Category: Articles

The Medscape Physician Compensation Report is the most comprehensive and widely used physician salary survey in the United States. This year’s report represents almost 20,000 physicians in more than 30 specialties who responded to Medscape’s salary survey, providing their salary information, number of hours worked, amount of time spent seeing patients, what they find most rewarding and challenging about their jobs, and more … read more

Wound healing is a complex process that is highly dependent on many skin cell types interacting in a defined order. With chronic wounds, this process is disrupted, and healing does not normally progress. Although there are different types of chronic wounds, those occurring from injury, such as skin tears or pressure injuries, are some of the most common. These injuries are a result of repeated mechanical irritation. Moisture-associated skin damage is another condition that can contribute to chronicity.1 Understanding the causes and contributors to these injuries can help to minimize patients’ risk of developing them. It can also aid in the formation of an optimal treatment plan for when injuries do occur, which reduces the healing time and leads to better patient outcomes … read more

According to the Agency for Healthcare Research and Quality,1 more than 17,000 lawsuits related to pressure ulcers are filed annually in the United States, second only to wrongful death lawsuits. One of the greatest gifts to defense attorneys was when the Centers for Medicare & Medicaid Services (CMS) published F-Tag 314, finally acknowledging that some ulcers can occur despite best care. The facility essentially can maintain, “Hey, we did everything we were supposed to, and despite that, the patient developed that pressure ulcer”—that is, the ulcer was unavoidable. To prove unavoidability, proper documentation (proof) of best care needs to be in place, as well as documentation that all proper prevention and treatment measures were implemented … read more

The revolutionary bioengineered healing glove created by researchers at the University of Texas at Arlington Research Institute (UTARI) and the University of Washington has completed another key step on the road toward commercialization … Empowered by a $227,000 award from the Medical Technology Enterprise Consortium (MTEC), the REHEAL Glove team at UTARI and REHEAL LLC has successfully developed a manufacturing process for the technology. The MTEC agreement, awarded in October 2017, funded the development of this low volume manufacturing process, which has created 100 flexible polymeric gloves for early stage clinical trials … read more

Improper management at the Department of Veterans Affairs office in Indianapolis led to one man having a below-the-knee amputation, federal officials said … The U.S. Office of Special Counsel said that management at the office directed social workers to stop entering home health care consults into a computerized patient record system …The decision was coupled without properly implementing a change. The visits weren’t properly logged … “As a direct result, one veteran had to have his leg amputated after he was not provided timely wound care,” the Office of Special Counsel stated in a press release … read more

Wound healing is a complex process that is highly dependent on many skin cell types interacting in a defined order. With chronic wounds, this process is disrupted, and healing does not normally progress. Although there are different types of chronic wounds, those occurring from injury, such as skin tears or pressure injuries, are some of the most common. These injuries are a result of repeated mechanical irritation. Moisture-associated skin damage is another condition that can contribute to chronicity. Understanding the causes and contributors to these injuries can help to minimize patients’ risk of developing them. It can also aid in the formation of an optimal treatment plan for when injuries do occur, which reduces the healing time and leads to better patient outcomes … read more

     Microcirculation Therapy Clinical Evidence & Sponsoring the 3rd International Microcirculation Conference

 

he conference focuses on advancing scientific research and medicine in all areas of vascular biology/medicine. Biennially, the ESM-EVBO hosts a four-day conference, where vascular enthusiasts from biology, preclinical and clinical research groups, and opinion leaders gather to share new fundamental scientific insights and current pre-clinical advances. Its network now has over 500 members worldwide, including representation in over 30 countries … read more

     putting the NICE guidance into practice

 

NICE supports the case for adopting UrgoStart dressings to treat diabetic foot ulcers and venous leg ulcers in the NHS, because they are associated with increased wound healing compared with non-interactive dressings. UrgoStart dressings are therefore recommended as an option for people with diabetic foot ulcers or venous leg ulcers after any modifiable factors such as infection have been treated … read more

Diabetic foot ulcers debridement should be part of the standard of care, and repetitive weekly debridement may be beneficial … Written by Kristin Della Volpe … Frequent debridement of chronic wounds is associated with improved healing, according to James Wilcox, RN, lead author of a retrospective study of more than 300,000 wounds. Diabetic foot ulcers accounted for a large percentage of these wounds … “An effective healing strategy for chronic wounds should include an early and accurate diagnosis of wound etiology, as well as the appropriate application of debridement and advanced healing modalities in an effort to achieve optimal outcomes,” said Mr. Wilcox, who is Director of Research and Quality for Medical Affairs at Healogics in Jacksonville, FL, and Immediate Past President of the Baromedical Nurses Association … read more

Here at Digital Trends we have covered a surprising number of fascinating high-tech wound dressings, such as one made of spider silk and a futuristic Star Trek-style patch, which uses cold plasma as part of the healing process. Adding to this growing subgenre of stories is a new smart bandage developed by researchers at the University of Nebraska-Lincoln. Not only is it capable of checking whether a wound is infected, but it can also proactively treat it with medication if it deems this to be the case … read more

The immune system has long been recognized for its importance in eliminating pathogens. Recently, it has become appreciated for additional distinct roles in normal tissue biology, contributing to tissue development and maintenance. Further, it is being revealed as a major force in diseases as diverse as fibrosis, type 2 diabetes, and Alzheimer’s disease, as well as cancer. The immune system is exquisitely selective; more than a billion different adaptive immune lymphocytes (T cells and B cells) survey the body. These can individually be sensitized to antigens … Perhaps the best-developed exemplar for an immune response that is neither focused on destruction nor tolerance, but rather on achieving tissue homeostasis, is in wound healing and tissue repair. In early wounds, infiltration of inflammatory neutrophils and monocytes provides wound sterilization. In late wound-healing responses … read more

Printing layers of skin to help treat chronic wounds or burns may be on the horizon, thanks to a newly developed mobile skin bioprinting system … The skin bioprinter at work … Scientists at the Wake Forest Institute for Regenerative Medicine (WFIRM) in Winston-Salem, NC, have created a bioprinter that uses a person‘s own skin cells to create layers of new skin and apply them directly to the wound … A new paper, which now in the journal Scientific Reports, details the development of this new technology … The procedure involves harvesting major skin cells called dermal fibroblasts and epidermal keratinocytes from a biopsy of a person‘s normal skin tissue … read more

     in Europe for Dystrophic Epidermolysis Bullosa

 

The topical gene therapy candidate KB103 to treat dystrophic epidermolysis bullosa (DEB) has been granted PRIME (PRIority MEdicines) designation by the European Medicines Agency (EMA) … KB103 is a gene therapy candidate developed by Krystal Biotech to deliver a functional COL7A1 gene directly to skin cells using a modified and safe herpes simplex virus. Mutations in the COL7A1 gene are the underlying cause of DEB and lead to a defective production of COL7 protein, causing layers of the skin to separate and form blisters … read more

     Chronic Diabetic Foot Ulcers

 

Approximately 150 patients with Diabetic Foot Ulcers will be enrolled into the trial at fifteen Wound Care Centers and Hospitals across the United States of America. Patients will be selected to receive standard wound care or standard wound care plus Natrox Oxygen Wound Therapy for their wounds. Patients will be monitored for 12 weeks. The primary comparator between the groups will be complete wound healing at 12 weeks, but other parameters will be assessed, such as pain, wound size reduction and infection status … read more

Adults with diabetes and severe vitamin D deficiency are three times more likely to develop a diabetic foot ulcer than similar patients with sufficient vitamin D levels, according to findings from a meta-analysis published in Nutrition & Diabetes … “Vitamin D has been suggested to play an important role in many chronic diseases, such as diabetes,” Yimin Chai, MD, PhD, professor in the department of orthopedic surgery at Shanghai Jiao Tong University, China, and colleagues wrote. “Low serum vitamin D levels are associated with insulin resistance, impaired beta-cell function and the development of [diabetes]. There is also ongoing interest in the association between lower level of vitamin D and diabetic complications.” … read more

The American Podiatric Medical Association (APMA) announced today the launch of a spring campaign featuring Today’s Podiatrist, in conjunction with April’s National Foot Health Awareness Month. The campaign will educate the public about the wide range of capabilities of Doctors of Podiatric Medicine (DPMs), with a particular emphasis on their surgical expertise .. Today’s Podiatrist is a foot and ankle expert, specially trained to treat and evaluate patients based on individual needs. Whether that evaluation necessitates surgical intervention or conservative care, Today’s Podiatrist will provide the appropriate treatment … “There is no foot and ankle injury beyond the capabilities of Today’s Podiatrist,” said APMA President David G. Edwards, DPM. “We keep patients on their feet by recommending and executing the right treatment for that specific condition and individual. From performing complex ankle reconstructions to caring for diabetic foot ulcers, we are at the forefront of foot and ankle medicine and surgery … “No matter the severity of your condition, when you have a foot or ankle issue you should turn to Today’s Podiatrist. In some cases, surgery may be the most appropriate treatment to alleviate discomfort or restore the function of your foot. Individual factors determine the length and kind of rehabilitation required to ensure a successful recovery … read more

     from P. aeruginosa, Study Shows

 

Pseudomonas aeruginosa, the most common bacteria found in cystic fibrosis (CF) patients, uses a virus to go unnoticed by the host immune system, a new study shows … Treatment with a vaccine designed to help the immune system detect the virus was found to significantly reduce P. aeruginosa’s ability to infect mice, suggesting it might represent a new way to treat CF patients … The study, “Bacteriophage trigger antiviral immunity and prevent clearance of bacterial infection,” was published in the journal Science … P. aeruginosa, dangerous for CF patients, is also common in diabetic ulcers, bedsores, and burn wounds. At the moment there is no approved vaccine against these bacteria, and they are increasingly becoming resistant to antibiotics …The World Health Organization categorized P. aeruginosa as one of the most dangerous pathogens to human health … “I see this every day in my clinical practice,” Paul Bollyky, MD, PhD … read more

     Wounds to be Presented at Diabetic Limb Salvage (DLS) Conference

 

SALT LAKE CITY, March 27, 2019 /PRNewswire/ — PolarityTE, Inc. (Nasdaq: PTE), a biotechnology company developing and commercializing regenerative tissue products and biomaterials, announced today that two clinical outcomes abstracts on SkinTE™ for the treatment of diabetic foot ulcers (DFUs) will be presented at the Diabetic Limb Salvage (DLS) Conference in Washington, DC being held on April 4-6, 2019. SkinTE is a first-of-its-kind autologous, homologous human cellular and tissue-based product designed to regenerate full-thickness, functional skin for the repair, reconstruction and replacement of patient’s own skin … One of the abstracts, which includes data from the pilot study for a randomized controlled trial evaluating SkinTE for DFUs, has been recognized with a Top Abstract Special Designation. The abstracts are being presented by investigators, independent providers and users of the Company’s SkinTE product …Charles M. Zelen, DPM, Foot and Ankle Associates of Southwest Virginia and Director of Professional Education and Research Institute, will present an abstract on the use of SkinTE for treatment of DFUs. This abstract was selected as one of only three abstracts for a Top Abstract Special Designation. The abstract presentation will detail the status of healing of eleven patients treated with SkinTE as part of the pilot study … read more

Receives Contract from Premier Inc., a Leading Healthcare Improvement Company

 

Cura Surgical has been awarded a contract with Premier Inc., a leading healthcare improvement company. This agreement enables Cura Surgical to provide a comprehensive line of unique silver-plated nylon dressings in both Silverlon® and TheraBond® product ranges … Premier Inc., is a healthcare improvement company utilizing an alliance of approximately 4,000 U.S. hospitals and health systems and approximately 165,000 other providers and organizations … “Silverlon has been included in numerous studies that have clearly demonstrated that silver nylon dressings can offer advantages that help to improve patient care,” said Raul Brizuela, president and CEO of Cura Surgical and Argentum Medical, provider of Silverlon. “We are grateful for this opportunity and look forward to working with Premier member hospitals providing improved patient care, enhanced savings, and creating exceptional value through clinical excellence.” …Silverlon® antimicrobial silver-plated dressings provide 50-100xs more silver than other silver-based antimicrobial dressings, and Silverlon’s efficacy is supported by multiple independent, peer-reviewed and published clinical studies. These studies suggest Silverlon® Dressings can be an important element in wound care and that control of wound bacteria within the dressing may help reduce the risk of infection … read more

It’s gory, sticky and undoubtedly on the nose, but a blend of icing sugar, chicken stock and flexible resin is proving to be the just the right recipe for creating realistic foot ulcers as part of a world-first podiatric training initiative at the University of South Australia … Concocted by UniSA’s Dr Helen Banwell and Dr Ryan Causby the gooey mixture is being added to newly printed 3-dimensional feet and is designed to mimic infected and non-infected diabetic foot wounds …The 3D printed feet are created with wound-like cavities in place. Made from thermoplastic polyurethane (a plastic with many properties, including elasticity, transparency, and resistance to oil, grease … read more

Researchers at Binghamton University, State University of New York, have developed skin-inspired electronics to conform to the skin, allowing for long-term, high-performance, real-time wound monitoring in users … “We eventually hope that these sensors and engineering accomplishments can help advance healthcare applications and provide a better quantitative understanding in disease progression, wound care, general health, fitness monitoring and more,” said Matthew Brown, a PhD student at Binghamton University … Biosensors are analytical devices that combine a biological component with a physiochemical detector to observe and analyze a chemical substance and its reaction in the body. Conventional biosensor technology, while a great advancement in the medical field, still has limitations to overcome and improvements to be made to enhance their functionality. Researchers at Binghamton University’s Intimately Bio-Integrated … read more

BioRobotics, Providing Access to its Proprietary Pump Cartridge Technology

 

BOSTON and REDWOOD SHORES, Calif., March 26, 2019 /PRNewswire/ — HydroCision, a pioneer in the use of high velocity water jet technology for the minimally invasive treatment of musculoskeletal, spine and wound care conditions, today announced it has provided an exclusive worldwide license of its pump cartridge technology to PROCEPT BioRobotics for use in Urology … The agreement provides PROCEPT BioRobotics with the rights to use HydroCision’s innovative means of pumping high pressure fluids with their AquaBeam^® Robotic System, the world’s first surgical robot providing autonomous tissue removal for the safe and effective treatment of Benign Prostatic Hyperplasia (BPH) … “This global agreement with PROCEPT BioRobotics is another significant and strategic step to bring the value of our differentiated technology into new surgical applications affecting millions of people around the world,” commented recently appointed HydroCision CEO, Alain Tranchemontagne.  “This is yet another important validation of the value of our proprietary technology.” … read more

In my recent WoundSource webinar on management strategies of venous leg ulcers (VLU), I discussed the complex pathophysiology of VLUs and procedural interventions that can help them reach closure … VLUs comprise the majority of lower extremity ulcers. These wounds are costly to treat and have a high rate of recurrence. Sequelae of VLUs include infection or sepsis risk, pain, loss of mobility, and possible amputation. Healing of VLUs requires an understanding of their multifactorial etiology, consideration of patient-specific risk factors, careful assessment, and best practice management for optimal clinical outcomes … The following categories of VLU prevention, management and treatment can help to answer some of the most frequently asked questions about VLU … read more

Diabetic foot ulcer (DFU) is a problem worldwide, and prevention is crucial. We hypothesized that the inability of the skin to respond to pressure is involved in DFU pathogenesis and could be an important predictive factor to take into account. We included 29 patients with DFU and 30 patients with type 2 diabetes without DFU. Neuropathy and skin blood flow at rest were assessed in response to acetylcholine, sodium nitroprusside, local heating (42°C), and to nonnoxious locally applied pressure. Results were compared with those obtained from 10 healthy age-matched control subjects. Vasodilatation in response to pressure was significantly impaired in both groups with diabetes compared with healthy subjects. The vasodilator capacity to pressure was significantly lower in patients with DFU compared … read more

Researchers at Karolinska Institutet in Sweden have identified a mechanism that can explain the impaired wound healing in diabetes which can lead to diabetic foot ulcers. The study is published in the scientific journal Proceedings of the National Academy of Sciences. In diabetic mice, wound healing improved when the identified signalling pathway was blocked … Diabetic foot ulcerations are a common complication of diabetes that constitute a major medical, social and economic issue. The lifetime risk of a person with type 1 or type 2 diabetes developing a foot ulcer is around fifteen percent. The treatment options are currently … read more

A virus that infects a dangerous bacteria helps it thrive in wounds, according to a study by Stanford researchers. But a vaccine against the virus dramatically cuts the bacteria’s infectivity … A common bacterial pathogen called Pseudomonas aeruginosa produces a virus that substantially increases the pathogen’s ability to infect us, according to a study by investigators at the Stanford University School of Medicine … P. aeruginosa weaponizes its resident virus to exploit the immune system’s distinct responses to bacterial versus viral infections … read more

FDA for INVOKANA® (canagliflozin) for the Treatment of Chronic Kidney Disease in Patients with Type 2 Diabetes

 

The Janssen Pharmaceutical Companies of Johnson & Johnson announced today the submission of a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) seeking a new indication for INVOKANA^® (canagliflozin) to reduce the risk of end-stage kidney disease (ESKD), the doubling of serum creatinine, which is a key predictor of ESKD, and renal or cardiovascular (CV) death in adults with type 2 diabetes (T2D) and chronic kidney disease (CKD). The submission is based on results from the Phase 3 CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) study, which evaluated the efficacy and safety of INVOKANA^® versus placebo in this high-risk patient population when used in addition to standard of care.

 

Primary investigators will present the CREDENCE data during a late-breaking clinical trials session at the International Society of Nephrology (ISN) World Congress of Nephrology (WCN) Annual Meeting in Melbourne, Australia on April 15 at 8:30 am AEST (April 14 at 6:30 pm EDT in the U.S.). An open access live-stream of the late-breaking presentation can be accessed here (registration is required).

 

“Today, millions of people living with type 2 diabetes and chronic kidney disease are at high risk of experiencing kidney failure, and unfortunately, we have not seen treatment innovation for these patients in almost 20 years. Janssen’s application is a significant step toward bringing a much-needed, new standard of care for those living with these serious conditions,” said James List, M.D., Ph.D., Global Therapeutic Area Head, Cardiovascular & Metabolism, Janssen Research & Development, LLC. “We look forward to presenting the CREDENCE data at the ISN World Congress of Nephrology and working closely with the FDA to bring this important medicine as quickly as possible to people living with type 2 diabetes and chronic kidney disease.” … read more

Highly regarded as one of the world’s finest limb salvage events, MedStar Georgetown University Hospital’s DLS conference brings together the most eminent lower limb specialists for an unforgettable meeting. It is a multidisciplinary team approach meeting that provides each member of the healthcare team with the education and resources needed to heal wounds and prevent amputations. It features a prominent international faculty that promotes the importance of a multispecialty approach in limb salvage. The course highlights evidence-based approach with emphasis on take-home points, techniques, and functional outcomes ….  read more

With this initiative EWMA will investigate the barriers and possibilities of advanced therapies  in the next generation wound management … The primary deliverable is a document including an introduction to the available technologies based on cellular therapies, tissue engineering and tissue substitutes, which are all technologies associated with the clinical discipline of regenerative medicine. The document also describes new treatments based on physical therapies and the potential of sensors and software … read more

Integra LifeSciences (NSDQ:IART) today revealed its receipt of a warning letter sent by the FDA last week about quality system issues at a Boston-area plant that makes products to treat chronic wounds … Plainsboro, N.J.-based Integra said the FDA inspected the plant last October and November, resulting in a Form 483 covering the problems found there. The facility makes extracellular bovine matrix products that accounted for less than 4% of Integra’s sales last year, the company said … read more

     and Pseudomonas aeruginosa in Diabetic Foot Ulcers

 

This study was conducted to evaluate the antimicrobial effects of medicinal maggots of Lucilia sericata on Staphylococcus aureus and Pseudomonas aeruginosa on diabetic foot ulcers (DFUs) … The sample comprised 50 adult patients from the clinic of the Academic Center for Education, Culture and Research of Tehran University of Medical Sciences, Iran. All participants who had at least 1 DFU present for at least 12 weeks, an arterial brachial index value of more than 0.6, and a hemoglobin A_1c value of less than 8% were included in this study … read more

Managing the growing incidence of diabetes in England is set to be one of the major clinical challenges of the 21^st century. Estimates suggest that the number of people with diabetes is expected to rise to 4.2 million by 2030, affecting almost 9% of the population. More than 64 000 people with diabetes in England and Wales are thought to have foot ulcers at any given time. Around 7000 leg, foot or toe amputations are carried out each year in people with diabetes, with an estimated cost in 2014/15 at around £1 billion … read more

Diabetic foot ulcers (DFUs) are rising in prevalence globally, and particularly in the Gulf region. Infection remains a common and serious complication in managing DFUs. A need was identified for local guidelines that considered cultural and religious practices in the Gulf region, as well as clinical issues. This consensus document aims to provide practitioners with guidance on identifying and managing DFUs, which can be directly applied to local practice … download (pdf)

The rise of bacteria that are resistant to multiple drugs highlights the urgency of developing new antibiotics to combat lower extremity infection. Accordingly, this author explores the potential of new pharmacological agents such as tedizolid, oritavancin, dalbavancin and delafloxacin, and discusses other agents in the pipeline … read more

The benefits of having an annual comprehensive diabetic foot exam are too numerous to mention. If a patient sees his or her podiatrist along with one other member of the diabetic foot team, the relative risk reduction of a high level amputation will decrease, with some studies showing a reduction of as much as 80 percent … It’s a simple thing. Just the patient getting into see his or her foot doctor can yield significant benefits down the road. We outlined with the American Diabetes Association many years ago what goes into a good quality diabetic foot exam … read more

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

“We are pleased that Anthem is now covering our AmnioBand allograft solutions,” said Kim Rounds, Vice President of Wound Care at MTF Biologics. “As a nonprofit and the nation’s leading tissue bank, we are extremely pleased by Anthem’s decision to include AmnioBand for the treatment of diabetic foot ulcers. Our expanding portfolio, including viable cryopreserved placental membranes, ambient storage placental tissues, and AlloPatch® Pliable (a human derived reticular dermal matrix), provides wound care professionals and their patients with some of the most safe, clinically proven and cost effective treatment options for chronic wounds.”

Read more

 

The third annual Amputation Prevention Summit will be held on Saturday, March 23, 2019 at Memorial Hermann Greater Heights, 1635 North Loop West, South Tower, First Floor, Houston, Texas, drawing clinicians from Houston and surrounding region. Memorial Hermann is the only health system in the Houston area that is part of the Amputation Prevention Centers of America® network … This CME event aims to highlight the urgent nature of the diabetes epidemic, the prevalence of peripheral arterial disease and diabetic foot ulcers, and how healthcare professionals can change and improve their practice in order to reduce lower extremity amputations … Diabetes is among the top 10 leading causes of death in Texas and the leading cause of non-traumatic lower extremity amputation. The risk of leg amputation for people with diabetes is 15 to 40 times greater than for a person without diabetes. Within two to four years of unilateral limb loss, one-third of all patients lose the other leg. Sadly, only about 50 percent of amputees survive within five years following a leg amputation due to ongoing complications of the chronic disease. With the future incidence of diabetes projected to rise to 550 million people worldwide by the year 2030, limb salvage is becoming a viable alternative, often producing better outcomes than amputation … read more

Vomaris Innovations, Inc. reports the U.S. launch and first uses of a revolutionary new post-surgical wound dressing. Procellera^® FlexEFit™ Antibacterial Wound Dressing employs a novel ‘Link & Build’ design that enables it to be ‘built’ during application to seamlessly cover incisions of virtually any length or curvature with just one product configuration. It is an important addition to Vomaris’s line of wound care products powered by V.Dox™ Technology. The only technology of its kind in the world, it employs embedded moisture-activated microcell batteries that wirelessly generate microcurrents designed to mimic the skin’s electrical energy … Procellera FlexEFit was first used by Orthopedic Surgeons Dr. Jimmy Chow and Dr. Brandon Gough, co-founders of the Orthopedic Institute of the West at Abrazo Scottsdale Campus in Phoenix, AZ … read more

Editor’s note. While this pertains to Great Britain and Whales, the concerns are universal.

We’ve got the background problem of foot ulcers and diabetes, which is a major problem and one which has been traditionally, perhaps, neglected by people, health care professionals. But we know it obviously causes tremendous suffering to the people who’ve got a foot ulcer, whether or not they go on to amputation, which is always the major threat … But it also is enormously expensive. And people don’t think of diabetic foot ulcers as being a major health care issue. And yet, care of diabetic foot ulcers we know costs at least a billion pounds each year to the NHS. That’s just about 1% of the total NHS budget, so it is an enormous problem, we know that … read more

Imagine a day when a bioprinter filled with a patient’s own cells can be wheeled right to the bedside to treat large wounds or burns by printing skin, layer by layer, to begin the healing process. That day is not far off … Wake Forest Institute for Regenerative Medicine (WFIRM) scientists have created such a mobile skin bioprinting system — the first of its kind — that allows bi-layered skin to be printed directly into a wound … read more

Bandages infused with electricity can help heal wounds faster than typical bandages or antibiotics—but for years, researchers have not really understood why … A recent study by a team at The Ohio State University is offering new clues about the science behind those bandages, and researchers say the findings could help lead to better wound treatment … The bandages belong to a class of therapies called electroceuticals, which are devices that use electrical impulses to treat medical issues such as wounds … read more

A 52-year-old black man with type 2 insulin-dependent diabetes mellitus presents to hospital suffering from significant weakness and nausea; he says he has had no appetite for the past week, but has not been vomiting. He reports seeing blood in his urine, and that his urinary output has decreased … He looks very ill but shows no signs of distress – he is mentally alert and aware of his surroundings. He does not use over-the-counter medications or herbal remedies, nor does he smoke, drink alcohol, or use any illicit drugs … read more

     for chronic wound care

 

Average saving of $3,947 per patient, and increased patient quality of life also reported … A study published in PLOS ONE by academics in Australia and the UK, shows that specialist wound management clinics are the most cost-effective route for the care of chronic wounds with better results for patients … The research team includes Dr Rosana Pacella, Head of Research at the University of Chichester, West Sussex, UK as part of an international health economics collaboration including Dr David Brain, and other researchers at the Queensland University of Technology … read more

Imagine a day when a bioprinter filled with a patient’s own cells can be wheeled right to the bedside to treat large wounds or burns by printing skin, layer by layer, to begin the healing process. That day is not far off … Wake Forest Institute for Regenerative Medicine (WFIRM) scientists have created such a mobile skin bioprinting system — the first of its kind — that allows bi-layered skin to be printed directly into a wound … read more

According to the Centers for Disease Control and Prevention (CDC), myiasis is infection with a fly larva, usually occurring in tropical and subtropical areas … There are a number of ways to contract it–getting an infection from accidentally ingesting larvae, from having an open wound or sore, or through your nose or ears. People can also be bitten by mosquitoes, ticks, or other flies that harbor larvae. In tropical areas, where the infection is most likely to occur, some flies lay their eggs on drying clothes that are hung outside … read more

     by suppressing inflammation via down-regulating MAPK-JNK signaling pathway in diabetic foot patients

 

Negative pressure wound therapy displayed significant clinical benefits in the healing of diabetic foot wounds. In the present study, we investigated the mechanism of regulation of MAPK-JNK (Mitogen-activated protein kinase- c-Jun N-terminal kinase) signaling pathway by negative pressure wound therapy on these wounds …

Read the full article on Diabetes Research and Clinical Practice

     Standard of Care in Diabetic Foot Ulcers (DFUs)

 

This prospective, multi-center, randomized, controlled clinical study compares NuShield® plus SOC to SOC alone in subjects with chronic DFUs. NuShield® will be used along with standard of care on diabetic foot ulcers of greater than 6 weeks which have not adequately responded to conventional ulcer therapy … One hundred and twenty five (125) subjects with a chronic DFU ranging in size from 0.5cm2 and 25 cm2 will be randomized 1:1 to either NuShield® and SOC or SOC alone following the 14 day screening period. Following screening and randomization, subjects shall be seen weekly for up to 24 weeks. For subjects that heal prior to week 24, a healing confirmation visit shall occur two weeks later to confirm maintenance of complete wound closure … read more

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

Acelity subsidiary KCI said today that it launched its Abthera open abdomen negative pressure therapy system in Japan … The San Antonio-based company’s Abthera is a temporary abdominal closure system intended to allow surgeons to manage challenging abdominal wall openings where primary closure is not possible and to manage repeat abdominal entries … KCI said that the system has be validated in clinical studies, showing increased patient survival, improved primary fascial closure rates, shorter intensive care unit stays and improved outcomes … read more

There are many risk factors associated with chronic wound development, with age being an unchangeable one. The good news is, there are also changeable risk factors. Understanding how to prevent and treat a chronic wound is crucial when caring for older adults. To help older adults, caregivers, and the professionals working with them, below are answers to some common questions about chronic wounds and tips for how to educate on risk factors … There is no true definition for a chronic wound, but it is typically a wound that does not progress normally through stages of healing and has not healed within four weeks. There are many different types of chronic wounds, examples include diabetic foot ulcers, venous leg ulcers, and pressure injuries … read more

     among hospitalized patients with diabetes

 

A member of East Liverpool City Hospital management and a production team from EM-Media are flying to Iceland today to learn more about using cod skin in the treatment of wounds … Kerecis Omega3 is intact fish skin rich in naturally occurring Omega3 polyunsaturated fatty acids. When grafted onto damaged human tissue, such as a burn or a diabetic wound, the material recruits the body’s own cells and is ultimately converted into living tissue, significantly speeding the time needed to close an open wound, hospital officials said … read more

     in populations at risk of foot ulceration: A cross-sectional study

 

Researchers performed a secondary analysis of a multi-site cross-sectional study examining foot conditions in a large inpatient population admitted into the hospital for any medical reason on one day, to assess, in those with diabetes or peripheral neuropathy, the prevalence of wearing inadequate outdoor footwear, as well as the related factors. Inadequate outdoor footwear wearing was reported in 47% of 726 inpatients–49% of the 171 in the diabetes subgroup and 43% of 159 in the neuropathy subgroup. Women were identified wearing inadequate footwear more frequently. They identified the necessity for more efforts to enhance the adherence to footwear recommendations in these populations to prevent foot ulceration.

From Medlinx

The calf muscles have been called the body’s “second heart,” improving blood circulation when exercised, usually by walking. Structured exercise training (SET) increases calf muscle pump function, lower limb circulation, and walking capacity for those with limited ambulation due to peripheral arterial disease (PAD)¹ or venous insufficiency.² This resulted in the Centers for Medicare and Medicaid Services (CMS) decision to reimburse up to thirty-six 30- to 60-minute, properly supervised hospital outpatient or office-based SET sessions over 12 weeks to treat intermittent claudication for patients with PAD. Exercise improves acute wound healing in diabetic mice³ and healthy elderly humans …. read more

     nanotubes complexed with chitosan

 

Impaired wound healing is commonly associated with many health problems, including diabetes, bedsores and extensive burns. In such cases, healing often takes a long time, which subjects patients to various complications. This study aims to investigate whether single-wall or multi-wall carbon nanotubes complexed with chitosan hydrogel can improve wound healing … read more

Local injection of mesenchymal stem cells derived from autologous bone marrow shows promise in healing recalcitrant neuropathic diabetic foot ulcers, a novel study from Egypt shows … Presenting the results at the European Association for the Study of Diabetes (EASD) 2016 Annual Meeting, Ahmed Albehairy, MD, from Mansoura University, Egypt, said: “In patients who received the mesenchymal stem cells, ulcer reduction was found to be significantly higher compared with patients on conventional treatment after both 6 weeks and 12 weeks of follow-up. This is despite the fact that initial ulcer size was larger in the stem-cell–treated group.” … read more

from Vizient for Silverlon Antimicrobial Surgical Dressings

 

Cura Surgical announced its Silverlon Antimicrobial Surgical Dressings have received a 2018 Innovative Technology designation from Vizient, Inc., the largest member-driven health care performance improvement company in the country. The designation was based on the recommendations of health care experts serving on a member-led council who interacted with the product shown at the Vizient Innovative Technology Exchange held on Oct. 4, 2018. The council determined the technology had the potential to enhance clinical care, patient safety, health care worker safety or improves business operations of health care organizations … Containing more metallic silver than any other silver-based dressing, Silverlon Antimicrobial Surgical Dressings are supported by multiple, peer-reviewed clinical studies demonstrating the effectiveness of Silverlon technology across multiple specialties. When activated by moisture, silver ions are released in the dressing, providing immediate antimicrobial activity and a protective barrier against a broad spectrum of pathogens including MRSA and pseudomonas … read more

     Has Higher Rates of Healing in Pressure Ulcers Than Standard of Care

 

A recently published multi-center, randomized, controlled trial (RCT) demonstrated higher rates of healing when using OASIS® Wound Matrix with standard of care (SOC) for the treatment of full-thickness Stage III or Stage IV pressure ulcers than when using SOC alone … Pressure ulcers are open wounds caused by pressure. They often occur when an individual remains in one position for an extended period … read more

Corstrata, a provider of digital healthcare IT solutions and services for wound prevention and care management, announced today that it will sponsor the nation’s first Post-Acute Care Wound Nurse Excellence Award. The Post-Acute Care Wound Nurse Excellence Award sponsored by Corstrata is a new annual program designed to recognize and honor the individual contributions of wound care nurses for their knowledge and expertise in providing exceptional patient care using evidence-based best practices to accelerate patient wound healing, improve patient outcomes and instill excellence in his/her overall practice of wound management … Sponsored by CORSTRATA and hosted by the Post-Acute Care Symposium (PACS): Advancing Quality Outcomes Through Wound & Incontinence Education, the Post-Acute Care Wound Nurse Excellence Award is open to all nurses working in post-acute care settings. The first annual award will recognize one individual for his/her direct contribution to overall wound care excellence in a post-acute care setting … read more

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

Cura Surgical announced that their existing Vizient Contract (number MS11396) has been extended through January 31, 2021. This contract allows a comprehensive line of unique silver-plated nylon dressings in both Silverlon® and TheraBond® product ranges to be available to Vizient members across the nation. Vizient represents a diverse membership base that includes academic medical centers, pediatric facilities, community hospitals, integrated health delivery networks and non-acute health care providers representing more than $100 billion in annual purchasing volume … “We are thrilled to extend enhanced savings on our Silverlon® product line through this contract to Vizient members,” said Raul Brizuela, president and CEO of Cura Surgical and Argentum Medical, provider of Silverlon. “Combating hospital acquired infections, including surgical site infections, remains a top priority to healthcare facilities, and we are proud make a positive impact in this field.” … Silverlon® antimicrobial silver-plated dressings provide 50-100xs more silver than other silver-based antimicrobial dressings, and Silverlon’s efficacy is supported by multiple independent, peer-reviewed and published clinical studies. These studies suggest Silverlon® Dressings can be an important element in wound care and that control of wound bacteria within the dressing may help reduce the risk of infection … read more

medwireNews: A low-cost, smartphone-based infrared (IR) camera works as well as a high-end IR camera for the detection of diabetic foot ulcers (DFU), study findings indicate … “An advanced home assessment tool to monitor the foot in people with diabetes is desirable, and for this measurement of foot skin temperature is a promising modality,” Rob van Doremalen (University of Twente, Enschede, the Netherlands) and co-authors explain … They acquired plantar images of both feet from 32 participants (mean age 67 years, 75% men) with a current (n=28) or recently healed (n=4) DFU using the FLIR-One IR camera (FLIR Systems, Wilsonville, Oregon, USA) attached to a Motorola XT1642 Moto G4 Plus smartphone (Motorola Mobility LLC, Chicago, Illinois, USA) … read more

With the dangerous complications diabetes can cause, including amputation and mortality, could smarter technology reduce the risk for complications?

I really think we are approaching a time when the line is completely blurred between medical devices and consumer electronics. That was really on display with the podcast I did with Davide Vigano, CEO of Sensoria, on NPR’s Tech Nation with Moira Gunn, PhD. We discussed technology and wearables for patients with diabetes … read more

     and Pseudomonas aeruginosa in Diabetic Foot Ulcers

 

Subjects were randomly selected for the maggot-treated (treatment) or conventional treatment (control) group. Conventional treatments such as antibiotic therapy, debridement, and offloading were done for both groups, but maggot therapy (MT) was added to the protocol of the treatment group. Bacterial burden was monitored and compared for both groups using cultures … read more

     will help wounds healing

 

Group of researchers at Kaunas University of Technology, Lithuania are developing new generation sponge-like wound dressings with hyaluronic acid. Antimicrobial, antioxidant, anti-inflammatory wound dressings stimulate tissue regeneration and can be especially efficient in treating deep wounds that are difficult to heal … According to data, of the total healthcare expenditure in the European Union, wound management makes up 2-4%. A single chronic wound can cost up to 10 thousand EUR to treat, and it is estimated that up to 1.5% of EU population has one or more of such wounds … read more

There are seemingly countless factors that contribute to increased risk for the development of pressure injuries among certain patient populations. For those who require a stay in long-term care, the incidence of pressure injuries can be a concern. Conditions that contribute to increased risk for pressure injury development include (but are not limited to) diabetes mellitus, peripheral vascular disease, malignancy, prolonged pressure on an area of the body … read more

Patients with diabetes have at least double the risk for developing hospital-acquired foot ulcers vs. those without diabetes, according to a study published in BMJ Open Diabetes Research & Care … In a prospective, multilevel regression analysis, Frances Wensley, PhD, MBBS,formerly of the Royal Free Hospitals NHS Foundation Trust in London, and colleagues analyzed data from 18,946 patients with 28,642 admissions of at least 2 days to the Ipswich Hospital NHS Trust between October 2008 and September 2010, including 3,076 individuals with diabetes with 5,043 admissions. Patients included in the analysis were aged at least 50 years and developed a hospital-acquired foot ulcer at least 48 hours after hospital admission … read more

Gemco Medical said it has added a new brand of advanced wound-care products … The Gemcore360˚ line was designed to maintain a moist wound environment, address bioburden, reduce pain, minimize friction and increase overall patient comfort, according to the Hudson Ohio-based company. It includes transparent thin films, alginate dressings, silver alginate dressings, hydrocolloid dressings, foam dressings, and PHMB foam dressings … read more

Researchers are studying whether a common antibiotic used to treat everything from acne to urinary tract infections could be converted to a powerful topical treatment for diabetic lower extremity wounds … In a study published in Wounds online, a group of Canadian scientists explained their efforts to develop a stable, topical doxycycline hyclate. DOXY, a type of tetracycline, could be used to inhibit protein synthesis … read more

     of UrgoStart for diabetic and venous ulcers

The UK’s National Institute of Health and Care Excellence (NICE) has published new guidance recommending UrgoStart wound dressings (Urgo Medical) for treatment of diabetic foot ulcers and venous leg ulcers. In a press release, Urgo Medical states that use of the wound dressing could prevent more than 3,000 diabetes-related amputations … The conclusion of the NICE medical technology guidance is that UrgoStart is associated with increased wound healing compared with non-interactive dressings and could result in fewer ulcer-related amputations. The committee recognised that the treatment is also associated with significant cost savings for the UK National Health Service (NHS) and improved quality of life for patients … read more

The funding has been allotted by NASA Nebraska Space Grant, one of the 52 space grant consortiums in the U.S. Copper 3D, the Chilean/USA based 3D printing industry leader, has made it to the headlines for receiving a new grant from NASA. Reportedly, the Copper 3D has been granted the award for testing antibacterial 3D printing material properties, for medical devices used on the International Space Station … Recent reports revealed that the funding has been allotted by NASA Nebraska Space Grant, which is one of the 52 space grant consortiums in the USA. The group is currently highlighting its innovative faculty research projects in 2019, one of which is its collaboration with Copper 3D. This work is focused towards validating new antimicrobial 3D printing materials to develop medical devices and help reduce microbial risks during long-duration spaceflight missions … read more

     formation is associated with the inflammation of pressure ulcers

 

Evaluating the bacterial bioburden of pressure ulcers through bacterial count and pathogenicity is important but is currently difficult to perform in the clinical setting. In order to address this problem, we proposed two methods: 1) measurement of bacterial count using a quantitative device and 2) detection of biofilm formation by wound blotting. The purpose of this study was to investigate the relationship between the bacterial bioburden, assessed by combining these two methods, and the presence of wound inflammation … The participants of this cross-sectional study were patients aged >20years with category II, III, IV, or unstageable pressure ulcers examined during a routine round in an interdisciplinary pressure ulcer team between July 2014 and April 2018. Relevant clinical information, including bacterial count, biofilm formation … read more

Brand of Advanced Wound Care Products

 

HUDSON, Ohio, Feb. 5, 2019 /PRNewswire/ — GEMCO Medical, a national distributor of medical products, is pleased to announce the addition of the GEMCORE360˚ brand of advanced wound care products. GEMCORE360˚ Advanced Wound Care offers healthcare professionals a simple, clear and cost-effective wound care range while ensuring excellent clinical outcomes for their patients … The product line includes transparent thin films, alginate dressings, silver alginate dressings, hydrocolloid dressings, foam dressings and PHMB foam dressings – all designed to maintain a moist wound environment, address bioburden, reduce pain and increase overall patient comfort … It is estimated that approximately 15 to 25 percent of individuals with diabetes will develop a foot ulcer at some point in their lifetime. GEMCO Medical was a pioneer in the diabetes supply industry over 27 years ago and has continued to evolve bringing on new product categories. The GEMCORE360˚ Advanced Wound Care product line is a logical addition to offer their healthcare professionals, so patients can receive the necessary treatment and find relief … read more

WE NEED YOUR HELP IN ESTABLISHING WOUND CARE AS AN ACGME-APPROVED SPECIALTY!

– Reminder – Comments Due By February 20, 2019! –

 

Dear Wound Care Providers,
As you are aware, The American College of Wound Healing and Tissue Repair (ACWHTR) was founded almost a decade ago, with the sole purpose of helping to promote wound care towards specialty status. The ACWHTR submitted a proposal to the ACGME seeking formal acceptance and approval of this specialty at the highest level of medical education in the US. The ACWHTR has created a balanced educational fellowship program which, if approved, can be adopted by many academic centers and help drive innovation and improve the lives of many patients over the years.

 

Here’s How You Can Help
Please see Dr William Ennis’ letter inviting you to participate by reviewing the proposal and providing your feedback and comment to the ACGME. The enclosed PDF provides an explanation of the proposal and a link to the ACGME website to access both the proposal and comment document. The deadline for comment is February 20, 2019, so time is of the essence in getting your input on this important and historic proposal.

 

We appreciate your time and attention and willingness to participate.

View Proposal

StimLabs, a provider of regenerative technologies and products, has enrolled first patient in its trial designed to assess the safety and efficacy of Revita human placental graft in diabetic foot ulcers (DFUs) … Revita is said to be the first amniotic placental membrane allograft to capture the complete intact membrane in a shelf-stable format … The multi-center randomized, comparative and controlled trial will assess the efficacy of Revita full thickness placental allograft in improving wound closure rates and mean closure time in DFUs compared against current standards of wound care treatment … StimLabs is carrying out the trial at primary institutions/centers in the US. The trial includes patients who suffer from type 1 or 2 diabetes … read more

     about impact of heart health on wound healing

 

An alarming 33 percent of Americans currently suffer from cardiovascular disease …Throughout Heart Health Awareness Month, Southeastern Health’s Southeastern Wound Healing Center, a member of the Healogics network, will work to spread awareness about how cardiovascular diseases can affect the wound-healing process. Cardiovascular diseases and other issues with the heart and vessels can cause blockages that obstruct the flow of blood needed for proper wound healing … Chronic wounds affect about 6.7 million people in the United States and, if left untreated, an unhealed wound on the foot or leg can lead to a diminished quality of life and possible amputation. As many as 82 percent of leg amputations are the result of poor circulation of the affected limb … read more

McGuire and Sebag wrote: “Early diagnosis and intervention for diabetic foot wounds is essential for the prevention of complications associated with these ulcers. We are all familiar with the term ‘the golden hour’ with respect to the first 60 minutes after the onset of a stroke or cardiac arrest. The rapid initiation of aggressive care is the key to positive outcomes for the patient. In this way, the diabetic foot ulcer (DFU) also has a golden hour. The 4-week period following the onset of a diabetic ulcer is a critical time for treatments aimed at preventing the development of a chronic wound, staving off infection, and allowing for early closure of the skin. Wounds that have not achieved 50% closure within the first 4 weeks are destined to become difficult-to-heal chronic wounds. A fundamental component of early intervention and resolution of diabetic foot ulcers is the use of an array of offloading devices that includes everything from total contact casting to depth shoes with molded inserts.”¹ However, as they go on to document, there is no consensus among practitioners … read more

Researchers in Michigan have developed a novel nitric oxide sensing device, providing new insight into the causes of diabetic foot ulcers and possible avenues for treatment … Approximately 9 to 26 million diabetic patients around the world develop foot ulcers every year. These ulcers can double the risk of death for diabetic patients and may take up to 120 days to heal. Previous research has suggested that the impaired healing associated with diabetic foot ulcers is caused by unregulated levels of nitric oxide. Measuring live concentrations of this compound has posed a significant challenge due to its highly reactive nature. Previous studies have used nitrite, a stable byproduct, to measure nitric oxide levels indirectly … read more

Wound-care company Applied Tissue Technologies said it has won FDA clearance of its negative-pressure wound therapy product, the Platform Wound Dressing (PWD). The class II device represents the first-of-its-kind embossed negative pressure wound therapy device to be used without foam or gauze, according to the Hingham, Mass. company.

 

The PWD is a transparent dressing with an integral adhesive base and a permanently embossed, impermeable membrane that combines the traditional functions of the negative-pressure wound therapy membrane and foam/gauze in currently marketed negative-pressure devices. When the negative-pressure pump is switched on, the embossed membrane is pulled into direct contact with all geometries of the wound, eliminating the need for foam or gauze. The space created between the embossments provides primary channels for air and fluid, while folds in the membrane create secondary channels that provide an even distribution of negative pressure across the wound … read more

HMP, a leader in healthcare events and education, today announced that its annual Symposium on Advanced Wound Care (SAWC) Spring, taking place in San Antonio, Texas, May 7-11, 2019, and serving as the annual meeting of the Wound Healing Society (WHS), has received endorsements from the following prominent organizations:

• American Physical Therapy Association’s Academy of Clinical Electrophysiology and Wound Management:

“The Wound Management Special Interest Group of the American Physical Therapy Association’s Academy of Clinical Electrophysiology and Wound Management endorses the Symposium on Advanced Wound Care,” says Melissa Johnson, Chair, Wound Management Special Interest Group. “SAWC promotes interdisciplinary wound management and provides robust continuing education for physical therapists and other healthcare providers enabling optimal care for patients with wounds.”

• Critical Limb Ischemia (CLI) Global Society, the only organization solely dedicated to patients and the public health aspect of CLI:

“The Critical Limb Ischemia Global Society is endorsing the Symposium on Advanced Wound Care, an important conference that brings together the latest technologies, best practices, and research in all areas of wound care,” says founding board member, Jihad A. Mustapha, MD. “In our efforts to further share information and educate practitioners, we are especially proud to take part in this year’s Spring meeting by organizing a session on CLI awareness, diagnosis, and treatment.”

• National Pressure Ulcer Advisory Panel (NPUAP), the nation’s leading scientific expert group on pressure injury prevention and treatment, is endorsing and organizing three sessions at the meeting:

“The National Pressure Ulcer Advisory Panel is proud to endorse and support the Symposium on Advanced Wound Care, an important medical conference for those of us who rely on the latest technologies to remain up to date on wound care and prevention,” says Dr. Nancy Munoz, DCN, MHA, FAND, Assistant Chief, Nutrition and Food Services, Southern Nevada VA System. “As part of our support and engagement, we are delighted to present three sessions during this conference, sharing expertise and best practices in areas of pressure injury prevention and treatment.”

• American Venous Forum (AVF), which fosters cutting-edge research and clinical innovation and educates healthcare professionals, patients, and policy makers about venous and lymphatic diseases, is endorsing SAWC Spring and coordinating a session at the meeting:

“The American Venous Forum proudly supports the Symposium on Advanced Wound Care and its role in furthering education, particularly in the areas of venous and lymphatic disease,” says William Marston, MD, Professor of Surgery University of North Carolina; and Secretary of the Board of Directors of the American Venous Forum. “The cutting-edge topics and emerging therapies presented at this meeting are important as we all continue to strive for improvements in the prevention and treatment of patients with chronic nonhealing wounds.” … read more

     Clinical Trial for Its Nu-3 Antimicrobial In The Bahamas

 

SARASOTA, Fla., Jan. 17, 2019 /PRNewswire/ — Lakewood-Amedex Inc., a leading developer of novel anti-infective pharmaceuticals, announced today it had entered into a collaboration agreement with Nassau based Foot and Ankle International (Bahamas) to conduct two Phase 2 cDFU clinical trial for its topically applied Nu-3 antimicrobial used to eliminate infection and promote wound healing in patients with chronic diabetic foot ulcers (cDFU).   The trial will be under the direction of the prominent Bahamian surgeon, Dr. Daniel Johnson, who is the principal and chief researcher of Foot and Ankle International (Bahamas). He is an acknowledged expert on the treatment of diabetic foot ulcers.

 

Nu-3, which belongs to a proprietary class of antimicrobials called Bisphosphocins™, was first used as a solution to treat infected diabetic foot ulcers for seven days in a Phase 1/2 a clinical trial completed late 2017, when it was well-tolerated with no reported adverse events related to treatment. Results showed promising trends with median wound area reduction (change from baseline) of 65.5% in the 2% Nu-3 treatment arm, versus 29.9% in the placebo arm.

 

Lakewood-Amedex, based in Sarasota, Florida, has developed a proprietary gel formulation of Nu-3, said they intend to conduct a Phase 2 clinical trial commencing early 2019 using this compound to treat chronic diabetic foot ulcers (cDFU), with a 28-day treatment period using escalating concentrations of Nu-3.  The company believes this longer treatment with increased Nu-3 concentration will improve the potential to reach a point of healing or partial healing of the patient’s ulcers.  Lake-Amedex also intends to conduct an ‘adaptive arm’ of this clinical trial which will involve treating an increased number of patients with the most effective concentration of the gel formulation to achieve robust clinical data.

 

Steve Parkinson, President and CEO of Lakewood-Amedex, said the company will seek to recruit up to 120 patients for the entire clinical trial and has identified the Bahamas as not only an up and coming location for medical specialty in DFU in the treatment of diabetic foot wounds and ulcers, but also a potential source of large numbers of patients … read more

More than 15,000 physicians told Medscape how they feel about burnout, depression, and suicidal thoughts, and also how they attain happiness …  read more

After a flesh wound, skin cells march forward to close the gap and repair the injury. Findings from a team led by Leah Vardy at A*STAR’s Skin Research Institute of Singapore now demonstrate how a carefully regulated set of molecular cues helps coordinate this healing migration … Vardy was particularly interested in a trio of organic molecules known as polyamines, which play a role in cellular proliferation. “They are well studied in cancer, but much less is known about how changes in their levels can drive normal … read more

WHITSETT, N.C., Jan. 15, 2019 /PRNewswire/ — Medical device manufacturer medi USA announced the launch of its new ready-to-wear circaid® juxtalite® hd. The juxtalite hd is an inelastic compression wrap for the management of venous disease and venous leg ulcers for patients with moderate to severe edema … Designed with patented, juxtaposing band technology and made with a soft but strong fabric, the juxtalite hd applies graduated compression over the entire lower leg. The effortless juxtaposing bands promote patient self-management and improve quality of life, enabling patients to easily adjust their compression wrap throughout the day and expedite the wound healing process. The juxtalite hd comes with a pair of new circaid compressive undersocks, which apply compression to the foot and ankle areas to effectively manage foot and ankle swelling. circaid products are designed with a patented, Built-In-Pressure System™ (BPS™) that enables multiple, measurable, targeted compression ranges in a single product … read more

HMP, a leader in healthcare events and education, today announced twelve new course locations for the 2019 Wound Certification Prep Course (WCPC), the leading comprehensive wound care training program. Based upon the ongoing demand for clinicians to possess increased specialized knowledge in wound management, WCPC will be expanding its course to 12 cities nationwide, including San Francisco, Philadelphia, Nashville, and Chicago. Furthermore, three of the 12 programs will be co-located with HMP’s leading medical conferences: the Symposium on Advanced Wound Care (SAWC) Spring and Fall meetings, the world’s largest wound care educational events; and the Amputation Prevention Symposium (AMP) … read more

Orpyx’s foot sensor technology is installed in foot insoles and monitors foot pressure on diabetic patients and those with foot numbness. The tech will then send alerts to smartphones or smartwatches when a person is at risk for a foot injury, so preventative actions can be taken. The company indicated that 25 percent of people with diabetes develop foot ulcers over their lifetime, with one in five of those people experiencing complications that lead to amputation … read more

Scientists have created a ‘bio-scaffold’ that could speed up the healing of wounds.

 

In a world first, the researchers designed materials that ‘talk’ to the body’s injured tissue to support its repair through every stage of the healing process.

 

Known as traction force-activated payloads (TrAPs), the scientists believe the technique will have ‘far-reaching uses’ on everything from broken bones to diabetic foot ulcers.

 

TrAPs were designed by scientists at Imperial College London in a study led by Dr Ben Almquist from the department of bioengineering.

 

While collagen sponges are already used on burns and scaffold-like implants help to strengthen broken bones, the researchers felt a material should be created that met the changing needs of damaged tissue as it goes through the healing process … read more

New research, published in the journal Advanced Materials, paves the way for “a new generation of materials that actively work with tissues to drive [wound] healing.” … As more and more surgical procedures are performed in the United States, the number of surgical site infections is also on the rise … Chronic wounds that do not heal — such as those that occur in diabetes — often host a wide range of bacteria in the form of a biofilm … Such biofilm bacteria are often very resilient to treatment, and antimicrobial resistance only increases the possibility that these wounds become infected … read more

     of intralesional epidermal growth factor in patients with diabetic foot ulcers

 

Authors assessed 36 feet of 34 candidates (mean age 61 ± 13.7 years) to examine the long-term consequences of intralesional epidermal growth factor injections in the treatment of diabetic foot ulcers. They observed participants’ demographics, Wagner classifications, recurrence and amputation rates, 55.40 ± 12.15 of Foot Function Index, Short Form 36, and 65.92 ± 17.56 of American Academy of Orthopedic Surgeons Foot and Ankle Module scores at the final follow-up review. They noted a complete response of wound closure in 87.9% of lesions with granulation tissue greater than 75%. The meantime of wound closure was recorded from 25 to 72 days. Toe amputation was performed in only 2 participants due to ischemic necrosis, suggesting a low recurrence and concise amputation rate with complete wound healing …. read more

A retrospective study of 513 cases from a single Centre in the Northern Territory of Australia

Diabetic foot ulcers (DFU) are a common problem in longstanding diabetes. However, mortality outcomes in Australian patients with DFU are still unclear … All patients with DFU presenting for the first time to the Multi-Disciplinary Foot Clinic (MDFC) at Royal Darwin Hospital, Northern Territory Australia, between January 2003 and June 2015 were included in this study … read more

     KB103, for Wound Healing

 

All four patients with dystrophic epidermolysis bullosa (DEB) enrolled in a Phase 2 study testing the safety and efficacy of Krystal Biotech’s topical gene therapy candidate KB103 have received the treatment.

 

Results are expected to be known by mid-year.

 

The protein type 7 collagen (Col7) binds the two top layers of the skin, and its deficit results in blisters and wounds. Mutations in the Col7A1 gene encoding Col7 results in either non-working or insufficient levels of Col7, causing the skin blistering observed in DEB patients.

 

KB103 is a gene therapy candidate designed to deliver functional Col7 directly to the impacted cells with the help of a modified herpes simplex virus (HSV-1;  this modified virus is unable to cause disease).

 

In the ongoing six-month study (NCT03536143; GEM-1), underway at Stanford University, KB103 or placebo were applied directly to skin wounds (topical administration) of four DEB patients, two adults and two children (age 5 or older) … read more

The healing of wounded skin in diabetes can be sped up by more than 50 percent using injections of stem cells taken from bone marrow, a new study in mice shows.

 

The research, led by scientists at NYU School of Medicine, focused on a chain of events in diabetes that makes skin sores more likely to form and less likely to heal.

 

Namely, the body’s failure in diabetes to break down dietary sugar creates molecules called free radicals that can wreak havoc on cells and damage their DNA. These free radicals also trigger an inrush of immune cells and chemicals meant to fight infection that, researchers say, instead kill normal cells and cause diabetic skin ulcers. These wounds, they note, can take twice as long to heal as in healthy mammals and are prone to infection.

 

Published in the January issue of the journal Diabetes, the study showed that the injected stem cells restore a cell signaling pathway called Nrf2/Keap1, recently shown by the NYU team to be disrupted in diabetes. The rebalancing brought on by stem cell therapy, the researchers say, decreased wound healing time to 21 days in treated diabetic mice compared with 32 days in untreated diabetic mice. By contrast, normal mouse skin wounds usually heal in 14 days.

 

“Our study shows that in mice, stem-cell-based therapies can stimulate the Nrf2/Keap1 pathway to counteract … read more

Using electricity to treat skin wounds may sound unconventional, but scientists in China and the US have developed a self-powered bandage that accelerated wound healing in rats. The findings are published in the journal ACS Nano. Skin has a remarkable ability to heal itself, but in some people, such as those suffering from diabetes, wounds heal very slowly or not at all. Such patients are thus at risk of chronic pain, infection and scarring. Doctors have explored various approaches to help chronic wounds heal, including bandaging, dressing, exposure to oxygen and growth-factor therapy, but these methods often show limited effectiveness. Meanwhile, as early as the 1960s, researchers have observed that electrical stimulation could help skin wounds heal. However, the equipment for generating an electric field is often large and may require patient hospitalization … Read more

DeRoyal’s Continuum solution consists of RFID tags and GPS units attached to negative pressure wound pumps, so that each pump can be tracked from the time it is assigned to a patient until that individual is finished using the pump at home, following discharge … Health-care technology company DeRoyal has released a solution for hospitals employing its Continuum UHF RFID-based platform, for use in tracking pumps that are utilized for negative pressure wound therapy (NPWT). The system leverages RFID technology built into cabinets, as well as tags and GPS technology—along with cellular and satellite connections—built into pump units to identify where they are located in real time. The solution enables the pumps to be used at hospitals, and to travel with patients after they are discharged, with insurance companies billed accordingly … read more

In mid-November 2018, the U.S. Department of Health and Human Services finally released new physical activity guidelines (as a 2nd edition) to update their previous set from a decade before. Various activity guidelines for adults with diabetes have been updated several times in the interim, including a 2010 position statement on exercising with type 2 diabetes published jointly by the American College of Sports Medicine and the American Diabetes Association; a 2016 ADA position statement on exercise and physical activity for all types of diabetes ; and a consensus statement on being active with type 1 diabetes published in The Lancet in 2017  … In those three sets of recommendations specific to diabetes, it was clear that everyone with diabetes can benefit from being more regularly active … read more

Advancements in molecular microbiology, microscopy technology, and techniques for study of bacteria have increased the ability to identify the existence of biofilms, but there still remains the unknown, such as differentiating between planktonic bacteria and biofilm.¹ Chronic non-healing wounds harbor bacteria across the wound etiology classification.^2–4 Malone et al. determined that the prevalence of biofilms in chronic wounds was 78.2% (confidence interval, 61.6–89, P < 0.002).² The development of biofilms moves through a common pattern: attachment, microcolony formation, maturation, and dispersion. The initial attachment is reversible, but the attachment becomes stronger as cells multiply and change their gene expressions. This cell communication process is referred to as quorum sensing, allowing cells to survive … read more

     Reproducibility and accuracy of a wound measurement app

 

The wounds of 87 patients were measured using the Swift Wound app and a ruler. The skin surface temperature of 37 patients was also measured using an infrared FLIR^™ camera integrated with the Swift Wound app and using the clinically accepted reference thermometer Exergen DermaTemp 1001. Accuracy measurements were determined by assessing differences in surface area measurements of 15 plastic wounds between a digital planimeter of known accuracy and the Swift Wound app. To evaluate the impact of training on the reproducibility of the Swift Wound app measurements, three novice raters with no wound care training, measured the length, width and area of 12 plastic model wounds using the app. High inter-rater reliabilities (ICC = 0.97–1.00) and high accuracies were obtained using the Swift Wound app across raters of different levels of training in wound care. The ruler method also yielded reliable wound measurements (ICC = 0.92–0.97), albeit lower than that of the Swift Wound app. Furthermore, there was no statistical difference between the temperature differences measured using the infrared camera and the clinically tested reference thermometer … read more

     and Managing Wound Bioburden

 

Advancements in molecular microbiology, microscopy technology, and techniques for study of bacteria have increased the ability to identify the existence of biofilms, but there still remains the unknown, such as differentiating between planktonic bacteria and biofilm.¹ Chronic non-healing wounds harbor bacteria across the wound etiology classification.^2–4 Malone et al. determined that the prevalence of biofilms in chronic wounds was 78.2% (confidence interval, 61.6–89, P < 0.002).² The development of biofilms moves through a common pattern: attachment, microcolony formation, maturation, and dispersion. The initial attachment is reversible, but the attachment becomes stronger as cells multiply and change their gene expressions. This cell communication process is referred to as quorum sensing, allowing cells to survive … read more

SHOREVIEW, Minn., and TORONTO, On, Nov 30 2018. Maxwell Healthcare Associates (MHA), a post-acute operational, financial, technological and regulatory consulting firm, today announced Swift Skin and Wound as its exclusive digital wound care management solution of choice for MHA home health clients.

The partnership comes just a few weeks before the January 2019 rollout of new Center for Medicare & Medicaid Services rules surrounding pressure ulcer prevention and management.

“At Maxwell we believe technology is key to not only surviving but thriving amid constant regulatory changes and reimbursement cuts,” said MHA CEO Tom Maxwell. “We began searching for a wound care technology for our clients and found it in Swift. More than 1,000 facilities are already successfully leveraging Swift Skin and Wound for better clinical outcomes. It’s the only one with a home health-specific focus build that allows home health clinicians to document in and out of the home.”

Swift Skin and Wound significantly improves clinical and administrative wound care management workflows through: the Swift app, which captures wound care information as easily as taking a picture; the Swift HealX, an FDA-registered adhesive marker applied to calibrate wound images for size, color and lighting; and Swift Dashboards that display real-time healing and treatment to help clinicians and administrators identify risks immediately and improve care … read more

Skin has a remarkable ability to heal itself. But in some cases, wounds heal very slowly or not at all, putting a person at risk for chronic pain, infection and scarring. Now, researchers have developed a self-powered bandage that generates an electric field over an injury, dramatically reducing the healing time for skin wounds in rats. They report their results in ACS Nano … read more

A pair of washable and reuseable socks with a special sensor could be key to continuously monitoring foot temperature in patients with diabetic neuropathy, according to a study in JMIR sponsored by Siren, maker of the socks. Researchers found that the socks were able to report temperature within 0.2 degrees Celcius of the reference standard, and that patients found the technology useable.

 

“The temperature studies conducted show that the sensors used in the socks are reliable and accurate at detecting temperature and the findings matched clinical observations,” the researchers of the study wrote. “Continuous temperature monitoring is a promising approach as an early warning system for foot ulcers, Charcot foot, and reulceration.” … read more

Healogics Research ServicesSM provides comprehensive market and clinical analytics that enable access to the largest database of wounded patients in the world. Healogics Research Services team analyzes comprehensive patient-level data to guide population identification, aid in study protocol development and identify patients for potential enrollment in late phase studies. JACKSONVILLE, Fla.–(BUSINESS WIRE)–Healogics®, the nation’s largest provider of advanced chronic wound care services, today announced the debut of their newest service: Healogics Research ServicesSM. With robust clinical data on treatments and outcomes of over 1.8 million patients with 5.2 million wounds, Healogics has the largest repository of wound care-specific clinical encounter data in the industry. This data enables Healogics Research Services to generate real world insights that drive patient outcomes, product effectiveness and appropriate utilization.

 

“With our nationwide network of nearly 700 Wound Care Centers®, we care for more than 330,000 patients living with non-healing wounds each year,” said David Bassin, Chief Executive Officer at Healogics. “These numbers translate into meaningful data that enables us to better reach and improve healing for more people living with chronic wounds. We are excited about the unlimited opportunities and insights this new service offers us, our partners and, most importantly, our industry.” … read more

Agreement with Highmark to Improve Patient Engagement, Raise Adherence and Lower Costs

 

SAN ANTONIO–(BUSINESS WIRE)–KCI, an Acelity Company, a global leader in advanced wound management, and Highmark Inc., a national diversified health care insurance provider, today announced they have entered into a performance-based agreement for the KCI iOn PROGRESS™ Remote Therapy Monitoring Program which aims to improve overall patient experience, while lowering costs through increased engagement and adherence. Used in conjunction with the ACTIV.A.C.™ Therapy System, iOn PROGRESS™ Remote Therapy Monitoring Program consists of 3 key components:

 

• Monitoring: A proprietary remote monitoring module attached to the ACTIV.A.C.™ Therapy device enables secure transmission of therapy data to KCI.
• Engagement: A highly trained team of KCI Virtual Therapy Specialists (VTS) analyze the data and interact directly with patients and healthcare professionals to support adherence.
• Adherence: 73% of patients demonstrated an increase in hours of NPWT use per day following an adherence call from a Virtual Therapy Specialist. A lower average 90-day wound-related cost was associated with those receiving remote therapy monitoring.¹

The agreement is the first-of-its-kind for negative pressure wound therapy (NPWT) and creates a performance-based payment structure for reducing total wound care costs. The partnership is a result of a diligent evaluation process by Highmark to understand how the iOn PROGRESS™ Remote Therapy Monitoring Program impacts its members in alignment with their commitment to improve quality while lowering total cost of care …. read more

Medical products and technologies company ConvaTec has welcomed the government’s support for the wound care industry as part of the Life Sciences Sector Deal, and has outlined its own objectives to supporting the government’s actions.

 

The company has been working with the Association of British HealthTech Industries, healthcare providers and UK academia to identify ways of improving patient outcomes and maximise financial efficiency in the wound care industry. This will include the use of new digital clinical decision support tools to try and support health professionals and patients.

 

Simon Whitfield, vice president & UK general manager of ConvaTec said: “We are proud to be contributing to the Wound Care Sector Deal, which brings key stakeholders across the NHS, government and industry together to reduce variation in wound assessments and deliver better outcomes for patients and healthcare professionals … read more

     an Innovative Treatment for Diabetic Foot Wound Healing

 

URGO Group, through its Urgo Medical division, received the Prix Galien France 2018 in the medical device category for UrgoStart®, the first dressing to have demonstrated clinical efficacy in the treatment of chronic wounds, especially in diabetic foot ulcers. This prestigious award recognizes URGO’s work and investment in R&D and its ongoing commitment to innovating for patients.

 

Urgo Medical: innovation as part of its DNA. URGO Group invests €25 million a year in R&D, in particular on medical technologies related to chronic wound healing.

 

“The prestigious Prix Galien rewards six years of collective hard work. Our R&D teams have spared no effort in developing the innovative UrgoStart® wound dressing,” said a beaming Hervé Le Lous, Chairman of URGO Group. “Our goal is to enable many more people to heal much faster, which will be a major benefit for patients, doctors and nurses, and society as a whole.”

 

UrgoStart®: a breakthrough in diabetic foot wound healing

 

With close to 425 million people affected worldwide, diabetes has become an epidemic that is growing steadily [1]. Nearly one out of every four patients with diabetes will suffer from a diabetic foot ulcer at least once in their lifetime[2].

 

Such wounds are also a major risk of infection which can lead to amputation and even death.

 

With one amputation carried out every 20 seconds, diabetes is the world’s leading cause of amputation[2]. In light of this finding, Urgo Medical launched the Explorer clinical study[3] in France, Spain, Italy, Germany and the UK, with the outcomes published in March 2018 in The Lancet Diabetes & Endocrinology. The results demonstrated the efficacy of UrgoStart® which led to a 60% increase in wound closure compared with standard care and reduced wound closure time by 60 days from an average period of 180 days.

 

The first dressing to be deemed a local treatment, UrgoStart® is a French innovation recognized at the international level and now honoured by the Prix Galien.

 

URGO Group: https://www.urgo-group.com/

Prix Galien France: https://www.prixgalien.fr/

1. International Diabetes Federation. IDF Diabetes atlas. 8th ed. 2017. Brussels: International, International Diabetes Federation https://www.idf.org/e-library/epidemiology-research/diabestes-atlas.html

2. Whiting, D. R., Guariguata, L., Weil, C., and Shax, J. 23011. “IDF Diabetes Atlas: Global Estimates of the Prevalence of Diabetes for 2011 and 2030.” Diabetes Res. Clin. Pract. 94 (3):311-21

3. Michael Edmonds, José Luis Lázaro-Martínez, Jesus Manuel Alfayate-García, Jacques Martini, Jean-Michel Petit, Gerry Rayman, Ralf Lobmann, Luigi Uccioli, Anne Sauvadet, Serge Bohbot, Jean-Charles Kerihuel, Alberto Piaggesi. Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Lancet Diabetes Endocrinol 2018;6 (3) :186-196

Press release from PR Newswire

     to Skin Temperature Monitoring in Journal of Medical Internet Research (JMIR)

 

— Paper details results of first at-home, continuous, wireless temperature monitoring system to detect onset of diabetic foot ulcers caused by neuropathy

— Temperatures measured by standalone sensors were within 0.2℃ of the reference standard

–Data demonstrates potential as promising approach for early warning of foot ulcers, Charcot foot, and re-ulceration

 

SAN FRANCISCO–(BUSINESS WIRE)–Siren, the health technology company that developed Neurofabric™, a machine-washable, machine-dryable smart textile with built-in sensors, today announced publication of a foundational paper supporting its approach in Journal of Medical Internet Research (JMIR), the leading peer-reviewed journal for digital medicine, and health & healthcare in the Internet age. In the paper, a team of international researchers led by Ran Ma, co-founder and CEO, and Alexander M Reyzelman, DPM; Samuel Merritt University, detail the role of Siren’s Diabetic Sock and Foot Monitoring System in maintaining continuous, wireless skin temperature monitoring for users at-home, demonstrating the potential for the reduction of foot ulceration for diabetic patients.

 

“Diabetic foot ulcers (DFU) result in considerable cost to the healthcare system when immediate ulcers, social services, home care, and subsequent ulcers are taken into consideration,” said Alexander M Reyzelman, DPM; Samuel Merritt University and lead author on the paper. “The cost per ulcer is over $33,000 per year and the cost per leg amputation is more than $100,000 per year. Over 100,000 legs are lost to diabetes each year. In diabetic foot complications such as foot ulcers, elevated temperatures in regions of the foot have been shown to be a precursor for ulceration.”

 

The JMIR publication details Siren’s pilot study of its Diabetic Sock and Foot Monitoring System to assess how comfortable their sensor-embedded socks were for daily use, and whether observed temperatures correlated with clinical observations.

 

In the study, patients wore the socks at home for a median of 7 hours, reporting that they felt just like their normal, everyday socks. Their stated willingness to wear the socks every day underscores the socks’ suitability for home use, suggesting that Neurofabric can seamlessly integrate into the life of the wearer.

 

“Several tools have been developed to measure plantar temperatures and the progression of foot ulcers, but they only measure temperature once a day which can lead to false-positives, or are only available for in-clinic use and not at home,” said Ran Ma, co-founder and CEO of Siren. “Now, for the first time, we highlight the striking connection between our Neurofabric’s powerful ability to capture data at home, every single second. The data is incredibly meaningful—it’s the largest amount of patient data that physicians have had wireless access to in real-time. This solidifies the potential for Neurofabric to change the trajectory of diabetic foot ulcerations and the many complications that can occur from it—including sepsis, and lower limb amputations.”

 

Patients also reported that Siren’s mobile app was easy to use and navigate. Through the mobile app, wearers can view the current temperature as measured at six points on the user’s foot. While the app was not set up to generate alerts in this study, users can receive a notification on their phone when a temperature increase is detected between contralateral positions.

 

“Digital health is a vast and burgeoning field and spans several aspects of health management—Neurofabric can facilitate the management of chronic conditions at home, including the effective and timely management of DFUs,” said Henk Jan Scholten, co-founder and COO of Siren. “The JMIR publication sheds light on both the ability of these Neurofabrics to improve quality of life for diabetes patients, and Siren’s first use-case to empowering people to take their health into their own hands.”

 

Siren is initiating a large-scale patient study in 2019.

 

Read the JMIR paper in full here: Continuous Temperature-Monitoring Socks for Home Use in Patients With Diabetes: Observational Study

 

About Siren

 

Founded in August 2016, Siren is a health technology company and the maker of Neurofabric™, machine-washable, machine-dryable smart textiles. Siren’s first product, Siren Diabetic Socks, are designed to help people with diabetes avoid amputations. Siren was previously named AARP Consumer’s Choice Award winner, 2017 CES TechCrunch Hardware Battlefield, 2018 CES Best of Innovation, Fast Co.’s 2018 Innovation by Design Award Honorable Mention, and 2018 ADA Healthtech Showcase winner. Siren’s investors include DCM, Khosla Ventures and Founders Fund.

press release from BusinessWire

SHOREVIEW, Minn., and TORONTO, On, Nov 30 2018. Maxwell Healthcare Associates (MHA), a post-acute operational, financial, technological and regulatory consulting firm, today announced Swift Skin and Wound as its exclusive digital wound care management solution of choice for MHA home health clients.

 

The partnership comes just a few weeks before the January 2019 rollout of new Center for Medicare & Medicaid Services rules surrounding pressure ulcer prevention and management.

 

“At Maxwell we believe technology is key to not only surviving but thriving amid constant regulatory changes and reimbursement cuts,” said MHA CEO Tom Maxwell. “We began searching for a wound care technology for our clients and found it in Swift. More than 1,000 facilities are already successfully leveraging Swift Skin and Wound for better clinical outcomes. It’s the only one with a home health-specific focus build that allows home health clinicians to document in and out of the home.”

 

Swift Skin and Wound significantly improves clinical and administrative wound care management workflows through: the Swift app, which captures wound care information as easily as taking a picture; the Swift HealX, an FDA-registered adhesive marker applied to calibrate wound images for size, color and lighting; and Swift Dashboards that display real-time healing and treatment to help clinicians and administrators identify risks immediately and improve care … read more

A record 169 people a week are having to undergo an amputation procedure as a result of diabetes, a study has found.

 

Analysis by the charity Diabetes UK found that 26,378 people had lower limb amputations linked to diabetes between 2014 and 2017, a 19.4% rise from 2010 to 2013. Unhealed ulcers and foot infections are the main cause of diabetes-related amputations. Diabetes affects almost 3.7 million people in the UK … read more

Demonstrated Substantial Clinical and Cost Benefits in Case Series Presented at Cleveland Clinic Accredited VEITH Symposium

 

SAN ANTONIO–(BUSINESS WIRE)–Tissue Regenix Group (AIM:TRX) (“Tissue Regenix” or “The Group”), a regenerative medical devices company, recently shared findings from a case series that concluded DermaPure, a decellularized human dermis product, was more cost effective, prompted faster healing times and improved quality of life versus other available options.

 

Undertaken by David Naar, MD, founder of Premier Vein Clinic, LLC. in collaboration with the Cleveland Clinic, the case series was shared at the 45th annual VEITH symposium and included six patients presenting with acute or chronic wounds, including necrotizing fasciitis and venous leg ulcers. Through the retrospective and prospective collection of data, the investigation showed a 65% mean surface area reduction in wound size at six weeks following an average of 1 DermaPure application per patient. One patient in the series, presented with a wound duration of over 10 years and had previously failed with multiple different graft options. Dr. Naar therefore concluded that DermaPure offers a significant health economic benefit to both patients and physicians in addition to its proven clinical advantage over current standard treatments … read more

     Tissue Products for the Treatment of Diabetic Foot Ulcers

 

In its recently released research compendium Diagnosis and Management of Diabetic Foot Complications, the American Diabetes Association (ADA) provides a comprehensive overview of the latest approaches for the manage- ment and treatment of DFUs and their complications. Produced by leading international DFU authorities, the compendium includes information about the use of adjunctive therapies, such as hyperbaric oxygen and negative pressure wound therapy, in instances in which DFUs do not respond to standard treatment.⁵ Among the treatments highlighted in the compendium that garnered the most attention were advanced cellular tissue products (CTPs). These are bioengineered cell-based therapies that supply the wound with the cells, tissues, proteins, and growth factors needed to support the healing process … read more (registration required)

and Sheffield Collaboratorium for Antimicrobial Resistance and Biofilms Awarded NBIC Grant to Advance Development of Neem’s First-in-Class Treatments for Wound Infections

 

Neem Biotech, a company focused on developing novel solutions to address antimicrobial resistance, together with the Welsh Wound Innovation Centre and Sheffield Collaboratorium for Antimicrobial Resistance and Biofilms (SCARAB) announced today the receipt of a £50,000 inaugural National Biofilms Innovation Centre (NBIC) Proof of Concept grant. This inaugural grant has been awarded to expand the development and testing of effective anti-biofilm interventions, in this case based on the pioneering research conducted by Neem Biotech. Biofilms are formed by many bacteria as a protective mechanisms for colonies of bacteria in a range of metabolic states. In humans, biofilms protect bacteria from the human immune system and antibiotics and also exude virulence factors which allow the colonies of bacteria to invade local tissues and spread infection. Products that inhibit the spread of infection in biofilms are called quorum sensing inhibitors.

 

Specifically, the collaborators will expand data on the biological activity of Neem’s candidate compounds for managing bacterial infections in wounds. The research is aimed at advancing rational drug design and accelerating translation of basic research into the clinic …. read more

Onduo, a Verily-Sanofi joint venture focused on digitally-driven diabetes management, is looking to further protect its members from foot ulcers and limb loss. Orpyx Medical Technologies’ diabetic foot ulcer sensors for its members.

 

Thanks to a newly announced deal struck between the companies, Orpyx Medical Technologies’ FDA-cleared SurroSense Rx system will be available to “select members” of Onduo’s diabetes management program in 2019. The system consists of a thin sensor that is placed in a patient’s shoes and a wirelessly connected smartwatch, which displays readings and alerts to the user when dangerous pressure levels are detected.

 

“Orpyx helps people with diabetes to prevent foot ulcers by providing insight that protects foot health and mobility and reduces the risk of complications that can lead to limb loss,” Breanne Everett, CEO of Orpyx Medical Technologies, said in a statement. “We are pleased to extend access to our foot sensor technology to the Onduo member community and to invite Orpyx US patients to take advantage of Onduo services.” … read more

     quality and cost implications

 

Adults with a new principal DPN diagnosis were categorized as initially untreated if they had no newly initiated DPNrelated medication within the fi rst 14 days after diagnosis. Bivariate logistic regression evaluated predictors for newly initiating medication versus being initially untreated. Multinomial logistic regression evaluated predictors for each medication category (antidepressants, anticonvulsants, or multiple medications versus opioids) … read more

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

 

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

 

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

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

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

Well September has passed but this is a wealth of information on DFUs from WoundSource:

 

As part of the WoundSource Practice Accelerator series, we present the following education on a variety of topics related to the assessment, management and prevention of diabetic foot ulcers.

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

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

 

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

 

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

 

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

 

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

 

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

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

 

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

originally posted in PR WEB

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

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

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

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

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

By Portia Wofford

 

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

 

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

 

Life Doesn’t Always Go As Planned

 

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

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

 

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

 

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

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

 

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

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

 

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

    at Innovations in Wound Healing Conference

 

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

 

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

 

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

     of Chronic Lower Extremity Wounds: A Case Series

 

This case series evaluates the outcomes of persons with chronic lower extremity wounds treated with an esterified hyaluronic acid matrix (EHAM). Materials and Methods.Data were abstracted from 12 consecutive patients with a total of 14 evaluated chronic wounds (12 [100%] men, mean age 58.72 years) presenting for care at a multidisciplinary wound care center. Nine of the 12 patients had diabetes. The mean wound duration was 39.2 weeks. All patients received surgical wound debridement and were started on therapy consisting of weekly to biweekly applications of the EHAM with a nonadherent, moisture-retentive dressing until complete epithelialization was achieved. Outcomes evaluated included time to complete wound closure and proportion of patients achieving wound closure in 20 weeks. Results. In total, 85.7% of wounds measuring a mean of 2.32 cm²healed in the 20-week evaluation period … read more

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

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

 

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

     to diagnose, monitor chronic wounds

 

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

 

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

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

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

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

     Highlighting Latest Treatments for Diabetic Foot Ulcers

 

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

 

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

 

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

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

 

from Cision PR Newswire

     a national observational study

 

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

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

 

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

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

This Quick Guide outlines the use of IODOSORB as part of a biofilm-based wound care approach and provides helpful tips for it’s implementation in practice … download pdf

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

     Coordination Chemistry for Wound Healing

 

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

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

     Diabetic Patients With a Foot Ulcer

 

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

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

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

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

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

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

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

 

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

 

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

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

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

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

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

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

Protease modulating therapies are used to assist in venous leg ulcer closure. However, a recent systematic review of the evidence¹ suggests a need to question the biomarker’s importance and further role in the future of targeted chronic wound healing therapies … Earlier research reported in the literature has suggested that reducing protease levels can improve venous leg ulcer healing beyond the use of first-line treatments, such as compression, according to Maggie Westby, Ph.D., research fellow in the School of Health Sciences at the University
of Manchester, UK … read more

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

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

     in diabetes: A national observational study

 

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

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

     of chronic wounds: the EUREKA trial

 

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