Delayed wound healing can cause significant issues for immobile and ageing individuals as well as those living with co-morbid conditions such as diabetes, cardiovascular disease, and cancer. These delays increase a patient’s risk for infection and, in severe cases, can result in the formation of chronic, non-healing ulcers (e.g., diabetic foot ulcers, surgical site infections, pressure ulcers and venous leg ulcers). Chronic wounds are very difficult and expensive to treat and there is an urgent need to develop more effective therapeutics that restore healing processes. Sustained innate immune activation and inflammation are common features observed across most chronic wound types. However, the factors driving this activation remain incompletely understood. Emerging evidence suggests that the composition and structure of the wound microbiome may play a central role in driving this dysregulated activation but the cellular and molecular mechanisms underlying these processes require further investigation. In this review, we will discuss the current literature on: 1) how bacterial populations and biofilms contribute to chronic wound formation … read more
Tag: Chronic wound
Closure of a Difficult-to-Manage Chronic Pressure Injury with the Use of Autologous Platelet-Rich Plasma
Pressure injury (PI) corresponds to a skin damage of ischemic aetiology that affects the integrity of the skin and is produced by prolonged pressure or friction between a hard internal and external surface. Treatment can be challenging when there is no resolution with usual care. The use of autologous platelet-rich plasma (APRP) gel arises as a therapeutic possibility in the presence of chronic pressure injuries. The case of a patient with chronic PI who has been treated with APRP is presented, achieving resolution of the lesion … read more
A Human Fibroblast-Derived Growth Factor Preparation in the Management of a Chronic Surgical Wound in a Diabetic Patient: A Case Report
The treatment of choice in patients with ischaemic heart disease is coronary artery bypass grafting. The procedure entails the harvesting of the great saphenous vein through a significant leg incision, which may result in infections and wounding at the incision site. Patients with diabetes mellitus pose a greater risk of developing non-healing wounds, which may significantly affect the patient’s quality of life. The use of anti-inflammatory factors and other chemokines derived from cultured human fibroblasts may represent a useful therapeutic approach for the management of surgical wounds in patients with the greatest probability of being wound healing compromised. This case study describes the treatment of a non-healing surgical tibial wound in a male diabetic patient treated with a preparation of human anti-inflammatory interleukins cytokines, and growth factors. The treatment resulted in swift recovery, significant pain reduction and complete wound closure with minimal scarring … read more
Refractory Wounds: Systemic Factors Affecting Repair – Iatrogenic Factors (Part 3 of 4)
Refractory wounds are a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in previous blogs (Part 1, Part 2). Wounds that fail to heal not only impact quality of life, but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity, and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well … read more
Refractory Wounds: Systemic Factors Affecting Repair – Extrinsic Factors (Part 2 of 4)
Refractory wounds are a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone, as discussed in a prior blog. Wounds that fail to heal not only impact quality of life, but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well … read more
A Rare Case of Invasive Keratinizing Squamous Cell Carcinoma of the Foot
In general, there are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Basal cell carcinoma is the most common primary skin cancer amongst these, and cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Sun-exposed areas are the most common site and mainly affect Caucasians. cSCC involving the lower leg and anogenital region have been more commonly associated with dark skin. It is of utmost importance to regularly monitor chronic wounds. The conversion from an ulcer to malignancy is usually a slow process and the exact pathogenesis is yet to be definitively known. It was Marjolin who, in 1827, first reported this process when he noted a malignant change in a chronic ulceration. cSCC is the most common secondary skin cancer noted to arise in chronic wounds, burn scars, trauma, and following radio necrosis … read more
Microcurrent as an adjunct therapy to accelerate chronic wound healing
and reduce patient pain
The primary aim is to assess the efficacy of microcurrent, a form of electrical stimulation, as an adjunct therapy in accelerating healing in chronic wounds by reducing wound size and pain level. The secondary aim is to assess the qualitative changes in these parameters: inflammatory symptoms, vasodilation, sleep quality, gait and frequency of bowel movement … read more
When and how to culture a chronic wound
Chronic wound infections are a significant healthcare burden, contributing to increased morbidity and mortality, prolonged hospitalization, limb loss, and higher medical costs. What’s more, they pose a potential sepsis risk for patients. For wound care providers, the goal is to eliminate the infection before these consequences arise.
Most chronic wounds are colonized by polymicrobial aerobic-anaerobic microflora. However, practitioners continue to debate whether wound cultures are relevant. Typically, chronic wounds aren’t cultured unless the patient has signs and symptoms of infection, which vary depending on whether the wound is acute or chronic … read more