research lecturer’s name was Terry, and he had my respect and attention. Many of the students were dreading the research modules but were cheered by the prospect of Terry taking us through it.

Terry included this little gem in his introduction to research. A group of researchers came up with a hypothesis that spiders had ears in their legs. How could they prove this, they wondered. They procured some arachnids of exactly the same type and took great pains to match them for all important parameters. They checked carefully the hearing of each. Placing them in turn in a quiet, stable tray, each time they yelled “Run!” every spider would take off at speed at the sound. The next step was to remove the spiders’ ears, so the legs of each spider were removed. Now when the researchers yelled “Run!” the spiders did not hear and did not move at all. So there you have it, clear undeniable proof, spiders have ears in their legs. It is very easy to see the flaw in this rather cruel piece of research, but sadly it is not always that easy … read more

TAMPA, Fla. – Principles from Tampa, Fla.-based Ally Medical Services and McKinney, Texas-based Preston Mobility Plus, dba Preston Wound Care, have merged. They’re now wholly owned subsidiaries of Acentus, also based in Tampa. Ally Medical is one of Florida’s larges providers of incontinence and medical nutritional supplies to children with special healthcare needs, and urological catheters to the neurogenic bladder patient population. Preston Wound Care is one of Texas’ largest wound care providers to patients living at home with diabetic ulcers and chronic wounds … read more

Role in Pathogenesis and Interest in Diagnosis

Infection of foot ulcers is a common, often severe and costly complication in diabetes. Diabetic foot infections (DFI) are mainly polymicrobial, and Staphylococcus aureus is the most frequent pathogen isolated. The numerous virulence factors and toxins produced by S. aureus during an infection are well characterized. However, some particular features could be observed in DFI. The aim of this review is to describe the role of S. aureus in DFI and the implication of its toxins in the establishment of the infection. Studies on this issue have helped to distinguish two S. aureus populations in DFI: toxinogenic S. aureus strains (harboring exfoliatin-, EDIN-, PVL- or TSST-encoding genes) and non-toxinogenic strains. Toxinogenic strains are often present in infections with a more severe grade and systemic impact, whereas non-toxinogenic strains seem to remain localized in deep structures and bone involving diabetic foot osteomyelitis. Testing the virulence profile of bacteria seems to be a promising way to predict the behavior of S. aureus in the chronic wounds … read more

     Board of Directors Elect New President

Moore will lead the Board of Directors of the largest wound care credentialing organization in the United States

For Immediate Release:
May 7, 2018, St. Joseph, MI—National Alliance of Wound Care and Ostomy (NAWCO®) Board of Directors announced today, it has elected Ms. Ottamissiah (Missy) Moore, RN, WCC, DWC, GC, CSD-LTC, President of the Board.

“As a long-standing member of our Board of Directors, Missy’s forwardthinking contributions have helped articulate our vision. We welcome her leadership as President to elevate our mission further,” said Cindy Broadus, Executive Director NAWCO.

Moore is a past president of the National Federation of Licensed Practical Nurses and a Lifetime member of the National Black Nurses Association. She served on the board for the District of Columbia State Board of Nursing and other appointed committee positions including:

• National Council of State Boards of Nursing, PN NCLEX Item Selection Committee
• Commission of Graduates of Foreign Nursing Schools, LPN Standards Committee
• National League for Nursing Licensed Practical Nurse Ad Hoc Committee.

“I am thrilled and honored to be elected President of the NAWCO Board of Directors. I am committed to elevate our support for this amazing group of certified healthcare clinicians,” said Moore.

Missy is employed as Community Liaison at Right at Home Of DC, located in Washington D.C. and Wound Education Consultant for Quality In-services and Training.

About NAWCO NAWCO is a non-profit credentialing board, dedicated to the advancement and promotion of excellence in wound care and ostomy management. NAWCO is the largest and fastest growing credentialing organization in the field of wound care and ostomy management for Nurses, Nurse Practitioners, Physical Therapists, Physical Therapy Assistants, Occupational Therapists, Occupational Therapy Assistants, Registered Dietitians/Registered Dietitian Nutritionists, Physician Assistants, and Physicians. For more information about NAWCO certifications, visit www.nawccb.org.

Extracellular Matrix Device Designed to Reinforce Soft Tissue in a Range of Implantable Settings

Columbia, MD—(April 11, 2018) – ACell, Inc. today announced the introduction of Gentrix Incisional, a new implantable device comprised of the company’s proprietary MatriStem UBM™ technology, designed to reinforce soft tissue in surgical site incisions.

Gentrix Incisional is an extracellular matrix that facilitates the remodeling of site-appropriate, functional tissue where scarring would be expected. The device provides a scaffold for cellular infiltration and neovascularization, and can be used to reinforce primary closure of soft tissue in a variety of surgical settings.

“Gentrix Incisional is ideal for surgical cases where there are concerns about the integrity of the soft tissue repair,” said Thomas W. Gilbert, Ph.D., Chief Science Officer. “It is targeted for patients and procedures where additional reinforcement of primary closure is desired.”

“We are excited to offer an additional tool to surgeons and their patients with the introduction of Gentrix Incisional,” said Patrick A. McBrayer, President and CEO. “This addition to our family of MatriStem UBM devices represents our continued commitment to providing innovative and effective solutions in the area of surgical soft tissue reinforcement.”

About ACell, Inc.

ACell, Inc. is a leading regenerative medicine company focused on the development, manufacturing, and commercialization of medical devices for wound management and surgical soft tissue repair. ACell is committed to becoming and remaining an innovative leader in regenerative medical technology, offering superior healing options for doctors and patients. ACell is a privately held company and operates manufacturing facilities in Columbia, MD and Lafayette, IN.

Contact

Angela Ortado
410-953-8527
angelaortado@acell.com

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    A Patient With Diabetes And Edema

A 56-year-old man presented to our institution with the chief complaint of a scaly, pruritic lesion on the lateral aspect of his left lower leg. He would notice some mild bleeding when scratching the area. He denied having any other lesions on his body and there was no previous treatment.

The patient’s past medical history included type 2 diabetes with Charcot arthropathy and neuropathy, hypertension, atrial fibrillation, and deep venous thrombosis. His past surgical history was remarkable for cardiac ablation. The patient is married and does not use tobacco products. He admitted to rare consumption of alcohol.

The patient’s physical exam revealed a man who appeared healthy. The pedal pulses were palpable with capillary refill in less than two seconds to the digits. Mild edema and varicosities were present at the ankle region bilaterally. The neurologic exam with the 10-gram Semmes-Weinstein monofilament showed decreased sensation to the dorsal and plantar aspects of both feet … read more

Abstract:
Introduction. Silver dressings are widely used in the treatment of chronic wounds to reduce bacterial bioburden. However, little is known about the mechanism of silver ions on the healing process. In this study, a mouse model of wound healing was used to examine the effect of silver dressings in normal and diabetic wounds.

METHODS:
Two 5-mm full-thickness wounds were created on the dorsal skin of diabetic BKS.Cg- m+/+Leprdb/J mice (experimental group) and wild type C57BL/6 mice (control group), and treated with either a silver or gauze dressing. Measurement of wound areas by digital planimetry demonstrated faster healing in the silver-treated wounds of both diabetic and control mice.

RESULTS:
Quantitative bacterial cultures showed a reduction of bioburden in silver-treated wounds in wild type mice. Unexpectedly, there was no decrease in bioburden in the silver-treated diabetic wounds compared to the control diabetic wounds, despite improved healing in the silver-treated diabetic wounds. Staphylococcus xylosus, a known biofilm producer, was the only bacteria identified in all the wounds. In vitro studies showed S. xylosus produced biofilms faster in higher glucose environments; this may explain the increased bioburden in the wounds in diabetic mice compared to wild type mice.

CONCLUSION:
The results demonstrate improved healing and reduced bioburden in normal wounds with silver dressings. In contrast, silver dressings improved healing in diabetic wounds despite no effect on bioburden, suggesting silver may have beneficial effects in addition to its antimicrobial properties.

Original article from The National Library of Medicine (NLM) 

This article is based on the proceedings of the one-day ‘Raising the Bar’ conference in Singapore held by Wounds International and supported by an educational grant from Urgo International on October 15, 2017. The day provided more than 100 clinicians from around Asia with an exceptional opportunity to gain insights and best practice recommendations from a faculty of local and regional wound care specialists, supported by visions from global practitioners … read more

in Type 2 Diabetic Patients With a Foot Ulcer: A Randomized Control Study

PURPOSE: 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.

DESIGN: Prospective, randomized controlled study.

SUBJECT AND SETTINGS: 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.

METHODS: 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 …. read more

Patients with diabetes must guard against nerve damage disorders that can numb feeling in their extremities. Engineering students developed a device to help patients with diabetes easily monitor their feet for cuts or other injuries.

Engineering students developed a device to help patients with diabetes easily monitor their feet for cuts or other injuries.

A simple device developed by Rice University students can help this population detect early signs of foot ulceration that, left untreated, could endanger their health and lead to amputation.The inspection device is likened to a foot stand one might see in a shoe store but with the addition of a clear plastic top, cameras, lights, a mirror and electronics that allow people to easily examine their feet.

The initial design attached a camera on a gooseneck to the end of a telescoping stick that patients could manipulate to manually inspect their feet … read more

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