Category: Articles

Feasibility of Virtual Simulation-Based Diabetes Foot Care Education in

Patients with Diabetes in Ethiopia: Protocol for a Randomized Controlled Trial

 

Fisseha Zewdu Amdie, Marian Luctkar-Flude, Erna Snelgrove-Clarke, Monakshi Sawhney, Shitaye Alemu, Kevin Woo

 

Diabetes mellitus is a rapidly growing global public health problem; the number of adults with diabetes is expected to increase from 424.9 million in 2017 to 628.6 million in 2045. Approximately 80% of diabetic patients live in low- and middle-income countries where access to care may be limited. For example, in Ethiopia, diabetes care is often rudimentary, and formal, structured diabetes education is almost non-existent. One potential solution to the lack of diabetes management education for patients could be virtual simulation-based diabetes education incorporating the contextual realities of patients in Ethiopia. Despite its great potential to improve glycemic control, delay diabetes-related complications and reduce mortality associated with diabetes, the feasibility of virtual simulation-based diabetes self-management education has not been studied in low … read more

A Comparative Study on Efficacy of Negative Pressure Wound Therapy

Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital

 

Background: Orthopedic surgeons face a difficult task in treating serious open fractures, which usually result in complications, morbidity, and even amputation. Compound fracture wounds were traditionally treated with a standard saline dressing. To avoid infection and problems during therapy, several studies found that open fractures require early skeletal stability as well as soft tissue repair. In favoring the above fact vacuum-assisted closure (VAC) is now undergoing a paradigm shift. With this background, this study aimed to compare the effects of VAC dressing versus standard wound dressing on compound fracture wounds … read more

Blueberry extract may aid wound healing

Treating wounds with an extract taken from wild blueberries may improve healing, according to a new study. The research will be presented this week in Philadelphia at the American Physiological Society’s (APS) annual meeting at Experimental Biology 2022 … More than $50 billion is spent on wound care each year. Chronic wounds, such as diabetes-related sores and pressure ulcers, may be categorized as “nonhealing” due to the reduced vascularization (development of nutrient-rich blood vessels) that often accompanies these conditions. Vascularization is necessary for wound healing … read more

Researchers develop footwear technology to prevent diabetic foot ulcers

To prevent diabetic foot ulcers, research scientists at The University of Texas at Arlington have developed footwear technology that relieves pressure on areas of the feet that experience high stress during walking and other activities … Muthu Wijesundara, principal research scientist and head of the Division of Biomedical Technologies at the University of Texas at Arlington Research Institute (UTARI), and his team have received a patent from the United States Patent and Trademark Office for a dual-layer insole apparatus for diabetic foot lesion prevention. The technology was developed in partnership with the University of North Texas Health Science Center … read more

New Janssen Initiative Aims to Advance Equitable Care and

Address Hidden Threat of Amputation Related to Peripheral Artery Disease (PAD)

 

TITUSVILLE, N.J. – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced the launch of Save Legs. Change Lives. Spot Peripheral Artery Disease Now, a multi-year initiative aimed at creating urgency and action to address the hidden threat of peripheral artery disease (PAD)-related amputation, with an initial focus on reaching Black Americans, who are more than twice as likely to be impacted by PAD.1 Janssen has joined forces with leading professional associations, healthcare systems and community organizations to advance equitable care for individuals and communities placed at an increased risk for cardiovascular disease in the U.S.

 

‘Save Legs. Change Lives. sets in motion a vision for more relevant, trusted and inclusive care for everyone affected by PAD,’ said Avery Ince, M.D., Ph.D., Vice President, Medical Affairs, Janssen Cardiovascular & Metabolism, Janssen Scientific Affairs, LLC. ‘As part of Johnson & Johnson, Janssen believes that major corporations have the power – and therefore the responsibility – to tackle pressing health challenges and make good health a reality for all people. We hope our efforts will inspire action to reduce amputations among people living with PAD.’

read more

Resarcio LLC launches new website

The name Resarcio was chosen because of its Latin meaning: to mend, renew, and rebuild.

 

Resarcio LLC, is a small, woman owned business. Rubina Heard and Hollie Headington established Resarcio LLC as a response to the need of providing new innovative products to the healthcare market.

 

Dermavest®
A Vital New Approach to Wounds, Ulcers, Burns, and Surgical Needs

 

Dermavest® is a replacement or supplement for damaged or inadequate integumental tissue for wounds, burns, and ulcers. Dermavest® wound treatment with highly effective outcomes. Our regenerative medicine products are developed in a unique proprietary process to maximize the retention of cell attachment proteins and growth factors and transform human tissue into biologics for therapy …

 

Dermavest® Product Information

Visit the new Resarcio website

The Peskin collaborative for advanced wound/surgical healing

Prof. Brian Scott Peskin, BSc., M.I.T.

A New Era in Expedited Healing Regardless of Underlying Etiology

 

Less Scarring
Fewer Patient Post-Ops
25%-35% Faster Healing
with Essential EFAs

Italian Plastic / Reconstructive Surgery Case Series Study (Italian Translation)

 

In my practice as a Plastic Surgeon, I have found myself understanding that to
obtain good postoperative results according to the intensity that varies from minor
to major operations (the majority are very intense operations) the repair phlogistic
resolution, edema and the scar tissue are all key factors to success.
My results have improved according to the use of new surgical techniques as well as
the use of antibiotics and antiphlogistic drugs.


However, I must point out a new major factor that
improved greatly my patients’ surgical results
after introducing certain “essential fatty acids” 15 days
prior to 30 days after surgery.


The level of tissue repair is what I look for especially in my practice and having the
trial opportunity of five patients using Brian Peskin’s EFA recommendations, I
found in all five patients an enormously improved result with better recovery by
just assuming a simple prescribed medical therapy with his EFA-based
recommendations.

 

Unlike fish oil, which causes excessive bleeding, Brian Peskin’s Protocol does not
cause excessive bleeding. In fact, it makes surgery easier and improves patient
recovery.

 

This improved recovery included:

  1. Faster healing
  2. Less inflammation
  3. Less scar tissue
  4. Less pain to the patient

I finally believe and feel it is necessary to continue this very interesting tissue repair
in the near future.

 

Dr. ANDREA RONCARATI FERRARA-Via Montebello 1 tel: 0532/200234 Specialista in
Chirurgia Plastica RAVENNA-Viale Cilla 20 tel: 0544/456511 Ricostruttiva ed Estetica
info@roncaratiandrea.it

read more (PDF)

Peskin Pharmaceuticals© website

Wound Care Community: Let’s Make Our Voices Heard to Drive Payer and Regulator Acceptance of Real-World Evidence

Marcia Nusgart, RPh

 

If you treat Medicare patients, you appreciate how a morass of complex coverage and payment regulations can dictate the care you provide. Payer coverage and payment regulations specify which technologies and procedures wound care clinicians can offer their patients, which ones they will (or will not) be reimbursed for, and at what level. Concerningly, coverage policies may be often outdated and/or out of step with scientific guidelines and current clinical practice. Underlying many policies that restrict coverage is a lack of shared clarity across researchers, regulators and payers surrounding what type and how much clinical evidence payers need in order to cover wound care products and procedures … read more


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Minimizing donor-site morbidity following limbs’ injuries with keystone perforator island flap reconstruction

Timea H. Virág MD, Maximilian V. Muntean MD, PhD, Alexandru V. Georgescu MD, PhD

 

Plastic surgeons strive to choose better techniques to reconstruct the defects of the limbs, minimizing the wound healing problems, improving the aesthetic and functional outcome with less complications. This study refers to the use of keystone perforator island flap in limbs’ reconstruction, their harvesting technique to minimize donor-site morbidity, maximize the functional and cosmetic outcome, and will point on the most important indications and advantages. Between January 2014 and June 2020, a number of 28 cases were treated in our department, with simple or complex defects of the limbs. The database included patients’ demographics, comorbidities, etiology, characteristics of the flap, surgical factors, follow-up period, flap outcomes. We performed 28 keystone perforator island flaps, 14 of Type I, 12 of Type IIA, 1 of Type III, 1 of Type IV, with an average size of 69 cm2 (ranged from 1.25 cm2 to 318 cm2). Trauma was the major cause of the defects. One flap exhibited approximately 4% partial superficial necrosis. All donor sites healed without any adverse events. All patients were satisfied with the functional and aesthetic results. The keystone perforator island flaps provide a simple and effective method of wound closure by using tissues of similar texture, thickness, color. Preserving the main artery and the underlying muscle this flap reduces the donor site morbidity. The use of keystone perforator island flaps seems to be one of the most suitable choices whenever possible … read more


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Pain Scales: Are They Legit?

Jarrod Shapiro, DPM, FACFAS, FACPM

 

“Dr X, my foot really hurts.”

“I’m sorry to hear that,” says Dr. X. “On a scale of 0 to 10, with 10 being the worst possible pain, how would you rate your pain?”

“It’s an 11. Yes, definitely an 11.”

I’m not sure how many times in my practice I’ve experienced something like the above conversation. Pain is the most common reason patients see physicians, yet it is a subjective complaint with many complexities. We call pain the 5th vital sign, and we are instructed to assess the severity of pain, but I often find this method to be challenging due to its subjectivity … read more


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Call to wean off Adverse Effects of Skin Pressure to drive the Pressure Ulcer Devices market

Pressure ulcers, better known as decubitus or bedsores, come across as injuries to the skin as well as the underlying tissue that is an outcome of skin being subject to prolonged pressure. They generally occur on the bony parts like the buttocks, elbow, back, ankles, heels, and shoulder. Those not able to move are more prone to pressure ulcers. If identified at early stages, sepsis, cellulitis, joint and bone infections, or cancer could be prevented, as stated by Persistence Market research in its latest market study entitled “Pressure Ulcer Devices Market”. This is where pressure ulcer devices play an active role … read more


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Internet-Based Patient Education Materials Regarding Diabetic Foot Ulcers: Readability and Quality Assessment

David Michael Lee, Elysia Grose, Karen Cross

 

While diabetic foot ulcers (DFU) are a common complication of diabetes, little is known about the content and readability of online patient education materials (PEM) for DFU. The recommended reading grade level for these materials is grades 6-8. The aim of this paper was to evaluate the quality and readability of online PEM on DFU … read more


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The Importance of Standardization in Pressure Injury Risk Assessment

Pressure injuries are common among patients who experience extended exposure to pressure on a bony prominence or shear to areas of poor turgor, two factors that lead to constriction of a patient’s blood supply to the exposed area. A patient who is bedridden or has certain chronic conditions, such as diabetes,1 is more likely to develop a pressure injury. When mechanical force is imposed on the skin, it can result in poor blood flow and damage to the bone-muscle interface, thus making tissue sensitive and painful. For patients with limited mobility, this can be especially frustrating because they may not be able to adjust positions or medical equipment. If pressure injuries are left untreated or unnoticed, they can also become infected and even enter muscle and bone. Risk assessment tools are available to assess pressure injury risk and can work in tandem with practice standardization, thereby leading to effective treatment plans for practitioners and patients … read more


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Applying a Silver-containing Dressing to the Incision Site and Its Effect on the Development

of Surgical Site Infection After Ostomy Closure: A Prospective Randomized Clinical Pilot Study

 

Tezcan Akin MD, Murat Kendirci MD, Ali Emre Akgün MD, Erdinç Çetinkaya MD, Sadettin Er MD, Merve Akin MD, Ahmet Çinar Yasti MD

 

Surgical site infections (SSIs) can occur after colorectal surgery. Ionic silver has been used to prevent the development of SSIs. New-generation dressings, defined as total occlusive ionic silver–containing dressings, have been shown to reduce bacterial colonization in SSIs. PURPOSE: To evalute the effect of a silver hydrofiber dressing on the development of SSIs at the abdominal incision after ostomy closure … read more


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Trials of new gene therapy cure ‘butterfly children’ of open wounds that had not healed for years

An experimental treatment created by researchers at Stanford University uses an engineered herpes virus to start production of the missing collagen VII protein, which stops the epidermis and dermis from separating … A gene therapy applied directly to the skin has cured nine patients who were suffering from a rare disease that causes blistering, wounding and scarring as a result of even the lightest contact. Some lesions can remain open for years without closing … read more


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Characteristics of Diabetic Foot Ulcer Patients Pre- and During COVID-19 Pandemic

Lessons Learnt From a National Referral Hospital in Indonesia

 

Abstract
Background: Diabetic foot ulcer (DFU) is one of the most terrifying diabetic complications for patients, due to the high mortality rate and risk for amputation. During the COVID-19 pandemic, many diabetic patients limited their visits to the hospital, resulting in delays for treatment especially in emergency cases.

 

Objective: This study aimed to compare the characteristics of patients with DFU pre- and during COVID-19 pandemic period. Methods: This study was a retrospective cohort study using foot registry data. We compared our patients’ characteristics pre-COVID-19 pandemic period (1 March 2019-28 February 2020) and during COVID-19 pandemic period (1 March 2020-28 February 2021).

 

Results: Cohorts of 84 and 71 patients with DFU pre- and during COVID-19 pandemic period, respectively, were included in this study. High infection grade (66.7% vs 83.1%, P = .032), osteomyelitis event (72.6% vs 87.3%, P = .04), leukocyte count (15 565.0/μL vs 20 280.0/μL, P = .002), neutrophil-to-lymphocyte ratio (7.7 vs 12.1, P = .008), waiting time-to-surgery (39.0 h vs 78.5 h, P = .034), and number of major amputation (20.2% vs 39.4%, P = .014) were significantly higher during the COVID-19 pandemic period.

 

Conclusion: During the COVID-19 pandemic, patients with DFU had more severe infection, higher proportion of osteomyelitis, longer waiting time for getting surgical intervention, and higher incidence of major amputation.

 

Keywords: COVID-19; amputation; diabetic foot ulcer; infection; mortality; waiting time to surgery.
from PubMed


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Ex-prisoner says Allegheny County Jail’s lack of care caused him to lose his leg

A person formerly incarcerated at the Allegheny County Jail has filed a lawsuit against multiple members of the jail’s medical staff alleging that a lack of medical treatment in the facility led to the amputation of his leg … In 2011, McCray was shot in the spine, which caused him to lose one of his kidneys and develop a drop foot, which due to dragging of the foot and numbness, made him more susceptible to developing ulcers on his foot, the lawsuit said … read more


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Pyoderma case study from Pure&Clean

Pure Clean
  • 86 year old female
  • Ankle Wound – Pyoderma Gangrenosum
  • After four years of treating using Santyl, honey, silver products, alginates, Aquacel Ag, Bactroban, sharp debridement, etc.
  • Positive biopsy for PG, Autoimmune disease (lupus) common comorbidity associated with PG
  • A home health, wound-care nurse treated 1.5 years
  • Patient now self-treating
  • Occasional visit to rheumatologist 40 mg of oral steroids
  • Wound healed in only 5 months with Pure&Clean
Pure Clean Photos

UA Surgeon Armstrong Urges New Focus on Diabetic Ulcers

Remission — rather than repair — needs to be the goal of treatment, according to Dr. David Armstrong, whose report on diabetic foot ulcers appears in the New England Journal of Medicine … Foot ulcers are a prevalent complication for millions of people with diabetes. Estimates indicate that as many as one-third of people with the disease will develop at least one foot ulcer over the course of their lifetime. These wounds can lead to further complications such as strokes, heart attacks, infections, loss of limbs and premature death … Yet, the morbidity and mortality directly associated with foot ulcers often go unrecognized by physicians and patients alike. Currently, the clinical focus is on repairing an ulcer’s surrounding tissue and healing the wound … read more


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RedDress Donates FDA-Cleared Wound Care Solution to Aid Injured Ukrainians

RedDress, a Florida-based Israeli medical company is shipping revolutionary blood-clotting wound care systems to Ukraine to help with serious injuries and severe trauma wounds … RedDress began shipments of 400 of their ActiGraft systems this week to multiple hospitals in Ukraine to help treat civilian casualties as a result of the indiscriminate Russian attacks … read more


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Tell-tale signs of diabetic foot — a common condition that’s a leading cause of amputation

The condition diabetic foot affects about half of people with
diabetes. It’s a type of peripheral neuropathy, where certain nerves in the body are damaged, triggering numbness, tingling, pain, or loss of sensation. In this case, symptoms occur in the feet leading to poor blood circulation, which causes wounds to heal slower and can trigger changes in the shape of the feet and toes. “This can be a serious condition, because peripheral neuropathy can lead to increased falls, cause pain, and lead to decreased quality of life,” says Kevin Springer, DPM, a podiatrist at The Ohio State University Wexner Medical Center … read more


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Managing Challenging Biofilms in Horse Wounds

by Christa Lesté-Lasserre, MA

 

Aggressive early treatment can help horses recover from wounds afflicted with these persistent bacterial conglomeration … Packed with well-protected pathogenic (disease-causing) bacteria, biofilms can form spontaneously on wound surfaces and in deeper wound layers, creating significant challenges for both the equine patient and the treating veterinarian … A biofilm’s resistant matrix makes it tough to treat with antimicrobials and allows it to evade the body’s immune response, resulting in wounds that get larger instead of healing, said Lynn Pezzanite, DVM, MS, PhD, Dipl. ACVS-LA, assistant professor of equine emergency and critical care at Colorado State University’s … read more


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Understanding the Risk: Asian Americans and Diabetes

by Joanne Saunders

 

Why do Asians and Asian Americans face an increased risk for diabetes and prediabetes? Joanne Saunders shares her father’s diabetes story to help shed light on this concerning problem … My father (pictured here with his grandson) was a 67-year-old Chinese American who immigrated to the United States in 1971. At 5’5” and approximately 150 pounds, he entered the emergency room on July 30, 2017, complaining of a severe headache, vomiting, and nausea … read more


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First ever gene therapy gel corrects rare genetic skin condition

Peter Marinkovich MD, director of Stanford Medicine’s Blistering Disease Clinic

 

Stanford researchers have been working on gene therapies for epidermolysis bullosa, or “butterfly disease,” for over a decade. A new gel helped wounds heal and stay healed in a clinical trial … A gene therapy gel applied to the wounds of nine people — three of whom were children — with the blistering skin disease epidermolysis bullosa helped the wounds heal and remain healed for several months in a trial headed by researchers at Stanford Medicine … The trial is the first to show that gene therapy vectors for skin diseases can be effective when applied topically. It is also the first trial of gene therapy in children with epidermolysis bullosa … read more


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Synergistically Detachable Microneedle Dressing for Programmed Treatment of Chronic Wounds

Tianqin Ning, Fenghe Yang, Danli Chen, Zhenzhen Jia, Rongqing Yuan, Zhenqin Du, Shuaiyin Liu, Yao Yu, Xiaochuan Dai, Xufeng Niu, Yubo Fan

 

Chronic wounds such as diabetic feet undergo a lifetime risk of developing into incurable ulcers. Current treatments for chronic wounds remain unsatisfactory due to the lack of ideal wound dressings that integrate facile dressing change, long-acting treatment, and high therapeutic efficacy into one system. Herein, a synergistically detachable microneedle (MN) dressing with a dual-layer structure is presented to enable programmed treatment via one-time dressing application. Such a dual-layer dressing MN system (DDMNS) is composed of chitosan (CS) hydrogel dressing (CSHD) on top of a detachable MN patch with a CS tip and a polyvinyl pyrrolidone (PVP) backing substrate incorporated with magnesium (Mg). The synergistic detachment is achieved with the backing Mg/PVP substrate dissolving within minutes due to the local moist environment of the CSHD enhancing the reaction between Mg and inflammation microenvironment. The combined treatment of Mg and panax notoginseng saponins (PNS) loaded in DDMNS achieves antibacterial, neovascularization, and activating a benign immune response so that the three overlapping periods of the inflammation, tissue proliferation, and tissue remodeling of wound healing reach a dynamic balance. This advanced DDMNS provides a facile approach for the programmed treatment of chronic wound management indicating potential value in wound healing and other related biomedical fields.

 

Keywords: chronic wound healing; drug delivery; magnesium; microneedles.

 

from Wiley Press


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Real Talk: When patients make you furious

Kristin Fuller, MD
Mr. K. was a 37-year-old male who I saw in my clinic for uncontrolled type-2 diabetes. Every time he came in, his HbA1c and rapid glucose were off the charts. He had multiple hospital admissions for diabetic ketoacidosis, and already had two toes amputated due to severe peripheral arterial disease, a known diabetes complication … One day, a surgeon called to inform me that Mr. K. was in the hospital and would be undergoing a below-the-knee amputation (BKA) due to extremely poor circulation as a result of poor glycemic control. The surgeon initially tried to blame me for not having my patient on the proper diabetic regimen. I explained that I had consistently tried to work with Mr. K., and he was stubbornly non-compliant with his diet and insulin regimen … read more


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Polypharmacy is Associated with Diabetic Foot Ulcers in Type 2 Diabetes mellitus

This observational study aimed to investigate the relationship between polypharmacy and the existence of diabetic foot ulcers in patients with type 2 diabetes. Methods: Patients with T2DM with and without diabetic foot ulcers who presented to the endocrinology outpatient clinic between August 2020 and November 2021 were involved in the study. Overall, five hundred and twelve patients with T2DM (293 patients with diabetic foot ulcer and 219 patients without diabetic foot ulcer) were included. The exclusion criteria were pregnancy, lactation, type 1 diabetes, patients under 18 years and over 65 years of age, and history of malignancy. The information of drugs administered, demographic and clinical data were obtained from the patient files. The Wagner score was used to evaluate the severity of ulcers … read more


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Efficacy and Safety of Topical Solution of Diperoxochloric Acid for Neuropathic Diabetic Foot Ulcer

Results from a Phase 3, Multicentre, Randomized, Active-controlled, Parallel-group Study

 

Diabetic foot ulcer (DFU), if untreated, accounts for lower-limb amputations affecting patients’ quality-of-life. Diperoxochloric acid (DPOCL) is known to heal DFU by its antibacterial and fibroblast stimulating activity. This was a phase 3, multicentre, randomized, double-blind, active-controlled, parallel-group study conducted to evaluate the efficacy and safety of topic solution of DPOCL compared with isotonic sodium chloride solution (ISCL). Adult patients with type 1 or 2 diabetes with random blood glucose levels of <250 mg/dL, with ≤ than three full-thickness foot ulcers were enrolled. Primary efficacy endpoint was complete wound closure and secondary was wound surface area. Adverse events were analyzed as safety endpoint. Of 311 enrolled patients, 289 were randomized … read more


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Topical Administration of Lactiplantibacillus plantarum Accelerates the Healing of

Chronic Diabetic Foot Ulcers through Modifications of Infection, Angiogenesis, Macrophage Phenotype and Neutrophil Response

 

This work aimed to evaluate the adjuvant treatment to surgical debridement using topical applications of Lactiplantibacillus plantarum ATCC 10241 cultures in complicated diabetic foot ulcers as compared to diabetic foot ulcers receiving surgical wound debridement. A randomised controlled trial was performed involving 22 outpatients with complicated diabetic foot ulcers that either received surgical debridement (SuDe, n = 12) or surgical debridement plus topical applications of L. plantarum cultures (SuDe + Lp, n = 10) every week during a 12 week treatment period. Compared to patients receiving SuDe, patients treated with SuDe + Lp exhibited significantly increased fibroplasia and angiogenesis, as determined by Masson’s trichrome staining and the study of CD34 cells, α-smooth muscle actin to semi-quantify vascular area, number of vessels and endothelial cells. In addition, a promotion of the polarisation of macrophages from M1 (CD68) to M2 (CD163) phenotype was observed in SuDe + Lp patients with remarkable differences in the tissue localisation … read more


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Piperacillin-tazobactam-Induced Pneumonitis: A Clinical Case Study

William Urbas, DPM, FACFAS, Deep N. Shah, DPM MBA, and Alex Pilkinton, DPM

 

This case study involves a 46-year-old male patient admitted with a localized necrotizing soft tissue infection of the right foot that developed an unusual and rare delayed hypersensitivity pneumonitis from the antibiotic Piperacillin-tazobactam … Drug hypersensitivity reactions present in multiple ways and have various presentations in timing. Piperacillin-tazobactam is a fourth-generation penicillin antibiotic combining a penicillin molecule (piperacillin) with a beta-lactamase inhibitor (tazobactam). Piperacillin-tazobactam is US Food and Drug Administration (FDA)-approved for 30-minute intravenous infusion at 2.25g, 3.375g, or 4.5g doses to help cover a broad spectrum of … read more


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Oleogel S-10 Significantly Improves Epidermolysis Bullosa Wounds at 12 Months

Dedee F. Murrell, MD, details the EASE trial findings presented at AAD 2022, and what the benefit of the novel topical gel may mean for patients with EB

 

A new phase 3 trial assessing a novel topical gel for the treatment of young patients with epidermolysis bullosa (EB) wounds show the birch bark-based product achieved nearly 50% heal of targeted wounds over 12 months … The interim EASE findings, presented in a late-breaking session at the American Academy of Dermatology (AAD) 2022 Annual Meeting in Boston, show birch triterpenes (Oleogel-S10) may provide a unique and broadly-applicable benefit for patients with rare, often deadly skin condition … In an interview with HCPLive at AAD 2022, study author Dedee F. Murrell, MD, director of dermatology at St. George Hospital, USNW, discussed the clinical history of Oleogel S-10 leading … read more


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Transforming Your Practice, Outcomes, and Productivity With Real-time Fluorescence Imaging of Wound Bacteria

presented by Thomas E Serena, MD, FACS, MAPWCA, FACHM and Jeffrey D Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA

 

This webinar will focus on “Keys to Success” for all qualified healthcare professionals who are using, or considering adopting, point-of-care fluorescence imaging of wound bacterial presence, location, and load. Dr Thomas Serena will focus on the clinical impact the fluorescence imaging procedure is having on getting ahead of infection, wound outcomes, and timing of CTP placements. Dr Jeffrey Lehrman will discuss appropriate CPT coding for this procedure and documentation tips to support how and why this procedure is performed on a given patient, as well as the imaging findings … learn more


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Manipulating the microbiome alters regenerative outcomes in

Xenopus laevis tadpoles via lipopolysaccharide signaling

Phoebe A. Chapman, Campbell B. Gilbert, Thomas J. Devine, Daniel T. Hudson, Joanna Ward, Xochitl C. Morgan, Caroline W. Beck

 

Xenopus laevis tadpoles can regenerate functional tails, containing the spinal cord, notochord, muscle, fin, blood vessels and nerves, except for a brief refractory period at around 1 week of age. At this stage, amputation of the tadpole’s tail may either result in scarless wound healing or the activation of a regeneration programme, which replaces the lost tissues. We recently demonstrated a link between bacterial lipopolysaccharides and successful tail regeneration in refractory stage tadpoles and proposed that this could result from lipopolysaccharides binding to Toll-like receptor 4 (TLR4). Here, we have used 16S rRNA sequencing to show that the tadpole skin microbiome is highly variable between sibships and that the community can be altered by raising embryos in the antibiotic gentamicin. Six Gram-negative genera, including Delftia and Chryseobacterium, were over-represented in tadpoles that underwent tail regeneration. Lipopolysaccharides purified from a commensal Chryseobacterium spp. XDS4, an exogenous Delftia spp. or Escherichia coli, could significantly increase the number of antibiotic-raised tadpoles that attempted regeneration. Conversely, the quality of regeneration was impaired in native-raised tadpoles exposed to the antagonistic lipopolysaccharide of Rhodobacter sphaeroides. Editing TLR4 using CRISPR/Cas9 also reduced regeneration quality, but not quantity, at the level of the cohort. However, we found that the editing level of individual tadpoles was a poor predictor of regenerative outcome. In conclusion, our results suggest that variable regeneration in refractory stage tadpoles depends at least in part on the skin microbiome and lipopolysaccharide signalling, but that signalling via TLR4 cannot account for all of this effect … from Wiley


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And I Only Am Escaped Alone to Tell Thee: A Patient’s Experience With Excruciating Pain and Redemption

Richard E. Maddy, PhD

The title for this article is taken from the title of the epilogue of the novel Moby-Dick, whose author, Herman Melville, had taken it from the Book of Job in the King James Bible. Like the fictional protagonist of Melville’s novel, and the messengers who informed the biblical patriarch of his great loss, I too have a message for the readers, borne of personal experience—one of excruciating pain, loss, rescue, and redemption … read more


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Understanding bacterial biofilms

Tagbo Niepa Receives $663K NSF CAREER Award for Work on Biofilm Micromechanics and Metabolic Properties
Biofilms are a ubiquitous, resilient form of microbial life. They can form where liquids and solids meet, like around a knee replacement; where air and liquid meet, like in the lungs; and where oil and water meet, like in an oil spill on the ocean … Because of this extreme versatility, the mechanism of how they grow and adapt to different environments is not yet well understood. But a better grasp of how biofilms can grow and adapt to different environments would not only help mitigate their deleterious health effects but also put them to work for us … read more


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neoplas med GmbH: Superiority of cold atmospheric plasmajet therapy in the treatment of

chronic wounds proven by gold-standard trial

 

Comparative clinical trial shows significant improvement in wound closure and infection control based on treatment with the plasmajet kINPen® MED from neoplas med compared to best practice wound care – cost-effectiveness analysis proves high cost-savings by innovative technology

 

GREIFSWALD, Germany and FELDKIRCH, Austria, March 22, 2022 /PRNewswire/ — The results of a randomized controlled trial (RTC) may offer new opportunities for the approximately two million patients with chronic wounds solely in Germany: The innovative cold atmospheric plasmajet (CAP-jet) technology showed significantly more healing progress in chronic wounds in comparison to best practice (BP) modern wound care at two study centers. Within six weeks, 59 percent of all wounds healed completely under cold plasma treatment compared to only 5.1 percent in patients under BP therapy. Time to complete healing was also considerably shorter under CAP-jet treatment, and wound infections were overcome statistically significant more rapid. With a very good tolerability profile, an economic analysis of the study data also showed a cost saving of 65 percent for the dressing material alone compared to the BP group. The study data were recently published in the journal Nature Scientific Reports.

 

Acceleration of wound healing and wound closure proven

In the study conducted by Prim. Univ.-Professor Robert Strohal, head of the Department of Dermatology and Venereology at the Federal Academic Teaching Hospital Feldkirch, the cold plasma procedure of the Greifswald-based company neoplas med GmbH was scientifically examined in wound care. For this purpose, he compared treatment with the CAP-jet kINPen® MED at the Austrian Federal Academic Teaching Hospitals Feldkirch and Bregenz with current best practice treatment in 78 patients with infected and non-infected wounds. ‘This study was the first to investigate the exclusive effect of tissue accessible cold plasma on wound healing and infection control without the use of an additional standard therapy,’ said Prim. Univ.-Prof. Strohal.

 

After treatment with the CAP-jet, the proportion of healthy tissue increased significantly faster than under the BP treatment and the wounds under CAP-jet therapy also healed significantly faster. At the end of the study, the wound area in the CAP group had reduced by 94.7 percent compared to the baseline value, in the comparison group it was only 56.3 percent. CAP also proved superior in terms of infection control. In contrast to BP therapy, all wounds infected at the start of the study showed complete resolution of infection signs. In addition, the signs of infection disappeared significantly faster under cold plasmajet therapy.

 

Patients’ quality of life can improve

Ulrike Sailer, CEO of the company neoplas med GmbH in Greifswald/Germany, explained: ‘The Joint Federal Committee (Gemeinsamer Bundesausschuss, G-BA) as the central decision-making body of the German health care system already recognized last year the potential of cold plasma for the innovative treatment of chronic wounds at our request. Therefore, the G-BA decided to carry out an observational trial for testing with the aim of obtaining health insurance approval. The results of the clinical trial that now have been published clearly demonstrate the superiority of the CAP-jet kINPen® MED compared to BP wound care. These results provide further evidence for the high clinical relevance of the CAP-jet precision technology. At the same time, it represents important news for millions of people who suffer from chronic wounds for years.’

 

Chronic wounds are often associated with high morbidity and considerable impairments in everyday life as well as the patients’ psyche. Faster wound healing and thus a shorter therapy duration by using the plasmajet kINPen® MED can therefore significantly improve the patients’ quality of life. Furthermore, a lower burden by pain during treatment can be observed, and a reduced number of dressing changes can be assumed. Patients confirmed the very good tolerability and even described the treatment as pleasant in the majority of cases.

 

Significant advantage in treatment costs

A cost-effectiveness analysis based on the available study data showed that 21.4 percent fewer physician visits and 34.3 percent fewer dressing changes were necessary in the CAP-jet group compared to BP. The savings alone in dressing material resulted in a cost advantage for CAP-jet therapy of 64.7 percent compared to BP. Previously, average costs of 10,000 € per patient and year were assumed. Ulrike Sailer: ‘Thus, the cold plasmajet kINPen® MED offers not only a more efficient and tolerable technology, but also opens up the opportunity for significantly higher cost-effectiveness in the treatment of chronic wounds.’

 

Further information material can be found under the following link: https://1drv.ms/u/s!Aph6cOwNbPEJgQCIbClSETCZ_lal?e=BvkuGi

 

Background Information:

The study included 78 patients with wounds up to 10 x 20 cm in size and existing for at least 6 weeks. The patients were randomized in a 1:1 ratio into two groups and treated for the study duration of 6 weeks either with the CAP-jet kINPen® MED (30 seconds per cm2 wound area) or suitable wound dressings according to BP wound care. Only one wound per patient was evaluated.

 

With regard to the treatment regime, CAP-jet therapy was administered 3 times in the 1st week in the CAP group, 2 times in the 2nd week and once a week in the following observation period; furthermore, the wounds were covered with gauze and a secondary dressing. In contrast, the BP group was treated with a wound phase-adapted dressing; infected wounds were additionally cleaned with an antiseptic. In both groups, patients with venous ulcers received compression therapy. The primary endpoint of the study was the amount of granulation tissue at the end of the study. In addition, cold plasma effects on wound infection, wound area, healing time, wound pH and exudate volume (wound fluid) as well as local tolerability were investigated.

 

Improvement in wound infection: All 13 wounds infected at baseline in the CAP-jet group showed complete resolution of infection signs without the need for additional antiseptics. In contrast, 4 of the 18 wounds infected at baseline in the BP group showed no improvement despite the use of antiseptics. Furthermore, the signs of infection decreased significantly faster under CAP-jet therapy compared to BP therapy. These data confirm the previously published evidence on the good antimicrobial efficacy of CAP.

 

Cold plasma is a gas containing ionized atoms, ions and electrons that has been shown to disinfect wounds and activate the wound healing process. With its fine jet, the plasmajet kINPen® MED enables highly precise treatment in anatomically and pathologically challenging areas under visual control and without touching, which is not possible with other wound therapies.

 

About neoplas med GmbH

neoplas med GmbH was founded in 2009 as a spin-off of the Leibniz Institute for Plasma Science and Technology e. V. (INP) in Greifswald, Germany. Ulrike Sailer took over the position of managing director at the end of 2019. Based on the INP research into plasma medicine, the emerging company develops innovative products for medical applications. The first product developed on this basis is the CE-marked kINPen® MED atmospheric pressure plasmajet, the first internationally approved and marketed plasmajet for the treatment of chronic wounds and pathogen-induced skin disorders. It is the result of a long-lasting cooperation with the INP institute, the university hospital of Greifswald, Germany, the Charité hospital of Berlin, Germany, and various industrial partners. In July 2021, the Federal Joint Committee, as the central decision-making body in the self-governing health care system, decided on a trial study with the cold plasmajet procedure and thus took an important step towards reimbursement by the health insurance companies.

 

About kINPen® MED

The plasmajet kINPen® MED is the first atmospheric pressure plasmajet to receive CE approval for the treatment of chronic wounds and pathogen-induced skin disorders. The plasmajet applies a physical cold plasma with a temperature of < 40 degrees Celsius with pinpoint precision and without wound contact. Areas with an uneven profile, recesses or cavities can be reached easily and treated evenly. The noble gas argon used for the generation of the plasma provides a controlled atmosphere around the generated plasma beam, thus ensuring a consistent high treatment quality.

 

Press contact

Claudia Kerber
Phone: +49 3834 515 201
Mobile: +49 (0)162 23 770 70
claudia.kerber@neoplas-med.eu
neoplas med GmbH
Walther-Rathenau-Straße 49a, 17489 Greifswald, Germany

Life and Limb: Advances in the Management of the Diabetic Foot

By Chase Doyle
If untreated or unsalvageable, the diabetic foot requires surgical interventions to address the risks to its viability. However, recent advancements in the field suggest that surgeons may not always have to sacrifice a limb to save a life.

During the 2021 virtual American College of Surgeons Clinical Congress, Lucas M. Ferrer, MD, described the use of endovascular venous arterialization for limb salvage, and William P. Robinson, MD, discussed the timing of foot amputation after revascularization … read more


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Medicaid Expansion Under ACA May Have Reduced Rate of Major Diabetes-Related Amputations

by Patrick Campbell

An analysis of data from 2013-2015 provides insight into the impact of Medicaid expansion under the Affordable Care Act on rate of major diabetes-related amputations and suggests a shift in the distribution of uninsured patients may have driven reductions observed in the study.

Data from a new study are providing clinicians with insight into the effects of the Medicaid Expansion Under the Patient Protection and Affordable Care Act (ACA) on rates of diabetes-related major amputations among racial and ethnic minority adults with diabetes … read more


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Adjunctive topical oxygen therapy for wound healing in patients with peripheral arterial disease

Gennady M Vulakh, Anil P Hingorani, Enrico Ascher, Natalie Marks

 

Abstract
Introduction: While the use of hyperbaric oxygen therapy has been supported by randomized prospective trials for the use of selective lower extremity wounds, it is associated with significant cost, inconvenience, and a small risk of pneumothorax, barotrauma to the tympanic membrane, and severe hypoglycemia. As topical oxygen therapy (tOT) avoids these issues and there is little literature examining its use for patients with peripheral arterial disease (PAD), we reviewed our experience with tOT as an adjunctive technique for wound healing with arterial wounds.

 

Methods: We reviewed our experience with tOT for lower extremity wounds over 8 years. PAD patients with non-healing ulcers were referred to tOT after having revascularization of the limb and/or debridement where appropriate. tOT was administered to affected areas 4 times a week with a local boot that delivered 100% oxygen to the wound at 1.03 atm for 90-min sessions. We had 28 patients with PAD, 57.1% male, and 36 individual wounds. Ages ranged from 37 to 93 (mean 62 ± 13.7). 82% had a history DM, 75% hypertension, and 60.7% hyperlipidemia. 78% had lower extremity arterial angioplasty and 11% had a LE bypass. The remainder had a debridement only and were not candidates for arterial revascularization.

 

Results: tOT duration ranged from 1 to 7 months (mean 3 ± 2). 29% stopped tOT before healing. 25% healed completely. One died during follow-up. Overall, 66% had reduction of the wound area ranging from 12% to 100%. None had major limb amputation. 18% underwent toe amputations. 25% of our patients were lost to follow-up.

 

Conclusion: While these data are from a single-center and are single-armed, they represent the largest reported series of this therapy. This home-based therapy does show promise and warrants further investigation.

 

Keywords: Topical oxygen therapy; ischemic ulcers; pad; peripheral arterial disease; wound healing.

from PubMed


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Interpretable Machine Learning for the Prediction of Amputation Risk Following

Lower Extremity Infrainguinal Endovascular Interventions for Peripheral Arterial Disease

 

Abstract
Purpose: Severe peripheral artery disease (PAD) may result in lower extremity amputation or require multiple procedures to achieve limb salvage. Current prediction models for major amputation risk have had limited performance at the individual level. We developed an interpretable machine learning model that will allow clinicians to identify patients at risk of amputation and optimize treatment decisions for PAD patients.

 

Methods: We utilized the American College of Surgeons National Surgical Quality Improvement Program database to collect preoperative clinical and laboratory information on 14,444 patients who underwent lower extremity endovascular procedures for PAD from 2011 to 2018. Using data from 2011 to 2017 for training and data from 2018 for testing, we developed a machine learning model to predict 30 day amputation in this patient population. We present performance metrics overall and stratified by race, sex, and age. We also demonstrate model interpretability using Gini importance and SHapley Additive exPlanations.

 

Results: A random forest machine learning model achieved an area under the receiver-operator curve (AU-ROC) of 0.81. The most important features of the model were elective surgery designation, claudication, open wound/wound infection, white blood cell count, and albumin. The model performed equally well on white and non-white patients (Delong p-value = 0.189), males and females (Delong p-value = 0.572), and patients under age 65 and patients age 65 and older (Delong p-value = 0.704).

 

Conclusion: We present a machine learning model that predicts 30 day major amputation events in PAD patients undergoing lower extremity endovascular procedures. This model can optimize clinical decision-making for patients with PAD.

 

Keywords: Endovascular intervention; Machine learning; Peripheral artery disease; Risk assessment.

from PubMed


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Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients

admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study

 

Mahin Amini, Feizollah Mansouri, Kamran Vafaee, Alireza Janbakhsh, Somayeh Mahdavikian

 

The coronavirus (COVID-19) pandemic has caused hospitalisation of patients worldwide with a wide range of clinical complications for a variety of reasons. The most important complication of COVID-19 in hospitalised patients is acute respiratory distress syndrome, which requires patients to use oxygen supply equipment such as a ventilator and a non-invasive ventilation (NIV) mask. COVID-19 patients admitted to the hospitals, especially the intensive care units (ICUs), are prone to pressure ulcers (PUs) as an important and double complication due to multiple complications of the disease such as inactivity, and some degree of immobility and the use of artificial airways. On average, during the corona pandemic in different countries of the world, COVID-19 patients occupy 21% of the ICU admission capacity with an average [95% CI = 6.99-8.63] 7.78 days per patient.3 Increasing the length of hospital stay causes PU and PU, in turn, increases LOS. PU, also called pressure sores or bedsores, causes injuries to the skin and underlying tissue that appear primarily due to prolonged pressure on the skin due to inactivity and factors such as age over 65.5 In particular, second- and higher-grade ulcers increase the length of hospital stay, increase mortality, and shorten patients’ lives and are recognised as an important challenge in the health system. PU causes more than 60 000 deaths annually in the United States.10 Data from a wide study showed that COVID-19 patients need more than three times as much care and attention to the occurrence of PU compared to other hospitalised patients … read more


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Podimetrics Secures $45 Million Series C To Help At-Risk Providers and Health Plans Prevent

Diabetic Amputations in High-Risk Patients

Every 4 minutes in the U.S., a patient loses a limb due to diabetes complications
Black Americans face diabetes-related amputations 3x as often as white Americans
Podimetrics strives to reduce disparities in diabetes care and unnecessary limb loss
SOMERVILLE, Mass., March 24, 2022 — Podimetrics, creator of the FDA-cleared SmartMat™ and integrated clinical care services that can help save the limbs and lives of complex patients with diabetes, today announced a $45 million Series C round led by D1 Capital Partners, along with two new investors, the Medtech Convergence Fund and an undisclosed strategic investor. Existing investors, Polaris Partners and Scientific Health Development, also participated in the financing. Prior to their Series C, Podimetrics had raised $28.3 million in funding to fuel development and distribution of their SmartMat.

 

With this latest round of funding, Podimetrics plans to focus on hiring to build out their product development and research teams, while also expanding the breadth of services delivered by their nurse support team. This new funding will help even more at-risk providers and health plans drive broader adoption of Podimetrics’ SmartMat so they can improve care outcomes for at-risk patients dealing with diabetic foot ulcers (DFUs) that often lead to amputations.

 

Podimetrics, founded in 2011, developed the SmartMat — the only easy-to-use, at-home mat that a patient steps on for 20 seconds per day. The mat detects temperature changes in the foot, which are associated with early signs of inflammation, often a precursor to DFUs. The FDA-cleared and HIPAA-compliant SmartMat is remotely monitored by Podimetrics’ in-house nurse support team. If the data from the mat are indicative of potential health issues, Podimetrics’ nursing team connects with the patient and the patients’ provider in as close to real time as possible. The SmartMat, which also has the Seal of Approval from the American Podiatric Medical Association, has already been used by thousands of patients through partnerships with leading risk-based healthcare providers and regional and national health plans, such as the Veterans Health Administration.

 

“The patients we serve at Podimetrics are extremely complex and have been largely ignored by our healthcare system,” said Jon Bloom, MD, CEO and Co-founder of Podimetrics. “With our SmartMat and this latest funding, we have the chance to put an end to ‘Civil War’–era amputations with early, home-based detection. We also have the opportunity to improve the overall health and well-being for patients dealing with diabetes because of the close relationship we’ve built through our trusted technology and clinical services.”

 

In a previous multi-center trial, diabetic foot complications were shown to be detected up to five weeks before they presented clinically. Even after one full year, about 70% of patients continued to use the SmartMat regularly. Early detection and related preventive care actions often result in significant cost-savings, too, anywhere from $8,000–$13,000 in savings per member per year (savings estimates based on customer research and analysis). In addition, considering Black Americans and Hispanics are two to three times more likely to require a diabetic amputation than others, Podimetrics’ SmartMat holds the power to help support health equity advancements over time.

 

Recent peer-reviewed research has also suggested the following benefits among patients using the SmartMat at home: 71% elimination of amputations; 52% reduction in all-cause hospitalizations; 40% reduction in emergency department visits; and a 26% reduction in outpatient visits.

 

Building on these notable data-driven findings, most recently Podimetrics published peer-reviewed research in Diabetes Research and Clinical Practice, the journal of the International Diabetes Federation. This research found that during episodes-of-care for DFUs, patients are 50% more likely to die and nearly three times more likely to be hospitalized. What this research shows is that patients with a DFU tend to have multiple other chronic health conditions, putting them at higher risk for hospitalization and even death. In addition, these medically complex patients are often among the costliest patients within a healthcare system. As a result of this research, diabetic foot complications can and should be viewed as indicators of other costly chronic conditions not commonly associated with DFUs.

 

In addition to this research, which was published in January 2022, Podimetrics has already gotten off to a strong start in 2022. The company doubled its revenue for the third year in a row, and also doubled the size of its team.

 

“We are proud to partner with Podimetrics and to support its efforts to save lives and limbs,” said James Rogers, Investment Partner with D1 Capital Partners. “Our growth capital will expand commercialization of the SmartMat which we believe has demonstrated the ability to reduce unnecessary healthcare costs through preventive, risk-based strategies that prioritize high-quality outcomes for vulnerable patients. We believe that Podimetrics is building a strong team and are honored to support its worthy mission.”

 

For more information on Podimetrics and how its FDA-cleared SmartMat and clinical care services can help prevent diabetic foot ulcers and improve patient outcomes, please visit Podimetrics.com.

 

About Podimetrics

Podimetrics is the creator of the FDA-cleared SmartMat™ and integrated clinical care services that can help save the limbs and lives of complex diabetic patients. Through partnerships with health plans and at-risk providers, such as the Veterans Health Administration and Independence Blue Cross, Podimetrics has helped prevent amputations associated with complex diabetes. By combining cutting-edge technology with best-in-class clinical care services, Podimetrics earns high engagement rates from patients and allows clinicians to save limbs, lives, and money — all while keeping vulnerable populations healthy in their own homes. For more information, visit podimetrics.com or follow us on LinkedIn and Twitter.

 

About D1 Capital Partners

D1 Capital Partners is a global investment firm that operates across public and private markets. The firm combines the talent and operational excellence of a large, premier asset management firm with the flexible mandate and long-term time horizon of a family office. Founded in 2018 by Dan Sundheim, D1 focuses on investing in the global internet, technology, telecom, media, consumer, healthcare, financial, industrial and real estate sectors.

AOTI Receives China FDA Approval for Topical Wound Oxygen (TWO2) Therapy

Providing Renewed Hope for World’s Largest Diabetic Foot Ulcer Population

 

OCEANSIDE, Calif., March 23, 2022 /PRNewswire/ — Advanced Oxygen Therapy Inc. (AOTI), the global leader in noninvasive topical oxygen wound healing solutions, announced today that is has received Chinese National Medical Products Administration (NMPA), commonly referred to as China FDA, approval for its unique cyclically pressurized Topical Wound Oxygen (TWO2) therapy. Making it the only advanced sustained wound healing therapeutic to have achieved such a designation and allowing the company to now commence marketing in China with its local partner.

 

China has the world’s largest Diabetic and resultingly Diabetic Foot Ulcer (DFU) population. The International Diabetes Federation estimates that 10.6% of the Chinese adult population now have diabetes that equates to 141 million people. This represents a 56%, or 50 million person, increase in the last 10 years alone.1 In China, the annual incidence of DFU and Amputation has recently been reported to be 8.1% and 5.1% respectively, representing a staggering 11.4 million ulcerations and 7.2 million preventable lower extremity amputations every year.2

 

AOTI’s globally patented TWO2 homecare therapy has been demonstrated in recently published high-quality Randomized Controlled Trial 3 and Real Word Evidence 4 studies to provide more durable complete DFU healing. Resulting in six-fold reductions in ulcer recurrence, with an unprecedented 88% reduction in hospitalizations and 71% reduction in lower extremity amputations seen over 12 months. Such sustained healing provides patients with renewed hope of limb preservation, while offering significant reductions in healthcare resource utilization with resultant health economic savings.

 

Professor Andrew Boulton, past-President of the European Association for the Study of Diabetes and Professor of Medicine at the University of Manchester, UK and University of Miami, USA, and Chairman of AOTI’s Scientific and Clinical Advisory Board, commented: “Diabetes is one of the fastest growing global health emergencies of the 21st century. It is a real game-changer to finally have clinically proven homecare therapeutics like TWO2 available that make meaningful impact in such critical outcomes as hospitalizations and amputations. Now that TWO2 therapy is authorized in China, the world’s largest diabetic foot ulcer population has a renewed hope for better outcomes.”

 

1 International Diabetes Federation. IDF Diabetes Atlas, 10th Edition. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org

 

2 Development and validation of a brief diabetic foot ulceration risk checklist among diabetic patients: a multicenter longitudinal study in China. Zhou, Q., Peng, M., Zhou, L. et al. Nature, Sci Rep 8, 962 (2018). https://doi.org/10.1038/s41598-018-19268-3

 

3 Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers; The TWO2 Study. Robert G. Frykberg et al, Diabetics Care 2020; 43:616-624. https://doi.org/10.2337/dc19-0476.

 

4 Reduced Hospitalizations and Amputations in Patients with Diabetic Foot Ulcers Treated with Cyclical Pressurized Topical Wound Oxygen Therapy: Real-World Outcomes; Jessica Izhakoff Yellin, et al; Advances in Wound Care 2022; http://doi.org/10.1089/wound.2021.0118

 

About AOTI
AOTI is a privately-owned company based in Oceanside, California USA and Galway, Ireland that provides innovative solutions to resolve severe and chronic wounds worldwide. Our products reduce healthcare costs and improve the quality of life for patients with these debilitating conditions. Our patented non-invasive Topical Wound Oxygen (TWO2) homecare therapy is clinically proven to deliver Sustained Wound Healing that reduces both Amputations and Hospitalizations, So Life Can Get Back to Normal.

 

For more information see: www.aotinc.net
Dr. Mike Griffiths
CEO & President
332487@email4pr.com
(760) 672 1920
SOURCE AOTI Inc.

Comparison of oxygenated flow patterns in diabetic foot ulcers subjects and controls in response to breath-holding

Kevin Leiva, Alexander Trinidad, Isabella Gonzalez, Aliette Espinoza, Thomas Zwick, Jason Edward Levine, Magaly Adelaida Rodriguez, Hadar Lev-Tov, Robert Kirsner, Anuradha Godavarty

 

Approximately 34% of people with diabetes will experience a diabetic foot ulcer (DFU) at some point throughout their lifetime. The perfusion of oxygen to the DFU is critical for promoting wound healing and closure. However, complications from diabetes can compromise the oxygenated flow to the wound site. Techniques such as transcutaneous oximetry and laser Doppler imaging have been used to assess perfusion to DFUs at discrete point-locations in the peri-wound. Widearea measurements of temporal oxygenation changes, as an indirect measure of perfusion, can provide additional insight of the oxygenated flow in the (peri-)wound and background tissue. Herein, our objective is to assess the differences in oxygenation flow patterns in and around the DFU regions and in the feet of control subjects as a potential biomarker for monitoring wound healing … read more


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Combined Regenerative Approach for a Complex Lower Extremity Wound: A Case Report

Pedro Salomão Piccinini, Mariana Rodrigues de Sousa Rebelato, Marwan Masri, Carlos Oscar Uebel, Rubem Lang Stümpfle, Milton Paulo de Oliveira

 

A diabetic foot ulcer (DFU) is a multifactorial complication affecting patients with diabetes mellitus (DM). These ulcers have a lifetime prevalence of 25% in this population and represent a major cause of hospitalization.1-4 Diabetic foot ulcers also generate an economic burden on the health care system and severely impact patient quality of life.5,6 Standard of care (SOC) consists of management of comorbidities, evaluation of vascular status and debridement, and provision of daily dressings, pressure offloading, and infection control. However, a majority of DFUs do not heal completely, and some lead to infection and amputation.3,7 Newer wound therapies have been shown to offer better alternatives by promoting angiogenesis to accelerate healing.4-6 In this context, the authors present the case of a patient with multiple comorbidities who presented with a chronic nonhealing plantar wound; while multiple prior treatments failed, the wound was successfully treated with nanofat grafting, negative pressure wound therapy … read more


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The contribution of intestinal Streptococcus to the pathogenesis of diabetic foot ulcers

by Yunyang Wang, Hong Zhang, Guixin Ma, Zibin Tian, Bin Wang

 

An analysis based on 16S rRNA sequencing
In this study, we intend to determine the microbial communities that are differentially expressed in diabetic foot ulcers (DFUs) from the view of species abundance difference and compositions. The EMBL-EBI database and QIIME2 platform were used to obtain and process 16S rRNA sequencing data of normal healthy and DFU samples. The LEfSe software was utilised to retrieve key intestinal bacteria differentially expressed in DFUs. Additionally, PICRUSt2, FAPROTAX and BugBase functional analyses were performed to analyse the potential microbial functions and related metabolic pathways. The correlations between intestinal microbiota and clinical indexes were evaluated using the Spearman correlation analysis. Significant differences existed in intestinal microbiota between DFU and normal healthy samples regarding species abundance difference and compositions at Kingdom, Phylum, Class, Order, Family, Genus and Species levels. Seven microbiota were demonstrated differentially expressed in DFUs that contained Bacteroidaceae, Prevotellaceae, Streptococcaceae, Lactobacillales, Bacilli, Veillonellaceae and Selenomonadales. Insulin signalling pathway may be the key pathway related to the functional significance of Streptococcus and Bacillus in the DFUs. The intestinal microbiota in DFUs exhibited susceptibility to sulphur cycling while displaying pathogenic potential. Last but not least, a close relationship between Streptococcus and the occurrence of DFUs was revealed. Taken together, this study mainly demonstrated the high abundance of Streptococcus in DFUs and its correlation with the disease occurrence … read more


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Navigating Wound Care From Hospital to Home

By Kari K. Harman, RN-C, CCM, CWCA, WCN-C, CSWD-C, ACCWS, DAPWCA
For patients discharged from the acute care setting, the road home can be laden with potholes and speed bumps. The fear of the unknown after being newly diagnosed with a wound or the exacerbation of a health condition can be overwhelming for many patients. Caregivers are likely to have the same feelings as patients. This blog will navigate through some avoidable roadblocks and barriers to ensure a smooth ride home. By establishing manageable expectations and partnering with home health agencies that have proficient wound care programs, the patient and caregiver can genuinely be on the road to recovery … read more


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Lipid Profiling Can Predict the Risk of Diabetes and CVD Years Before Onset

Janet Falade, PharmD Candidate, South College School of Pharmacy

 

The increased risk of having type 2 diabetes (T2D) and cardiovascular disease (CVD) has been a significant concern in the health care sector worldwide. Also, it has been regularly reported by the World Health Organization (WHO) that cardiovascular diseases (CVDs) and diabetes mellitus are part of the ten major leading causes of death globally. Some changes, such as increased blood pressure, cholesterol, and blood sugar level, are usually apparent before the onset of these diseases. Therefore, early detection of individuals at increased risk of having this disease is essential in preventing the disease Incidence. Furthermore, these diseases can influence specific measures like lifestyle changes such as healthy diet and exercise. In addition, machine learning models can help predict the risk of having T2D and CVD. Other factors such as lipid level and blood sugar levels, particularly evaluation of gene variations, protein complements, and metabolome, which includes lipidome, may aid in identifying physiopathology pathways that might be … read more


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Debridement: How Deep Is Too Deep?

Debridement is the process of removing nonviable tissue and foreign objects (such as glass or shrapnel) from a wound bed to help the wound heal.1 Decaying tissue can trap bacteria and lead to a harmful infection such as gangrene, which is the death of body tissue resulting from a lack of appropriate blood flow or in response to a severe bacterial infection.2 Debridement is thus critical to effective wound management … read more


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Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer

David G. Armstrong, Mark A. Swerdlow, Alexandria A. Armstrong, Michael S. Conte, William V. Padula & Sicco A. Bus
Diabetic lower extremity complications remain enormously burdensome. Most notably, DFU and LEA appear to be more than just a marker of poor health. They are independent risk factors associated with premature death. While advances continue to improve outcomes of care for people with DFU and amputation, efforts should be directed at primary prevention as well as those for patients in diabetic foot ulcer remission to maximize ulcer-free, hospital-free and activity-rich days … read more


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The Impact and Importance of Public Engagement in Wound Care

by Desmond Bell DPM CWS FFPM RCPS Glasgow
We Are Failing Our Patients With Diabetes” was the title of my article in Today’s Wound Clinic in November 2021. Non-traumatic amputation rates have been rising since 2009, despite technological advancements and ever-increasing levels of evidence .. After having been part of the wound care community for a quarter of a century, I—like many of you—have been looking for solutions and answers not only to improve quality of care, but to reverse this worrisome trend … My takeaway from this is that while technological advancements are critical and helpful, the way to solve this problem is through proactive measures … read more


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Gentiopicroside PLGA Nanospheres: Fabrication, in vitro Characterization

Antimicrobial Action, and in vivo Effect for Enhancing Wound Healing in Diabetic Rats

May Almukainzi, Thanaa A El-Masry, Walaa A Negm, Engy Elekhnawy, Asmaa Saleh, Ahmed E Sayed, Mohamed A Khattab, Dalia H Abdelkader

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Purpose: Gentiopicroside (GPS), an adequate bioactive candidate, has a promising approach for enhancing wound healing due to its antioxidant and antimicrobial properties. Its poor aqueous solubility negatively affects oral absorption accompanied by low bioavailability due to intestinal/hepatic first-pass metabolism. Our aim in this study is to fabricate GPS into appropriate nanocarriers (PLGA nanospheres, NSs) to enhance its solubility and hence its oral absorption would be improved.

 

 

Methods: Normal and ODS silica gel together with Sephadex LH20 column used for isolation of GPS from Gentiana lutea roots. Crude GPS would be further processed for nanospheres fabrication using a single o/w emulsion solvent evaporation technique followed by in vitro optimization study to examine the effect of two formulation variables: polymer (PLGA) and stabilizer (PVA) concentrations on the physical characterizations of prepared NSs. Possible GPS-PLGA chemical and physical interactions have been analyzed using Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). The optimum GPS-PLGA NSs have been chosen for antimicrobial study to investigate its inhibitory action on Staphylococcus aureus compared with unloaded GPS NSs. Also, a well-designed in vivo study on streptozotocin-induced diabetic rats has been performed to examine the wound healing effect of GPS-PLGA NSs followed by histological examination of wound incisions at different day intervals throughout the study.

 

 

Results: The optimum GPS PLGA NSs (F5) with well-controlled particle size (250.10± 07.86 nm), relative high entrapment efficiency (83.35± 5.71), and the highest % cumulative release (85.79± 8.74) have increased the antimicrobial activity as it exhibited a higher inhibitory effect on bacterial growth than free GPS. F5 showed a greater enhancing impact on wound healing and a significant stimulating effect on the synthesis of collagen fibers compared with free GPS.

 

Conclusion: These findings demonstrate that loading GPS into PLGA NSs is considered a promising strategy ensuring optimum GPS delivery for potential management of wounds … read more


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High-Tech Footwear May Help Diabetics

North Texas researchers hope their development will help ward off diabetic foot ulcers, which can lead to amputation.
Research scientists at The University of Texas at Arlington have developed footwear technology that may prevent the development of diabetic foot ulcers … People with diabetic neuropathy deal with numbness in their legs and feet and are often unable to detect and respond to stress-related pain by adjusting their foot loading … read more


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Prevalence of Foot At-Risk and its Associated Characteristics among Outpatients with

Diabetes Mellitus in a Peruvian Public Hospital

Marlon Yovera-Aldana 1, Sonia Pérez-Cavero 2, Isabel Pinedo-Torres 3, Carlos Zubiate-López

This article was originally published here

 

ABSTRACT

 

OBJECTIVE: To assess the prevalence of patients at risk of developing diabetic foot complications(i.e.foot at-risk) and its clinical components according to the updated International Working Group on Diabetic Foot (IWGDF) criteria and to describe demographic and diabetes-related characteristics. METHODS: We conducted a cross-sectional study at María Auxiliadora Hospital between 2017 and 2018. The criteria for foot at-risk in the IWGDF 2019 risk stratification system are classified into four risk categories, R0-R3, ranging from no peripheral arterial disease (PAD) and no peripheral neuropathy (PN) to the presence of PAD or PN in combination with previous foot ulcer, amputation, or end- stage renal disease (R3). According to this system, we obtained prevalence ratios (PR) of foot at-risk categories dependent on sex, age, diabetes duration, and Total Symptom Score. A sample size of 402 subjects was included in the study. RESULTS: Subjects included had a mean age of 61 years, and 66% were female. There were no patients with type 1 diabetes, and 59% percent had a diabetes duration of less than ten years. The prevalence of foot at-risk was 54.3% defined by the IWGDF 2019 criteria, which gave prevalence17% higher than that defined with the previous 1999 criteria. PN and PAD frequency was 37.3% and 30.1%, respectively. Foot at-risk prevalence was 40% higher in those with severe Total Symptom Score (PR 1.40, 95% CI 1.09-1.80) and also 39% higher in men than in women (PR 1.39, 95% CI 1.17-1.64). Likewise, diabetes duration of more than ten years had a 25% higher prevalence of foot at-risk (PR 1.25, 95% CI 1.05-1.49), and those older than 60 years had a 20% higher presence of this condition (PR 1.20, 95% CI 1.0011.43). CONCLUSIONS: Our hospital faces a substantial burden of diabetic foot risk in men, patients with long diabetes duration, and those with painful neuropathy. More initiatives are required at primary or hospital level to detect this critical condition. Likewise, reference centers with multidisciplinary teams to apply prevention and therapeutic interventions are urgently needed.

 


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Threats, obscenities, homicide: Healthcare workers stressed by pandemic face elevated violence

By Hailey Mensik
Millions of healthcare workers across the country are becoming inured to workplace violence, which can range from verbal abuse and threats to physical attacks and even homicide.

It’s not unusual for Kimberly Mullen to get kicked, scratched, pushed or threatened during one of her shifts as a registered nurse in the telemetry unit at Kaiser Permanente’s South Bay Medical Center in Los Angeles … It’s considered part of the job when dealing with patients who are sometimes confused, frustrated and feeling a loss of control in an unfamiliar hospital setting, she says. Still, she’s thankful she hasn’t fared worse, like one of her coworkers who was attacked by a patient’s family member … read more


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New physicians want work-life balance in first job, survey says

by Richard Payerchin
Work-life balance is the most important factor for new physicians choosing their first jobs – possibly as a result of dealing with stresses brought on by COVID-19, according to a new survey … The responses confirmed and surpassed a similar finding from a study of 2018, according to health staffing consultant CHG Healthcare. The company announced the survey from its CompHealth division, which surveyed 145 physicians who had been out of residency for two to three years … read more


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WoundGenex Partners with MIMEDX to Launch Premier Graft Program to Wound Care Providers Nationwide

TAMPA, Fla., March 16, 2022 /PRNewswire/ — Leading wound care management and clinical services provider, WoundGenex, today announced a strategic partnership with MiMedx Group, Inc. (Nasdaq: MDXG) (“MIMEDX”), a transformational placental biologics company, to launch an exclusive version of WoundGenex’s Premier Graft Program to its clients across the country, providing clinicians access to industry-leading allograft products through a convenient purchasing option.

 

WoundGenex Partners with MIMEDX to Launch the first-of-its-kind Premier Graft Program.
The partnership adds the portfolio of MIMEDX advanced wound care products to the list of treatment options available to clinicians who rely on WoundGenex’s expertise in clinical documentation requirements, wound care revenue cycle, and reimbursement policies. Premier Graft Program members tap into group purchasing power that allows WoundGenex to facilitate product ordering at no upfront cost to the provider or organization. WoundGenex Program Liaisons work with providers and billing specialists to help streamline the entire process, including proper utilization of products, documentation of medical necessity, coding, and coding education, and more. A first-of-its-kind program, no payment is due from the ordering providers until reimbursement is realized on the product.

 

MIMEDX is a leading provider of placental allografts in the Cellular Tissue Products/Skin Substitute segment of the advanced wound care category. MIMEDX’s flagship advanced wound care product, EPIFIX®, is covered by 100% of national commercial payors for the treatment of diabetic foot ulcers, totaling over 300 million covered lives.

 

“WoundGenex is thrilled to be able to partner with MIMEDX to introduce a meaningful solution to providers to maximize clinical and reimbursement outcomes. Clinical expertise, industry leading advanced wound care products, and a strong understanding of reimbursement across all sites of service is the key for a successful practice,” said WoundGenex President and Co-founder, Thomas Smith.

 

“In partnering with WoundGenex, we are able to further substantiate our mission to increase access to innovative technologies for patients and customers alike,” said Rohit Kashyap, Ph.D., MIMEDX Chief Commercial Officer. “We are excited for the opportunity this program will provide to ensure more patients receive the care they need, as well as the opportunity to continue strengthening our reimbursement and service offerings for clinicians who choose our products.”

 

About WoundGenex
Founded in 2014 in Tampa, Florida, WoundGenex optimizes the way clinicians provide wound care to their patients in various places of service such as physician practices, hospitals, surgical centers, nursing homes, free-standing wound centers across the country. Thanks to more than two decades of experience in both the clinical and administrative aspects of wound care WoundGenex provides true solutions to help meet the challenges of providing best-in-class care from start to finish – from clinical and operational excellence to financial and procedural optimization.

 

To learn more about WoundGenex and the Premier Graft Purchasing Program, please visit https://woundgenex.com.

 

Media Inquiries: Media@WoundGenex.com

 

About MIMEDX
MIMEDX is a transformational placental biologics company, developing and distributing placental tissue allografts with patent-protected, proprietary processes for multiple sectors of healthcare. As a pioneer in placental tissue engineering, we have both a commercial business, focused on addressing the needs of patients with acute and chronic non-healing wounds, and a promising late-stage pipeline targeted at decreasing pain and improving function for patients with degenerative musculoskeletal conditions. We derive our products from human placental tissues and process these tissues using our proprietary methods, including the PURION® process. We employ Current Good Tissue Practices, Current Good Manufacturing Practices, and terminal sterilization to produce our allografts. MIMEDX has supplied over two million allografts, through both direct and consignment shipments. For additional information, please visit https://MIMEDX.com

 

MIMEDX Contacts

 

Investors:
Jack Howarth
Investor Relations
404.360.5681
jhowarth@mimedx.com

 

Media:
Hilary Dixon
Corporate & Strategic Communications
404.323.4779
hdixon@mimedx.com

 

Cision View original content:https://www.prnewswire.com/news-releases/woundgenex-partners-with-mimedx-to-launch-premier-graft-program-to-wound-care-providers-nationwide-301503626.html

 

SOURCE WoundGenex

Orange County musician back on stage, credits Wound Care team for saving his hand

On March 26, 2021, Vaughn Schnakenberg made a few final adjustments on the ‘76 Corvette he’d lovingly restored for his wife and took it out for a test drive. Minutes later, a drunk driver traveling at a high rate of speed broadsided him, smashing the windshield and sending the hood flying off its hinges. Mr. Schnakenberg was ejected from the driver’s seat and landed on top of the car’s flaming engine, suffering major burns to his right arm and hand … read more


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Clinic-Based Hidradenitis Suppurativa Surgery Gets High Marks From Patients

by Pam Harrison, Contributing Writer, MedPage Today
High satisfaction after three-fourths of procedures, despite frequent recurrences

Clinic-based surgery for hidradenitis suppurativa (HS) had high patient satisfaction despite frequent recurrences, a retrospective cohort study showed … investigators sought to address three principal patient-centered issues: how long to return to work or school, how long to return to normal activities, and how long to wound healing … “These patients are used to wound care — that is normal care for them — and if you give them a chance for the wound to fully heal after 4 to 6 weeks as opposed to a wound that never heals, it’s a major upgrade for them … rather than having them deal with a perpetual wound, wound care, and pain every day,” he added … read more


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Multidisciplinary Approach Best for Managing Chronic Wounds

By Chase Doyle
As the treatment of nonhealing wounds continues to evolve, multidisciplinary care is playing an increasingly important role in the management of complicated patients. During the 2021 virtual American College of Surgeons Clinical Congress, Nicolas J. Mouawad, MD, the chief of vascular and endovascular surgery at McLaren Health Care, in Bay City, Mich., discussed the benefits of multidisciplinary wound care and how to incentivize institutional collaboration.

“Patients with difficult wounds who would often be considered for amputation with a single-specialty approach can now be managed successfully with a multidisciplinary wound team,” he said … read more


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Phase 3 Trial of EB-101 for RDEB Meets Target Enrollment

by Teresa Carvalho MSc
The pivotal Phase 3 VIITAL clinical trial of EB-101, Abeona Therapeutics’ experimental cell therapy for wound healing in people with recessive dystrophic epidermolysis bullosa (RDEB), has met its enrollment target.

The company also announced that top-line results from the VIITAL trial (NCT04227106) are expected in the in third quarter of this year … read more


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The Effect of Topical Cow’s Milk on the Healing of Diabetic Foot Ulcers

A Randomized Controlled Pilot Clinical Trial

 

Diabetic foot ulcer (DFU) is a very serious side effect among the diabetic patients with substantial clinical and economic consequences. The aim of this study was to investigate the efficacy of cows’ milk topical ointment, as an available and cost-effective natural product, on accelerating the healing of DFU. In this randomized controlled clinical trial, patients with grade 1 or 2 DFU were randomly divided into two groups of intervention (n = 50) and control (n = 49). For patients of intervention group, cows’ milk 20% topical ointment was applied on the ulcer once daily for two weeks, while a type of novel dressing was used for control group with the same frequency and duration. Both groups received usual standard wound care measures. The percentage of change in the ulcer size and the number of cases with complete wound healing (>90% reduction in the ulcer size) were recorded in the both groups. The ulcer size significantly reduced in both groups on the seventh and 14th days of intervention; however, the percentage of reduction was significantly higher in the intervention (milk) group compared to control at both time points … read more


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A Wound Clinician’s Guide: Anatomy and Physiology of the Skin

To understand the concepts of a wound and wound healing, we must examine the skin and its pathophysiology, as well as its unique structures and functions. Skin care and wound management must be grounded in a comprehensive knowledge base of the structure and functions of the skin. The skin is the largest organ of the body, covering approximately 18 square feet and weighing about 12 pounds, or up to 15% of total adult body weight. It requires one-third of an individual’s circulating blood volume to sustain it. Normal surface skin temperature is 92 degrees, compared with a core body temperature average of 98.6 degrees … read more


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The clinical effectiveness and safety of using epidermal growth factor

fibroblast growth factor and granulocyte-macrophage colony stimulating factor as therapeutics in acute skin wound healing: a systematic review and meta-analysis

 

Promoting wound healing is crucial to restore the vital barrier function of injured skin. Growth factor products including epidermal growth factor (EGF), fibroblast growth factor (FGF) and granulocyte-macrophage colony stimulating factor (GM-CSF) have been used for decades although no systematic evaluation exists regarding their effectiveness and safety issues in treating acute skin wounds. This has resulted in a lack of guidelines and standards for proper application regimes. Therefore, this systematic review and meta-analysis was performed to critically evaluate the effectiveness and safety of these growth factors on skin acute wounds and provide guidelines for application regimes … read more


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Wound Infection in Clinical practice – principles of best practice

We have over 100 resources, free for everyone to browse and read and share. These resources are suitable for a range of skin and wound care disciplines, roles, and educational purposes
Wound infection continues to be challenging for people with a wound, their families and health professionals. Wound infection can lead to protracted wound healing, multiple health service visits and increased hospital admission duration. This comes at significant economic cost and negatively impacts quality of life outcomes for the person with a wound and their family. Accurate and timely identification of the signs and symptoms of wound infection are critical to achieving effective management of wound infection … read more


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Risk Factors for PAD Development

Manesh Patel MD, Christopher Granger MD and Larry Allen MD

 

One thing that you mentioned about risk factors is interesting, and I’m going to ask Larry, how do you usually think about comorbidities, including heart failure? I tell our fellows in clinic, if the patients don’t smoke and don’t have diabetes, those are overrepresented in PAD [peripheral artery disease]. This comes from data that are a bit older, but the PARTNERS study where they evaluated patients doing an ABI [ankle-brachial index] in primary care clinics, about 7000 patients, and they found that a quarter of them had PAD. If they were 50 years old and over, they tested whether they had diabetes and tobacco use, or over 70. Unrecognized PAD probably exists in about a quarter [of patients] in our primary care clinics, and it fits with these comorbidities … read more


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Limb salvage in Charcot deformity correction: A case series of 20 limbs

by Jordan James Ernst, DPM, MS, FACPM; Dalton Ryba, DPM; Alan Garrett, DPM, FACFAS
Charcot arthropathy is a disabling complication of peripheral neuropathy, with progressive osseous destruction often necessitating operative intervention to prevent ulceration and even amputation. The prospect of a stable, plantigrade foot is one that is best sought through timely intervention. While a host of procedures and techniques for Charcot reconstruction have been described in the literature, no clear consensus has been reached on a superior method or modality, nor on what factors most significantly affect outcomes and complications. We present a case series of 18 patients (20 limbs) operatively treated at our institution and followed for an average of 3 years for Charcot deformity … read more


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Paths to Practice Perfection Case Study – Diabetic Foot Abscess and Sepsis: Amputation or Limb Salvage?

from  Brent Bernstein, DPM
A 48-year-old Type II insulin dependent diabetic male presented in the acute care setting with sepsis due to an abscess of the right foot involving bone and deep soft tissue structures of the midfoot. The wound and associated sepsis made limb loss and/or mortality a pressing concern. Options were primary limb amputation versus an attempt at limb salvage … In addition to his diabetes, past medical history included chronic kidney disease stage 3, sleep apnea with continuous positive airway pressure dependence, peripheral neuropathy, hyperlipidemia, hypertension, hypothyroid, morbid obesity, Moya disease, and secondary renal hyperparathyroidism … read more


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JWC Masterclass on Bovine Dermal Scaffolds Webinar

Diabetic foot ulcers can be extremely challenging to treat and are associated with a high morbidity and mortality. A recent large randomised controlled trial (RCT), undertaken in the US, found that a single application of a fetal bovine acellular dermal matrix plus standard of care (SOC) is a faster and more effective treatment for these ulcers than SOC alone. This masterclass will explore this evidence base and debate how to optimise use of this dermal scaffold for this indication.

 

Wed, Mar 23, 2022 · 2:00 PM · EDT

 

John C. Lantis II
Chief of Surgery, Mount Sinai West Hospital

register

The patient’s perspective of diabetic foot ulceration

A phenomenological exploration of causes, detection and care seeking
From Rebecca M CrockerTze-Woei TanKelly NB PalmerDavid G Marrero

 

Diabetic foot ulceration can contribute to lowered life expectancy and quality of life for people with diabetes, and yet, scant attention has been given to improving preventive and educational measures. This article uses a phenomenological approach to explore individuals’ lived experiences of diabetic foot ulcerations to explore factors that can be harnessed to achieve improved outcomes … This was a qualitative study using semi-structured interviews grounded in a phenomenological framework to explore how patients perceive and understand their foot problems … read more


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Under the Off-Load: A Pilot Case Series to Identify Ideal Dressings to use Under Total Contact Casts (TCC)

Michael S. Miller DO,Lindsey Markey RN, BSNRegina Yoder RNKevin Powers DPMTCC Kits provided by M-Med

 

Introduction:
It is well stated in the literature that Total Contact Casting (TCC) is a standard of care for off-loading of neuropathic ulcers of the plantar surface. Another standard of care is to provide a moist wound healing environment. Evidence to support appropriate wound dressings under TCC is currently unavailable despite recognition that the wound environment and thus the amount of drainage changes as the wound progresses towards healing. This pilot case series of three patients with plantar based diabetic neuropathic ulcers uses two dressings, a five layer silicone foam with absorbent polymer and moisture retentive backing dressing (SF)* for low to moderate drainage and a non-adherent super-absorbent (SAP)† polymer dressing for moderate to high exudate levels.

 

Clinical Problem:
Many TCC kits include a generic, open-cell, polyurethane foam dressing (OCF). These dressings do not absorb or retain fluid in a moderate to high exudate environment which can lead to maceration and non-healing. Furthermore, due to the high moisture vapor transmission rate of OCF, wounds with low exudate may experience desiccation and result in the development of slough and biofilm.1

 

Methods:
This pilot case series evaluates the performance of two dressings under a TCC‡. The 1st dressing is a five-layer silicone foam with super-absorbent polymer and moisture retentive backing for low to moderately exuding wounds (SF)*. The 2nd dressing is a non-adherent absorbent (SAP)† polymer dressing for moderate to high exudate levels. A total of 3 Wounds were assessed, cleansed, debrided if necessary, categorized by exudate level, and TCC was applied for 7 days. The expected outcomes were to avoid maceration, increase in healthy granulation/epithelial tissue, and achieve maximum wear time of TCC.

 

Results:
All three of the pilot cases healed completely in acceptable time with no untoward complications. The important feature was that the changes in the amounts of drainage which were identified as the healing progressed were compensated for by changing the dressings based on the amounts of exudate identified. This effectively minimized associated peri-wound maceration, damage to the increasing granulation tissue and improved tolerance of their feet to the total contact casting.

 

Conclusion:
TCC kits should consider including dressings for low-moderate and moderate-high exudate and cease adding the one-dressing-fits-all generic foam into the kit. Additionally, although foam dressings are lumped into single category, their individual traits such at total volume handling, exudate retention, and MVTR have erratic variation in function. The SF in this case series exceeded expectation and can be a standard of care unless exudate overwhelms the dressing in the 7 day expected wear. At that time, SAP should be used in place of SF to manage high exudate. Our experience is that this combination of dressings progresses wounds towards healing, enhances the clinical benefits and wear time of TCC, and decreases the potential for wound healing complications.

 

Case History 1
45 year old Insulin-dependent diabetic male (IDDM) with a history of poor compliance presented with a plantar ulcer of 2 years duration. He had developed an acute Charcot’s Arthropathy, misdiagnosed as osteomyelitis and had surgery to remove “infected” bone. He had ongoing significant drainage with periwound skin maceration and no evidence of healing.
Course of Treatment:
Aggressive debridement of the ulcer was performed with identified bone at the base of the ulcer. However, further workup did not demonstrate osteomyelitis. He was placed in a TCC and SAP used due to concerns about the excessive drainage. With the drainage controlled, maceration resolved and offloading successfully managed, he went on to heal completely.
Case History 2
64 year old IDDM with a history of a Diabetic Neuropathic foot ulcer of the plantar heel. He had undergone surgery years before leaving him with a soft tissue deformity predisposing him to recurrent ulcers.
Cource of Treatment
An aggressive debridement was performed with no bone exposure noted. He had moderate serous drainage from the ulcer and so SF was used to control the drainage without creating a dry wound base. TCC was performed weekly with changes of the SF dressing. With the drainage controlled and offloading accomplished, he went on to heal completely.
Case History 3
A 64 year old female with advanced rheumatoid arthritis and foot deformity presented with a 6 month history of a nonhealing ulcer of the right plantar foot. A surgery to correct this had incisional dehiscence. Topical dressings and an offloading boot were previously used unsuccessfully.
Course of Treatment
An aggressive debridement was performed with no bone exposure noted. Her significant serous drainage was treated with SAP and TCC applied weekly for offloading. Over the next several weeks, the drainage decreased and the dressing was changed to SF due to decreasing wound drainage. With the drainage controlled and offloading in place, she went on to heal completely.

References
1. Hurlow J, Couch K, Laforet K, Bolton L, Metcalf D, Bowler P. (2015) “Clinical Biofilms: A Challenging Frontier in Wound Care”. Adv Wound Care (New Rochelle) 4(5): 295–301.
* KerraFoam is a registered trademark of Crawford Woundcare Ltd. † KerraMax Care is a registered trademark of Crawford Woundcare Ltd.
‡ Total Contact Casting Kits by M-Med, Mebane, NC., supplied at no charge for this case series.
This poster abstract is funded and supported by Crawford Healthcare Inc.
© Copyright Crawford Healthcare Ltd, 2016. This literature and product report is supported and funded by Crawford Healthcare Ltd. 2016


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Thrombi Formation during Wound Healing—New Insights

Researchers at the Royal College of Surgeons in Ireland (RCSI University of Medicine and Health Sciences, along with collaborators in Germany and Switzerland, say their work has revealed new information about how blood clots are formed during wound healing. Their study “Platelets drive fibronectin fibrillogenesis using integrin αIIbβ3”, which appears in Science Advances, examines the behavior of platelets at a wound site, specifically their ability to sense where within a blood clot they are and remodel their surroundings accordingly … read more


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The Cellular Cleaning Program Autophagy Helps In Wound Healing

A team led by Maria Leptin has shown in the fruit fly Drosophila that autophagy, a mechanism of stress responses in cells, plays an important role in wound healing: When a wound heals, the process of autophagy is initiated and regulated by the protein complex TORC1. This is a newly discovered function of autophagy and the first evidence that autophagy controls the formation of syncytia (multinucleated cells). While syncytia are also formed during the development of muscles or the placenta, their role in wound healing and the involvement of autophagy are new discoveries. The article, ‘Autophagy-mediated plasma membrane removal promotes the formation of epithelial syncytia’ has been published in The EMBO Journal … read more


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RedDress Secures Agreement with Premier, Inc., a Leading Group Purchasing Organization

RedDress, a privately held U.S. and Israel-based wound care company, announced today it has been awarded a group purchasing agreement with Premier Inc. This agreement allows Premier members, at their discretion, access to RedDress’ wound care product, ActiGraft® system … ActiGraft is the first wound care product that enables health care providers to produce—in real time—an in vitro blood clot from a patient’s own blood. Once applied, the blood clot serves as a protective covering and supports the body’s natural wound healing response. ActiGraft can be used for a wide variety of hard-to-treat chronic wounds, including diabetic foot ulcers, pressure injuries, venous ulcers, traumatic wounds, and post-surgical wounds … read more


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When time doesn’t heal all wounds

ASU researcher explores innovative treatment methods for chronic wounds
Many wounds aren’t a big deal — generally, all you need to do is clean them, apply bandages and let them heal. However, chronic wounds that don’t heal on their own affect more than 8 million people in the United States and represent more than $20 billion in management costs each year.

Chronic wounds are exacerbated by infection, obesity, aging and other factors. They also increase the risk of amputation and mortality for people with diabetes, which affects one in 10 Americans, with one in three currently experiencing pre-diabetes … read more


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Abeona Therapeutics Achieves Target Enrollment in Pivotal Phase 3 VIITAL™ Study

of EB-101 in RDEBTopline data from VIITAL™ expected in the third quarter of 2022
Abeona Therapeutics (Nasdaq: ABEO), a fully-integrated leader in gene and cell therapy, today announced that target enrollment has been achieved in its pivotal Phase 3 VIITAL™ study. The objective of VIITAL™ is to evaluate the safety and effectiveness of Abeona’s investigational EB-101 product for the treatment of recessive dystrophic epidermolysis bullosa (RDEB), a rare connective tissue disorder characterized by severe skin wounds that cause pain and can lead to systemic complications impacting the length and quality of life. Large chronic wounds typically do not heal spontaneously and inflict the greatest pain and clinical burden on RDEB patients. Large chronic wounds treated in VIITAL™ measured greater than 20 cm2 of surface area and had remained open for more than six months. In a phase 1/2a study conducted at Stanford University, large chronic wounds treated with EB-101 showed considerable wound healing and reduction in associated long-term pain for up to six years … read more


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Microbion Corporation Announces Granting of a US Patent for the Use of Topical Pravibismane

for Diabetic Foot Ulcer Infections
Microbion Corporation today announced that the US Patent and Trademark Office (USPTO) issued United States Patent No. 11,207,288 to Microbion on December 28, 2021, with claims to the use of Microbion’s proprietary pravibismane topical composition for diabetic foot infections (“DFI”). The patent, entitled “Bismuth-thiol compositions and methods for treating wounds,” extends topical pravibismane patent protection through to mid-2039. The granted claims cover the administration and use of topical pravibismane compositions in diabetic foot ulcer infections. This patent further expands Microbion’s patent portfolio, comprising granted claims to its pravibismane composition and methods of treating wounds and diabetic foot ulcers.

 

“We are pleased that the USPTO has granted this new patent supporting our pravibismane program for the treatment of diabetic foot infections,” said Dr. Brett Baker, Microbion’s President and Chief Innovation Officer. “This patent includes claims built on data from our Phase 1b clinical studies in infected patients. In these studies, topical pravibismane demonstrated a 3-fold reduction in chronic wound size compared to placebo when administered as an adjunct to standard of care treatment in patients with moderate to severe DFI. We are committed to developing novel therapies that fulfill the unmet needs caused by diabetic foot ulcer infections and faced by these patients every day.” … read more


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Why This Woundologist Transitioned From Hospital-Based to Office-Based Wound Care

by Stephen “Andy” Rohrer, MSN, RN, APRN, AGACNP-BC, FNP-BC, CWS

I practice in West Memphis, Arkansas, about 15 miles from the city of Memphis, Tennessee. The location is suburban but the culture is rural. My people in Arkansas primarily work in farming and “blue collar” industries. West Memphis, Arkansas is separated from Memphis, Tennessee by the Mississippi River. We find that many Arkansans are simply intimidated by even the thought of crossing the bridge to go into Memphis (population about 650,000).

I am fiercely protective of my patients and our way of life here in Arkansas. I know they are hard-working, independent people who often try to fix things themselves; unfortunately, they show up for medical care only when things have progressed to dire circumstances. The drive time for patients to reach me varies from a few minutes to more than 2 hours. Our payer mix is increasingly Medicare Advantage plans … read more


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Placental and Umbilical Tissue Applied to an Amputation Site

by Charles B Parks, DPM, FACFAS

In this video, Charles B Parks, DPM, FACFAS, University of California San Francisco, showcases the use of placental and umbilical tissue in a case presentation on the application of STRAVIX TISSUE and GRAFIX PRIME Cryopreserve Placental Membrane on an amputation site.

This presentation is part of an 8-part case series on “Advancing the Standard of Care With Cellular- and Tissue-Based Products.”

View additional cases in the series here.

view video


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Perceptive Solutions Expands WoundZoom® Mobile Solution with Auto Border Functionality

WoundZoom Digital Wound Management solution expands solution benefits to healthcare providers

 

STEVENS POINT, WI – March 16, 2022 – Perceptive Solutions, Inc., maker of WoundZoom Digital Wound Management, today announced the expanded functionality and benefits of their WoundZoom Mobile application with auto border wound detection technology among the primary solution developments. These expanded capabilities create further workflow efficiencies for healthcare providers that measure, document, and treat wounds.

 

“Our new auto border functionality automatically traces wound edges saving clinicians time while increasing accuracy during the measurement process without the need for external reference markers. This provides a more streamlined approach with wound measurement for caregivers, while still allowing them to use their clinical expertise during this crucial step,” said Mark Lacerte, President of Perceptive Solutions. “Additionally, we have expanded our documentation capability while implementing additional user interface enhancements to make WoundZoom the most user-friendly yet comprehensive and accurate digital wound technology on the market today.”

 

WoundZoom is available for download on the Apple app store and Google Play with application access granted via a WoundZoom user license. Epic EHR facilities can also find our application in the App Orchard.

 

About Perceptive Solutions
Perceptive Solutions modernizes the practice of wound care with technology-enabled systems designed to increase clinical efficiency, improve care quality, and mitigate risk. Integrating smoothly with your EHR, WoundZoom utilizes the latest AI and imaging technology to capture accurate wound images and measurements from your smart device, automatically prompt and document appropriate actions, and create a continuous, standardized clinical record across shifts, floors, and facilities. For more information, visit https://perceptivesol.com.

 

Media Contact
Karen Guzdzial
Director of Marketing
(727) 225 7944
karen.guzdzial@woundzoom.com

Identifying and managing wound pain – module

Pain associated with chronic wounds can affect quality of life and have a major impact on physical, emotional and cognitive function. This module explores the importance of pain management, the mechanism and types of pain, as well as how to assess and manage pain.
Chronic wounds, Pain Management, Quality of life, Wound Care, Wound pain … read more


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Evidence for Person-centred Care in Chronic Wound Care

EWMA video explainer: What is person-centred wound care?
This EWMA video explains the concept of person-centred wound care and illustrates how you can start implementing this approach already today in your clinical practice.

Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients’ perspectives, beliefs and autonomy.
read more

 

Author Group:
Georgina Gethin (Editor), Ireland

Patricia Price, United Kingdom

Sebastian Probst, Switzerland

Jan Stryja, Czech Republic

Natalia Christiansen, Denmark


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Abdominal Negative Pressure Wound Therapy Devices for Management of the Open Abdomen

PURPOSE:
The purpose of this technologic analysis was to analyze technologic features of abdominal negative pressure wound therapy (NPWT).

APPROACH:
Published literature regarding abdominal negative pressure wound therapy (aNPWT) devices was reviewed. A summary of management approaches for the open abdomen provides a foundation for understanding the benefits of aNPWT. Safety information regarding aNPWT was derived from the Manufacturer and User Facility Device Experience (MAUDE) Database.
read more

 

by Carolyn Crumley, DNP, RN, ACNS-BC, CWOCN, Saint Luke’s East Hospital, Lee’s Summit, Missouri; University of Missouri Sinclair School of Nursing, Columbia, Missouri; and Section Editor JWOCN Evidence-Based Report Card.


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2022 physician suicide report: A bleak reality

Key Takeaways

    • Medscape’s Physician Suicide Report 2022 found that one in 10 physicians considered or attempted suicide in 2021.
    • Current licensure requirements and stigma may deter doctors from seeking the mental health support they require.
    • Physicians must demand proper support from their employers, advocate for local licensure reform, and communicate with colleagues they suspect are struggling.

It’s been nearly 2 years since the tragedy, but Dr. Lorna Breen’s death still reverberates. A dedicated physician who ran the ED at New York-Presbyterian Allen Hospital in Upper Manhattan, Dr. Breen was in the thick of the pandemic’s dreadful early days, with intubated patients packing her hospital’s hallways and staffing scarce … read more


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What is the Relationship Between Caregiver Attendance at Wound Clinic Visits

and Wound Healing in Patients With Diabetes?
Not unlike other chronic diseases, clinicians and family members observe that people with diabetes often cannot manage, or have difficulty managing, the condition alone. As witnessed by the author and supported by a qualitative vascular study by Zamani and colleagues, patients with diabetes-associated wounds often related feeling overwhelmed. Additionally, these patients may have compromised mobility, be physically unable to reach the lower limb to apply wound dressings, or unable to drive. Loss of visual acuity, common to diabetes, can impair wound dressing techniques and all aspects of diabetes self-care … read more
Carol Jessee, MSN, FNP


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Harold Bays, MD: A Different World for Obesity Treatment

A look into the uptake of semaglutide, what the agent represents, and what is coming further in obesity management.

For many clinicians, the approval of semaglutide for chronic weight management in patients with overweight or obesity may have represented what they had been waiting for in a weight treatment.

Harold Bays, MD, Chief Science Officer, Obesity Medicine Association, explained that while there have been other safe and effacious anti-obesity drugs, there was not a treatment that always met expectations of the patients.

“Up until semaglutide, we just really didn’t have the kind of anti-obesity drug treatment that met the degree of expectation that we often often find from patients where they would like to lose that 10 to 15% of their body weight,” he said. “And I think that’s the biggest central message.”
read more – watch video
Harold Bays, MD, Chief Science Officer, Obesity Medicine Association


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Fundamentals of pressure ulcer care

30 March 2022, 12.30 pm – 4.00 pm
Our (Society of Tissue Viability) educational sessions promote the best practices in skin health and wound healing.
It’s estimated that just under half a million people in the UK will develop at least one pressure ulcer in any given year. These wounds cause pain and suffering and impact significantly on a person’s quality of life. The financial impact to the NHS is approximately £2.2 billion a year and the costs of litigation is rising annually.

Education for both health and social care workers and patients is essential if this situation is to improve. This session will provide delegates with the fundamentals of pressure ulcer prevention and management using tools that can be applied in practice to help reduce pressure ulcers in their clinical areas.
Keynote Speaker: Sarah Gardner
read more


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Overview of diabetic neuropathy and review of FDA-approved oral therapies

Diabetic neuropathy is the most common complication of uncontrolled and chronic diabetes. Neuropathy is the result when the somatosensory system is compromised leaving patients with irreversible nerve damage. The continuity of this neuropathic pain may lead to disorders such as insomnia, depression, and anxiety. The cause of neuropathic pain cannot be treated, and current treatment management focuses on treating the symptoms. A review of current literature on diabetic neuropathy and of FDA approved oral therapies is performed to provide an extensive overview in order to reduce and prevent the progression of this disease. The epidemiology of diabetic neuropathy can be characterized by its prevalence and risk factors. Symmetric polyneuropathy is the most common type of diabetic neuropathy … read more


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Hematoma of the Lower Extremity: Operative Interventions in the Wound Clinic Setting

Hematoma in the soft tissue, a swelling in the tissue caused by bleeding, is not an uncommon occurrence following trauma or operative procedures. Hematomas of the extremities can be seen in as many as 33 per 10 000 individuals annually. Most hematomas are considered to be minor problems following the initial injury; however, accumulation of blood in the tissues can result in necrosis of the overlying skin due to increased tissue pressure which occludes the subdermal and dermal capillaries. Even in the absence of increased tissue pressure, multiple cellular and biochemical changes that can result in tissue ischemia and necrosis have been identified. Platelets and white blood cells in the wound can release inflammatory cytokines, proteolytic enzymes, and toxic reactive oxygen species causing significant tissue damage … read more


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Wound Care Technology: Advanced Tissue Therapeutics

Human knowledge is growing exponentially. This explosion is clearly evident in the field of Medicine. We hear almost daily about advances in cardiovascular and oncologic treatments. Medicine appears to be on the verge of extending human life well beyond 100 years. Fortunately, Wound Care physicians and their patients are also reaping the benefits of this rapid knowledge advancement. In the last decade, key elements in the body’s cellular healing processes have been elucidated. A major thrust has been in the development of human tissue therapies … Wounds heal in an orderly and progressive set of overlapping phases. Failure of these normal processes will lead to formation of a chronic ulcer (defined as non-healing after 30 days). Recent trends in chronic wound care have been in the use of “biologic” grafts to help restore the normal healing sequence … read more


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The Latest Development in the Management of Chronic Diabetic Foot Ulcers

A Purified Reconstituted Bilayer Matrix – webinar March 17, 12 PM EDT
This webinar will examine the use of purified reconstituted bilayer matrix (PRBM) as a treatment for chronic diabetic foot ulcers. Dr Charles Zelen will review a recent clinical study and outline the clinical benefits of purified reconstituted bilayer matrix to improve wound healing outcomes. Dr Zelen will also address questions from attendees … read more


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Ukrainian Diabetes Care, Insulin Access ‘Severely Disrupted’

Diabetes care and access to insulin and other medications in Ukraine have been “severely disrupted” since Russia’s invasion, with shortages resulting more from distribution problems than supply itself, according to multiple sources … In 2021, there were about 2.3 million people with diabetes in Ukraine, roughly 7% of the total population. Of those, about 120,000 have type 1 diabetes and depend on insulin to live, while a similar number have insulin-treated type 2 diabetes … read more


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Efficacy of Placental and Umbilical Tissue in an Infected Diabetic Foot Ulcer

In this video, Harry Schneider, DPM, FACFAS, Harvard Medical School, Cambridge Health Alliance Podiatry, showcases the use of placental and umbilical tissue in a case presentation of an infected diabetic foot ulcer in a 52-year-old male.

This presentation is part of an 8-part case series on “Advancing the Standard of Care With Cellular- and Tissue-Based Products.”

View additional cases in the series here.
watch


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Elevating Patient Voices in Your Clinic

Research shows that having engaged patients reduces errors and the risk of malpractice, as well as increases patient loyalty and employee satisfaction. A PFAC is a partnership between staff, clinicians, and volunteer patients and family members, who offer important feedback, insights, and advice to improve healthcare outcomes. The most effective PFACs include at least an equal number of PFAs and staff, including senior executives, leading clinicians, and representatives from marketing and community relations. The PFAs should reflect the diversity in the communities the clinic serves … read more


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What you need to know about transparent film dressings

Transparent film dressings provide a moist, healing environment; promote autolytic debridement; protect the wound from mechanical trauma and bacterial invasion; and act as a blister roof or “second skin.” Because they’re flexible, these dressings can conform to wounds located in awkward locations such as the elbow. The transparency makes it easy to visualize the wound bed … Transparent film dressings are waterproof and impermeable to bacteria and contaminants. Although these dressings can’t absorb fluid, they’re permeable to moisture … read more


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Protein p53 plays a key role in tissue repair, study finds

New research led by the University of Bristol has found the protein p53 plays a key role in epithelial migration and tissue repair. The findings could improve our understanding of the processes used by cells to repair tissues, and be used to identify interventions that could accelerate and improve wound repair … Epithelial tissues are the linings that protect the body’s external skin and internal cavities, and their ability to repair themself is important. ?It is known that wounded epithelia repair themself thanks to the ability of the remaining cells to start migrating, collectively, to seal the breach. Specialised migratory cells called leader cells … read more


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Angiosome-guided endovascular revascularization for treatment of diabetic foot ulcers

with peripheral artery disease
Because diabetic foot ulcers (DFUs) are difficult to heal and cause huge economic losses to society, accelerating their healing has become extremely important. The purpose of this study was to evaluate the effect of revascularization based on the angiosome concept on DFU … Between January 2018 and July 2020, 112 consecutive legs with DFUs in 111 patients who were discharged from the vascular surgery department of our hospital were retrospectively evaluated. The legs were assigned to two groups depending on whether direct arterial flow to the foot ulcer based … read more


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The Rise of the Machine: Can Artificial Intelligence Impact Wound Care Outcomes?

WOUND CARE Q&A from Podiatry Today
Windy Cole, DPM, CWSP, Barbara Aung, DPM, DABPM, CWS, FAPWHc, Matthew Garoufalis, DPM, FASPS, FACPM, CWS, FFPM RCPS (Glasg), Brian Lepow, DPM, DABPM, and Eric J. Lullove, DPM, CWSP, DABLES, FAPWHc

 

Over the past several years, artificial intelligence (AI)-based innovation in the medical field has emerged, including in various types of imaging. How might such technology apply to the field of wound care? In this edition of the Wound Care Q & A column, the panelists share their experiences and thoughts on if AI could bring a new era of improved outcomes … read more


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People with diabetic foot disease fear amputation more than death

Dane K. Wukich, MD, Katherine M. Raspovic, DPM, Natalie C. Suder, MPHF
The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. Methods. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non–diabetes-related foot pathology. Results. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis … read more


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COVID-19 has Amplified the Need to Establish Unavoidable Pressure Injury Criteria in Acute Care

by Laura Swoboda DNP, APNP, FNP-C, FNP-BC, CWOCN-AP
With the onset of the COVID-19 pandemic, there has been increased confusion regarding the diagnostic clarity of some skin lesions, especially in the critical care population. These lesions can be challenging to differentiate from other dermatological conditions seen in this population, including skin failure and deep tissue pressure injuries. During severe SARS-CoV-2 infection, endothelial dysfunction and hypercoagulability1 occur, and COVID-19 patients are at increased risk for ischemic lesions that mimic the appearance of deep tissue pressure injuries. In addition, similarities in underlying pathophysiologic mechanisms of these skin conditions can cause diagnostic overlap … read more


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Latest Medicare Payment Updates for Physicians and Other Qualified Healthcare Professionals

by Kathleen D. Schaum

Many readers ask this author “why don’t you publish Medicare payment information immediately after the Medicare Physician Fee Schedule (MPFS) Final Rule is released?” Actually, this author used to publish MPFS payment changes right after the release of the Final Rule. Unfortunately, the Final Rule is not always final. For the last few decades, significant changes have always been made after the Final Rule was released … read more


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Why Won’t This Wound Heal? Identifying Complicating Factors – webinar

Tuesday, March 29, 2022 Harry Schneider, Assistant Professor of Surgery at Harvard Medical School

Chronic wounds are difficult to heal, and they are often stuck in the inflammatory phase of wound healing. Stalled healing can be caused by a variety of factors, including infection, patient comorbidities, insufficient wound bed preparation, and other issues.

In managing a chronic wound, advanced therapies may aid in wound closure. These modalities include products that aid in bioburden management, those that provide scaffolding to aid in granulation tissue growth and wound closure, devices that remove excess fluid, and other products and techniques.

Clinicians participating in this webinar will be able to:

  • Recognize the clinical burden of diabetic foot ulcers (DFUs) on patient quality of life and examine the benefits of cellular therapies in wound care
  • Identify treatment options for chronic DFUs

register


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Help Build Solutions to Wound Evidence and Coverage Challenges – Join Payers and Policy Makers in May!

As a board member of the Alliance of Wound Care Stakeholders, I invite you to our upcoming Wound Care Evidence Summit where we will explore the key question: What type and quantity of clinical evidence is required by payers in formulating positive coverage policies for wound care products and procedures?

If you are involved in the field of wound care, you know that wound care coverage policies are becoming increasingly restrictive. You try to get the payer to approve the use of a product that’s available on the market and that works in your hands, only to be told it isn’t covered because the payer isn’t convinced by the data. Or, you are pretty sure that a product will help a patient with a limb-threatening wound … read more


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Factors Associated With Pressure Injury Development in Older Hospitalized Patients

A Prospective Descriptive Study
A pressure injury (PI) results from local injury to the skin and/or underlying tissues due to unrelieved pressure or pressure with shear or friction. PIs are usually not the primary cause of hospitalization, but PIs adversely affect patient well-being and nurse workload. Hospital-acquired pressure injuries can create a substantial financial burden on a health care system … Pressure injuries frequently occur in patients who are immobile, with more than 72% of PIs occurring in older adults. Advancing age can result in skin changes and, when coupled with reduced mobility and multiple comorbidities, increases the risk of PI development. Multiple chronic health conditions must be taken into consideration, including nutrition, older age, comorbidities, diabetes, peripheral arterial disease, immunodeficiency, poor nutrition associated with frailty and older populations, corticosteroid therapy, and smoking status … read more


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Solving skin and wound challenges together Annual Conference

18-19 May 2022 – Glasgow, UK
We believe that skin health and wound healing is everyone’s business and that change happens when we work together, not in silos.

We believe that skin health and wound healing is everyone’s business and that change happens when we work together, not in silos. Come to our annual face to face conference and you can join our community and listen to live lectures, interviews and discussions, take part in workshops, visit industry exhibition booths, network with colleagues and speakers and join the live conversations during the sessions.

Our conference really is space where professional connections are made, ideas are shared and collaborative action happens … read more


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Polymer-Based Wound Dressing Materials Loaded with Bioactive Agents

Potential Materials for the Treatment of Diabetic Wounds
Diabetic wounds are severe injuries that are common in patients that suffer from diabetes. Most of the presently employed wound dressing scaffolds are inappropriate for treating diabetic wounds. Improper treatment of diabetic wounds usually results in amputations. The shortcomings that are related to the currently used wound dressings include poor antimicrobial properties, inability to provide moisture, weak mechanical features, poor biodegradability, and biocompatibility, etc. To overcome the poor mechanical properties, polymer-based wound dressings have been designed from the combination of biopolymers (natural polymers) (e.g., chitosan, alginate, cellulose, chitin, gelatin, etc.) and synthetic polymers (e.g., poly (vinyl alcohol), poly (lactic-co-glycolic acid), polylactide, poly-glycolic acid, polyurethanes, etc.) to produce effective hybrid scaffolds for wound management … read more


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Effects of biofilms on venous leg ulcers

The healing trajectory of many chronic wounds, such as venous leg ulcers (VLUs), can be affected by the presence of biofilm. As a microbiologist studying wound biofilms in 3M’s medical solutions division, here are my insights into the complexity and antibacterial effects of the wound biofilm community … Antibacterial effects are often assessed in a laboratory environment where meaningful experiments can be performed in a controlled environment. However, the bacteria we encounter in our daily lives are not usually found in the lab, which poses a significant challenge to antibacterial effectiveness … read more


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Health economics for treatment of diabetic foot ulcers

a cost-effectiveness analysis of eight skin substitutes
Skin substitutes are frequently used to treat chronic diabetic foot ulcers (DFU), and many different options are available. While the clinical efficacy of many products has been evaluated, a comprehensive cost-effectiveness analysis comparing the most popular skin substitutes and using the most recent cost data has been lacking … read more


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The cellular cleaning program autophagy helps in wound healing

A team led by Maria Leptin has shown in the fruit fly Drosophila that autophagy, a mechanism of stress responses in cells, plays an important role in wound healing: When a wound heals, the process of autophagy is initiated and regulated by the protein complex TORC1. This is a newly discovered function of autophagy and the first evidence that autophagy controls the formation of syncytia (multinucleated cells). While syncytia are also formed during the development of muscles or the placenta, their role in wound healing and the involvement of autophagy are new discoveries. The article, ‘Autophagy-mediated plasma membrane removal promotes the formation of epithelial syncytia’ has been published in The EMBO Journal … read more

More about Professor Maria Leptin


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Supporting Wound Closure With Cellular and/or Tissue-Based Products

Cellular and/or tissue-based products (CTPs) comprise an exciting and emerging technology in wound care. Deep and large wounds require more than just a standard dressing, topical ointments, and time. Wounds that penetrate the reticular dermis and below (deeper than ~0.57 mm) require additional scaffolding to support wound closure and prevent significant scarring.1 CTPs provide this scaffolding as well as naturally occurring chemicals and cells that support wound healing … read more


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Seattle Lower Extremity Surgical Symposium (SLESS)

March 16-19, 2022
Cedarbrook Lodge
St. Anne’s Hospital
Up to 18 CECH– Lectures (3/17-18)
Up to 8 CECH—Labs (3/19)
The 5th Annual Seattle Lower Extremity Surgery Symposium—SLESS offers continuing medical education on surgical techniques for lower extremity trauma and reconstruction. SLESS is a 3-day course, featuring two days of didactic lectures held at the Cedarbrook Lodge, 5 minutes from Seatac airport and one day of cadaveric skills sessions held at nearby St Anne’s Hospital 5 minutes’ drive from the hotel . Learn from a faculty of leading (MD and DPM) lower extremity surgeons … read more


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A new district nursing model improves venous leg ulcer healing rates

The predominant aetiology of lower leg ulcers (VLU) are caused by venous insufficiency. In 2016 a new district nursing model was introduced using nurses specialising in leg ulcer assessment and management. The specialist nurses provided district nurse education on leg ulcers and conducted vascular assessments to identify venous ulcer aetiology, enabling early compression therapy to increase healing rates and prevent wound chronicity … read more
This article requires membership of Wounds Australia


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Pressure area care module

Education for pressure ulcer assessment and prevention is essential to ensure that patients receive safe, effective, harm-free care. Aligning an effective care bundle with the best possible evidence-based practice helps to safeguard patients by reducing the risk of this classic avoidable harm.
Pressure area care … read more


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Socioeconomic deprivation tied to amputation risk in people with diabetic foot ulcers

People with diabetic foot ulcers (DFUs) who live in areas with a high level of deprivation may be more likely to require major amputation than those living in less deprived areas, suggest findings from a French cohort study … Jean-Baptiste Bonnet (Hôpital Lapeyronie, Montpellier) used the French National Health Data System to evaluate amputation data from 15,507 individuals in the Languedoc-Roussillon administrative area with any type of diabetes who experienced a first DFU between 2015 and 2017. These people were aged an average of 70 years, 55% were men, and 20% required hospitalization … read more

When and how to culture a chronic wound

Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise … Most chronic wounds are colonized by polymicrobial aerobic-anaerobic microflora. However, practitioners continue to debate whether wound cultures are relevant. Typically, chronic wounds aren’t cultured unless the patient has signs and symptoms of infection, which vary depending on whether the wound is acute or chronic … read more

Is Your Wound Bioburdened? Case 3

A 77-year-old, non-smoking female with diabetes came into the clinic for a postoperative assessment … The patient presented with a non-healing surgical wound resulting from a great toe amputation 3 weeks prior … She had poor vascularity, normal blood sugar levels, and there were no signs or symptoms of infection (no malodor, purulent drainage, or cellulitis) … read more

PRESENT 5-Minute Podiatry Clinical Challenge – Drug-Induced Neuropathy

This week’s 5MinClinChallenge contributed by Robert G Smith, DPM, MSc, RPh, CPRS, focuses on a drug-induced neuropathy. This is an entity that you will see rarely, but when you do, you’ll want to be ready. See if you agree with Dr Smith’s approach … An 84-year-old female who resides in a temporary shelter presents with a complaint of new onset paresthesia in a stocking-glove distribution. She states that the numbness developed over the last month … read more

Hematoma of the Lower Extremity: Operative Interventions in the Wound Clinic Setting

Hematoma in the soft tissue, a swelling in the tissue caused by bleeding, is not an uncommon occurrence following trauma or operative procedures. Hematomas of the extremities can be seen in as many as 33 per 10 000 individuals annually. Most hematomas are considered to be minor problems following the initial injury; however, accumulation of blood in the tissues can result in necrosis of the overlying skin due to increased tissue pressure which occludes the subdermal and dermal capillaries. Even in the absence of increased tissue pressure, multiple cellular and biochemical changes that can result in tissue ischemia and necrosis have been identified. Platelets and white blood cells in the wound can release inflammatory cytokines, proteolytic enzymes, and toxic reactive oxygen species causing significant tissue damage … read more

N-Acetyl-Cysteine Increases Activity of Peanut-Shaped Gold Nanoparticles Against Biofilms

Formed by Clinical Strains of Pseudomonas aeruginosa Isolated from Sputum of Cystic Fibrosis Patients
Despite the clinical introduction of a spectrum of therapeutics with anti-bacterial and/or anti-inflammatory activities along with agents facilitating clearance of airways from thick and dehydrated sputum, the mortality rate of patients suffering from cystic fibrosis (CF) is still alarmingly high.1 Chronic inflammation and persistent Pseudomonas aeruginosa colonization are recognized as the major causes of lung tissue damage, lung transplantation, and mortality in CF subjects.2 Regardless of the intravenous or inhaled antibiotic therapies, the efficient treatment of pulmonary infections is considerably hampered mostly by the intrinsic or acquired resistance of P. aeruginosa to a variety of antibiotics,3 which is reinforced by its ability to produce drug-resistant biofilms. The latter is defined as three-dimensional communities of bacteria enclosed and protected by a self-produced extracellular polymeric substance (EPS) matrix, composed of polysaccharides (alginate), lysed cell debris proteins, lipids, extracellular DNA (eDNA), and bacteria-specific factors.4 Importantly, bacteria growth within biofilm in CF lungs is associated with their adaptation to antibiotics used frequently in the therapy of reoccurring pneumonia in CF patients. In this condition, an increased number of mutations associated with antibiotic resistance is generated. Such decreased susceptibility to the applied treatment followed by a lower metabolic rate of biofilm-embedded bacteria and their persistence makes the eradication of biofilms a challenging task.4 An approach to treat lung infections in patients with CF has evolved beyond antibiotic therapy, with the implementation of various airway clearance techniques (ACTs), in particular mucus thinners, to eliminate excess sputum … read more

Apps You and Your Patients With Diabetes Should Know

The trend toward real-time digitization of primary disease management continues to increase. Major reasons for this trend are that digitization can enable increased awareness of current patient health status, adherence to a treatment plan, and closer patient follow-up. Nowhere has this trend been more embraced than in the management of diabetes. Mobile applications (apps) have evolved to play a meaningful role in chronic disease management. Moreover, as diabetes-focused foot care is essential to helping people with diabetes avoid common and preventable complications such as wounds and lower extremity amputations (LEAs), a growing number of foot health-specific apps can aid in the management of this population … read more

Larva therapy makes a comeback

David Armstrong faced a predicament. He had a patient with an open wound that he needed to clean to remove dead tissue that could prevent proper healing, or worse. Infection could lead to severe pain and require limb amputation. But he didn’t have access to an operating room. Left with few other choices, he turned to an unexpected surgical assistant: maggots … While this scene might seem like one that unfolded on the front lines of the US Civil War or in a remote field hospital, Armstrong is actually a present-day surgeon at the University of Southern California. He is one of many clinicians turning to medical maggots as a tool for treating challenging wounds … read more

Odour management for chronic wounds – video

Sylvie Hampton describes the impact a malodorous wound may have on a patient’s quality of life and the mode of action of an activated charcoal dressing, which can be used as part of symptom management … watch

Could Custom Footwear Improve Adherence In An Ulcer Remission Program?

The authors took a closer look at adherence to footwear usage when patients with diabetes at high-risk for ulceration had custom-made shoes.1 Researchers assessed the percentage of overall steps during which subjects wore their custom-made shoes indoors and outdoors at baseline, 1-, and 12-months post-shoe dispensing. They created two cohorts based on indoor baseline adherence to shoe gear, less than 80% (primary group, n = 23) and greater or equal to 80% (secondary group n = 8). The authors also looked at peak plantar pressures of custom vs. non-custom indoor footwear, patient-related usability of the custom shoes, and ulcer recurrence at 12 months … read more

Exufiber® and Exufiber® Ag+: A review of the scientific and clinical evidence

Wound dressings have been created to manage a number of clinical conditions, including cavity wounds and wounds where exudate levels may vary from low levels in a relatively dry wound to highly exuding wounds where there is a genuine risk of damage to the surrounding skin. The evidence included in this supplement highlights some of the key pre-clinical and clinical studies conducted to evaluate the performance of Exufiber and Exufiber Ag+ gelling fibre dressings … read more

Diabetic foot ulceration Module

It is estimated that one in four people with diabetes will have a diabetic foot ulcer during their lives, as a result of a combination of diabetes-related complications. Development of infection in a diabetic foot ulcer may be limb- or life-threatening. However, with good diabetes management and regular assessment this can be prevented … read more

Can probiotics improve healing of diabetic foot ulcers? Results from a randomized controlled trial

Patients with a diabetic foot ulcer who received probiotic supplementation for 12 weeks experienced faster wound healing coupled with an improved glycemic and lipid profile compared with patients assigned placebo, according to findings from a randomized controlled trial … Sima Mohseni, of the infectious diseases and tropical medicine research center at Babol University of Medical Sciences in Iran, and colleagues analyzed data from 60 adults aged 40 years to 85 years with grade 3 diabetic foot ulcer, who randomly received either probiotic supplementation (n = 30) or placebo (n = 30) daily for 12 weeks between March and June 2016. Probiotic capsules contained lactobacillus acidophilus, lactobacillus casei, lactobacillus fermentum and Bifidobacterium bifidum. All participants also underwent standard treatment for wound care. Participants provided blood samples at baseline and 12 weeks and 3-day dietary records at baseline. Wound healing and glucose parameters served as the primary outcome … read more

Reconstructing the Holey Temple: A Composite Approach

Surgical defects involving multiple facial cosmetic subunits can be challenging to reconstruct. We report on a patient with a complex temporal defect following Mohs micrographic surgery (MMS) for a basal cell carcinoma (BCC). The extension of the defect across the left temple, cheek, and forehead hindered the utilization of linear closures or flaps. Healing by secondary intention was considered but was determined to be a suboptimal approach given the involvement of the convex cheek. A modified full-thickness skin graft (FTSG) with linear closures of the distal poles of the wound was ultimately utilized, with excellent cosmetic results at three-month follow-up. Herein, the authors summarize this case and the indications for FTSG and secondary intention healing (SIH) for surgical defects involving the face… read more

Treating Burns with Hypnosis

Patients can learn how to better react to acute and chronic pain.
Burn injuries lead to 1200 people (including 300 children) seeking emergency care every day in the United States. Burns cause physical pain, short and long-term psychological distress, and can also lead to long-term physical impairment because of scarring … The pain associated with burns can be caused by the injury, but sometimes there is even greater pain caused by the repeated cleansing and dressing of the wound … The circumstances that lead to the development of burns and related to wound care are sometimes so overwhelming that they lead patients to develop major mental illness including anxiety disorder … read more

The analysis for time of referral to a medical center among patients with diabetic foot infection

Diabetic foot infection (DFI) is a limb- and life-threatening complication for diabetic patients needing immediate and comprehensive treatment. Early referral of DFI patients to a diabetic foot center is recommended but there appears limited validated evidence, with the association between referral time and clinical outcomes of limb- preservation or in-hospital mortality still lacking … This retrospective research studied consecutive type 2 diabetic patients with DFI treated at the major diabetic foot center in Taiwan from 2014 to 2017. Six hundred and sixty-eight patients presented with limb-threatening DFI. After stratifying their referral days into quartiles, the demographic information and clinical outcomes were analyzed … read more

American Limb Preservation Society (ALPS) Names New CEO Georgia Krehbiel

The American Limb Preservation Society (ALPS) board of directors has named Georgia Krehbiel its new CEO. With more than 25 years of experience in both national and international organizations, Krehbiel has a proven track record of leading strategic initiatives to drive revenue and expand programs and services for those in need … “We are thrilled to welcome Georgia as the founding CEO,” noted David G. Armstrong, a Professor of Surgery at the Keck School of Medicine of the University of Southern California (USC) and the founding President of ALPS. “She has that rare combination of strategic vision, drive and innate humanity that is going to benefit not only ALPS, but the clinicians and patients we serve.” … read more

TELA Bio Announces U.S. Commercial Launch of SiteGuard™ No Rinse Antimicrobial Solution

Company expands product portfolio with focus on addressing surgical site infections in plastic reconstructive surgery

 

MALVERN, Pa., March 03, 2022 (GLOBE NEWSWIRE) — TELA Bio, Inc. (NASDAQ: TELA), a commercial-stage medical technology company focused on providing innovative soft-tissue reconstruction solutions that optimize clinical outcomes by prioritizing the preservation and restoration of the patient’s own anatomy, today announced the commercial launch of its SiteGuard No Rinse Antimicrobial Solution for use in plastic reconstructive surgery.
 
SiteGuard utilizes Next Science’s proprietary XBIO® Technology that supports surgical site and post-operative infection control by addressing the biofilms that make bacteria more resistant to traditional antimicrobial agents, disinfectants, and host immune defenses. XBIO Technology deconstructs biofilm, destroys the bacteria enveloped in the solution, and defends against bacterial recolonization. There is no known bacterial resistance to XBIO Technology, and the no-rinse delivery allows the solution to provide over five hours of ongoing protection against bacterial biofilms with exceptional rates of pathogen removal.
 
“SiteGuard is a complementary technology that we believe enhances our mission to deliver a portfolio of next-generation soft-tissue solutions that are both clinically effective and economically impactful,” said Antony Koblish, President and CEO of TELA Bio. “Early test market experience with SiteGuard has been encouraging, and we look forward to broadening awareness and usage of the technology nationwide.” … read more

Frailty Is a Risk Factor for Poor Diabetic Foot Ulcer Healing and Re-hospitalisation

The prevalence of frailty was higher in patients hospitalised with diabetic foot ulcers (DFUs) and was associated with poor wound healing and re-hospitalisation events … A better understanding of frailty may help guide individualised care planning for patients with DFUs … A prospective cohort study included 76 patients with DFUs (type 1 diabetes, n = 8; type 2 diabetes, n = 68) admitted to St Thomas’ Hospital, London … read more

Is Comedy a Prerequisite to a Successful Medical Career?

Milton Packer explores the innumerable reasons why laughter is essential to medicine
Like everyone else, I have been reading the distressing headlines about the Ukraine. The most important figure in the current conflict may be Vladimir Putin. But the most fascinating person is Volodymyr Zelenskyy (anglicized Zelensky) … A long-standing advocate of Ukrainian-Russia harmony, Zelenskyy was elected in a landslide as the President of the Ukraine in 2019. Although he initially underestimated the extent of Putin’s ambitions, Zelenskyy has become the central symbol for the Ukrainian resistance. Most people expected Zelenskyy would abdicate, fleeing the country to save his own life … read more

BOVINE DERMAL SCAFFOLDS – JWC Masterclass

Diabetic foot ulcers can be extremely challenging to treat and are associated with a high
morbidity and mortality … A recent large randomised controlled trial (RCT), found that a single application of a fetal bovine acellular dermal matrix in combination with standard of care (SOC) is a faster and more effective treatment for these ulcers than SOC alone* … In this masterclass, the RCT investigators will discuss the evidence, and explore the implications for practice with other clinicians who have used the dermal scaffold. The debate will focus on how to optimise the use of this technology on this wound type … read more

Swift Medical Launches the World’s First All-in-One Hyperspectral Imaging Device

to Make Healthcare More Accessible
Swift Medical, the global leader in digital wound care technology, unveiled the Swift Ray 1, a groundbreaking hardware device that wirelessly attaches to a smartphone camera and captures comprehensive clinical data to better support assessment, treatment and monitoring of skin and wound conditions. The Swift Ray 1 fits in the palm of a clinician or patient’s hand, making powerful medical imaging accessible anywhere, from the hospital to the home. Further, this advanced imaging enables the capture of accurate clinical data for every patient, regardless of skin tone, making wound care more equitable for everyone … “The future of wound care goes beyond what the naked eye can perceive and beyond the walls of the clinic, which is why our dream has always been to equalize and improve healthcare access for humanity through intelligent diagnostics,” said Carlo Perez, co-founder and CEO of Swift Medical. “The Swift Ray 1 gets us one step closer by helping clinicians and patients see below the surface of the skin, to heal wounds faster or prevent them from ever even developing.” … read more
Swift Medical Website

Obesity crisis is fuelling a rise in amputations linked to diabetes and gangrene

So many people with type 2 diabetes are losing limbs that it is now seen as normal – and we desperately need to take action

During the years I practised as a hospital doctor I saw only one amputee. He’d had his lower leg amputated for bad circulation worsened by smoking . He wouldn’t give up his Woodbines, though, not even if his other leg was in jeopardy … It’s a totally different picture today. Amputation is becoming commonplace – as a complication of diabetes. And no one seems worried … That’s because so many people are obese and it’s accepted as normal. Fat people develop Type 2 diabetes, and that, in turn, has become ‘normal’ … read more

A Comparison of the Biomechanical Performance of 3 Negative Pressure Wound Therapy Foams

Negative pressure wound therapy (NPWT) is a popular treatment option for a variety of chronic wounds, surgical incisions, and related conditions such as enterocutaneous or enteroatmospheric fistulae.1–8 The primary principle underlying NPWT, application of suction to a wound to promote healing, traces its roots to antiquity.1 The technology has evolved beyond the use of dedicated people who would use their mouths to suck on open skin wounds to the use of bell jars and hand pumps, which would mitigate the unsanitary practice of wound sucking. Modern technology now employs systems that range from simple manually actuated pumps (“mechanical” NPWT) or electrically powered and control system-regulated pumps … read more

Nurse creates app to help home health workers care for wounds virtually

Bri-Anna Guillory has worked in home health care for several of her 10 years as a licensed vocational nurse. Since the start of the pandemic, she’s noticed a major uptick in nurses leaving hospitals and joining her field … young nurses often don’t know the best ways to treat pressure sores, ulcers and post-surgical wounds. So Guillory started Divine Healthcare Consultants, which specializes in virtual wound care consulting … read more

Swift Medical Unveils Next-Generation Technology to Make Healthcare More Accessible for Everyone

Swift Medical, the global leader in digital wound care technology, is launching an innovative product that will revolutionize the future of healthcare … Today at 2pm EST / 11am PST, Swift Medical’s co-founder and CEO Carlo Perez will host a live broadcast from the TIFF Bell Lightbox in Toronto. At this event, Swift Medical will unveil a first-of-its-kind technology that will allow patients to access hospital quality care from anywhere and empower clinicians to prevent wounds before they even happen … Chronic wounds are one of the largest public health crises worldwide, with more than 8.2 million patients suffering from chronic wounds in North America alone. As rates of obesity, diabetes and other chronic conditions skyrocket, the number of patients at risk of developing chronic wounds will continue to rise … read more

How Does Jack Reacher Heal So Fast?

If you’re one of many who have binged Reacher recently ― or read the bestselling books by Lee Child ― you’ve enjoyed lethal weapon Army veteran Jack Reacher delivering his share of wish-fulfillment vengeance in satisfying ways. Even though the character is 6’5″ and essentially a slab of muscle (convincingly played by real-life slab of muscle Alan Ritchson), Reacher does indeed bleed … read more

Reshaping wound care: Evaluation of an artificial intelligence app to improve wound assessment

and management amid the COVID-19 pandemic
Individuals with wounds can be found across all age groups and all health care specialties. Some causes of wounds include trauma, burns, skin cancers, infections or underlying medical conditions such as diabetes.1 Wound care is generally considered a comorbid disease, for example, diabetic foot ulcers, venous leg ulcers, pressure injuries, but despite this, patients are treated in the silo of their medical specialty.1 The impact is that the approaches to wound care may differ between specialties, and currently there is no specialist patient-centred wound care approach … read more

Dried human cultured epidermis accelerates wound healing in diabetic mouse skin defect wounds

The shortage of donor sites for skin grafts is a significant problem for the treatment of severe burn injuries. In such cases, cultured epidermal autograft (CEA), which is a cultured keratinocyte sheet prepared from the patient’s skin, is a promising treatment option1. However, the clinical use of CEA is limited owing to its lower take rate, especially on an infected bed, mechanical fragility, and frequent spontaneous blistering, particularly in the early stages2. In addition, a delay of 3 to 4 weeks, required for the preparation of a CEA, creates a fundamental clinical problem, as it occurs during the life-threatening phase in patients with severe burns … read more

The time is now for stewardship in diabetic foot infections

Diabetes, first described in ancient Egypt, remains at the forefront of health care in modern times. Roughly 537 million adults aged 20 to 79 years are living with diabetes worldwide, a number expected to rise over the next decades … Diabetic complications are vast. Diabetic foot infection (DFI) is a chronic, more severe complication that affects roughly 15% of people with diabetes. DFIs have been associated with decreased quality of life, frequent and prolonged hospitalizations and greater risk for lower extremity amputation … read more

The Role of Early Revascularization and Biomarkers in the Management of Diabetic Foot Ulcers

A Single Center Experience

Diabetic neuropathy and Peripheral Arterial Disease (PAD) are the main etiological factors in foot ulceration. Herein, we report our experience of diabetic foot ulceration (DFU) management, with an analysis of the relationship between the rate of lower extremity amputation, in persons with infected DFU, after revascularization procedures performed to prevent major amputation. This study highlights the role of different biomarkers, showing their usefulness and potentiality in diabetic foot ulcer management, especially for the early diagnosis and therapy effectiveness monitoring. A retrospective analysis, from September 2016 to January 2021, of diabetic patients presenting diabetic foot with DFU, was performed. All patients were treated with at least one vascular procedure (endovascular, open, hybrid procedures) targeting PAD lesions … read more

Debridement – Module from Wound Care Today

Debridement is a key component of wound bed preparation for acute and chronic wounds because it helps to improve conditions at the wound bed to encourage healing. This, in turn, helps to reduce the risk of infection and improve patient quality of life.
Debridement … read more

Top 5 Tips for Marketing Your Practice to Diabetic Patients

When doctors ask how they can expand their practice without adding additional nail care patients, most of them cringe when I say to focus their marketing efforts on diabetic patients. Diabetic patients are the fastest-growing patient population for podiatrists. They are the patients that need you the most and can financially benefit your practice when you prescribe/dispense diabetic shoes, perform ABI/PVR testing, treat diabetic wounds, and dispense wound care supplies. If you are ready to get started but not sure of the next steps, here are my top five tips for marketing your podiatric practice to diabetic patients … read more
From AMERX Health Care

MolecuLight Featured in Unprecedented 32 Presentations and Posters at World Union of …

Wound Healing Societies (WUWHS) 2022 Conference
NEWS PROVIDED BY

MolecuLight
Mar 01, 2022, 06:13 ET

 

Wide-Spread Clinical Evidence using the MolecuLight i:X Platform Reveals its Significant Global Adoption and Proven Utility in Wound Care

 

TORONTO and ABU DHABI, United Arab Emirates, March 1, 2022 /PRNewswire/ – MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of wounds containing elevated bacterial loads, announces that its MolecuLight wound imaging platform is featured in an unprecedented 32 presentations and posters at at the World Union of Wound Healing Societies (WUWHS) 2022 Annual Conference, being hosted from March 1 – 5, 2022 in Abu Dhabi, United Arab Emirates. Held every 4 years, WUWHS is the largest global wound care conference with over 6,500 wound care professionals expected to attend in-person as well as virtually this week.

 

“We are humbled by the number of clinicians globally that have made our MolecuLight point-of-care device an invaluable tool in their wound care practices,” says Anil Amlani, MolecuLight’s CEO. “The impressive collection of 32 talks and posters from so many facilities across 6 countries shows how the MolecuLight imaging device is becoming a new standard-of-care in wound care. This clinical evidence is echoed in the 55+ peer-reviewed publications that include data collected from over 1,400 patients, showing the significant benefit of the MolecuLight i:X® and DX™ to clinical wound assessment and practice.”

 

“The evidence is definitive. The MolecuLight imaging platform is a “must have” device for wound care clinics. The abundance of published clinical evidence showing improvements in bioburden detection, better clinical decision making, and improved outcomes is clear validation for its medical necessity,” says Dr. Thomas Serena, the Founder and Medical Director of The SerenaGroup® and author and presenter of 15+ talks and posters featuring MolecuLight at WUWHS 2022. “There is real clinical benefit for using the MolecuLight alongside a broad range of wound care procedures, in all wound care settings. Evidence now proves that clinical signs and symptoms under perform and contribute to haphazard prescribing of antimicrobials and antibiotics. Used concurrently, information from MolecuLight images is flagging at risk wounds earlier. This leads to improved wound management, reduced antibiotic overprescribing, fewer infection complications, and faster healing.”

 

The collection of 16 presentations and 16 posters featuring the MolecuLight imaging devices show how the devices inform clinical decision-making through the real-time detection of elevated bacterial burden in wounds. They span the wound care continuum, including detection of bacteria within biofilm, wound cleansing and hygiene, antimicrobial stewardship, and impact on detecting surgical site infections. They also include health economic benefits and wound healing results accelerated by RCT-accelerated findings. The results being presented illustrate the significant clinical improvements to wound care outcomes provided by the MolecuLight platform.

 

A selection of the clinical posters and presentation featuring the MolecuLight i:X from World Union of Wound Healing Societies (WUWHS) 2022 Annual Conference 2022 are as follows:

(a)  Select Clinical Posters citing the MolecuLight point-of-care device include:

  • Uncovering the high prevalence of bacterial burden in surgical site wounds with point-of-care fluorescence imaging
    Kylie Sandy-Hodgetts et al., School of Biomedical Sciences, Pathology and Laboratory Science, University of Western AustraliaPerth, Australia
    Download poster

  • The use of an advanced fluorescence imaging system to target wound debridement, decrease bioburden, improve healing rates, and provide positive revenues in an outpatient wound care setting
    Windy Cole, DPM et al., Kent State University College of Podiatric Medicine. Kent OH
    Download poster

  • RCT Evaluating Impact of Routine Fluorescence Imaging of Bacteria on DFU Healing Rates
    Alisha Oropallo, MD et al., Northwell Comprehensive Wound Health Center and Hyperbarics, Lake Success NY
    Download poster

  • Wound Assessment Paradigm Shift: A 350-Patient Multisite Clinical Trial Incorporating Bacterial Fluorescence Imaging into Standard of Care
    Thomas Serena MD FACS MAPWCA FACHM et al., SerenaGroup Research Foundation, Cambridge, Massachusetts, USA
    Download poster

(b) Select Clinical Presentations citing the MolecuLight point-of-care device include:

  • Early detection of wound infection: advances in diagnostics
    Dr. Thomas Serena
    (Tuesday, March 1, 20228:40 AM – 8:50 AM as part of Society Meeting – International Surgical Wound
    Complications Advisory Panel (ISWCAP)), Hall 4 (Part B)

  • Wound hygiene: which cleansing agents and techniques are most effective?
    Session #FC 05B – ID 205/(N)
    Alisha OropalloMD
    (Wednesday, March 2, 202204:00 PM – 06:00 PM) Capital Suite 5

  • Tissue saving approach by guided debridement with fluorescence imaging – or how to treat a sternal surgical site infection with pseudomonas aeruginosa
    FC 78 – ID 275
    Heinrich Rotering, MD
    (Wednesday, March 2, 202202:15 PM – 03:30 PM), Capital Suite 7

  • Optical detection of bacteria: changing the paradigm
    Dr. Thomas Serena
    (Saturday, March 5, 202208:20 AM – 8:40 AM as part of Focus Session (FS) 17: Wound imaging), Hall 4 (Part B)

The complete listing of the 32 presentations & posters is available here.

In additional to the clinical posters and presentations at WUWHS 2022, the MolecuLight i: and DX™ imaging devices will be available for demonstration in the MolecuLight booth #A-06 in the Exhibit Hall at the Abu Dhabi National Exhibition Centre (ADNEC) in Abu Dhabi, UAE.

The MolecuLight i:X® and DX™ imaging systems are the only imaging devices for the real-time detection of elevated bacterial burden in wounds that are FDA cleared and CE and Health Canada Approved. With over 2,000 systems sold, they are commercially available and used by leading wound care facilities globally.

About MolecuLight Inc.
MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i: and DX™ fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection of wounds containing elevated bacterial burden (when used with clinical signs and symptoms) and for digital wound measurement. MolecuLight procedures performed in the United States can benefit from an available reimbursement pathway including two CPT® codes for physician work to perform “fluorescence wound imaging for bacterial presence, location, and load” and facility payment for Hospital Outpatient Department (HOPD) and Ambulatory Surgical Center (ASC) settings through an Ambulatory Payment Classification (APC) assignment. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.

www.moleculight.com

Biofilm Module

Biofilm is thought to be present in all chronic wounds. Understanding what biofilm is and how to manage it is important to avoid delayed healing.
Biofilm … read more

Preventing complications at wound dressing changes

This module aims to make clinicians aware of:

  • The importance of skin health and what makes it vulnerable to damage.
  • The damage that can occur when using medical adhesives and improper removal techniques.
  • The impact that MARSIs (medical adhesive-related skin injuries) can have on patients.
  • Ways to reduce the risk of MARSIs by providing appropriate treatment for at-risk patients groups.

read more

Wound Care Service Development Over a Five-Year-Period of National Change

Role of Partnership Working and Education Delivery
This article outlines the development of a community tissue viability service over the same five-year-period in which a number of national issues with wound care were identified through research. These included a lack of evidence-based practice, a changing community workforce and an unwarranted variation in care attributed to a lack of education and training among generalist practitioners. The author describes how a proactive approach was taken to local service development to address these issues, and how partnership working with both colleagues and industry enabled improved wound care education delivery and uptake among a generalist community workforce … read more

Analysis of Bias Criteria Checklist for Wound Care Registries & EHRs

Chronic wounds affect nearly 15% of Medicare patients (8.2 million people) and may cost as much as $96.8 billion per year. The most common are not venous or diabetic, even though they are the most often studied in prospective trials. The most common chronic wounds are surgical incisions that dehisce and the “wounds with no name” due to the patients’ underlying medical conditions. That is because wounds are not a disease – they are a symptom. The US Wound Registry (USWR), a 501 (c)(3) non-profit organization, has been a patient registry since 2005. Since 2014, the USWR has been recognized by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Clinical Data Registry (QCDR) that collects medical and/ or clinical data for the purpose of improving the quality of patient care. While we understand that randomized, controlled trials are needed to demonstrate efficacy in a perfect world, real-world patients have an average of 6 serious co-morbid conditions and take 10 medications. These complicated patients are invariably excluded from clinical research studies, which makes it impossible to know what treatments work best. We believe the way to demonstrate effectiveness in the real world is by using real-world data … read more

Latest Clinical Evidence Presented at APWCA’s Wound Week™ 2022 Illustrates the Significant …

Clinical Utility of the MolecuLight Point-of-Care Imaging Platform
PRESS RELEASE
February 24, 2022

Toronto, ONTARIO and Philadelphia, PENNSYLVANIA – (February 24, 2022) MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of wounds containing elevated bacterial loads, announces the presentation of 8 Clinical Posters and a Presentations and a Hands-On Workshop at the American Professional Wound Care Association’s (APWCA) Wound Week™, held from February 24 – 27, 2022 in Philadelphia, PA. Wound Week is a leading multidisciplinary meeting of wound care professionals that presents cutting-edge clinical findings and best practices presented by its expert faculty.

“We are thrilled with the significant number of presentations and posters at Wound Week showing the impressive results derived from MolecuLight point-of-care devices,” says Anil Amlani, MolecuLight’s CEO. “The clinical insights that are informed by the MolecuLight platform span the wound care continuum, including wound cleansing and hygiene, antimicrobial stewardship, detection of wound-related cellulitis and surgical site infections. The outcomes presented in these studies illustrate the significant clinical improvements to wound care provided to clinicians by the MolecuLightplatform”.

The 8 clinical posters and the presentation featuring the MolecuLight i:X at Wound Week 2022 are as follows:

Posters by Dr. Alisha Oropallo (Northwell Comprehensive Wound Healing Center and Hyperbarics, Lake Success NY) include:

  • Wound Hygiene: Which Cleansing Agents and Techniques Are Most Effective?
     Download poster
  • 12-week RCT Evaluating Impact of Routine Fluorescence Imaging of Bacteria on DFU Healing Rates
     Download poster

Posters by Dr. Charles Andersen (Vascular/Endovascular/Limb Preservation Surgery Service, Madigan Army Medical Center, Joint Base Lewis-McChord, WA) include:

  • Diagnosis and Treatment of the Invasive Extension of Bacteria (Cellulitis) from Chronic Wounds Utilizing Point-of-Care Fluorescence Imaging
     Download poster
  • Guidelines for point-of-care fluorescence imaging for detection of wound bacterial burden based on Delphi consensus
     Download poster

Posters by Dr. Thomas Serena (SerenaGroup Research Foundation, Cambridge, MA) include:

  • Reliance on Clinical Signs & Symptoms of Bacterial Burden in Chronic Wounds Leads to the Misuse of Antimicrobials: Analysis of the FLAAG Clinical Trial
     Download poster
  • Point-of-care fluorescence imaging enhances detection of high bacterial burden in surgical site wounds
     Download poster
  • Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds
     Download poster
  • An image is worth 10,000 microbes: How fluorescence imaging augments IWGDF criteria for detection of bacterial burden in diabetic foot ulcers
     Download poster

The Clinical Presentations citing the MolecuLight point-of-care device is:

  • All That Glows is Not Good (Innovative Technologies: What’s in the Pipeline?)  by Dr. Oropallo on Sat., Feb. 26, 2022, 9:00 – 10:00 am in the Commonwealth Room

In addition to the clinical posters and presentations at Wound Week,, the MolecuLight i:X® and DX™ imaging devices will be demonstrated at the Hands-On Workshop on Thursday, February 24th from 1:30 pm – 5:30 pm in the Regency B Ballroom. They will also be available for demonstration in the MolecuLight booth #36 in the Exhibit Hall at the Loews, Philadelphia, PA.

 

About MolecuLight Inc.

MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i:X® and DX fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection of wounds containing elevated bacterial burden (when used with clinical signs and symptoms) and for digital wound measurement.  MolecuLight procedures performed in the United States can benefit from an available reimbursement pathway including two CPT® codes for physician work to perform “fluorescence wound imaging for bacterial presence, location, and load” and facility payment for Hospital Outpatient Department (HOPD) and Ambulatory Surgical Center (ASC) settings through an Ambulatory Payment Classification (APC) assignment. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.

 

For more information, contact:

Rob Sandler
Chief Marketing Officer
MolecuLight Inc.
T. +1.647.362.4684
rsandler@moleculight.com
www.moleculight.com

Leg wounds: topical timolol accelerated healing times in elderly patients

Managing a surgical wound on the lower leg can be a challenge. Often, higher wound tension, atrophic skin, edema, and compromised circulation result in higher risks of wound dehiscence and infection, and significantly limit the capacity of wound closure post-surgically. Therefore, healing by secondary intention is a practical option for many lower leg Mohs defects. However, a secondary intention wound on the lower leg is expected to take a longer time to heal. Certain factors such as older age and health conditions of the host may adversely affect healing time … Timolol is a nonselective beta-adrenergic receptor antagonist that has FDA approval for the treatment of glaucoma. In addition to this FDA-approved indication, topical timolol has several off-label uses in dermatology, such as for the treatment of infantile hemangiomas, venous stasis ulcers, and refractory wounds. Although timolol solution has been used in chronic wounds … read more

Custom-made indoor footwear may be beneficial for people with diabetes at risk for ulceration

“Custom-made footwear is an effective intervention to help prevent foot ulceration and is recommended in international guidelines,” but ensuring consistent use is “a challenge,” particularly indoors, explain Sicco Bus and co-authors from Amsterdam University Medical Center in the Netherlands … To address this issue, the researchers carried out a study of 31 people with type 1 (23%) or type 2 (77%) diabetes with moderate-to-high risk for plantar foot ulceration who already possessed custom-made footwear prescribed by a rehabilitation medicine specialist. These people were provided with additional custom-made footwear specifically designed for indoor use, with the same biomechanical offloading capacity as their existing footwear … read more

Fast Five Quiz: Type 2 Diabetes and Peripheral Artery Disease

According to the International Diabetes Federation, 537 million people around the world have diabetes. This number is projected to rise to 700 million by 2045. In 2021, diabetes was responsible for 6.7 million deaths. Type 2 diabetes accounts for around 90% of diabetes cases, making it a global health crisis. Peripheral arterial disease (PAD) is an athero-occlusive disease and a chronic complication of diabetes. It is a risk factor for both foot ulceration and amputation. More than two thirds of patients with diabetic foot ulceration have associated PAD. Estimates suggest that more than 230 million people worldwide have PAD. Early recognition and treatment of patients with diabetes and feet at risk for ulcers and amputations can prevent or delay adverse outcomes … read more

New Updates on the Diabetes Epidemic Within the United States

A recent report from the Centers for Disease Control (CDC) revealed startling new updates to the number of individuals with diabetes and prediabetes in the United States. The data obtained from 2017-2020 showed that one in ten Americans have diabetes, and over one-third have prediabetes. It also mentioned that of the 37.3 million people with diabetes, around 8.5 million are undiagnosed. This was similar in those with prediabetes: of the 96 million adults that have it, approximately 19% are unaware of their prediabetes status. In addition, an even more alarming aspect of the finding was the substantial rise in diabetes and prediabetes in young adults and even children … read more

Helping to prevent pressure ulcers

A quick guide for registered managers of care homes

A healthcare professional should reassess a person’s pressure ulcer risk:

  • after surgery or other investigation
  • if they move to a different care setting
  • if their underlying condition worsens
  • after a change in their mobility.

If the person has several risk factors or a history of pressure ulcers, they should be assessed as being at high risk of developing a pressure ulcer. A trained healthcare professional should complete a skin assessment for anyone assessed as high risk … read more

Wound Cleansing With a Hypochlorous Acid–Preserved Wound Cleanser in Pediatric Patients With Burns

Wound cleansing and wound bed preparation is an important step toward healing of any wound etiology. A hypochlorous acid–preserved wound cleanser (HAPWOC; Vashe, Urgo Medical) is used widely across the continuum of care in the author’s large hospital system, which includes a pediatric burn unit. HAPWOC is used widely in inpatients and outpatients for acute and chronic wounds, including burns. Its use is of particular importance when wound bioburden is a consideration … read more

Why the Current State of Wound Care Research Makes Me Mad ….

and How You Can Help Fix it at the Wound Care Evidence Summit
The Wound Care Evidence Summit will take place May 19-20, 2022 at the Hyatt Regency Bethesda, MD. If you are involved in the field of wound care (e.g., Chief Medical Officers, researchers, Regulatory Affairs staff, Clinical Association representatives, manufacturers, etc.) you need to register now because spots are limited. The meeting will convene commercial and government payer medical directors, the FDA, NIH senior staff, wound care researchers, manufacturers, and policymakers.

Here’s why I care about this so much: In about 1997, I was one of several investigators participating in the prospective clinical trial of Becaplermin (REGRANEX®) Gel for Diabetic foot ulcers (DFUs). That trial enrolled mostly Wagner 1 DFUs and Wagner Grade 2 DFUs (as long as the Wagner 2 DFUs had no exposed tendon, capsule or bone – which means, not really Wagner 2 DFUs). In addition to studying … read more

Microbiological Identification and Resistance Profile of Microorganisms in Pressure Injuries

After the Use of Polyhexamethylene Biguanide: A Series of Fourteen Cases
Introduction. Colonization of a pressure injury with microorganisms can negatively affect wound healing. Thus, it is necessary to evaluate which products best facilitate wound healing. Objective. This case series evaluated the effectiveness of the antimicrobial polyhexamethylene biguanide (PHMB) on microorganisms in pressure injuries. Materials and Methods. Fourteen patients (14 wounds) were treated with PHMB in the hospital setting after collection of a wound swab sample for microbiological analysis and determination of the risk profile using the disk diffusion method. Results. Thirteen lesions (92.9%) were positive for 1 or more bacterial strains, the most prevalent of which were Staphylococcus aureus and Pseudomonas aeruginosa. Two strains of methicillin-resistant S aureus (MRSA) were also identified. Klebsiella pneumoniae demonstrated 100% resistance to the tested antibiotics, with Acinetobacter demonstrating 90% resistance … read more

35 Years of Pressure Injury Science and Knowledge Translation

Our celebratory 35th publication year continues with our fourth annual themed issue on pressure injuries (PIs), an important global concern.

This issue provides recent PI research in print and online from the US and around the world. Some of the international authors’ contributions include the following:

  • Finnish data on PI prevention
  • A study from Turkey on managing PIs in home care
  • Brazilian research on PIs in ICU patients.

read more

Epigenetics and Biochemistry of Stress in Wound Care

Wound care can be a surprisingly emotional field. Some days it can feel like every patient visit contains challenging emotional situations that clinicians must also recover from with resilience not to carry that energy to the next visit. These stressors can be related to the patient’s medical status and critical conversations regarding their health, pain and anxiety, the death of a patient’s close family members, and even access to basic necessities like safe housing and social support. Factors other than the health care they receive are driving outcomes, consistent with what we know about social determinants of health which determine 80% of health outcomes. These life stressors and the stressors that have occurred throughout the patient’s life can contribute to physiologic changes that further delay wound healing … read more

NHG programme for diabetic foot disease reduces major amputations by 40 per cent

An innocuous injury to his left little toe in late 2019 led to an infection that resulted in nine foot-related operations and five lower limb angioplasties in just over a year for Mr Toh Eng Cheng. His gangrenous toe had to be amputated, and another six later, to curb a recurrence of diabetic foot ulcers, but the 52-year-old counts himself lucky. “I could have lost the lower part of my leg or maybe the whole leg,” said the former security supervisor, who has three toes left on his right foot. “Of course, I did not like the idea of amputating my toes at first,” he told The Straits Times. “But if I didn’t accept it, then who knows, I might not be talking to you now,” he said. He added that he is glad he is still able to walk without the need for a walking frame or walking stick … read more

Increased temperature at the healed area detected by thermography predicts recurrent pressure ulcers

Preventing recurrent pressure ulcers is an important challenge in healthcare. One of the reasons for the high rate of recurrent pressure ulcers is the lack of assessment methods for their early detection. Therefore, this study aimed to determine the thermographic characteristics of the healed area and to consider the predictive validity of thermographic images for recurrent pressure ulcers within a 2-week period. This observational study was conducted at a long-term care facility in Japan between July 2017 and February 2019 among patients whose pressure ulcers had healed. Thermographic images of the healed area were recorded once a week until recurrence or until the end of the study. We enrolled 30 participants, among whom 8 developed recurrent pressure ulcers. The generalised estimation equation revealed that the thermographic finding of increased temperature at the healed area compared to that of the surrounding skin was significantly associated with recurrent pressure ulcers … read more

Foundations of Best Practice for Skin and Wound Management – E-book

Foundations of Best Practice for Skin and Wound Management is a comprehensive document intended to help health-care professionals in the prevention and management of wounds … Developed by teams of interprofessional experts with a deep wealth of knowledge and experience, the chapters that make up Foundations have been built using a rigorous process of researching, writing and reviewing. Each chapter provides a best practice approach to the prevention and management of a particular wound type, except the first two, which offer a broad overview of skin physiology and wound healing and the prevention and management of wounds in general … order

Chronic Wounds: Economic Impact & Costs to Medicare

A new study, “An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds,” published in the International Society For Pharmacoeconomics and Outcomes Research’s Value in Health journal (Jan. 2018) demonstrates the economic impact and full burden of chronic nonhealing wounds in the Medicare population. The study analyzed the Medicare 5% Limited Data Set for CY2014 to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type, and by setting. Topline findings show that chronic wounds impact nearly 15% of Medicare beneficiaries … read more

Called to the Principal’s Office: My Experience With a TPE Audit

One day, as medical director of three wound centers—two with hyperbaric services in a five-hospital system—I was called to the wound care administrator’s office. I heard the three things that I never wish to hear going into a meeting:

1.    “Please come to my office and close the door.”

2.    “I would like to give you a heads-up.”

3.    “You are being audited by Medicare for a targeted probe and educate.”

read more

Iranian firm produces, exports advanced wound dressings

An Iranian knowledge-based company has produced advanced wound dressing products, with structures similar to human skins
Wound dressings are important because wounds and damaged tissues go through a relatively-complicated and time-consuming process to heal. And using low-quality products could lead to infection or scars on the skin after wounds heal.

The products manufactured by Teba Zist Polymer (Treetta) company, after eight years of research and development, use a host of technologies to ensure quick and seamless healing of wounds … read more

Does HBOT promote the healing of diabetic foot ulcers?

Hyperbaric oxygen therapy (HBOT) is a treatment option that involves a person breathing almost pure oxygen in a special room or small chamber. Evidence suggests that HBOT may have a variety of applications, including the promotion of wound healing. Due to this, it may help treat diabetic foot ulcers … During the natural wound healing process, the body uses oxygen to stimulate the healing and growth of new tissue. HBOT helps encourage the formation of new blood vessels around the wound area, and these supply the area with more oxygen. This influx of oxygen and other healing nutrients helps generate new, healthy tissue … read more

Free Triiodothyronine and Free Triiodothyronine to Free Thyroxine Ratio Predict

All-Cause Mortality in Patients with Diabetic Foot Ulcers
Purpose: Free triiodothyronine (FT3) and FT3/free thyroxine (FT4) ratio have been associated with mortality in various diseases. However, no study to date has identified a link between FT3, FT3/FT4 ratio and all-cause mortality in patients with diabetic foot ulcers (DFUs). This study aimed to investigate this relationship.
Methods: This retrospective cohort study included 726 patients diagnosed with DFUs in a public hospital from January 2015 to October 2019. Patients were classified by the optimal cut-off values of the FT3 and FT3/FT4 ratio, respectively. The association of FT3 and FT3/FT4 ratio with all-cause mortality was evaluated in a multivariable cox regression model. Directed acyclic graphs were used to assess the minimally sufficient sets of confounding variables … read more

Peer-Reviewed Study Demonstrates Increased Cost-Effectiveness of MIMEDX

Dehydrated Human Amnion Chorion Membrane (DHACM) in Lower Extremity Diabetic Ulcer (LEDU) Treatment Compared to Standard of Care
Use of MIMEDX PURION® Processed DHACM Provided Improved Clinical Benefits, Shorter Average Length of Treatment and Increased Quality-Adjusted Life Years
MiMedx Group, Inc. (Nasdaq: MDXG) (“MIMEDX” or the “Company”), a transformational placental biologics company, today announced the publication of a peer-reviewed study in the Journal of Wound Care evaluating the cost-effectiveness of the Company’s PURION® processed dehydrated human amnion/chorion membrane (DHACM) allografts (EPIFIX®) compared with standard of care for treating lower extremity diabetic ulcers (LEDUs), including diabetic foot ulcers (DFUs).

The study analyzed a retrospective cohort (2015-2019) of 10.9 million Medicare patients diagnosed with diabetes, 1.2 million of whom had a LEDU, and tracked outcomes such as amputations and healthcare utilization. Findings across propensity-matched cohorts demonstrated that the timely use of DHACM resulted in a significant reduction in long-term healthcare related costs, driven by the associated improved clinical benefits indicated by patients receiving DHACM, compared to those receiving standard of care, or receiving no advanced treatment (NAT) … read more

Outcomes of Telehealth for Wound Care: A Scoping Review

The aim of this scoping review is to synthesize the literature on delivering wound care via telehealth and compare clinical, healthcare utilization, and cost outcomes when wound care is provided via telehealth (telewound) modalities compared to in-person care … read more

SMART researchers discover unique lysin capable of killing deadly multidrug-resistant bacteria

Novel lysin Abp013 has shown promising antimicrobial ability against Acinetobacter baumannii and Klebsiella pneumoniae

Researchers from the Antimicrobial Resistance (AMR) Interdisciplinary Research Group (IRG) at Singapore-MIT Alliance for Research and Technology (SMART), MIT’s research enterprise in Singapore, alongside collaborators at Nanyang Technological University, have identified a novel phage lysin – Abp013 – that could be used as an alternative antimicrobial agent against two of the most deadly bacteria: Acinetobacter baumannii and Klebsiella pneumoniae. The study is supported by the National Research Foundation (NRF) Singapore, under its Intra-CREATE Collaborative Seed Grant … Antimicrobial resistance remains an ever-growing threat to humankind, and an increasing number of people die each year from superbug infections. The development of new bacteria-killing agents is crucial, and lysins have shown great promise in treating deadly chronic wound and lung infections against which no antibiotics are effective … read more

MediWound awarded a U.S. Department of Defense research grant for the development of Nexobrid for the U.S. Army

Research project award is for the development of Nexobrid as a non-surgical solution for field care
YAVNE, Israel, February 17, 2022 — MediWound Ltd. (Nasdaq: MDWD), a fully-integrated biopharmaceutical company focused on next-generation bio therapeutic solutions for tissue repair and regeneration, today announced that the U.S. Department of Defense (DoD), through the Medical Technology Enterprise Consortium (MTEC), has awarded MediWound a $1.7 million research project for the development of NexoBrid® as a non-surgical solution for field-care burn treatment for the U.S. Army (the “MTEC Research Project Award”).

“We are privileged to join forces with the U.S. DoD, supporting its goals of improving treatment outcomes and saving lives of service members who suffer traumatic burn injuries in the battlefield,” said Sharon Malka, Chief Executive Officer of MediWound. “This non-dilutive funding provides important recognition of NexoBrid’s merits as a non-surgical, easy-to-use, effective solution for eschar removal of severe burns and highlights its potential role in treating severe burn injuries in the field as early as the point of injury. We thank the U.S. Army Medical Research and Development Command (USAMRDC) for the award and look forward to working with them to have NexoBrid available for military use by the U.S. Army.”

“The military services require simple and effective non-surgical solutions to treat severe burn patients as close to point of injury as possible. MTEC is excited to support MediWound’s effort to advance an effective non-surgical debriding solution for far forward burn treatment to benefit U.S. service members. This work could result in a transformational change to the current standard of care of burn injuries,” stated Lauren Palestrini, PhD, MTEC Director of Research Programs … read more

Creating a Crash-Proof Retirement for Doctors

Can your portfolio weather fickle market fluctuation?
To the uninitiated, a crash proof retirement can seem like a white whale — impossible to capture. That’s because to most physicians, investing in general seems like such a risky endeavor, best left to financial advisors or financial planners. That is how the financial industry makes a lot of its money. However, once you begin your financial education and learn the simple investing strategies that will lead you to financial freedom … read more

How a Dumpster Inspired a Wound Center Revolution

About 25 years ago I was hired to assist a wound center in Sherman Oaks as it moved away from its management company, Curative. It was one of the first instances of a hospital insourcing their wound center and canceling their management contract. To say that the process was contentious would be a gross understatement. On my first day, two program directors from other local wound centers run by Curative, showed up at the facility to take everything that belonged to the company … read more

Scoop of Practice Episode 1: Designing a Wound Career

During my reflections on my Designing Your Life1 immersion experience I referenced my mother’s great words of wisdom: “if you love your profession then it really isn’t work. If you put your best foot forward and work hard you can achieve miracles.” … Choosing to become a doctor was not a difficult decision at all. Perhaps growing up with a father whose passion in life was to study the inner workings of a car to fix a malfunction underlay my own fascinations with what is going on under the hood. My mother was a medical administrator and because of my parents’ examples as compassionate and dedicated life mentors, I am the person I am today. I also draw upon my work mentors as I travel along my odyssey … read more

Spray with Nitric Oxide Donor Accelerates Wound Healing: Potential Off-the-Shelf Solution for Therapy?

Nitric oxide (NO) is a highly active gaseous signaling molecule that is synthesized by NO synthases and mediates many physiological processes, from vasodilation to signal transmission in neurons. In addition, NO has a bactericidal effect, the ability to activate cellular and humoral immunity, induces the proliferation and synthetic activity of fibroblasts, activates the proliferation of keratinocytes and the antioxidant system. The variety of these effects provides NO comprehensive effect in various stages of wound healing and accelerates regeneration. Currently, there are three distinct ways for increasing the concentration of NO in wound tissues: the application of inductors of NO synthesis, NO-containing gas flows, and donor molecules. Using NO donors is one of the most promising and actively developing areas because of the large variety of donor chemical compounds … read more

Letter to Noridian: Wound and Ulcer Care LCD/LCA

The Alliance submitted a letter requesting that Noridian revise it Wound and Ulcer Care LCD (L38904) and LCA (A58567) to ensure that that CPT and HCPCS code descriptors are correct and to update incorrect/outdated terminology within the policy. The Alliance submitted a detailed list of suggested revisions … read more (available to Alliance members only)

Old and New Pearls for Wound Healing

This old pearl is as pertinent as ever, Kirsner said. While there are many available products on the market for wound healing, dermatologists need to use evidence-based therapies, especially when considering which of the more than 80 cell- and tissue-based products would benefit the individual patient most. Examples of those products with evidence include bi-layered cellular products … read more

Pressure Injuries (Pressure Ulcers) and Wound Care

Although the terms decubitus ulcer, pressure sore, and pressure ulcer have often been used interchangeably, the National Pressure Injury Advisory Panel (NPIAP; formerly the National Pressure Ulcer Advisory Panel [NPUAP]) currently considers pressure injury the best term to use, given that open ulceration does not always occur. [1] According to the NPIAP, a pressure injury is localized damage to the skin and underlying soft tissue, usually over a bony prominence or related to a medical or other device. It can present as intact skin or an open ulcer and may be painful. It occurs as a result of intense or prolonged pressure or pressure in combination with shear … read more

Effects of physical activity as an adjunct treatment on healing outcomes and

recurrence of venous leg ulcers: A scoping review
Healing time is protracted and ulcer recurrence is common in patients with venous leg ulcers. Although compression is the mainstay treatment, many patients do not heal timely. Physical activity may be a clinically effective adjunct treatment to compression to improve healing outcomes. This scoping review provides a broad overview of the effect of physical activity as an adjunct treatment to compression on wound healing and recurrence. We followed the six-step framework developed by Arksey and O’Malley. We searched electronic databases and trial registration websites for relevant studies and ongoing trials. Two authors independently screened and selected articles. Findings were presented in a descriptive statistical narrative summary. We consulted and presented our findings to the wound consumer group to ensure the relevance of our study. Physical activity interventions in 12 out of the 16 eligible studies consisted of only one component, eight studies were resistance exercises … read more

Using Augmented Reality to Improve Patient Outcomes With Negative Pressure Wound Therapy

Digital technology is already immensely integrated within health care, but new innovations in this space could result in unconventional opportunities to improve patient outcomes. Augmented reality (AR), which is the enhancement of reality by virtual content, is one such innovation.1 Augmented reality has many uses in health care, such as education, remote viewing, and hands-free imaging and/or data retrieval.2 The AR device uses a heads-up display, which allows for information to be relayed and displayed in real time to the wearer via an Internet-connected device. The integrated cameras in the device enable the wearer to virtually livestream their point of view. The use of AR to virtually assess wounds has been found to have promising reliability … read more

Antimicrobial Stewardship In Wound Care

Antimicrobial resistance (AMR) is now one of the leading causes of death around the world. The World Health Organization (WHO) has declared that AMR is one of the top 10 global public health threats facing humanity. The inappropriate use of antimicrobial drugs contributes to AMR and adverse events, and improving antimicrobial prescribing practices is a patient safety priority.[5] In 2013, the Centers for Disease Control and Prevention (CDC) estimated that at least 2 million illnesses and 23,000 deaths per year were caused by antibiotic-resistant bacteria in the United States. A more recent study estimated that in 2019, 44,800 deaths were directly caused by AMR and 186,000 deaths were associated with AMR in North America … By default, chronic wounds are contaminated by several types of bacteria. When the host (patient) does not adequately respond to bacterial contamination, this contamination can turn into colonization, which can further turn into infection. Wound infections are often caused by bacteria that are becoming increasingly resistant to common antibiotics due to antibiotics misuse and/or overuse.[2][3] It is thus imperative that antibiotic prescribing practices evolve such that antibiotics are prescribed only when they are essential … read more

Practice Management Education Opportunities February 23, Austin, TX

Take the first few steps to coding and billing by joining us for a comprehensive workshop covering the fundamentals of coding and billing for foot and ankle surgeons. Learn the foundation of the coding and billing process from expert colleagues before taking the ACFAS Coding and Billing for the Foot and Ankle Surgeon course. This course is for residents, fellows, new practitioners, office staff of foot and ankle surgeons or anyone who wants to learn more of the basic coding and billing terminology and process. Plus, if you’re a resident and attending Residents Day in the morning the day of the event, this course is a great next step to learning more about coding and billing for your future practice and can be bundled in your pricing … read more

What Do Medical Records Reveal About the Effectiveness of Care for Diabetic Foot Health?

Medical records are frequently the source of clinical data used in research of the diabetic foot. However, due to variations in the records, problems can result in collecting and using the data for such research … Worldwide, there are vast differences in the type of medical record, the quality of the medical record and how providers and or health systems manage the data it contains. Medical records can range from simple, handwritten notes that often include some short cuts or abbreviations, to sophisticated electronic health records. The issues of who collects the data and how it is documented will ultimately influence how it can be harvested, manipulated, and used in research … read more

The use of medical grade honey to achieve healing in an older patient with chronic wounds and

complex co-morbidities: a case report
Aging is associated with an increased likelihood of co-morbidity and other factors that are known to delay wound healing (Gosain and DiPetro, 2004; Bonifant and Holloway, 2019). Additionally, aging itself is a risk factor for chronicity as a consequence of changes in the epidermis and dermis. The dermo-epidermal junction becomes flattened, and elasticity of the skin reduces due to morphological changes in collagen and elastin, which predispose the tissue to shear and friction forces (Gosain and DiPetro, 2004; Bonifant and Holloway, 2019). Moreover, the microcirculation and lymphatic drainage of the dermis is decreased with age, and this affects its ability to adapt to injury and clear the wound of pathogens thus inhibiting wound contraction (Gosain and DiPetro, 2004). Older patients, frequently described in the literature as aged 65 years or above, often have multiple comorbidities, such as poor circulation, poor nutritional and hydration status, and the presence of diseases such as diabetes that affect general health (Leung et al, 2018; Wilkinson and Hardman, 2020). These comorbidities can negatively influence the wound healing trajectory, making vigilance during wound management … read more

UrgoClean Ag in Real Life

In 2019, the International Diabetes Federation (IDF) reported that over 77 million individuals have diabetes in India, which will increase to over 100 million by 2030 (IDF, 2019). Of these people with diabetes, 25% will develop a diabetic foot ulcer (DFU), equating to 5 million by 2030. Overall, half of ulcers become infected during the healing process, necessitating hospitalisation, while 20% of these patients require amputation. DFUs contribute to approximately 80% of all non-traumatic amputations performed annually in India (Ghosh and Valia, 2017). It is indicated that social epidemiology regarding DFU in India differs from the West due to many factors including socio-economic and cultural factors. This can lead to significant delay in specialist referral, with patients still relying on treatment based on local ethnic methods and not based on scientific data. This results in patients presenting with highly infected ulcers (Rastogi and Bhansali, 2016) … read more

‘No difference’ between endovascular, open vascular surgeries for diabetic foot ulcers

Adults with diabetic foot ulcers and peripheral artery disease who receive revascularization surgery are at no greater risk for amputation or death following endovascular surgery compared with open vascular surgery, according to findings published in the Journal of Diabetes and its Complications … “The present large cohort study showed in a propensity score-adjusted analysis that there was no difference in amputation-free survival in patients with diabetic foot ulcers and peripheral arterial disease regardless of whether endovascular or open vascular surgery was chosen as first-line vascular intervention,” Talha Butt, MD, of the department of cardiothoracic and vascular surgery at Skåne University Hospital in Sweden … read more

Diabetic foot ulcers associated with mortality, hospitalization for chronic conditions

Diabetic foot ulcer episodes were associated with all-cause mortality and all-cause inpatient hospital admissions, according to new results published in Diabetes Research and Clinical Practice … “The impact of diabetic foot ulcers has been historically difficult to quantify, but our study shows that these foot wounds are associated with higher rates of all-cause hospitalization and all-cause mortality,” Brian J. Peterson, co-founder and chief scientist at Podimetrics, told Healio. “In our research, we found that during episodes-of-care for diabetic foot ulcers, individuals are 50% more likely to die and nearly three times more likely to be hospitalized.” … read more

Guard Medical Announces FDA 510k Clearance for Additional Sizes of Its Novel NPseal

the First All-in-One NPWT Surgical Dressing
Privately-held company Guard Medical Inc. today announces FDA 510k clearance for additional sizes (10 and 15cm) of its next generation Negative Pressure Wound Therapy (NPWT) dressing NPsealTM for the treatment of closed surgical incisions. NPsealTM is an easy-to-use and cost-effective NPWT surgical dressing with an integrated pump that establishes and maintains negative pressure with just a few pinches … “We’re excited to expand our NPsealTM portfolio, now with the 5, 10 and 15 cm sizes. NPsealTM can now be used on a large percentage of closed surgical incisions across multiple specialties. Receiving FDA clearance for the larger sizes is another significant milestone towards becoming the NPWT dressing of choice for the treatment of surgical incisions,” stated Machiel van der Leest, CEO of Guard Medical. “NPsealTM ease-of-use and cost effectiveness makes, for the first time, prophylactic use of NPWT for all eligible closed surgical incisions possible.” …
read more

Guidelines Highlight Role of Nutrition in Management of Diabetic Foot Ulcers

New guidelines recommend healthcare providers develop and implement an individualized nutrition care plan for individuals with diabetes with or at risk of a DFU
New guidelines endorsed by the American Limb Preservation Society highlighted the importance of nutrition in wound healing for adults with diabetes, who also experience diabetic foot ulcers (DFU).

The guidelines stated that nutritional interventions were “recommended for all patients who could benefit now or in the future from nutritional care.” As such, healthcare providers should develop and implement an individualized nutrition care plan for individuals with or at risk of a DFU, who are additionally malnourished or at risk of malnutrition … read more

Amnio Technology Launches Two New Dual-Layer Allografts

FDA Recognizes Products as Minimally Manipulated, Homologous Use HCT/Ps
Amnio Technology, a global leader in the development of and distribution of amniotic tissue allografts is announcing the launch of two new PalinGen® membrane products, PalinGen® Dual-Layer Membrane and Dual Layer PalinGen® X-Membrane. The new allografts, like the entire family of PalinGen® membrane products, are minimally manipulated, homologous use and chorion-free. The dual-layered nature of the allografts allow for unidirectional application with two outward facing epithelial sides. The proprietary Advantek® process used to manufacture PalinGen® membranes preserves the extracellular matrix components and regulatory proteins present in amniotic tissues. Preserving the characteristics of the natural tissue aids in wound management.

PalinGen® Dual-Layer Membrane and Dual Layer PalinGen® X-Membrane are indicated for patients suffering from non-healing acute and chronic wounds as well as complex and/or open surgical wounds and burns.

Senior Director of New Product Development, Robert Diller, PhD, shared his insight into the motivation for developing a multilayered amniotic product, “The PalinGen® Dual layer membranes have increased durability and slower resorption, which makes them ideal for use in robotic and other surgical applications” … read more

South Korea approves Cuban medicine

In a rare breakthrough into a developed market, the South Korean pharmaceutical regulatory agency approved a Cuban medicine, Cuba’s Center for Genetic Engineering and Biotechnology (CIGB) announced in a tweet.

No further context was immediately available.

According to the CIGB tweet, South Korea’s Ministry of Food and Drug Safety approved Heberprot-P, a biotech product that treats diabetic foot ulcers, for use with Korean patients.

Recombinant human epidermal growth factor-based Heberprot, which was first approved in Cuba in 2006, has been registered in Vietnam, Malaysia, Turkey, Argentina, Colombia, Kuwait, Ukraine, and Russia, among others. An agreement with a U.S. company in 2016 to bring Heberprot-P to clinical testing in the United States seems to have faded … read more

Diabetic Neuropathy, Avoiding Amputation, and Foodie – Blog

Dr. Tea Nguyen podiatrist specializes in diabetic wound care, why educates against the webMD diagnosis, her honest and forward speech to patients, fat relocation advances for surgical outcomes, and shares her martial and daily staff tips and foodie.

Dr. Tea Nguyen is Fellowship trained in wound care particularly with diabetics.

Big reason why diabetics have the wounds that can require amputation is because of peripheral neuropathy and losing the pain sensitivity. One of the problem is a patient doesn’t know a cut may have happened and can’t see it because of back pain or poor vision and therefore they get systemic symptoms or a bad smell before they know something is wrong … listen more

A tool to promote patient and informal carer involvement for shared wound care

Shared wound care encompasses approaches and interventions that enable patients to participate in care planning and delivery, rather than just being a passive recipient of services provided. A key step in facilitating greater shared care is identifying the individuals (patients and informal carers) who would be good candidates to be involved in shared wound care. An international survey was conducted to help identify the characteristics that may indicate an individual’s suitability to participate in shared wound care. The results of which informed the development of a guide that clinicians can use to direct discussion to better understand patient and informal carer suitability for shared wound care and identify the approaches and interventions that may be suited to the patient and informal carer’s needs … read more

5 Wound Care Myths Still in Practice Today

Since WCA was founded 20 years ago, our industry has made great strides and advancements in both technology and method. Unfortunately these changes aren’t always well-known, allowing for less effective and sometimes even harmful practices to continue.

In this blog we’ll cover 5 common myths we still see in wound care treatment and how you can avoid them … read more

Factors associated with adherence to using removable cast walker treatment among patients with …

diabetes-related foot ulcers
Adherence to using knee-high offloading treatment is critical for healing diabetes-related foot ulcers (DFUs). However, few studies have investigated patients’ adherence to using knee-high offloading treatment. We aimed to investigate the levels and factors associated with adherence to using knee-high removable cast walker (RCW) treatment among patients with DFUs … read more

Comparing the standard surgical dressing with dehydrated amnion and platelet-derived …

growth factor dressings in the healing rate of diabetic foot ulcer: A randomized clinical trial
In patients having diabetic foot ulcers, a better-improved healing results from dehydrated amnion dressing than platelet-derived growth factor dressing and surgical debridement … This is a multi-arm parallel-group randomized trial including 243 patients with a minimum 4-week medical history of diabetic foot ulcers with Wagner’s grades 1 and 2, no infection, and adequate tissue blood flow … They were randomized to one of three 81-person groups: surgical debridement (the standard method), dehydrated amnion dressing, or platelet-derived growth factor dressing; and were followed up for 12 weeks … Regarding the type of ulcer, the area of ulcer, Wagner’s grade, the period, and the ulcer’s size, all three study groups were comparable … read more

Animal experimental models of ischemic wounds – A review of literature

Critical limb ischemia is a serious form of peripheral arterial disease (PAD). The consequences of lower limb ischemia are pain, claudication and chronic non-healing wounds. Patients with diabetes are especially at a high risk for developing non-healing ulcers. The most serious complication is major amputation. For this reason, there is a significant medical requirement to develop new therapies in order to prevent the progression of PAD. For research purposes, it is crucial to find an appropriate model of chronic ischemia to explore the processes of wound healing. According to recently acquired information, rodents are currently the most commonly used animals in these types of studies. The main advantage of using small animals is the low financial cost due … read more

TissueTech Announces Rebranding, Adopts BioTissue Name Across Entire Business

TissueTech, Inc.—a pioneer in the clinical application of cryopreserved human birth tissue products to treat ocular surface disease and disorders, chronic wounds, and musculoskeletal conditions—has unveiled a corporate rebranding, including a name change and a new logo. BioTissue, Inc. and Amniox Medical, Inc. will now both be known under a single commercial, customer facing entity, BioTissue, Inc. … With three decades of continual advancements in regenerative medicine, BioTissue has been a clear leader in the ocular space. By adopting the BioTissue name across the entire organization, the company will also reflect that innovative heritage and promise in its surgical business, which was previously known as Amniox Medical … “For years, health care professionals have known our products—regardless of their specific applications—for providing mother nature’s most natural gift of healing so their patients can get back to the lives they love,” said Ted Davis, president and CEO, BioTissue. “Our new, unified brand supports our entire pipeline of human birth tissue products to aid the treatment of wounds, musculoskeletal conditions, trauma-induced injuries, ocular surface disease, and burns.” … read more

Complex multilevel and multivessel endovascular revascularization through an occluded

femoral-popliteal bypass in a patient with chronic limb threatening ischemia
Chronic limb-threatening ischemia (CLTI) represents the end stage of peripheral artery disease, a problem of growing prevalence and increased health care costs around the globe. CLTI is a highly morbid disease, incurring significant mortality, limb loss, pain, and diminished health-related quality of life. The major cause of non-traumatic lower extremity amputation are related to diabetes and CLTI. Between 2% to 3% of patients with peripheral artery disease present with a severe case of CLTI, a condition that is correlated with multilevel and multivessel arterial disease, calcification, and chronic total occlusions. Multiple technical strategies to successfully cross long occlusions in arterial segments have been described. Recanalization can be performed using endoluminal, subintimal, and retrograde techniques … read more

First Patients Enrolled in Prospective Randomized Multi-Center Comparative Clinical Study Evaluating Restrata®

for the Treatment of Venous Leg Ulcers
Acera Surgical, Inc. (Acera), a leading bioscience company developing and commercializing a portfolio of fully synthetic materials for regenerative medical applications, today announced its first patient enrollment in a multicenter, head-to-head clinical study evaluating Restrata® for the treatment of non-healing venous leg ulcers (VLUs). William Marston, M.D., the George Johnson Jr. Distinguished Professor of Vascular Surgery at the University of North Carolina School of Medicine is the study’s lead investigator. The study will be the first level 1 clinical comparison between Restrata and a biologic skin substitute.

Venous leg ulcers (VLUs) are a chronic ulcer type which affect 3% of the world population, including over 2 million people annually in the US.1,2 VLUs are a major cause of morbidity and poor quality of life resulting from venous insufficiency in the lower limbs. This type of wound presents clinical challenges as VLUs may require many months of treatment before healing is achieved.3 The US economic burden of VLU treatment was close to $15 billion in 2014 … read more

New Diabetic Foot Ulcer Guidelines Highlight Importance Of Nutrition

New guidelines endorsed by the American Limb Preservation Society highlighted the importance of nutrition in wound healing for adults with diabetes, who also experience diabetic foot ulcers (DFU) … The guidelines stated that nutritional interventions were “recommended for all patients who could benefit now or in the future from nutritional care.” As such, healthcare providers should develop and implement an individualized nutrition care plan for individuals with or at risk of a DFU, who are additionally malnourished or at risk of malnutrition … read more

New guidance highlights the importance of nutrition to support people living with diabetes and foot ulcers

A multidisciplinary team of medical professionals developed guidance for healthcare professionals outlining the importance of nutrition therapy to support wound healing for foot ulcers … The guidance provides expert consensus regarding how nutrition from arginine, glutamine, hydroxymethylbutyrate (HMB), and micronutrients can help improve wound-care therapy for people living with diabetes who are more likely to develop foot ulcers … read more

Incision care and dressing selection in surgical incisions wounds

Findings from an international meeting of surgeons from Northern Europe
Post-surgical incision care must be optimised, particularly in terms of reducing the risk of infection and associated complications (Sandy-Hodgetts et al, 2017; 2018; Morgan-Jones et al, 2019). An international consensus meeting was conducted in 2019 to examine post-surgical care and dressing selection for surgical incisions closed with primary intention (Morgan-Jones et al, 2019). A group of surgeons from Germany, Denmark, Finland and Norway convened online to discuss the findings raised in the 2019 international report and how they fit with local practice with the following aims … read more

Latest APMA Health Policy and Advocacy Wins

APMA works tirelessly to advocate for the podiatric medical profession. Over the past year, APMA has been successful in ensuring podiatrists receive equitable reimbursement, and patients have full access to care provided by podiatrists. Recent successes include:

HealthNet Federal Services (HNFS), the TRICARE administrator for the West Region, agreed to APMA’s previous request, and now permits podiatrists to order non-invasive vascular or arterial studies for TRICARE beneficiaries … read more

Evidence-Based Care in Diabetic Foot Ulcers | Video

My name is Alton Johnson. I’m a DPM, (and a) certified wound specialist as well. Currently, a clinical assistant, professor, podiatrist, pediatric surgeon, wound care specialist at the University of Michigan Hospital System – Michigan Medicine, currently working as a podiatrist and wound care specialist.

By the statement, “Not all DFUs are created equally,” (this) simply means that no one wound is ever the same when it comes to diabetic foot ulcerations. That could be applicable to all ulcerations but in general, you don’t know … watch

Practice Alert New ICD-10 Codes for MASD

In response to an initiative spearheaded by the Wound, Ostomy and Continence Nurses Society (WOCN), new diagnosis codes moisture-associated skin damage (MASD) were added to the current version of the International Classification of Disease, Clinical Modification (ICD-10-CM). These codes arc used globally to identify diseases and health conditions of patients in the United States. They are also linked to third-party payment for health care and related supplies … read more

Impact of the COVID-19 pandemic on patients with hidradenitis suppurativa

Compared to prior to the pandemic, fewer patients consulted their primary physician for changing wound dressings and more changed the dressings themselves or were assisted by their family members. 13% of patients avoided doctor visits due to fear of COVID-19 and 26.1% minimised doctor visits … The Dermatology Life Quality Index showed a moderate to very severe impact on patients’ Quality of Life (mean score = 10.06). Only one patient used telemedicine. Due to limited access to primary care and fear of COVID-19, the pandemic had a detectable impact on the hospital management of patients with HS in our facility. Telemedicine still plays a negligible role in primary wound care … read more

Watch this mama chimp treat her son’s open wound by applying insect “poultice”

In November 2019, Alessandra Mascaro was observing a community of chimpanzees in the Loango National Park in Gabon as part of her volunteer service with the Ozouga Chimpanzee Project when she noticed some unusual behavior. A chimp named Suzee was inspecting a wound on the foot of her son, Sia. Suzee suddenly caught an insect from a nearby leaf, put it into her mouth for a moment, and then pressed it to Sia’s wound.

Mascaro caught the unusual interaction on video and forwarded it to two scientists on the project: Tobias Deschner, a primatologist with the Ozouga Chimpanzee Project, and Simone Pika, a cognitive biologist at Osnabrück University. The researchers thought the interaction could be suggestive of prosocial behavior among chimpanzees and the capacity for empathy—a question of heated debate in the field—and they spent the next 15 months looking for other examples of this type of wound-treating behavior … read more

Custom-made footwear designed for indoor use increases short-term and long-term adherence

in people with diabetes at high ulcer risk
To explore changes in footwear adherence following provision of custom-made indoor footwear in people with diabetes at high risk for plantar foot ulceration and in possession of regular custom-made footwear … Adherence indoors and outdoors was assessed objectively as percentage of steps custom-made footwear was worn, at baseline (in regular custom-made footwear), and at 1 and 12 months after providing custom-made indoor footwear (in both indoor and regular footwear). Primary group: participants with low (<80%) baseline indoor adherence; secondary group: participants with high (≥80%) baseline indoor adherence. Peak plantar pressures of the indoor footwear were compared with … read more

A new look For WOCN’s Continuing Education Center (CEC)

We (WOCN) are excited to introduce our new and improved look and feel to the WOCN® Continuing Education Center (CEC). With this new look also comes some exciting additions to the site and resources for users, including:

  • New tutorial videos outlining new features of the site and how to utilize the “My Account” functions once logged into the CEC
  • More user-friendly ways to navigate the CEC:
    • The ability to easily search for content by topics of interest
    • The ability to easily search for content by content “tags”
  • A refreshed, clean look to match WOCN branding

Check out the tutorial videos below to learn more about the new CEC!
read more

Wound Care Specialization for the Advanced Practice Clinician

Nursing is a unique and varied field often described as a union between art and science. Nursing appeals to many individuals as a first or second career, and these people see the profession through different lenses. When questioned about why they want to enter the field, many students respond that they “want to help others,” “give back to society,” or “find meaning in my work.”

Many of us can recall our transition from student to entry-level nurse, whether we started on the specialized unit of our dreams or were “strongly” encouraged to start in a general setting. There comes the day when we realize that we have begun to master a clinical knowledge set we once thought impossible. If you are at this crossroads in your career … read more

CALL FOR WOUND, OSTOMY, AND CONTINENCE-RELATED PHOTOS

It is a goal of the Wound, Ostomy, and Continence Nurses SocietyTM (WOCN®) to continuously improve the educational content of the Wound Treatment Associate (WTA®) and Ostomy Care Associate (OCA®) Programs as well as the resources available to all WOCN members. Additionally, it is a goal of WOCN to work at continuous improvement in the areas of diversity, equity, and inclusion. As such, we’d like to extend an invitation to our WOC nurse colleagues to submit photographs of wounds and ostomies, specifically representing individuals of diverse skin tone. We would also invite you to submit photos related to continence-related issues, also in diverse skin tones. A wide variety of photograph examples serve to improve the education of our members and other healthcare providers by ensuring competency in wound, ostomy, and continence (WOC) assessment for all individuals. In this way, the care of all individuals with wound, ostomy, and continence care needs can be improved … read more

Frank & Lizzie Show: Episode 011, Wound Week 2022

Frank & Lizzie are excited to see you in Philadelphia for The American Professional Wound Care Association’s (APWCA) annual conference, Wound Week 2022 at the Loews Hotel February 24-27, 2022. Frank and Lizzie shared their excitement for this advanced wound care conference with THE experts from all disciplines.

Growing Evidence That Oral Antibiotics are the New IV

A recent systematic review in the American Journal of Medicine aims to challenge the dogma surrounding antibiotic therapy for certain types of infections, including osteomyelitis.1 This constitutes superb work from Wald-Dickler and coworkers, adding to the growing body of evidence that (to coin a phrase from senior author Brad Spellberg, MD) shorter may be better and oral greater than IV … Researchers set out to evaluate if current data supports long-standing tenets regarding the superiority of IV antibiotics for the full treatment course for osteomyelitis, bacteremia and infective endocarditis. Their review included 7 randomized controlled trials regarding osteomyelitis, specifically. None of the 21 total studies among all examined infections demonstrated superiority of IV-only antibiotic treatment … read more

Early Identification of Deep-Tissue Pressure Injury Using Long-Wave Infrared Thermography

A Blinded Prospective Cohort Study
The current clinical standard for diagnosing deep-tissue pressure injury (DTPI) is visual inspection. This method is subjective and only presents to the observer the external “picture;” deeper tissues are disguised from the observer. In contrast, long-wave infrared thermography (LWIT) can capture an image of the area of concern and detect tissue temperature relative to the level of tissue perfusion … To determine the efficacy of a handheld LWIT device and software solution as an adjunct to the current clinical standard of visual skin assessment to detect nonvisual pathophysiologic changes of DTPI … read more

A Case Study of Chronic Wound Management

Mr. King presented with 3 wounds located on the medial and lateral aspects of both ankles. Each wound was present for more than 3 years. In that time, he had been seen by 14 wound care physicians and another 8 podiatric and surgical specialists, in the outpatient setting. His care also included home health nursing visits for over 2 years, most commonly with daily dressing changes ordered by the many physicians trying to treat him … At 77 years old, he has many comorbidities that can impair wound healing such as; PAD, PVD, IDDM II, HDL, CKD II, HTN, Varicose Veins and uncontrolled chronic pitting edema. As a result of his wounds not healing, he was no stranger to receiving poor prognoses on the outcomes and resolution of his wounds. Because of poor choices in treatments and a lack of holistic care, more often, his wounds would get worse not better and in some cases Mr. King was told, “there’s nothing I can do, your wounds are not going to heal,” or “you’re going to lose your legs.” Most of the physicians he saw wanted to do some type of surgery or skin grafts. But Mr. King had known too many people that went in for a surgery on the leg or foot, trying to heal a wound, and ended up with an amputation … read more

Nutrition Interventions in Adults with Diabetic Foot Ulcers

Diabetic foot ulcers (DFU) are chronic wounds in the foot or feet associated with neuropathy and/or peripheral artery disease (PAD) of the lower limb in patients with diabetes mellitus. Reports from the Centers for Disease Control and Prevention show that in the United States there are nearly one in four adults living with diabetes, which indicates that a large number of Americans are at risk of DFU. DFUs will develop in up to 34% of patients with diabetes at some time in in their lives, and of those, approximately 15%–25% will require an amputation. Moderate or severe malnutrition has been identified in over half of patients with DFU, and malnutrition in DFU is correlated with increased lower-extremity amputation. Improvements in wound care therapy, including nutrition interventions, can reduce the financial burden of DFUs and increase life expectancy and quality of life … read more

To Conquer or Be Defeated: The Strategy Behind Winning the Wound Infection Battle | webinar

Wound infection has a significant impact on wound healing potential. When managing a wound, the first step is to determine if you are looking at an acute or chronic wound infection. Acute wound infection can be devastating and is often an underappreciated clinical condition that has been reported to increase the cost of care by up to 70%. Chronic wound infections are microbiologically, immunologically, and clinically distinct from acute wound infections and require a different treatment strategy … register

The significance of surface pH in chronic wounds

Wound healing is a complex, multifaceted process which is influenced by both intrinsic and extrinsic factors. The pH of the wound can affect many factors including oxygen release, angiogenesis, protease activity, and bacterial toxicity. Chronic non-healing wounds have an elevated alkaline environment. Healing occurs more readily in an acid environment. Current wound bed assessment is dependent on subjective evaluation with few diagnostic instruments available or suited to routine practice. Monitoring surface pH may provide a method of ‘measuring’ the condition of the wound bed and ultimately aid in determining the wound’s response to treatment … read more

Automating wound care in hospitals

Chronic wounds are a global medical problem closely linked to diabetes. Every year, two per cent of the US population suffers chronic wounds, many resulting in amputation because they do not heal naturally and are typically infected with antibiotic-resistant bacteria. Consequently, conventional treatment methods such as antibiotics are often not an option. However, start-up VulCur Medtech has now developed an automated laser solution writes the Technical University of Denmark in this press release … While competitors are focusing on surface treatment, VulCur MedTech’s treatment goes deeper, cleaning the wounds from the inside out using an automated laser device that kills bacteria while avoiding human cells … read more

The Wound Care Evidence Summit™

The Summit will provide a critically needed multi-disciplinary meeting for payers, government agency policymakers, prominent researchers, wound care medical specialty societies, patient and clinical associations, wound care clinics and manufacturers to address the shared goals of:

  • Addressing the current state of wound care research and clinical trial design
  • Exploring solutions to address the limitations in the wound care evidence-base
  • Communicating with payer medical directors on the development of coverage policies and the use of clinical practice guidelines in coverage decisionmaking
  • Defining “next steps” to actualize solutions
  • Participating in a uniquely intimate gathering of leading decisionmakers

register

Bio Plaster Produced from the 3D Printer Aboard the International Space Station

The long-term goal of the experiment is to cover skin wounds with bio-ink from a 3D printer like a band-aid … The new technology should help to significantly improve wound care on space missions, but also in daily medical use on Earth … Human cells from the 3D printer, with which skin wounds can be covered like an adhesive plaster – that is the long-term goal of the Bioprint FirstAid experiment. As part of the mission “Cosmic Kiss”, the German ESA astronaut Matthias Maurer has now carried out the test series on the International Space Station. The mobile hand-held device is intended to significantly improve wound care … read more

Obesity, Diabetes and Peripheral Neuropathy in Patients With Class 3 Obesity

In individuals with class 3 obesity, obesity itself may be as strong as prediabetes or type 2 diabetes (T2D) in driving the risk of peripheral neuropathy (PN), a study in the Journal of Clinical Endocrinology and Metabolism suggests.

The study analyzed plasma global metabolomics and targeted lipidomics in participants with obesity who either had PN (n=44) or didn’t have PN (n=44). These participants were matched for glycemic status and compared with a lean, non-neuropathic control participants … read more

U.S. diabetes deaths top 100,000 for second straight year

Jan 31 (Reuters) – More than 100,000 Americans died from diabetes in 2021, marking the second consecutive year for that grim milestone and spurring a call for a federal mobilization similar to the fight against HIV/AIDS.

The new figures come as an expert panel urges Congress to overhaul diabetes care and prevention, including recommendations to move beyond a reliance on medical interventions alone. A report released earlier this month calls for far broader policy changes to stem the diabetes epidemic, such as promoting consumption of healthier foods, ensuring paid maternal leave from the workplace, levying taxes on sugary drinks and expanding access to affordable housing, among other areas … read more

Steps Towards Preventing and Reducing Hypertrophic Scars: One Surgeon’s Experience

Hypertrophic scarring secondary to wound dehiscence remains an ongoing challenge for foot and ankle surgeons, despite advancements in surgical techniques and products development. Unattractive or thick scars on any patient exasperate me, but they are especially tough to endure when the patient is a child. A significant portion of my practice focuses on pediatric patients. A thick, wide, noticeable scar on this patient cohort can discourage the parents, the patient, and the doctor alike … read more

Building knowledge of wound care through competency-based education programs

Throughout Covid-19, the pandemic media has highlighted the burden it puts on healthcare systems and professionals. Providing timely and professional care to people suffering from acute and chronic wounds has been particularly difficult. There are two challenges: access to care and access to professional care. Although medical professionals are aware of the need for advanced education, it can be difficult to obtain advanced wound care education due to the increased workload and limited access to education.

A nurse specializing in wounds, ostomy, and continence in Canada (NSWOCC) works with Canadian clinicians to address the lack of access to professional wound care. NSWOCC owns and operates the WOC (Wound, Ostomy, and Continence) laboratory. The WOC-Institute is a practice and competence base of various standards to help healthcare professionals improve their wound, ostomy, and excretion skills and understanding by taking advantage of both online and direct learning opportunities. We offer the program of. The WOC-Institute’s competency-based education program is a team of knowledgeable and dedicated nurse leaders from the Canadian Association of Nurses (CNA) certified nurses specializing in wounds, osteoporosis, and excretion … read more

Glycemic Control Reduces Risk of Diabetic Foot Ulcers in Type 1 Diabetes

Early intensive glycemic control decreases the long-term risk of diabetic foot ulcers (DFUs) in patients with type 1 diabetes (T1D), according to a study in Diabetes Care … Researchers evaluated the effects of intensive treatment (INT) vs conventional treatment (CON) in patients with T1D from the Diabetes Control and Complications Trial (DCCT) on the subsequent risk of DFU and lower-extremity amputations (LEA) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study … read more

Using Negative Pressure Wound Therapy With Instillation and Dwell Time to Create a Path …

to Closure for Older Patients With Chronic Wounds: A Retrospective Case Series
BACKGROUND: Chronic podiatric wounds are common causes of morbidity and mortality in older patients. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been recommended in wounds with high levels of exudate, contaminated wounds, and wounds in which healing progression has stalled. PURPOSE: This retrospective case series describes the use of NPWTi-d to prepare 4 chronic wounds for closure in older patients with multiple comorbidities. METHODS: Patients (N = 4) ranged in age from 65 to 95 years and had wounds present for at least 90 days. Previous treatments included conventional NPWT and debridement. NPWTi-d consisted of instillation of 10 to 20 mL normal saline, dwell time for 1 minute, followed by 3-hour cycles of -125 mm Hg. Antibiotics were administered as needed. Wounds included a 210-day Wagner grade 3 diabetic foot ulcer (3.2 × 1.8 × 0.3 cm3), a 90-day dehisced wound (9.5 × 2.6 × 0.4 cm3), a 300-day neuropathic ulcer … read more

Diabetes: Know it! Fight it! Webinar

Every wound-care clinician treats diabetic patients regardless of your care point. In this course, Nancy will help you evaluate the wound, identify the best plan of treatment and steer you away from the potential setbacks for better healing rates and overall patient outcomes … register

What is the practice and understanding of podiatrists towards patient-centred consultations regarding diabetic foot care?

Background: Patient education is an integral part of diabetes management, yet research shows that increased knowledge alone does not translate into behaviour change. Behaviour change techniques (BCTs) have the potential to increase foot self-care and reduce the incidence of diabetic foot disease. Aims: The aim of this study was to explore the practice and understanding of podiatrists towards patient-centred support versus prescriptive instruction in consultations regarding diabetic foot care. Methods: The study was a cross-sectional design with a web-based questionnaire distributed to members of the College of Podiatry in the UK. Descriptive statistics, conceptual content analysis and the Pearson product-moment correlation coefficient were used to analyse the data. Results: Most respondents reported using BCTs in their consultations “often” or “very often” and that they “strongly agree” or “agree” that their consultations were patient-led, yet most were categorised as having a partial or poor understanding of these terms. Three themes emerged regarding barriers and facilitators, including ‘Skills and confidence’, ‘Patients do not want to take control … read more

Advertise on WoundCareWeekly.com

We will soon be relaunching the Wound Care Weekly newsletter to our list of 7,000 wound care and podiatry professionals. We are looking for sponsors to keep the lights on for WCW. In addition to the newsletter, sponsor exposure would include prominent website visibility (website gets close to 30,000 page views per month), Facebook header and sticky posts (FB page has 1,600 likes and followers) and LinkedIn posts (about 1,200 connections). I expect dramatic growth for web traffic from the newsletter based on activity from when it was previously active. Our latest media kit is below, let me know if you have any questions.
WCW-media_kit_2022.pdf
-Andy Durban

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The white coat: Symbol of respect, or a liability?

A doctor’s white coat is not only a staple of healthcare attire, but it’s also a symbol of professionalism, authority, kindness, and trust. While medical students know that trust is earned through practice, donning the white coat marks an important milestone in their journey to doctorhood … But the glory of this esteemed garment may dwindle when one considers the harm it could cause. Not only do white coats serve as vehicles for pathogens, but they also shine a light on patients’ perceptions of gender and professionalism, revealing gender bias in some cases … read more

Comments at HCPCS Public Meeting

The Alliance spoke at the Dec. 1-2, 2021 HCPCS Public Meeting in support of the CMS HCPCS Workgroup’s preliminary coding decision to establish three new Level II HCPCS codes for non-pneumatic compression devices. “Including disparate devices into the same HCPCS code would severely limit the ability of CMS and other interested parties to collect data and assess the utilization, cost, efficacy and clinical outcomes of these new devices. Therefore, we are in agreement with the creation of three new K codes since it will allow CMS to establish appropriate product segmentation thereby avoiding issues related to data collection and analysis,” the Alliance told the Workgroup … read more

Antimicrobial peptide derived from insulin-like growth factor-binding protein 5 improves diabetic wound healing

Impaired keratinocyte functions are major factors that are responsible for delayed diabetic wound healing. In addition to its antimicrobial activity, the antimicrobial peptide derived from insulin-like growth factor-binding protein 5 (AMP-IBP5) activates mast cells and promotes keratinocyte and fibroblast proliferation and migration. However, its effects on diabetic wound healing remain unclear. Human keratinocytes were cultured in normal or high glucose milieus. The production of angiogenic growth factor and cell proliferation and migration were evaluated. Wounds in normal and streptozotocin-induced diabetic mice were monitored and histologically examined. We found that AMP-IBP5 rescued the high glucose-induced attenuation of proliferation and migration as well as the production of angiogenin and vascular endothelial growth factor in keratinocytes. AMP-IBP5-induced activity was mediated by the epidermal growth factor receptor … read more

Case Study – Diabetic Foot Abscess and Sepsis: Amputation or Limb Salvage?

A 48-year-old Type II insulin dependent diabetic male presented in the acute care setting with sepsis due to an abscess of the right foot involving bone and deep soft tissue structures of the midfoot. The wound and associated sepsis made limb loss and/or mortality a pressing concern. Options were primary limb amputation versus an attempt at limb salvage … read more

Classifying diabetic foot ulcers

Dermatologists must be able to distinguish between infected and noninfected diabetic foot ulcers because whether or not a DFU is infected can help determine treatment protocol, says Warrent S. Joseph, D.P.M, FIDSA.
While dermatologists are unlikely to treat patients with severe foot infections that require hospitalization, they must be able to diagnose and manage mild-to-moderate infections in diabetic foot ulcers (DFUs), and follow current Infectious Diseases Society of America (IDSA) guidelines regarding antibiotic use, according to Warren S. Joseph, D.P.M., FIDSA, who presented at DERMfoot 2018. He is a consultant, lower extremity infectious diseases, Roxborough Memorial Hospital, Philadelphia, and a co-author of the IDSA guidelines, which appeared in Clinical Infectious Diseases in June 2012 … read more

What Is the Difference Between RPM and RTM?

Ever since the CPT® 2022 codebook was released by the American Medical Association, this author has received many calls and e-mails from wound/ulcer management professionals and providers inquiring about the similarities and differences between the 5 new remote therapeutic monitoring (RTM) services codes and the 5 remote physiologic monitoring (RPM) services codes that were created in 2019. Therapists were particularly eager to learn about the new RTM codes and rules. Therefore, this author created the following table, which displays the frequently asked questions and the side-by-side comparison of the answers as they pertain to RPM and RTM … read more

Hyperbaric Oxygen Therapy in Managing Minimally Invasive Aesthetic Procedure Complications

A Report of Three Cases
Minimally invasive aesthetic procedures such as filler injections and thread lifts have gained popularity recently. Complications from these aesthetic procedures are difficult to avoid. This increasing public health concern requires a combination of effective therapeutic modalities. Hyperbaric oxygen therapy (HBOT) has generated favorable results in treating a diversity of wounds, inflammation, and infection … The cellular inflammatory cascade and wound healing process is triggered by tissue hypoxia. Maintaining an oxygen pressure of at least 30 mmHg in tissues is essential to provide an environment suitable for wound healing … The wound was clinically evaluated every 3 days. As the days progressed, the inflammation began to reside as the area of infection continued to shrink, leaving a once-blurred, now clear margin around the wound (Figure 1C). The wound fully healed within one year … read more

E-Learning and Blended-Learning Program in Wound Care for Undergraduate Nursing Students

To respond to the nursing shortage in the canton of Geneva, the School of Health Sciences increased the yearly number of Bachelor of Nursing students from 426 in 2016 to 497 in 2019 (HES-SO, 2020; 2021). In 2020, 190 students started, representing an increase of 18% since 2016. This increase had a major effect on the current face-to-face teaching methods, not only for the availability of lecturers, but also for the logistical resources. To face this problem, different virtual learning tools such as blended and e-learning were implemented. Blended learning is a combination of online learning and the traditional face-to-face learning (Siemens et al., 2015; Singh, 2003) using different technological approaches such as podcasts, lecture captures, or virtual web-based classrooms (Leidl et al., 2020), whereas e-learning is an online education method … read more

Healogics 2022 Healing Can’t Wait Program Raises Awareness about the Impact of Heart Health on Wound Healing

Healogics, the nation’s leading provider of advanced wound care services, as part of their 2022 Healing Can’t Wait program, is promoting awareness of heart health and its impact to wound healing through their seventh annual Heart Health Awareness campaign. Throughout Heart Health Awareness Month, Healogics will work to spread awareness about how cardiovascular diseases can affect the wound healing process.

An alarming 48 percent of Americans currently suffer from cardiovascular disease. Cardiovascular disease can take many forms:

  • Coronary Artery Disease (CAD)
  • Peripheral Artery Disease(PAD)
  • Vascular Insufficiency Diseases

read more

Health Equity podcast #6: Preventing diabetic foot ulcers

In this episode, we are joined by Dr. Ernest Moy, Executive Director of the Office of Health Equity and Dr. Jeffrey Robbins, director of VA Central Office Podiatry Service. Also participating is Suzanne Shirley, director of Partnerships and Community Engagement with the VA Innovation Ecosystem.

Do you know why it is so crucial to address diabetic foot ulcers?

Moy discusses differences in Veterans affected by diabetic foot ulcers and why this program to manage and reduce foot ulcers can improve the health of our Veterans.
listen

Local Tranexamic Acid Reduces Surgical Blood Loss

Tranexamic acid (TXA) is a synthetic lysine analog that reduces perioperative blood loss by blocking lysine-binding sites on plasminogen molecules. It has been reported to be effective in limiting blood loss and transfusion needs in various orthopedic surgeries and for pediatric patients at high risk of blood loss.1,2 Randomized controlled trials (RCTs) supporting the capacity of TXA to reduce blood loss and improve outcomes associated with various surgical procedures have increased fourfold in the 10 years since Evidence Corner addressed this topic, which highlighted the capacity of locally delivered TXA to reduce blood loss during … read more

The US Wound & Podiatry Registries

As part of a QCDR, the US Wound & Podiatry Registries serve many purposes:

Follow the natural history of a disease, estimate the magnitude of a problem, document the type of patients served, estimate complication rates, understand variations in outcomes, determine clinical effectiveness of treatments in the real world, understand cost-effectiveness, monitor safety, measure and improve clinical quality … read more

Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Medical Care in Diabetes—2022

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction … read more

Stop Chasing Your Tail With High-pH Product Selection | webinar

Are you unknowingly promoting a hostile wound healing environment with your choice of wound cleanser, allowing for the colonization of bacteria in the wound bed? Recent studies have shown that pH is a critical factor in the balance of wound healing, and the use of high-pH products such as sodium hypochlorite can be detrimental to healthy tissue. Furthermore, more data have recently been published to show that high-pH environments trigger metabolic responses in fungi that lead to further degradation of skin conditions or environment. High pH in the wound bed also seems to select positively for pathogens … register

The Wound Man

For years I was the only medical doctor doing inpatient wound consults in my hospital. I was continually amazed at the variety of wounds that reflected a wide gamut of human disease. Each wound was unique, and beyond the many pressure injuries and venous stasis lesions there were wounds from cancer, substance abuse, vasculitis, trauma, surgical dehiscence, and hematologic disorders … read more

The Amputation Prevention Symposium | August 17-20, 2022

Driven by a team of multidisciplinary course directors and led by Jihad A. Mustapha, MD, a pioneer in the field of interventional cardiology, AMP provides an unrivaled experience for endovascular and vascular specialists to gain knowledge on the latest advances in revascularization and explore groundbreaking techniques that will improve the future for CLI patients … The unequaled CLI education paired with the paramount interaction among faculty and attendees makes AMP an impactful, inspiring experience that you cannot miss … register

The Issue of Noncompliance in Wound Care Patients

Dealing with patients who either can’t or won’t participate in their care can be a challenge for health care providers across all settings. In wound care, this lack of participation can result in greater financial costs, diminished quality of life, and suboptimal clinical outcomes. This is part one of a two-part series on noncompliance in wound care patients. Part one addresses possible reasons for noncompliance. In part two, strategies to address these issues and increase patient participation are discussed … read more

Third-Degree Burn on the Neuropathic Lower Extremity in a Patient With Diabetes While …

Wearing a Copper–Containing Compression Sock: A Case Report
Many patients who have diabetes and peripheral neuropathy wear compression socks, which are widely available and may be purchased with a copper component. There is also a well-documented history of patients with neuropathy developing thermal burns from heat sources. Patients with diabetes are at an increased risk of complications when they sustain burns. PURPOSE: To describe a patient with diabetes and neuropathy who developed third-degree burns while wearing a copper-containing compression sock. CASE REPORT: A 68-year-old man with type 2 diabetes and peripheral neuropathy wore a copper-containing compression sock while sitting in the sun for several hours. Afterward, he noted severe blistering and was ultimately diagnosed with several areas of second- and third-degree burns. Wound treatment included sharp debridement … read more

Hospital-Acquired Pressure Injuries: Management and Risk Adjustment

Hospital-acquired pressure injuries (HAPIs) continue to occur despite our many improvement strategies. In this webinar, we will discuss the challenges we encounter in HAPI prevention and the sustaining of HAPI improvement strategies, especially during the COVID-19 pandemic. Three methods to address these challenges will be presented … register

COVID-19 Accelerates Virtual Wound Care

One of the journal’s initial goals was to keep our readers abreast of the latest developments and research in our specialty field.1 The COVID-19 pandemic has resulted in the greatest generational threat to “in-person” wound care and patient visits. We have been challenged with the need for social distancing, quarantines, lockdowns, and limited visitation to healthcare facilities. Healthcare professionals, patients, and providers have been forced to find viable alternative methods of care delivery … read more

Micro Medical Solutions receives FDA breakthrough device designation for MicroStent vascular stent

Micro Medical Solutions (MMS) recently announced that the US Food and Drug Administration (FDA) has granted breakthrough device designation for its MicroStent vascular stent. This novel technology is designed to achieve and maintain vessel patency, enhance wound treatment, and improve quality of life and blood flow in order to reduce amputation and mortality for patients with chronic limb-threatening ischaemia (CLTI) resulting from peripheral arterial disease (PAD) … read more

Venous Disease: Ulcers and So Much More

As wound care practitioners, we commonly encounter patients who are referred for evaluation and management of venous ulcers due to venous hypertension. These ulcers are the most common lesions of the lower extremities, affecting 1%-3% of the US population.1 Patient may have coexisting medical comorbidities such as cardiac failure and advanced arterial disease, which may impact the usage of compression therapy. The longstanding venous disease may be associated with additional morbidities such as pain, disability, and malignant transformation. Effective clinical outcomes require patient adherence with recommendations that involve a lifelong commitment to management. This article will serve as a generalized overview of this burdensome disease … read more

Calcipotriol Speeds Wound Healing, Lessens Itching in Small DEB Trial

Treatment with ointment containing a low dose of calcipotriol — an analog (similar compound) of vitamin D3 — helped to speed wound closure and reduce itching in people with dystrophic epidermolysis bullosa (DEB) in a clinical trial.

“While corroboration of our results by large-scaled studies is pending, our preliminary data suggest that topical low-dose calcipotriol ointment significantly reduces itch, accelerates wound healing, and can be safely implemented into the daily wound care of DEB patients,” the researchers wrote … read more

Likelihood of Hospital Admission Up During Foot Ulcer Episodes

Diabetic foot ulcer episodes are associated with an increased likelihood of all-cause inpatient admissions and death compared with periods after ulcer healing, according to a study published online Jan. 18 in Diabetes Research and Clinical Practice.

Brian J. Petersen, from Podimetrics in Somerville, Massachusetts, and colleagues examined data from the Medicare Limited Data Set from 2013 to 2019 to develop and validate an episode-of-care model for diabetic foot ulceration. Episodes of care were defined by clustering diabetic foot ulcer-related claims such that the longest time interval between consecutive claims in any cluster did not exceed a duration … read more

An electrically charged thin film patch used to promote wound healing

A team of researchers working at the University of Electronic Science and Technology of China has developed an electrically charged thin film patch for promoting faster wound healing. In their paper published in the journal Science Advances, the group describes their patch, how it works, and how well it performed when tested on rats … Humans have been looking for ways to promote faster healing of wounds for thousands of years in order to reduce both the length of time a patient experiences pain and the chances of infection. In this new effort, the researchers created an electrically charged thin film patch … read more

Building a better bandage

With a $2 million grant from NIH, MSU is working to better understand and treat chronic wounds
The National Institutes of Health has awarded Michigan State University’s Morteza Mahmoudi more than $2 million to further his team’s efforts in finding effective treatments for chronic wounds … Chronic wounds are complex injuries affecting millions worldwide that don’t heal on their own and can lead to amputation or even death. Mahmoudi said available bandaging techniques can be costly and are currently unable to overcome all of the challenges that prevent wounds from healing … read more

Non-invasive, tiny indicator changes color if the wound shows early signs of infection

The non-invasive indicator, which is around the same size as one of our fingertips, is the first of its kind. It does not make any contact with the wound but detects the beginnings of infection by sniffing the air above it.

It can be added to already existing bandages and allows infections to be detected without taking off the dressing – something which can inhibit the healing process and increase the likelihood of wound infection … read more

RevitaDerm Wound Care Gel Recalled Over Bacterial Contamination, FDA Warns

Double-check your medicine cabinet: One lot of RevitaDerm, a wound care gel, is being recalled due to bacterial contamination, per a notice posted by the Food and Drug Administration (FDA).

Blaine Labs triggered the voluntary recall after testing revealed that one bottle of RevitaDerm contained Bacillus cereus, a bacteria that could lead to “life-threatening, invasive infections,” per the FDA. No adverse events related to this recall have been reported yet … read more

New Guidelines For Addressing Nutrition Deficits In People With DFUs

Current estimates show that 37.3 million people, or 11.3 percent of the United States population, have diabetes.1 More than one-third of these patients will develop a diabetic foot ulcer (DFU) and recently published guidelines suggest that more than half of these patients have moderate or severe malnutrition.2

Recognizing the dearth of randomized controlled trials that specifically look at nutrition in people with DFUs as well as the challenges with nutrition adherence in this patient population, the authors of the new guidelines have emphasized practical screening and assessment tools, including key tips for physical exams, patient history and lab testing workups. The guidelines also provide an overview of dietary factors and nutrients, ranging from hydration and calorie intake … read more

Medical device-related pressure ulcers and the COVID-19 pandemic: from aetiology to prevention

This article describes the aetiology of medical device-related pressure ulcers (MDRPU) and the vicious cycle that leads to these (typically, hospital-acquired) injuries. In this cycle, the primary, deformation-inflicted cell damage leads to a secondary inflammatory oedema-related damage and then to tertiary ischaemic cell and tissue damage. These three damage factors act cumulatively, and, once the first deformation-inflicted massive cell death initiates in the distorted tissues, each of these factors escalates the cell death and tissue damage further, under and near the applied medical device. The primary pathophysiological factors of the COVID-19 pandemic — including the cytokine storm, hypoxia and hyper-coagulation, which are typical to seriously ill patients who require life-support (skin-contacting) medical devices — can fuel the damage spiral of pressure injury. A continuous positive airway pressure (CPAP) mask is a classic example of a commonly used medical device … read more

Integrating adjunctive therapy into practice: recognising ‘hard-to-heal’ wounds

The problem of delayed wound healing has been highlighted in several publications which has stimulated debate on variance and the need for updated care pathways. This paper demonstrates how adjunctive therapy can be added to the ‘standard care’ model, described in the National Wound Care Strategy Programme’s recommendations for lower limb wounds, to enhance outcomes for patients with ‘hard-to-heal’ lower limb wounds (NWCSP, 2020). A decision-making pathway based on published literature is described which uses wound assessment and observed response to treatment to allow the effective and targeted introduction of adjunctive therapies for ‘hard-to-heal’ wounds. This approach will allow the cost-effective introduction of new and evolving therapies, such as WoundExpress™ (Huntleigh Healthcare), which addresses the underlying problems associated with resistant lower limb oedema and … read more

Acetic Acid and Dakin’s Solution: Is Ancient Medicine Appropriate in Modern Times?

A study showed that in wound care there is an overuse of practices that lack evidence and science to support them and an underuse of approaches with evidence. The use of Dakin’s solution and acetic acid are two examples of what that study was referring to. Wound care clinicians, and especially certified wound care clinicians, have a responsibility to provide patients with wound care treatments based on science or clinical evidence. I myself am guilty of promoting practices that didn’t meet those criteria back in the early days of my career because I largely trusted the clinicians teaching me were doing the right thing. As I gained more knowledge and experience and heard some of my practices challenged by other “experts” in the industry, I began to question things … read more

Tiny dot that shows early signs of infection, invented by NI scientists

A small dot that changes colour if a patient’s wound shows early signs of infection has been invented by scientists at Queen’s University Belfast … The non-invasive indicator does not make any contact with the wound but detects the beginnings of infection by sniffing the air above it – it is the same size as a fingertip … It is the first of its kind and is predicted to bring major benefits to healthcare, especially because it can be added to already existing bandages … read more

Self-Bonded Hydrogel Forms Basis of Flexible Wound Patch

With wounds being a part of everyday life, it is important to evaluate the level of healing of individuals. This can vary due to conditions that slow down healing, such as diabetes and can be categorized into acute and chronic wounds … Acute wounds can take up to a number of months to heal; however, chronic wounds may extend to several years, with continued inflammation being a large issue … Approximately 300,000 people are hospitalized per year in the United States for acute wounds … read more

Ted Davis to Succeed Amy Tseng as President and CEO of TissueTech

TissueTech, Inc., a pioneer in the clinical application of cryopreserved human birth tissue products to treat ocular surface disease and disorders, chronic wounds, and musculoskeletal conditions, has named Ted Davis as the company’s new president and CEO. Davis—a seasoned biologics and orthopedics executive—takes the helm of an emerging company experiencing exponential growth, succeeding TissueTech founder and former CEO Amy Tseng, who retired January 3. Tseng remains a member of the company’s board of directors … TissueTech, Inc. is an emerging biotechnology company and leader in regenerative medicine using human birth tissue. TissueTech’s pioneering amniotic membrane products are processed using its proprietary CRYOTEK® cryopreservation technology, designed to retain the tissue’s structural and functional integrity. Today, TissueTech is breaking new ground with multiple Investigational New Drug clinical trials underway as the company pursues 351 biologics’ approval for products to treat patients’ unmet clinical needs. TissueTech is committed to empowering healthcare professionals with solutions to deliver optimal patient outcomes by fostering innovation through evidence-based science. Since its inception, clinicians have performed over 600,000 human implants with its products and published over 380 peer-reviewed studies supporting TissueTech’s platform technology. Learn more at https://tissuetech.com
read more

Perceptive Solutions Integrates with Epic, Joins Epic App Orchard Marketplace

WoundZoom Digital Wound Management solution now available on Epic’s App Orchard Marketplace

 

STEVENS POINT, WI – JANUARY 27, 2022 – Perceptive Solutions, Inc., developer of WoundZoom
Digital Wound Management, today announced its integration partnership with Epic and the availability of
WoundZoom in the Epic App Orchard marketplace. The purpose of this partnership is to provide a
seamless exchange of wound care data between WoundZoom and a facility’s Epic EHR system.
Perceptive Solutions joins the Epic App Orchard as a trusted integration partner so our customers can
leverage the benefits of WoundZoom while eliminating additional steps in their workflow. Data captured
using WoundZoom at the bedside, such as precise wound measurements, images, and clinical
assessments automatically sync to patients’ charts, creating a more efficient workflow and a complete
patient record in the EHR.

 

“Our innovative digital wound management solution enables clinicians to spend more time with patients
through automated charting, wound imaging and elimination of the manual measurement process. We are
excited to provide accessibility of WoundZoom to hundreds of healthcare organizations using EPIC,” said
Mark Lacerte, President of Perceptive Solutions. “The technology integration through Epic’s certification
process enables seamless and efficient data flow from our solution into Epic’s clinical charts. This enables
healthcare facilities to more efficiently share valuable wound care data between both clinical and
administrative team members within their EHR.”

 

About Perceptive Solutions
Perceptive Solutions modernizes the practice of wound care with technology-enabled systems designed to
increase clinical efficiency, improve care quality, and mitigate risk. Integrating smoothly with your EHR,
WoundZoom utilizes the latest AI and imaging technology to capture accurate wound images and
measurements from your smart device, automatically prompt and document appropriate actions, and
create a continuous, standardized clinical record across shifts, floors, and facilities. For more information,
visit https://perceptivesol.com/

 

Media Contact
Karen Guzdzial
Director of Marketing
(727) 225 7944
karen.guzdzial@woundzoom.com

Wound Care / Ulcer Debridement March 17, 2022

On March 17, 2022, APMA will host the fourth installment of its Coding Basics Webinar Series, “Wound Care / Ulcer Debridement.” Sarah Abshier, DPM; Mitchel Hilsen, DPM; and Lawrence Santi, DPM, will present.

This content is available to APMA members only. If you are a member, please log in to see the full content.

New Year’s Resolutions In Wound Care: Reflections And Looking Forward

Most of the panelists cite the COVID-19 pandemic as a common thread impacting their wound care practices last year. Kazu Suzuki, DPM, CWS shares that patients deferring care and mental stress on both patients and health care workers were dominant themes. He adds that his hospital system is over capacity and has been for months. Christine Miller, DPM, PhD, FACCWS, CWSP says that although her team routinely faces challenges due to socioeconomic issues, the pandemic led to the extra burden of staffing shortages … read more

Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness

and Cardiometabolic Risk Profile in Individuals With Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2)
OBJECTIVE
In the Italian Diabetes and Exercise Study_2 (IDES_2), behavioral counseling promoted a sustained increase in physical activity (PA) volume (+3.3 MET h ⋅ week−1), moderate- to vigorous-intensity PA (MVPA) (+6.4 min ⋅ day−1), and light-intensity PA (LPA) (+0.8 h ⋅ day−1) and decrease in sedentary time (SED-time) (−0.8 h ⋅ day−1). Here, we investigated the relationships of changes in PA/SED-time with changes in physical fitness and cardiometabolic risk profile in individuals with type 2 diabetes … read more

Promoting digital, data driven wound care

By: Una Adderley
Una Adderley discusses the importance of data collection and analysis in changing practice and outcomes.
If I were a stick of rock, you would find the word ‘NURSE’ right through me (or maybe ‘community tissue viability nurse’ if there was enough room for all those letters!) So, in 2018, when I came into post as director of the National Wound Care Strategy programme (NWCSP), I saw the issue primarily through a clinical lens. I was not so cloistered that I thought wound care was just a nursing issue, but I did think that it was primarily a clinical challenge. If we could just get the clinical pathways sorted and get everyone who saw people with wounds (GPs, paramedics, podiatrists, surgeons and so on) to work in a more collaborative and coordinated way, we would solve the problem … read more

Promising Natural Products in New Drug Design, Development, and Therapy for Skin Disorders

An Overview of Scientific Evidence and Understanding Their Mechanism of Action
The skin is the largest organ in the human body, composed of the epidermis and the dermis. It provides protection and acts as a barrier against external menaces like allergens, chemicals, systemic toxicity, and infectious organisms. Skin disorders like cancer, dermatitis, psoriasis, wounds, skin aging, acne, and skin infection occur frequently and can impact human life. According to a growing body of evidence, several studies have reported that natural products have the potential for treating skin disorders. Building on this information, this review provides brief information about the action of the most important in vitro and in vivo research on the use of ten selected natural products in inflammatory, neoplastic, and infectious skin disorders and their mechanisms that have been reported to date. The related studies and articles were searched from several databases, including PubMed, Google, Google Scholar, and ScienceDirect. Ten natural products that have been reported widely on skin disorders were reviewed in this study, with most showing anti-inflammatory, antioxidant, anti-microbial, and anti-cancer effects as the main therapeutic actions. Overall, most of the natural products reported in this review can reduce and suppress inflammatory markers, like tumor necrosis factor-alpha (TNF-α), scavenge reactive oxygen species (ROS), induce cancer cell death through apoptosis, and prevent bacteria, fungal, and virus infections indicating their potentials. This review also highlighted the challenges and opportunities of natural products in transdermal/topical delivery systems and their safety considerations for skin disorders. Our findings indicated that natural products might be a low-cost, well-tolerated, and safe treatment for skin diseases … read more

Robert S. Kirsner, MD, PhD,’s Wound Healing Pearls

Robert S. Kirsner, MD, PhD, discusses new and tried-and-true wound healing methods in his presentation at the Maui Derm for Dermatologists meeting.

Robert S. Kirsner, MD, PhD, chairman and Harvey Blank professor in the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine in Miami, Florida, shares his pearls for greater efficacy in his presentation at the current Maui Derm for Dermatologists meeting held in Maui, Hawaii. His pearls included: letting evidence guide decisions, debriding the wound edge along with the wound, using microbes to improve healing, and more … read more

Guidelines and standards for comprehensive clinical diagnosis and interventional treatment for diabetic foot in China

Diabetic foot (DF) is one of the most common complications of diabetes and is associated with high morbidity, disability, lethality and low cure-rate. The clinical diagnosis and treatment of DF need to be standardized. The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF, which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China. In line with the latest developments in diagnosis and treatment, the Alliance, along with other 89 institutions, developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China … read more

Covid-19 lockdown appears to have had a positive effect on diabetic foot ulcers

We conducted a prospective, observational, single-center study without modification of care. All patients followed for a DFU in the study center between 15th April 2020 and 11th May 2020 were included. The baseline assessment occurred 4 weeks after the beginning of lockdown and the follow-up visit 4 to 6 weeks after easing of lockdown. The primary analysis was based on the SINBAD classification … read more

Wound care research sponsored by the Department of Defense

Due to the need for more information about Department of Defense sponsored wound healing research, the Wound Healing Foundation initiated the writing of this article. It briefly describes the Vision, Mission and Goals of the Department of Defense Strategic Medical Research Plan. It also describes the current objectives of Department of Defense research funding and where to access this information in detail. The grant cycle, the timing of request for proposals and some of the specifics of their requirements are also mentioned. A brief discussion of budgeting and overhead is also included … read more

Role of Ultrathin Skin Graft in Early Healing of Diabetic Foot Ulcers

A Randomized Controlled Trial in Comparison With Conventional Methods
Diabetic foot ulcers (DFUs) are a global burden on health care systems. Despite the availability of various treatment modalities, many DFUs do not heal. Nonhealing wounds can lead to various complications, which add to significant morbidity in terms of the degree of moisture retained in the dressing, pain, foul order, and restriction of daily activities. A different treatment modality that can promote the wound healing process earlier (and is cost-effective, easy to use, and readily available) may be necessary to consider. Objective. The purpose of the current study was to demonstrate the efficacy of ultrathin skin grafting (UTSG) in the early healing of DFUs in terms of cost-effectiveness, reduced total number of hospital visits, and final wound outcome (ie, limb salvage rate). Materials and Methods. A randomized controlled trial was conducted in which 52 patients were treated with either UTSG … read more

The International Alliance Of Wound Care Scholarship Foundation® Announces inaugural scholarship recipients

Three rising wound care clinicians receive up to $1,500 each
KOKOMO, Ind., Jan. 25, 2022 /PRNewswire/ — The International Alliance of Wound Care Scholarship Foundation® has awarded inaugural scholarships to three recipients to commence their scholarship award program! … These scholarships are awarded to health care professionals for advanced wound care education and certification. This aids IAWCSF® in its purpose to help reduce the U.S. and global burden of wounds and associated costs by creating a larger number of providers who are educated specifically in treating wound care issues. After a thorough evaluation and assessment by the IAWCSF® Scholarship Review Board, three scholarship recipients were selected as follows … read more

 

The International Alliance of Wound Care Scholarship Foundation®

RECELL® System Data to be Presented at 44th Annual John A. Boswick Burn & Wound Care Symposium

AVITA Medical, Inc. (NASDAQ: RCEL, ASX: AVH), a regenerative medicine company that is developing and commercializing a technology platform that enables point-of-care autologous skin restoration for multiple unmet needs, announced today that six abstracts highlighting the clinical benefits of the RECELL® Autologous Cell Harvesting Device (RECELL® System) have been accepted at the 44th Annual John A. Boswick Burn & Wound Care Symposium. The international conference will be held in Maui, Hawaii, January 22-27, and covers the latest advancements in burn care, wound healing, and infection control … read more

DME for Partial Foot Amputations

The last issue of the year for Podiatry Management is typically dedicated to diabetes. Consistent with that, this article will expand on this issue’s article on PFA (partial foot amputation) written by Jeanette Smith … Devices typically used for patients with PFA range from stuffing a block of materials (toilet tissue, paper towels, rags, etc.) into the toe box of the shoe to a sophisticated hybrid lower extremity prosthetic prescribed by a physician. This article will provide some basic information on why it is important to provide the proper device … read more

Medtronic Recalls HawkOne Directional Atherectomy System

Medtronic has recalled 95,110 HawkOne Directional Atherectomy Systems because of the risk of the guidewire within the catheter moving downward or prolapsing during use, which may damage the tip of the catheter … The US Food and Drug Administration (FDA) has identified this as a Class I recall, the most serious type, because of the potential for serious injury or death … The HawkOne Directional Atherectomy system … read more

StrataGRT–A Breakthrough in Treatment on Chronic and Hard-to-Treat Wounds | video

Transcript: Hello, my name is Dr Matthew Regulski. I’m the medical director for the wound Institute of ocean County, New Jersey, and senior partner at Ocean County Foot & Ankle Surgical Associates … I want to bring to your attention today about a new fast filming, forming silicone that I think has made significant progress in the treatment of both chronic and acute wounds. I’ve been in practice for 17 years and I treat chronic wounds of all types. This has made a substantial impact on the treatment of very hard-to-heal chronic wounds … watch

Wound Management in Post-Acute Care: The Patient Journey

Friday, February 18, 2022 | 9:00AM – 4:20PM EST
Our seminar is both virtual and immersive. With a focus on applying tomorrow what you learn today, this unique experience enables you to participate in your own learning through exploration of case scenarios and interactive exercises … Effective wound prevention and management in the post-acute care setting is essential to reducing unnecessary hospital readmissions and improving patient outcomes … register

The Courage to Do the Right Thing

I was introduced to this problem early in my career. More than two decades ago, I was an Associate Professor at the University of Texas Health Science Center, Houston … Wound Center was the first of its kind (at least, that I know of) to perform “point of care” electronic documentation (in the room with the patient), using a system that internally calculated the physician’s billed level of service and collected discrete data about patients and their wounds … CMS proposed a facility billing system based on wound SIZE. That proposed system was never adopted because during a meeting with CMS, Intellicure President and CEO, David Walker, used Intellicure data from thousands of patient visits to demonstrate that, if implemented, 99% of wound center visits would be billed at the lowest level of … read more

Ouch! Assessing and Managing Acute and Chronic Wound Pain

Pain has been a prevalent health care challenge in the United States for some time, with data from the Centers for Disease Control and Prevention showing that approximately 16% of men and 20% of women experience pain on most days or even every day.1 As health care providers, we understand that unrelieved pain and suffering have direct results on the healing cascade and impair both physical and mental health. The topic of pain is almost always addressed in the health care setting, with pain even at one time being recognized as the “fifth vital sign.” … read more

Development of a prediction model for foot ulcer recurrence in people with diabetes using …

easy-to-obtain clinical variables
We used data from a prospective analysis of 304 people with foot ulcer history who had 18-month follow-up for ulcer outcome. Demographic, disease-related and organization-of-care variables were included as potential predictors. Two logistic regression prediction models were created: model 1 for all recurrent foot ulcers (n=126 events) and model 2 for recurrent plantar foot ulcers (n=70 events). We used 10-fold cross-validation, each including five multiple imputation sets for internal validation. Performance was assessed in terms of discrimination using area under the receiver operating characteristic curve (AUC) (0–1, 1=perfect discrimination), and calibration with the Brier Score (0–1, 0=complete concordance predicted vs observed values) and calibration graphs … read more

Aedicell Expands Availability of Advanced Wound Therapies to US Patients

ROCHESTER, N.Y., Jan. 24, 2022 /PRNewswire/ — To provide a growing number of patients with advanced regenerative wound therapies, Aedicell secured a Group Purchasing Agreement with Premier, Inc. making its skin substitute product Dermavest® available nationally to Premier alliance members. To accommodate the expected demand, Aedicell announces plans for a new production facility located in Cape May County, NJ, in addition to its American Association of Tissue Banks certified facility in Rochester, NY.

Premier, Inc. is a leading healthcare improvement company, uniting an alliance of more than 4,400 U.S. hospitals and health systems and approximately 225,000 other providers and organizations to transform healthcare.

“We’re here to transform the lives of people needing skin substitutes by transforming human tissue into therapies,” said Aedicell CEO Ted Burke. “This Premier Agreement will make our clinically proven therapies with enhanced patient outcomes available to more people at a lower cost, and our new facility in New Jersey will enable us to meet the expected demand for our products.” … read more

COVID-19 Proning Teams Benefit From Wound Care Specialist Nurse

The inclusion of a certified wound and skin care nurse on a multiprofessional prone-positioning team significantly reduces the odds of pressure injuries developing in patients hospitalized with severe COVID-19, according to a study published in the January issue of the American Journal of Critical Care … Connie Johnson, R.N., from Penn Medicine Princeton Health in Plainsboro, New Jersey, and colleagues evaluated the association between including a certified wound and skin care nurse on a multiprofessional pronation team and the prevention of pressure injuries … read more

Targeted nanoparticle delivery provides boost for diabetes transplant

Delivering immunosuppressant treatment via targeted nanoparticles could open the door to a long-lasting cure for type 1 diabetes. Transplanting insulin-producing cells is a promising approach to treat the disease; however, it is plagued by issues of immune rejection. In a new study, published January 17 in Nature Nanotechnology, mice treated with a reengineered therapy could tolerate a transplant for much longer with fewer side effects … For the 1.6 million people in the U.S. living with type 1 diabetes, keeping the body’s blood sugar levels within the right window at all times can be an ongoing challenge … read more

Have a slow healing wound? You need to be eating more protein.

Frustrated with a chronic wound that refuses to close? Or stay closed? It’s time you cashed in on the power of protein … Your body is programmed to heal, over and over again. Even in the face of diabetes and artery/vein diseases … So how can you speed up the body’s natural healing process? By listening to what your body is asking for. And when you have a wound, your body is craving protein … Healing the body with food isn’t about using “natural” foods on an open wound. Raw honey, apple cider vinegar, tea bags, coconut oil, and “miracle” food don’t belong on your wound. They post a huge risk of infection and moisture imbalance, which will slow healing … read more

Higher rates of all-cause mortality and resource utilization during episodes-of-care for diabetic foot ulceration

Researchers aimed at ascertaining if higher all-cause rates of mortality and resource utilization are recorded during periods of diabetic foot ulceration. In addition, an episode-of-care model for diabetic foot ulceration has been developed and validated.

  • The Medicare Limited Data Set between 2013 and 2019 was analyzed for retrieval of data for this study.
  • Episodes-of-care were defined by clustering diabetic foot ulcer linked claims such that the longest time interval between consecutive claims in any cluster did not extend beyond a duration which was adjusted to match two characteristics of foot ulcer

read more

New organic dressing invented in Oman could help wounds heal faster

A new bandage-type dressing for wounds, which has been made from plants, could be used to help them heal faster, a researcher in Oman has discovered … Saied Vakilian, a researcher at the Laboratory for Stem Cell and Regenerative Medicine at the Natural and Medical Sciences Research Centre at the University of Nizwa, led a team that used compounds made from two medicinal plants to help wounds heal faster … “This winning project aimed to evaluate a bioactive multilayer wound dressing based on chitosan and alginate,” said Vakilian … “To enhance healing potential, dracaena cinnabari and aloe vera were loaded as separate layers into the scaffold. The bare and bioactive multilayered scaffolds were fabricated by an iterative layering freeze-drying technique.” … read more