Category: Articles

High Levels of Oxidative Stress and Skin Microbiome are Critical for Initiation and Development of Chronic Wounds in Diabetic Mice

A balanced redox state is critical for proper healing. Although human chronic wounds are characterized by high levels of oxidative stress (OS), whether OS levels are critical for chronic wound development is not known. For these studies, we used our chronic wound model in diabetic mice that has similar characteristics as human chronic wounds, including naturally developed biofilm. We hypothesize that OS levels in wound tissues are critical for chronic wound initiation and development. We show that increased OS levels in the wound correlate with increased chronicity. Moreover, without increased OS levels, biofilm taken from chronic wounds and placed in new excision wounds do not create chronic wounds. Similarly, high OS levels in the wound tissue in the absence of the skin microbiome do not lead to chronic wounds. These findings show that both high OS levels and bacteria are needed for chronic wound initiation and development … read more

Bromelain-based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial

Chronic wounds are estimated to affect over 6 million people annually in the United States with an estimated annual cost of $25 billion. Debridement represents a key step in their management and is considered a basic necessity to induce the functional process of tissue repair. However, there is an unmet need for an efficient rapid acting non-surgical debridement agent. Bromelain-based enzymatic debridement has been proven to provide an effective, selective and safe non-surgical debridement in deep burns. EscharEx (MediWound Ltd, Yavne, Israel), is a bromelain-based enzymatic debridement agent currently in development for chronic wounds. The aim of this study was to assess its safety and efficacy in chronic wounds. Seventy-three patients suffering from a lower extremity ulcer of diabetic/venous insufficiency/post-surgical/traumatic aetiology were enrolled in a multicentre … read more

NEW! APWCA/ASWC WEBCAST SERIES RELEASED

In the first webcast, Elizabeth Faust, MSN, CRNP, CSWS, CWOCN-AP, DAPWCA, of the American Professional Wound Care Association interviews three leaders of the World Council of Enterostomal Therapists (WCET) on their recent article about the International Ostomy Guideline 2020. The discussion includes the inception of the guideline, the extensive work that went into creating a guideline suitable for resource-limited and resource-abundant countries, key takeaways for various members of the healthcare team, and the importance of preoperative education and stoma site marking. Be sure to watch all the way to the end for a big announcement from the WCET.

EB-101 Healed Wounds, Eased Pain Up to Six Years in Trial

Treatment with Abeona Therapeutics‘‘ investigational cell therapy EB-101 led to successful wound healing and eased pain in seven adults with recessive dystrophic epidermolysis bullosa (RDEB) who were followed for up to six years in a clinical trial … “The updated Phase 1/2a results showed safety and durable efficacy follow up, with EB-101 treated wounds continuing to show a considerable reduction in both wound burden and associated long-term pain for up to six years,” Vishwas Seshadri, PhD, head of research and clinical development at Abeona, said in a press release.

Wearable Sensor Measures Light Emission on Skin to Monitor Tissue Oxygenation

Researchers have combined an oxygen-sensing film and machine learning to create a wearable sensor capable of measuring tissue oxygenation through a person’s skin. Developed by researchers at the Wellman Center for Photomedicine at Massachusetts General Hospital and Harvard Medical School, the sensor works by detecting the phosphorescence lifetime and intensity of the acrylic oxygen-sensing film that adheres to the skin … The researchers said that the wireless sensor can monitor oxygen levels on a continuous basis and is easy to operate, making it suitable for remotely monitoring oxygen levels outside of health care settings … –

Essity joins United Nations Foundation expert group in tackling antimicrobial resistance

Hygiene and health company Essity expands its partnership with United Nations (UN) Foundation by joining a cross-industry group that brings together corporate experts in the fight against antimicrobial resistance (AMR). Essity is a global provider of hand hygiene and wound care solutions, essentials in the fight against antimicrobial resistance, one of the greatest global public health threats predicted to be responsible for 10 million annual deaths worldwide by 20501. Essity has been a partner to the United Nations Foundation since 2017 … read more

Abeona Therapeutics Announces Updated EB-101 Phase 1/2a Clinical Results in Recessive …

Abeona Therapeutics Inc. (Nasdaq: ABEO), a fully-integrated leader in gene and cell therapy, today announced updated Phase 1/2a clinical trial results up to six years following treatment with Abeona’s investigational EB-101 for recessive dystrophic epidermolysis bullosa (RDEB). The data showed that investigator assessment of wound healing of 50% or greater from baseline was present in 69% of treated wounds (n=18/26) at 3 years, 93% (n=14/15) at 4 years, 80% (n=12/15) at 5 years, and 80% (n=4/5) at 6 years. The results were reported in a poster, titled “Long-Term Healing, Pain Reduction, and Patient-Reported Outcomes in Recessive Dystrophic Epidermolysis Bullosa Following EB-101 Treatment of Large, Chronic Wounds,” at the Society for Pediatric Dermatology (SPD) 46th Annual Meeting … read more

Impact of repeated remote ischemic conditioning on diabetic foot ulcers: A proof-of-concept study

Patients with a diabetic foot ulcer (DFU) suffer disabilities and are at increased risk for lower extremity amputation. Current standard of care includes debridement, topical antibiotics, and weight off-loading—still resulting in low rates of healing. Previous small-scale research has indicated that repeated remote ischemic conditioning (rRIC) is a novel modality that delivers significantly higher DFU healing rates. This proof-of-concept study was performed to expand the research on the utility of rRIC as an adjunctive treatment in the healing of chronic DFUs. Forty subjects (41 wounds) received rRIC treatment three times weekly in addition to standard of care for 12 weeks. Subjects that did not heal in this time frame but had a significant reduction in wound size were eligible to continue for an 8-week extension period. By the end of the extension period, 31 of the 41 DFU wounds (75.6%) in this study were determined to be healed. This compares favourably to the 25–30% standard of care average healing rate … read more

Dissemination of microbiota between wounds and the beds of patients with pressure injuries: a cross-sectional study

Pressure injuries (PIs) are localised injuries to the skin and/or underlying tissue caused by sustained pressure1, with a reported prevalence of 9–14.5% in the elder care setting2–4. Although their prevalence is declining due to advances in prevention and treatment5, up to 30% of PIs develop infections, which is a life-threatening complication6–8. Therefore, controlling wound infections is a crucial intervention after the development of PIs … Most patients with PIs are compromised hosts due to old age and malnutrition. Thus, treatment directed at improving the overall condition of the patient (e.g., nutritional support) is provided to treat those with PIs. Additionally, breaking the route of transmission of bacteria by using dressings is recommended … read more

Diabetic foot ulcer, the effect of resource-poor environments on healing time and direct cost: A cohort study during Syrian crisis

This study was intended to assess the healing time of diabetic foot ulcer (DFU) during what is considered one of the worst humanitarian crises of the 21st century. Researchers examined 1,747 DFUs from the main diabetic foot clinic in Damascus (2014-2019). They conducted SINBAD Classification to grade the severity of ulcers. This study’s findings demonstrate that the environment with resource-poor settings should be added to the traditional risk factors that delay the healing of DFUs for months or even years. There is a need for more studies to analyze low-cost materials that could be cost-effective in applying standard care to the diabetic foot … read more

A Novel Method to Offload Neuropathic Ulcers of the Distal Phalanges in the Presence of First Ray Metatarsal Hypermobility

The standard practice to heal neuropathic ulcers on the toes is to offload the affected areas with special types of therapeutic footwear including shoes and boots to reduce the amount of pressure on the wound. Once healed, the individual wears custom insoles to prevent the development of new wounds. In our practice, we found that some newly healed wounds will reulcerate despite wearing therapeutic footwear. We devised a method to prevent and offload neuropathic foot ulcers on the distal phalanges in the presence of first ray metatarsal hypermobility, a common problem associated with the development of wounds … read more

CMS Assigns APC Reimbursement Code for Kent Imaging’s SnapshotNIR® for Non-Invasive Near-Infrared Imaging Services

Kent Imaging Inc., a leading innovator of medical technology, is pleased to announce that the Centers for Medicare & Medicaid Services (CMS) has released claims submission guidelines for CPT® Codes 0640T-0642T as referenced in the MLN Matters MM12289 … CPT Codes 0640T-0642T are a family of Category III codes specific to SnapshotNIR for non-contact, near-infrared (NIR) spectroscopy studies of flap or wound for image acquisition, interpretation, and reporting. The codes 0640T and 0642T which include a component on image interpretation, have been classified as reimbursable at the discretion of the payor based on medical necessity. The code 0641T, a procedural code for image capture, was assigned to the APC grouper code 5732 for utilization by outpatient facilities … read more

When Should I Perform Point-of-Care Fluorescence Imaging of Wound Bioburden? Guidelines Based on Delphi Consensus

Bacteria and biofilm plague chronic wounds, impair the healing process, and can increase the risk of infection and antibiotic overprescribing. Fluorescence imaging of bacterial burden (MolecuLight i:X) is the only point-of-care solution to visualize the presence of significant bacterial burden in wounds. This information, when added to standard of care, supports informed clinical decision making and more proactive bacterial management practices. This point-of-care imaging technology is quickly becoming a standard in wound care … View webinar start time in your timezone.

EB Affects All Aspects of Daily Life, Patients Say in Interview Study

Ways to improve the quality of life for people with epidermolysis bullosa (EB) are needed, as those living with the disorder report a range of psychological and social impacts … In a series of interviews, a group of children and young adults with EB described their disease as significantly affecting daily life and interactions at school, within the family, and in society at large … Findings are detailed in the study “Psychosocial impact of epidermolysis bullosa on patients: A qualitative study,” published in the journal Pediatric Dermatology … read more

What are the Benefits of Moist Wound Healing?

The process of keeping a wound in an optimally moist environment to aid faster healing is known as moist wound healing. According to studies, the moist wound heals faster than the wounds allowed to dry out … Studies have demonstrated that moist wound healing is more beneficial than treating wounds in a dry environment, and clinical data has backed this up for years. Since a moist environment keeps new skin cells alive and encourages cell renewal, moist wound healing has been demonstrated to enhance re-epithelialization and can result in a reduction of scar formation … In addition, treating wounds in a moist environment looks promising for generating a microenvironment that promotes regenerative healing without the formation of scars. Clinicians frequently choose dressings that establish and regulate a moist wound environment for these reasons … read more

The Role of Physical and Occupational Therapy in Pressure Injury Prevention

Physical and occupational therapists are not always thought of when it comes to pressure injury prevention; however, their training and knowledge makes them key players in the interprofessional team. Pressure injuries are costly medical issues that can impact a patient’s ability to rehabilitate. Therapists need to understand the causes of pressure injuries to help reduce a patient’s risk. Nursing uses risk assessment instruments to identify patients who are risk for developing a pressure injury. Many of the elements that therapists address in an evaluation and daily treatment are those that are also being addressed in the risk assessment instruments. This article provides an overview to help therapists recognize ways to incorporate pressure injury prevention into their evaluation and daily practice and effectively communicate with other health care professionals … read more

Epidemiology, Pathophysiology, and Management Strategies of Neonatal Wound Care

Guidelines for neonatal skin care are scarce, and there is no consensus on the best management practices for neonatal skin breakdown. This review presents the pathology and phases of wound healing, reasons for neonatal skin fragility, and approaches to recognition of commonly encountered neonatal wounds. This review also provides general strategies for neonatal wound prevention, care, dressing, and management to avoid further damage to the fragile neonatal skin. The importance and role of retaining moisture in expediting wound healing is discussed, as well as updated classifications on how to grade and assess pressure ulcers and the role of negative pressure wound therapy and silver dressings. Lastly, this review discusses prevention and treatment options for surgical wounds, intravenous extravasation wounds, congenital wounds, and thermal injuries, in addition to how to differentiate these wounds from the common diaper dermatitis and contact dermatitis … read more

Thermal Imaging Offers Early Alert for Chronic Wound Care

New research shows thermal imaging techniques can predict whether a wound needs extra management, offering an early alert system to improve chronic wound care … It is estimated that 1-2% of the population will experience a chronic wound during their lifetime in developed countries. In the U.S., chronic wounds affect about 6.5 million patients with more than $25 billion each year spent by the healthcare system on treating related complications … read more

THE COST OF DIABETIC FOOT ULCERS

The annual cost of diabetes is tremendously expensive; according to the American Diabetes Association, it was $245 billion in 2012.1 While nearly $70 billion of this figure was associated with reduced workforce productivity, the remaining $176 billion occurred as excess healthcare expenditures.1 These costs can, in turn, be divided into those associated with treatment of the disease itself, those associated with chronic complications of diabetes, and those native to O&P professional interests: foot ulcers … read more

Lack of access to vascular specialists creates major disparities in amputation rates across the USA

Speaking on current trends in amputation rates with critical limb-threatening ischaemia (CLTI) patients, Misty Humphries (Sacramento, USA) tells Vascular News that while Medicare data shows that amputation rates are decreasing across the USA overall, there are “certain geographical areas” that have high rates, with many of these “located in the south” or in regions that “may not have vascular specialists” … “The disparities that we see in my research I believe are truly access-based,” says Humphries, further drilling down to emphasise health insurance, time and other factors such as appropriate preventive care measures that come into play contributing to the increased risk of amputation … read more

Optimising wound care through patient engagement

Patient engagement is a crucial and timely topic, both in terms of wound healing (and, in some cases, symptom management), and in improving individuals’ experiences of the process. This document aims to provide clear guidance in listening and engaging with individuals, and thus optimising the care experience for all key stakeholders, of which the patient is the most important. The document was developed with input from both healthcare professionals and individuals using healthcare services … read more

The Annual Scientific Meeting (The National) is coming to Denver, July 29–August 1

Get ready to explore new frontiers with APMA in 2021! The Annual Scientific Meeting (The National) is coming to Denver, July 29–August 1. The must-attend meeting for every podiatrist will offer attendees up to 29.5 CECH with a diverse educational program touching on all aspects of foot and ankle surgery and medicine.

At this point in time APMA is closely monitoring the COVID public health crisis and preparing for multiple scenarios. We hope to see our attendees in person for four days of learning and networking. However, given the uncertainty of the situation and recognizing the need to accommodate everyone’s personal level of comfort, we are planning a hybrid event that will allow virtual attendees to concurrently stream the event.

Check out the preliminary program, and watch your APMA publications for more information. Registration for The National is now open.

A Collaborative Call for Changes in Reimbursement Policies for pressure injury

A Collaborative Call for Changes in Reimbursement Policies for pressure injury coauthored by leadership from NPIAP, AAWC and WOCN has been published in the Journal of Patient Safety.

This paper examines reimbursements to improve pressure injury prevention for
CMSGov.

  1. Capitated payment for prevention bundles
  2. Deferred payments for safe discharge
  3. Equal sided risk mode that rewards good performance

Read the full paper here

Advanced Wound Dressings with Integrated Healing Sensors

These antimicrobial, multifunctional dressings include fluorescent sensors that glow brightly when exposed to UV light on the onset of infection and can be used for monitoring the healing process … A research team from RMIT University has developed smart dressings that manipulate the potent antifungal and antibacterial properties of magnesium hydroxide. When compared to silver-based dressing, the smart dressings can be produced cost-effectively but are equally effective in fighting fungi and bacteria, thanks to their antimicrobial power that lasts up to a week … read more

Thermal imaging offers early alert for chronic wound care

New research shows thermal imaging techniques can predict whether a wound needs extra management, offering an early alert system to improve chronic wound care … It is estimated that 1-2% of the population will experience a chronic wound during their lifetime in developed countries – in the US, chronic wounds affect about 6.5 million patients with more than US$25 billion each year spent by the healthcare system on treating related complications … The Australian study shows textural analysis of thermal images of venous leg ulcers (VLUs) can detect whether a wound needs extra management as early as week two for clients receiving treatment at home … read more

When Should I Perform Point-of-Care Fluorescence Imaging of Wound Bioburden? (webinar)

Bacteria and biofilm plague chronic wounds, impair the healing process, and can increase the risk of infection and antibiotic overprescribing. Fluorescence imaging of bacterial burden (MolecuLight i:X) is the only point-of-care solution to visualize the presence of significant bacterial burden in wounds. This information, when added to standard of care, supports informed clinical decision making and more proactive bacterial management practices. This point-of-care imaging technology is quickly becoming a standard in wound care … View webinar start time in your timezone

Pandemic leads to changes in delivery of care for diabetic foot infections

The COVID-19 pandemic led to early disruptions in diabetic foot care during lockdowns, and cases of diabetes-associated foot infections increased after lockdowns were lifted, according to a speaker … Brian Schmidt, DPM, an assistant professor of internal medicine in the division of metabolism, endocrinology and diabetes at the University of Michigan School of Medicine, said during a virtual presentation at the American Diabetes Association Scientific Sessions that poor messaging at the start of the COVID-19 pandemic may have kept many patients with diabetic foot conditions from contacting providers about complications, leading to increases in infections after stay-at-home orders were lifted … read more

Next Science Product Featured in Lifetime Channel Program on Treating Chronic Wounds

Next Science (ASX:NXS), an innovative medical technology company and leader in treating biofilm-based infections in humans, today announced new educational broadcast content about chronic infections, which impact 17 million Americans each year. “The Balancing Act,” a lifestyle show that airs on the Lifetime channel, will feature a segment that discusses the costly and debilitating nature of these infections and how physicians can more effectively treat patients suffering from chronic wounds, including diabetic wounds, by using BLASTX, Next Science’s antimicrobial wound gel … In addition to treating diabetic foot and leg ulcers, BLASTX can also be used for stage I-V pressure ulcers, partial- and full-thickness wounds, post-surgical wounds, first and second degree burns, and grafted and donor sites. BLASTX, which uses Next Science’s patented XBIO® Technology, which physically deconstructs the protective shell over the bacterial biofilm matrix, destroys bacteria within the gel and defends from recolonization while maintaining a moist wound environment. BLASTX is non-toxic and lasts up to five days … read more

Decreased Physiological Serum Total Bile Acid Concentrations in Patients with Type 2 Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN), one of the most frequent diabetic microvascular complications, is characterized by symmetrical, bilateral distal motor and predominantly sensory abnormality, starting distally and gradually spreading proximally in a glove-and-stocking distribution. It is estimated that DPN would affect approximately 50% in those with over 10 years’ duration.1 DPN has been reported to lead to neuropathic pain, diabetic foot ulcers and lower-limb amputations, all of which contribute to a substantial effect on patient’s quality of life and a significant financial burden. However, other than improving glycemic control, there is no licensed pathogenetic treatment for DPN. Therefore, it would be of great importance if a simple, inexpensive, and reliable indicator is available for the early identification and management of individuals at high risk for DPN in clinical settings, and further effective strategies are formulated to prevent its development and progression … read more

Tips for providing diabetes foot care through telemedicine

Before the COVID-19 pandemic, foot evaluations — including wound debridement, off-loading, radiographs, dressing recommendations and infection control — required in-person visits. With the pandemic closing clinics and canceling hospital services, providers had to explore different ways to continue monitoring people in need of diabetic foot care … At the University of Southern California, providers were forced to make a rapid shift to telemedicine when COVID-19 stay-at-home orders began. In the 6 weeks before the pandemic, all patient contacts for diabetes foot care took place through clinic visits. In the first 6 weeks after COVID-19 lockdowns … read more

Pandemic Underlines Importance of Alternative Support Surfaces in Pressure Wound Care

Hospital Acquired Pressure Injuries (HAPIs) – long a major healthcare problem for hospitalized patients – have the potential to increase with the increasing amount of patients requiring ICU care due to COVID-19. Regardless of primary diagnosis, when immobility, pressure, friction, shear, poor nutrition, and poor profusion plague the hospitalized patient, HAPIs often occur. Each year, more than 2.5 million patients suffer from these injuries, costing the U.S. healthcare system anywhere from $9.1 – 11.6 billion annually … read more

Healogics® Receives Accreditation from American Nurses Credentialing Center

Healogics®, the nation’s leading provider of world-class wound care, is proud to announce its accreditation from the American Nurses Credentialing Center (ANCC) …The ANCC Accreditation Program identifies organizations that exhibit excellence in Nursing Continuing Professional Development (NCPD). In order to be awarded accreditation, rigorous standards must be met for providing continuing professional development to registered nurses. Healogics earned this distinction by promoting excellence in nursing and patient safety, and providing nurses with the knowledge and skills to help improve care and patient outcomes … “We are proud to achieve the highly regarded Accreditation from ANCC,” said Healogics Vice President of Clinical and Quality Process Excellence, Carolyn M. Shinn … Healogics nurses will have the opportunity to participate in the highest level of education to meet certification or licensure requirements, as ANCC-accredited continuing education is the most impressive and viable strategy in improving professional nursing practice … read more

From the Editors’ Desk

Over the last year, COVID-19 has forced healthcare professionals to rapidly change the way they think and practice. This includes quickly assessing patients and reevaluating clinical situations with new eyes for optimal resource utilization and effective patient care options. Some facilities have reassigned professional personnel, and the entire industry has had to rethink traditional clinical paradigms … read more

Dr. Alisa Savetamal Presents the Health Economics of Allograft VS

In this webinar Alisa Savetamal, MD FACS will present the health economics of allograft vs. NovoSorb BTM. She will review two patients with full thickness injuries to both legs. Each patient received serial allograft applications on one leg and BTM on the other. This presentation will review the economics of the entire patient experience including product cost, repeat OR cost, impact on the surgeon, and impact on the patient throughout the healing process. This presentation was originally scheduled during ABA 2020 … read more

New research a ‘step change’ for diabetes patients

Millions of people with diabetes are at risk of developing foot ulcers, which often lead to amputations and other health complications. Now, Scientists from the Centre for Biomechanics and Rehabilitation Technologies (CRBT) have developed a new method to reliably detect this risk without the need for complex electronic in-shoe sensors … read more

How can we deliver oxygen to wounds?

How does oxygen work in wound healing? We are all familiar with how necessary oxygen is for life in general. A few minutes of holding your breath (if you can last that long) proves the point quickly. We are taught the basics of how oxygen is important for essential processes such as energy conversion in the adenosine triphosphate (ATP) cycle, yet not typically processes in which oxygen plays a critical role in wound healing … read more

New Feature in Wound Care Software Fills Patients’ Shopping Carts with Physician-Recommended Nutrition

Wound care physicians often struggle to ensure patients receive the proper nutrition to accelerate wound healing. Intellicure is fighting that struggle by providing physicians unique tools that place recommended nutritional supplements in the hands of patients … Intellicure already automated the prescribing and ordering of medications and durable medical equipment inside its wound care EHR and its recently released SMART wound care app. However, certain nutritional supplements that are clinically proven to support wound management in some patients are sold over the counter. Often these supplement names and quantities are written down for the patient to purchase on their own time, leaving the physician to wonder if the patient ordered the correct products and quantities needed for a speedy recovery … read more

Fluorescence in situ Hybridization (FISH) in the Microbiological Diagnostic of Deep Sternal Wound Infection (DSWI)

Postoperative mediastinitis after cardiac surgery is still a devastating complication. Insufficient microbiological specimens obtained by superficial swabbing may only detect bacteria on the surface, but pathogens that are localized in the deep tissue may be missed. The aim of this study was to analyze deep sternal wound infection (DSWI) samples by conventional microbiological procedures and fluorescence in situ hybridization (FISH) in order to discuss a diagnostic benefit of the culture-independent methods and to map spatial organization of pathogens and microbial biofilms in the wounds … –

Swift Medical launches integrated digital wound care solution with Homecare Homebase

Homecare Homebase (HCHB), the nation’s #1 software for home health and hospice, is partnering with global digital wound care leader Swift Medical to provide high-quality, cost efficient care through an integrated solution. Through this expanded partnership, Swift Medical becomes the exclusively preferred wound care technology partner for HCHB, with an enhanced integration offering to streamline workflows and eliminate double documentation … read more

Debridement

In the English language, the word debridement is used in the specific sense of cleaning a wound of infected, potentially infected, necrotic (dead), eschar (Figure 1), or foreign material (such as fragments of old dressings). To the best of the authors’ knowledge, the word is not used in any other context in English. The word debridement comes from the French language and is even pronounced in English as a French word (de-breed-ment), where it means taking a bridle (the head straps that hold the mouthpiece in place) off a horse … read more

Negative pressure wound therapy for open traumatic wounds

Traumatic wounds (wounds caused by injury) range from abrasions and minor skin incisions or tears, to wounds with extensive tissue damage or loss as well as damage to bone and internal organs. Two key types of traumatic wounds considered in this review are those that damage soft tissue only and those that involve a broken bone, that is, open fractures. In some cases these wounds are left open and negative pressure wound therapy (NPWT) is used as a treatment. This medical device involves the application of a wound dressing through which negative pressure is applied and tissue fluid drawn away from the area. The treatment aims to support wound management, to prepare wounds for further surgery, to reduce the risk of infection and potentially to reduce time to healing … read more

Refractory Wounds: Systemic Factors Affecting Repair – Extrinsic Factors (Part 2 of 4)

Refractory wounds are a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in a prior blog. Wounds that fail to heal not only impact quality of life, but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well … read more

A Compendium of Perspectives on Diabetes: A Challenge for Sustainable Health in the Modern Era

Diabetes is a chronic illness. Hyperglycemia is the characteristic of this disorder. Diabetes is a global crisis which affects the economy and health of all nations. Over the last decades, the number of individuals living with diabetes has significantly increased worldwide. Asia is a key epicenter of the emerging diabetes epidemic, with China and India the two nations having the highest number of diabetic people. Economic development, modernization, unhealthy diet, population aging, and sedentary lifestyles are the major factors responsible for the increasing diabetes epidemic. Diabetes is associated with several complications, and cardiovascular disease is the most important cause of morbidity and mortality among people with diabetes. These life-threatening problems can be prevented or delayed by proper management of diabetes. Lifestyle modification is an important factor to decrease the diabetes risk. The frequency of diabetic complications will rise if there is a lack of cost-effective and sustainable interventions. Hence, prevention of diabetes and its complications such as diabetic retinopathy and cardiovascular disease … read more

Wound Odor

Wound odor, also referred to as malodor, is typically the result of necrotic tissue or bacterial colonization in the wound bed. Certain dressings like hydrocolloids, also tend to produce a characteristic odor as a result of the chemical reaction that takes place between the dressing and wound exudate, causing odor. While not directly harmful to the patient, wound odor is often indicative of bioburden or other barriers to wound healing. In addition, the psychological effects of malodorous wounds on the patient, relatives, or caregiver can be significant … read more

2,000,000 TWO2 Treatments Milestone Reached as TWO2 Study Is Highlighted in Systemic Review of Topical Oxygen Therapies

“This is another enormous milestone for our company and a testament to the ease-of use and durable clinical efficacy of TWO2 therapy, as well as to the tenacity of our entire dedicated care team. AOTI is proud to have been able to help heal the Diabetic Foot Ulcers and Venous Leg Ulcers of so many high-risk patients safely at home. Effective homecare therapeutics, such as provided by TWO2, have become vital in maintaining continuity-of-care by caregivers for their patients, especially during the recent COVID-19 pandemic,” stated Dr. Mike Griffiths, CEO and Medical Director of AOTI … read more

Refractory Wounds: Etiologic Factors and Management (a Four-Part Series)

Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone. Wounds that fail to heal not only impact quality of life but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well … read more

Adding a Hypochlorous Acid-Preserved Wound Cleanser to the Pressure Injury Management Toolbox: A Case Series

Pressure injuries (PIs) can impair quality of life, and the goal of management is to create an optimal local wound healing environment. PIs can be difficult to manage and are associated with significant morbidity and mortality. Wound cleansing is a routine part of managing these wounds and can aid in the removal of exudate, debris, and contaminants.3 PIs located on the sacrum or ischium are at high risk of infection due to exposure to urine and feces; for these wounds, regular cleansing is extremely important … read more

A Rare Case of Invasive Keratinizing Squamous Cell Carcinoma of the Foot

In general, there are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common primary skin cancer amongst these, and cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Sun-exposed areas are the most common site and mainly affect Caucasians. cSCC involving the lower leg and anogenital region have been more commonly associated with dark skin. It is of utmost importance to regularly monitor chronic wounds. The conversion from an ulcer to malignancy is usually a slow process and the exact pathogenesis is yet to be definitively known. It was Marjolin who, in 1827, first reported this process when he noted a malignant change in a chronic ulceration. cSCC is the most common secondary skin cancer noted to arise in chronic wounds, burn scars, trauma, and following radio necrosis … read more

Antibacterial Effect and Promoting of Skin Wound Healing After Infected with Methicillin-Resistant Staphylococcus aureus for the Novel Polyvinyl Nanoparticles

Wounds represent a serious, and often overlooked, health problem in the global world. Importantly, if left untreated, several complications arise including infection, amputation, and long-term morbidity. The wound treatment has placed a massive financial burden on the health-care system, with serious and disturbing consequences for the affected patients. The development of new treatments that enhance the wound healing process and prevent, or limit, scarring is needed. Impaired wound healing is characterized by a loss of synchronization of the molecular interactions required for skin tissue repair.4 Six million patients a year are affected by wounds, costing the health-care system an estimated $25 billion dollars. Wound infection is the most common impediment to wound healing, leading to increase the morbidity and mortality among patients … read more

Emerging Roles of Long Non-Coding RNAs in Diabetic Foot Ulcers

Diabetes mellitus is one of the most widespread metabolic diseases in the world, and diabetic foot ulcer (DFU), as one of its chronic complications, not only causes a large amount of physiological and psychological pain to patients but also places a tremendous burden on the entire economy and society. Despite significant advances in knowledge on the mechanism and in the treatment of DFU, clinical practice is still not satisfactory, and our understanding of its cellular and molecular pathogenesis is far from complete. Fortunately, progress in studying the roles of long non-coding RNAs (lncRNAs), which play important regulatory roles in the expression of genes at multiple levels, suggests that we can apply them in the early diagnosis and potential targeted intervention of DFU. In this review, we briefly summarize the current knowledge regarding the functional roles and potential mechanisms of reported lncRNAs in regulating DFU … read more

Wound Healing Activity of Opuntia ficus-indica Fixed Oil Formulated in a Self-Nanoemulsifying Formulation

Delayed wound healing represents a common health hazard. Traditional herbal products have been often utilized to promote wound contraction. The current study aimed at assessing the wound healing activity of Opuntia ficus-indica seed oil (OFI) and its self-nanoemulsifying drug delivery system (OFI-SNEDDS) formula in a rat model of full-thickness skin excision.
Methods: Based on droplet size, an optimized OFI-SNEDDS formula was prepared and used for subsequent evaluation. Wound healing activity of OFI and OFI-SNEDDS was studied in vivo.
Results: The optimized OFI-SNEDDS formula droplet size was 50.02 nm. The formula exhibited superior healing activities as compared to regular OFI seed oil-treated rats at day 14 of wounding. This effect was further confirmed by histopathological examinations of H&E and Masson’s Trichrome-stained skin sections. Moreover, OFI-SNEDDS showed the highest antioxidant and anti-inflammatory activities as compared to OFI seed oil-treated animals. Both OFI and OFI-SNEDDS significantly enhanced hydroxyproline skin content and upregulated Col1A1 mRNA expression … read more

Hydrosurgical Debridement Use Associated With Decreased Surgical Site-Related Readmissions: A Retrospective Analysis

Debridement is the cornerstone of wound care management. It allows for the removal of fibrinous and necrotic debris from the wound bed as well as the reduction of bacterial bioburden, thus allowing for proper granulation and wound healing. Hydrosurgical debridement uses a controlled, high-pressure fluid jet to cut and remove necrotic debris, contaminants, and bacteria, thereby facilitating a potentially more aggressive debridement. Objective. The efficacy of this system was compared with that of other methods of debridement in reducing … read more

FDA clears Koya Medical’s Dayspring compression system for lower extremities

Koya Medical announced today that it has received US Food and Drug Administration (FDA) 510(k) clearance for its active compression therapy system Dayspring for the treatment of lymphoedema and venous diseases that impact lymphatic flow in the lower extremities. The company also announced the appointments of three veteran executives to its leadership team to support commercialisation … read more

Vital Role of Wound Care Imaging Technology in HealthTech

Wound care technology is digital, which corresponds to the digital distribution of medical records. Wound treatment documentation can now be uploaded to EHRs for unified treatment across all providers involved in a patient’s recovery process … Wound care is vital to the overall healthcare industry, clinicians, and patients. It is crucial to diagnose a wound with pinpoint accuracy and document healing, infection, and other important wound care parameters. Wound care imaging technology has been developed by innovators using technology and clinical knowledge … read more

First Patient Enrolled in Restrata® Randomized Controlled Trial

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 clinical study evaluating Restrata, Acera’s leading wound care product, for the treatment of non-healing diabetic foot ulcers (DFUs). The study will generate level 1 clinical evidence to support coverage and reimbursement from US health insurers for Restrata’s use in outpatient wound clinics and physician office settings … Non-healing foot ulcers are among the most debilitating outcomes affecting people with diabetes in the United States. Roughly 1 out of 3 people with diabetes will develop a foot ulcer over the course of their lifetime1. More than 50% of diabetic foot ulcers become infected, and roughly 20% of diabetic foot infections result in amputation. That means that almost every 20 seconds, a lower limb is amputated due to complications associated with diabetes2. In the United States, an estimated $237 billion is spent annually on direct costs for diabetes, and as much as one third of that will be spent to treat lower extremity complications3 … read more

2,000,000 TWO2 Treatments Milestone Reached as TWO2 Study Is Highlighted in Systemic Review of Topical Oxygen Therapies

“This is another enormous milestone for our company and a testament to the ease-of use and durable clinical efficacy of TWO2 therapy, as well as to the tenacity of our entire dedicated care team. AOTI is proud to have been able to help heal the Diabetic Foot Ulcers and Venous Leg Ulcers of so many high-risk patients safely at home. Effective homecare therapeutics, such as provided by TWO2, have become vital in maintaining continuity-of-care by caregivers for their patients, especially during the recent COVID-19 pandemic,” stated Dr. Mike Griffiths, CEO and Medical Director of AOTI … read more

Beating Biofilm Is Key to Fighting Surgical Infections

Health care is at a perilous crossroads. “[D]eaths from drug-resistant infections are set to skyrocket to over 10 million per year worldwide and could cost the global economy as much as $100 trillion by 2050,” a STATISTICA article reports. The same concerning fact is stressed by United States public health officials, who agree that “antimicrobial resistant pathogens (AMR) threaten everyone”.Both reports suggest a grim future of consequences from bacterial resistance, with U.S. officials believing AMR is occurring at a rate of more than 2.8 million antibiotic resistant infections in the U.S. each year, ending in a heavy economic price and over 35,000 deaths annually. The Centers for Disease Control and Prevention (CDC) believes “no one can completely avoid the risk of resistant infections, with some people at greater risk than others.” Eye-opening research suggests at least 80% of these infections are biofilm related … read more

Wound-specific Bacteria May Be Targets for DEB Treatment

A distinct set of bacteria colonizes the skin in and around wounds in people with dystrophic epidermolysis bullosa (DEB), according to a new study … The finding suggests that these patients may benefit from therapies that specifically target those bacteria and that encourage the growth of non wound-associated bacteria instead … The study, “Evidence for cutaneous dysbiosis in dystrophic epidermolysis bullosa,” was published in the journal Clinical and Experimental Dermatology … read more

Breaking the Barrier: An Innovative Approach to Mature Biofilm

Addressing skin and wound bioburden is of utmost importance to wound care clinicians. The tendency of microorganisms to develop biofilms within a wound has been well documented in the literature. A recent meta-analysis underscored the presence of biofilm in 78.2% of chronic wounds. Biofilms may lead to chronic infection and impact wound healing by perpetuation of the inflammatory phase. Contrasting with free-floating, acutely infectious planktonic microorganisms, a biofilm is an aggregated colony of bacteria, usually of multiple species, that produces a protective EPS and establishes its own microenvironment that is conducive to survival. The biofilm and its surrounding EPS mature over time … read more

Factors Associated With Healing of Diabetes-Related Foot Ulcers: Observations From a Large Prospective Real-World Cohort

Diabetes-related foot ulcers (DFUs) affect around 20 million people annually and are a leading cause of the global disability burden (1). DFUs are complex to treat, take months to heal, result in poorer quality of life, and place patients at high risk of hospitalization and amputation. Thus, understanding the influence that different factors have on healing of DFUs is vital … read more

A new approach to understanding the biology of wound healing

Our bodies frequently heal wounds, like a cut or a scrape, on their own. However patients with diabetes, vascular disease, and skin disorders, sometimes have difficulty healing. This can lead to chronic wounds, which can severely impact quality of life. The management of chronic wounds is a major cost to healthcare systems, with the U.S alone spending an estimated 10-20 billion dollars per year. Still, we know very little about why some wounds become chronic, making it hard to develop effective therapeutics to promote healing. New research from Jefferson describes a novel way to sample the cells found at wounds – using discarded wound dressings. This non-invasive approach opens a window into the cellular composition of wounds, and an opportunity to identify characteristics of wounds likely to heal versus those that become chronic, as well as inform the development of targeted therapies … read more

The Foot & Ankle Treatment Center Joins Illinois Bone & Joint Institute

DES PLAINES, Ill., June 1, 2021 /PRNewswire/ — Illinois Bone & Joint Institute (IBJI), the largest independent, physician-owned orthopedic practice in Illinois, welcomes Dr. Bruce Noxon and Dr. Paul Goodman, of The Foot & Ankle Treatment Center, to our practice as of June 1, 2021. Dr. Goodman and Dr. Noxon will continue to provide the same high-quality, affordable care for Glenview and the neighboring communities as they have for the last 22 years, now as part of the expert team of IBJI podiatrists and foot and ankle specialists … read more

AUSTRALIAN WOUND IRRIGATION DEVICE CLEARED BY FDA

On April 23, 2021, the FDA notified the company that its single step application wound irrigation solution, XPERIENCE No Rinse Antimicrobial Solution, has been 510(k) cleared in the U.S. for immediate distribution. The device was originally submitted to the FDA as MIS Solution but is now being marketed as XPERIENCE.

The company says the residual solution remains in the surgical site after closure and, “continues to help defend against pathogens for several hours, giving surgeons a simple and effective adjunct to help prevent surgical site and post-operative infections.” … read more

How Does Your Documentation Measure Up to Medicare Standards? Debridement 101

Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure accuracy. However, HMP and the author do not represent, guarantee, or warranty that coding, coverage, and payment information is error-free and/or that payment will be received.

To our readers: This article is the beginning of a series of articles on proper documentation practices for wound care. In this series, I will discuss different topics in wound care documentation practices that I have seen in my travels and found to be insufficient in light … read more

Decreasing Pain and Increasing the Rate of Chronic Wound Closure With the Use of a Noninvasive Bioelectronic Medical Device: A Case Series

Chronic wounds are a source of significant morbidity. Medical and scientific efforts are ongoing to further therapeutic modalities improving pain scores and augmenting healing while decreasing complications and reducing the social and economic burden of wounds. Electrical current therapy, or electrical stimulation (ES), has been shown to decrease and modulate both acute and chronic pain; however, understanding of the role of ES in wound closure is limited. Objective. This single-center case series reports use of a topical ultrahigh frequency ES (UHF-ES) therapy to decrease wound pain and improve the rate of closure in difficult-to-heal wounds in 9 patients. Materials and Methods. Initially, each patient underwent individualized care of their chronic wounds for a minimum of 8 weeks … read more

Sensing technology to prevent diabetic foot ulcers

Innovative in-sole sensors will alert diabetic patients during excessive or extended activities that could trigger foot ulcers in a new system being developed at the University of Southampton … The Load Monitoring and Intervention System (LOMIS) processes real-time data from three directional force sensors and detects physical activities over extended periods of time in a five-metric dimensional risk model … Live risk alerts are communicated to patients through a connected App to mitigate the risk and dangers of ulceration and amputation … read more

New wound care best practice consensus document for pharmacy teams

DURING the COVID-19 pandemic, pharmacists have increasingly played a key role as being the first point of contact for people with wounds, both chronic and acute. As the burden of wound care increases through the ageing population and with many people being reluctant to go into the hospital or primary care setting, this key role will continue to develop and grow … Now, a multidisciplinary group of experts, including a team from the University of Huddersfield’s Institute of Skin Integrity and Infection Prevention (ISIaIP), have been working in collaboration with Wounds UK … read more

Hyperbaric oxygen therapy for chronic diabetic foot ulcers: An overview of systematic reviews

Researchers assessed clinical evidence of hyperbaric oxygen therapy in the management of diabetic foot ulcers, via this overview of systematic reviews. They analyzed systematic reviews (SRs) assessing the impacts of hyperbaric oxygen therapy in individuals with diabetic foot ulcer. Inclusion criteria were fulfilled by 11 SRs/MAs. They found limited clinical evidence in favor of hyperbaric oxygen therapy in the management of diabetic foot ulcers, routine application of hyperbaric oxygen therapy to all patients with diabetic foot ulcers, particularly those with non-ischemic diabetic foot ulcers, is not advised. Certain potential of hyperbaric oxygen therapy to promote ulcer healing as well as decrease amputation rate in patients with ischemic diabetic foot ulcers has been observed, but because these results are supported by low quality and small quantity of the SRs/MAs, widespread recommendations require high-quality studies with rigorous … read more

Development and validation of a clinical prediction rule for development of diabetic foot ulceration: an analysis of data from five cohort studies

Development of a CPR using individual participant data from four international cohort studies identified by systematic review, with validation in a fifth study. Development cohorts were from primary and secondary care foot clinics in Europe and the USA (n=8255, adults over 18 years old, with diabetes, ulcer free at recruitment). Using data from monofilament testing, presence/absence of pulses, and participant history of previous ulcer and/or amputation, we developed a simple CPR to predict who will develop a foot ulcer within 2 years of initial assessment and validated it in a fifth study (n=3324). The CPR’s performance was assessed with C-statistics, calibration slopes, calibration-in-the-large, and a net benefit analysis … read more

BD Launches Industry First Ready-to-Use Iodine-Based Surgical Irrigation System

FRANKLIN LAKES, N.J., May 25, 2021 /PRNewswire/ — BD (Becton, Dickinson and Company) (NYSE: BDX), a leading global medical technology company, announced today the availability of BD Surgiphor™ Sterile Wound Irrigation System, the first and only ready-to-use aqueous povidone-iodine (PVP-I) irrigation solution that mechanically loosens and removes wound debris . . . read more

RedDress Selected to Exhibit ActiGraft at Vizient Innovative Technology Exchange

RedDress has been selected to exhibit ActiGraft®, a wound solution that recreates the natural wound healing environment by utilizing the patient’s own blood, at the Vizient Innovative Technology Exchange. Vizient, Inc, the nation’s largest member-driven health care performance improvement company, will hold the Exchange virtually September 21-23, 2021 read more

VIVEX Biologics, Inc. Launches New Family of Allografts, VIAGENEX™

MIAMI, May 19, 2021 /PRNewswire/ — VIVEX Biologics, Inc., a leading regenerative medicine company specializing in the development of naturally sourced treatments, announced the launch of VIAGENEX™, a family of amniotic allografts processed to retain the inherent mechanical properties of amniotic tissue and rich supply of extracellular matrix, growth factors, and cytokines read more

Study Of The LimFlow System Demonstrates Sustained Amputation-Free Survival And Wound Healing In Patients With No-Option Chronic Limb-Threatening Ischemia

Paris, May 20, 2021 — LimFlow SA, a pioneer in the development of minimally-invasive technology for the treatment of chronic limb-threatening ischemia (CLTI), a severe form of peripheral artery disease (PAD), today announced the publication of 12-month data from the full patient cohort in its PROMISE I study of the LimFlow Percutaneous Deep Vein Arterialization System in the Journal of Vascular Surgery. Results showed sustained positive outcomes for both amputation-free survival and wound healing. The minimally-invasive LimFlow System is designed to bypass blocked arteries in the leg and deliver oxygenated blood back into the foot via the veins in CLTI patients who are facing major amputation and have exhausted all other therapeutic options read more

Advanced Oxygen Therapy Inc. Named Among the 10 Most Innovative MedTech Solution Providers to Watch in 2021

(https://thehealthcareinsights.com/advanced-oxygen--inc-dedicated-to-resolving-acute-and-chronic-wounds-through-its-unique-multi-modality-two2therapy/) how AOTI is dedicated to resolving acute and chronic wounds through its patented cyclical-pressure Topical Wound Oxygen (TWO2) therapy. Thereby providing clinically proven complete healing outcomes and wound protective care to high-risk patients safely at home. Maintaining such continuity-of-care has become even more vital during the recent COVID-19 pandemic read more

Advanced Oxygen Therapy Inc. Named Among the 10 Most Innovative MedTech Solution Providers to Watch in 2021

OCEANSIDE, Calif., May 20, 2021 /PRNewswire/ — Advanced Oxygen Therapy Inc. (AOTI) announced today that it had been named among the 10 Most Innovative MedTech Solution Providers to Watch in 2021 by the journal The Healthcare Insights and is highlighted as the cover story of its May 2021 print edition … (https://thehealthcareinsights.com/advanced-oxygen-therapy-inc-dedicated-to-resolving-acute-and-chronic-wounds-through-its-unique-multi-modality-two2therapy/) details how AOTI is dedicated to resolving acute and chronic wounds through its patented cyclical-pressure Topical Wound Oxygen (TWO2) therapy. Thereby providing clinically proven complete healing outcomes and wound protective care to high-risk patients safely at home. Maintaining such continuity-of-care has become even more vital during the recent COVID-19 pandemic read more

A flexible multiplexed immunosensor for point-of-care in situ wound monitoring

Chronic wounds arise from interruption of normal healing due to many potential pathophysiological factors. Monitoring these multivariate factors can provide personalized diagnostic information for wound management, but current sensing technologies use complex laboratory tests or track a limited number of wound parameters. We report a flexible biosensing platform for multiplexed profiling of the wound microenvironment, inflammation, and infection state at the point of care. This platform integrates a sensor array for measuring inflammatory mediators [tumor necrosis factor read more

St. Louis Doctor Helps Patients Avoid Unnecessary Diabetic Amputations Using Minimally Invasive Procedure

ST. LOUIS, May 22, 2021 /PRNewswire/ — The Midwest Institute for Non-Surgical Therapy (MINT) is leading the way in providing early diagnosis and innovative treatments for St. Louis, Missouri, patients who suffer from vascular disease, greatly reducing the need for amputations … read more

Midwest Institute for Nonsurgical Therapy
Midwest Institute for Nonsurgical Therapy

Led by Dr. Goke Akinwande, a board-certified endovascular specialist, the Vascular Center at MINT is one of the few centers in St. Louis dedicated to the outpatient treatment of venous and arterial diseases. Since the Center opened in 2019, MINT has become a regional leader in preventing potentially life-threatening amputations among patients who suffer from diabetes. Dr. Akinwande and his team use innovative technology and non-surgical techniques to treat diabetic sores and prevent amputations.

Several prediction tools provide “objective” post-amputation outcome forecasts, but further work is needed

A recent systematic review and narrative synthesis has found several tools that demonstrate “acceptable-to-outstanding discrimination” for predicting key outcomes following major lower limb amputation. However, authors Ryan A Preece (Royal Gwent Hospital, Cardiff, UK) and colleagues note that “additional robust external validation” is needed to strengthen the clinical applicability of the prediction tools assessed. This research appeared online in the European Journal of Vascular and Endovascular Surgery (EJVES).

Can Topical Oxygen Have An Impact On DFU Healing?

Data continue to accumulate for some role of topical oxygen (TOT) in tissue repair and wound healing. A study from Golledge and colleagues in Australia reveals some interesting developments.1 Their systematic review and meta-analysis examined evidence for the benefit of topical oxygen therapy in healing diabetic foot ulcers (DFUs) … read more

What to Do When Sharp Debridement is Contraindicated

Sharp debridement is by far the fastest way to remove non-viable tissue from a wound bed. This modality must be performed by a licensed skilled practitioner using sharp instruments or tools to remove unhealthy tissue. It is reimbursed by most payers when documentation and medical necessity support its use. There are times when sharp debridement is contraindicated, however. This blog reviews the contraindications and alternatives to sharp debridement … read more

Topical oxygen therapy in the treatment of diabetic foot ulcers: a multicentre, open, randomised controlled clinical trial

Perfusion and blood oxygen levels are frequently insufficient in patients with hard-to-heal wounds due to poor circulation, vascular disruption and vasoconstriction, reducing the wound’s capacity to heal. This study aimed to investigate the effect of topical oxygen on healing rates in patients with hard-to-heal diabetic foot ulcers (DFUs) (i.e., non-responsive over four weeks) … read more

Army Wants New Medical Gel that Seals Off Hemorrhaging Wounds on the Battlefield

Army researchers are eyeing a promising new wound-care technology that could allow soldiers to seal hemorrhaging trauma wounds on parts of the body where pressure bandages can’t stop bleeding … The Army Research Laboratory, or ARL, is providing technical oversight on a new hemostatic gel, known as StatBond, that stops uncontrolled bleeding in noncompressible areas of the body such as the groin, armpit, neck and internal organs … read more

Sustainable fabric made from tree bark could cut MRSA infection rates

A traditional Ugandan cloth that uses tree bark to make sustainable textiles could be used to treat skin wounds after new research shows it has antimicrobial properties to fight against tough infections such as MRSA … MRSA—Methicillin-resistant Staphylococcus aureus—is an infection caused by bacteria that is resistant to many different antibiotics … continue

PolarityTE Announces Diabetic Foot Ulcer Trial Met Primary and Secondary Endpoint

PolarityTE, Inc. (Nasdaq: PTE) today announced preliminary topline data demonstrating that a multi-center randomized controlled trial evaluating treatment of Diabetic Foot Ulcers with SkinTE® plus standard of care (SOC) vs SOC alone (NCT03881254) met the primary endpoint of wound closure at 12 weeks and secondary endpoint of Percent Area Reduction (PAR) at 12 weeks. 100 patients were evaluated across 13 sites with 50 patients receiving SkinTE plus SOC and 50 patients receiving SOC alone … continue

Smart Socks? How This Tech Startup Is Targeting a Common Medical Problem

When Ran Ma told her parents she was dropping out of her master’s program in business administration to work on a sock prototype for diabetic patients, their reaction wasn’t exactly encouraging … “My dad said, ‘We’re not going to talk until you figure out your life,’ ” says Ma. “I don’t think my parents understood what I was doing.” … continue

Keys To Addressing Forefoot Plantar Ulcerations

The Centers for Disease Control and Prevention (CDC) estimates one in ten Americans have diabetes and one in three have prediabetes … Diabetes is also increasing among younger populations and can lead to sleep apnea, cardiovascular disease, pulmonary disease and risk of cancer … One major complication of diabetes is diabetic peripheral neuropathy (DPN), seen in 50 percent of the geriatric population with diabetes … continue

Could Patients Tap Their Way To Better Health?

When recommending activity regimens to patients, is one style of dancing an “untapped” resource? … A recent study in BMJ Open Diabetes Research and Care examined how tap dance as an activity might affect plantar pressure, postural stability, ankle range of motion and lower extremity functional strength for older patients at risk for diabetic foot complications … This randomized, single-blind, prospective study looked at 40 at-risk patients … continue

Extremity Gangrene Caused by HBV-Related Cryoglobulinemia Vasculitis in a Patient with Diabetes – A Case Report

We presented a case of hepatitis B virus (HBV)-related type III cryoglobulinemia vasculitis (CryoVas) characterized by extremity gangrene in a patient with diabetes. The 60-year-old female had a 10-year history of poorly controlled type 2 diabetes mellitus. She complained of sudden onset pain and swelling of toes which quickly progressed to gangrene, with fingers becoming pain and dark violet. The patient was initially misdiagnosed as diabetic foot (DF). Although DF is one of the common chronic complications of diabetes, it rarely involves the hand. What is more, the ischemic manifestations of the extremity were not consistent with the results of the vascular examination and immune system changes. The patient had Raynaud’s phenomenon, arthralgia, and extremity gangrene. Test results showed cryoglobulinemia multiple positive, polyclonal immunoglobulin with rheumatoid factor negative, lower complement 3, leukocytoclastic vasculitis, and HBV infection. HBV-related type III CryoVas was finally diagnosed, and a conservative therapy strategy was given … continue

Net Health Adds Industry Leader Proteus Genomics Lab Testing to Wound Care Platform

PITTSBURGH, April 28, 2021 /PRNewswire/ — Net Health, a leading provider of cloud-based software for specialty medical providers, announced today that users of the company’s EHR software solution, Net Health® Wound Care (formerly WoundExpert®), can now place in-chart orders for laboratory services through Proteus Genomics … The agreement is the first Net Health partnership with a laboratory services provider and continues the expansion of in-chart ordering options for clients. The program will initially be launched in April to Net Health customers in the Southeast, including Texas, Florida, North Carolina, Louisiana, Georgia, Mississippi, Tennessee, Arkansas and Alabama, with plans to expand nationally within the next year … Recognized as a market leader, Proteus Genomics is a highly-specialized genetic and microbiology laboratory facility … continue

T-Natural Killers and Interferon Gamma/Interleukin 4 in Augmentation of Infection in Foot Ulcer in Type 2 Diabetes

Epidemiology studies have shown that diabetes has the highest incidence of any chronic disease worldwide and is a huge threat to human health. Diabetes is clinically divided into types I and II.1 The prevalence of type II diabetes mellitus (T2DM) increases with age across all regions and income groups.2 Still, the prevalence is increasing in young age groups due to unhealthy life routines present since childhood … Insulin resistance (IR) associates with T2DM. Diabetes-related foot complications are important causes for disability worldwide. More than one-third of patients with diabetes worldwide will develop diabetic foot ulcer (DFU), which can progress to diabetic foot infection (DFI), and gangrene, consuming most of the healthcare costs dedicated for patients with diabetes. Around 17% of DFI will require amputation. Studies showed that patients with diabetes fear amputation more than death. The DFI patients will demand extensive debridement … continue

Predictive model identifies risk factors for major adverse limb events in diabetes

A risk score may be able to identify adults with type 2 diabetes at high risk for major adverse limb events, including in those without a history of peripheral artery disease, according to a study published in Diabetic Medicine … “This post hoc analysis of the EXSCEL trial yielded a predictive score for major adverse limb events among participants with diabetes that had a C statistic of 0.822, generally considered as very good … … continue

Wound care awareness

One in four families has a member with a chronic wound. For this reason, it is crucial for us as wound care experts to educate patients, caregivers and other health care providers about chronic wounds and advanced wound care treatment options … Nearly 7 million people in the U.S. are living with a chronic wound, and the number is expected to grow over the next decade. A chronic wound can be painful, dangerous and scary for patients and drastically affect people by diminishing their overall quality of life and potentially decreasing life expectancy if left untreated …They are also dangerous and damaging to our health care industry. The cost associated with chronic wounds is more than $50 billion annually, and this affects 14.5% of Medicare beneficiaries each year … continue

Music in the Wound Care Center: Effects on Anxiety Levels and Blood Pressure Measurements in Patients Receiving Standard Care

In the United States, chronic wounds (including venous ulcers, diabetic foot ulcers, and pressure ulcers/injuries) affect approximately 8.2 million people as estimated by a 2018 retrospective analysis of Medicare beneficiaries, and treatment costs ranged from $28 billion to $96.8 billion annually.1 These numbers are expected to increase with the growing aging population and higher prevalence rates of chronic diseases, such as diabetes and peripheral artery disease, in older adults.1 Patients with chronic wounds are reported as having poor quality of life associated with chronic pain and odorous exudate.2 The treatment of chronic wounds in the wound care center (WCC) requires wound assessment, minor procedures, and dressing changes. WCCs provide a specialized level of care using various wound care therapies to promote healing.3 Anxiety has been reported during treatment and may lead to increased pain sensation and stress.4 Pharmacological treatment has been a traditional way to alleviate anxiety; however, this can increase the risk of drug dependency and unwanted side effects.5 Nonpharmacological approaches are considered to be more desirable because of fewer side effects and greater cost-efficiency … continue

What Is a Kennedy Terminal Ulcer?

Many questions arise and confusion develops when wound care providers mention Kennedy terminal ulcers (KTUs). Because these wounds are not frequently seen, and because they develop rapidly and observation ends abruptly with the death of the patient, wound care providers may have never observed a KTU, even in a long career in wound care. Although the literature reveals that there is a lack of knowledge regarding the exact cause of a KTU, let’s look at the facts currently known from published resources … continue

May Hope Bloom and Grow

Depending on which part of the world you live in, after a dark winter, May signals the emergence of warmer weather, the birth of wildlife, and the blooming of flowers. In the Southern Hemisphere, the month of May signals the end of warm weather with the promise of cooler temperatures to provide relief. For still others, it marks the beginning of increasingly hot weather. As with so much, our judgments about May change based on our perspective. Our journal is an international journal—and in this issue (print and online) you will find articles from six different countries (Australia, Egypt, India, Korea, Spain, and the US) that address different aspects of skin care and wound healing. The diversity of these international viewpoints can enrich our toolkit for effective practice … continue

Nuo Therapeutics Announces Publication of Final Decision Memo for Autologous Blood Derived Products for Chronic Non-Healing Wounds by Centers for Medicare

HOUSTON, April 20, 2021 /PRNewswire/ — Nuo Therapeutics, Inc. (OTC Pink: AURX) (“Nuo” or the “Company”), today announced the recent publication of the final decision memo for Autologous Blood-Derived Products for Chronic Non-Healing Wounds (CAG-00190R4).  On April 13, 2021, Centers for Medicare & Medicaid Services (CMS) concluded in its final coverage decision memo (available at the URL at the bottom of this release) that Medicare will cover autologous platelet-rich plasma (PRP) for treatment of chronic non-healing diabetic wounds (DFUs) under section 1862(a)(1)(A) of the Social Security Act.  This final decision follows the favorable proposed decision memo which was published December 21, 2020 and followed by a thirty-day public comment period.  In its final decision memo, CMS concluded that the coverage for DFUs would be for a duration of 20 weeks and limited to devices whose FDA cleared indications include the management of exuding cutaneous wounds such as DFUs.  Coverage of autologous PRP beyond 20 weeks for DFUs and for the treatment of all chronic, non-healing wounds will be determined by local Medicare Administrative Contractors (MACs) … continue

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Reducing Disparities in Diabetic Amputations

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Foluso A. Fakorede, MD, a cardiologist in Bolivar County, MS, has used prevention, screening, and treatment strategies to reduce amputations by 88% in the Mississippi Delta area where he practices. Here, Dr. Fakorede discusses risk factors for peripheral arterial disease (PAD) and amputation in patients with diabetes, and how to reduce disparities in diabetic amputations.…

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Outpatient Diabetic Foot Ulcer Diagnosis With Positive Wound Culture Linked to Subsequent Hospital Admission

Outpatient diagnosis of a diabetic foot ulcer with a positive wound culture is associated with subsequent hospital admission for systemic infection, according to research results published in Open Forum Infectious Diseases … Researchers conducted an exploratory, retrospective study in order to evaluate the relationship between outpatient diagnosis of an index diabetic foot ulcer and any subsequent admissions for invasive bacterial infection including osteomyelitis, bacteremia, or endocarditis … read more

Q&A: CPT CODING FOR EXCISIONAL WOUND DEBRIDEMENT WITH VAC

Gloria Miller, CPC, CPMA, CPPM, former vice president of reimbursement services at Comprehensive Healthcare Solutions Inc. shares which CPT codes to use.
A version of this article was first published April 23, 2021, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2×4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)?

A: The debridement would be reported using CPT code 11042 (debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq cm or less). This procedure involves the sharp removal of nonviable subcutaneous tissue until viable tissue is encountered … read more

Wound healing, infection can be determined by genetics

Texas [US], April 25 (ANI): Researchers from Texas Tech’s Department of Biological Sciences and Natural Science Research Laboratory recently determined that some genes have an association with the pathogens that infect chronic wounds and hinder the healing process … In a first-of-its-kind study, researchers have determined that genetics may play a role in how wounds heal. Caleb Phillips, an assistant professor at Texas Tech University and director of the Phillips Laboratory in the Department of Biological Sciences, and doctoral student Craig Tipton led the study, “Patient genetics is linked to chronic wound microbiome composition and healing,” according to a study published in the open-access, peer-reviewed medical journal PLOS Pathogens.
Phillips, who also serves as Curator of Genetic Resources at the Natural Science Research Laboratory’s (NSRL) Robert J Baker Genetic Resources Collection, said the study determined that certain genes are associated with the number of bacteria and abundance of common pathogens in wounds … read more

Differentiation of Diabetic Foot Ulcers Based on Stimulation of Myogenic Oscillations by Transient Ischemia

Purpose: Diabetic foot ulceration is a chronic complication characterized by impaired wound healing. There is a great demand for a diagnostic tool that is able to monitor and predict wound healing.
Patients and Methods: Oscillations in the microcirculation, known as flowmotion, can be monitored very distinctly and precisely using the Flow Mediated Skin Fluorescence (FMSF) technique. The flowmotion response to hypoxia was measured quantitatively in 42 patients with diabetic foot ulcers.
Results: The flowmotion response to hypoxia parameters FM(R) and HS were used to differentiate the diabetic foot ulcers and correlate them with clinical status. In some cases, FMSF measurements were continued over the period of a year in order to monitor disease progress. The clinical status of the quarter of patients with the highest HS values (group A, HS = 50.2± 18.3) was compared to the quarter with the lowest HS values (group B, HS = 4.3± 1.7). The patients in the group B were identified as having low prognosis for healing and were characterized by higher incidences of hypertension, hyperlipidemia, prevalent CVD, neuropathy and nephropathy.
Conclusion: Impaired flowmotion responses to hypoxia induced by transient ischemia can be used for differentiation of diabetic foot ulcers and identification of cases with low prognosis for healing.

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SANUWAVE® Rebrands to Reflect Evolved Wound Care Solutions

“Energy First” Protocol Improves Clinical Outcomes

SUWANEE, Ga.–(BUSINESS WIRE)–SANUWAVE Health, Inc. (OTCQB: SNWV), focused on the development and commercialization of a robust and innovative advanced wound care product portfolio for the repair and regeneration of skin and vascular structures, today announced its rebranding. The new brand reflects the evolution of SANUWAVE’s solutions addressing the entire wound care pathway through its portfolio of noninvasive and biological response therapeutics that help expedite the wound healing process at the cellular level, resulting in less time and resources spent on more costly treatments …. full press release

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iWounds News

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Results of two-year study show Zilver Vena Venous Stent is safe and effective The results of a two-year study support the continued safety and effectiveness of the Zilver Vena Venous Stent (Cook Medical) in treating symptomatic iliofemoral venous outflow obstruction, according to findings presented at the 2021 meeting of the Society of Interventional Radiology (SIR;…

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