Tag: covid-19

The impact of the SARS-CoV-2 pandemic on the management of chronic limb-threatening ischemia and wound care

In the wake of the coronavirus pandemic, the critical limb ischemia (CLI) Global Society aims to develop improved clinical guidance that will inform better care standards to reduce tissue loss and amputations during and following the new SARS-CoV-2 era. This will include developing standards of practice, improve gaps in care, and design improved research protocols to study new chronic limb-threatening ischemia treatment and diagnostic options. Following a round table discussion that identified hypotheses and suppositions the wound care community had during the SARS-CoV-2 pandemic, the CLI Global Society undertook a critical review of literature using PubMed to confirm or rebut these hypotheses, identify knowledge gaps, and analyse the findings in terms of what in wound care has changed due to the pandemic and what wound care providers need to do differently as a result of these changes. Evidence was graded using the Oxford Centre for Evidence-Based Medicine scheme. The majority of hypotheses and related suppositions were confirmed, but there is noticeable heterogeneity, so the experiences reported herein are not universal for wound care providers and centres … read more

Where Do You Get Your Information?

One of the rewarding and fun projects I have been involved with for the past 2 years has been the development of a YouTube video program called “Inside the Doctors” Lounge.”

“The Lounge” is part of a bigger project called MD Coaches and is a talk show–like forum that takes place in an imaginary doctors’ lounge within the YouTube universe. Anyone who has spent time in a doctors’ lounge understands it is a place of respite and where discussions with colleagues can cover a wide range of topics, but most importantly, there is no associated fear of violating HIPAA or other repercussion. Everyone in the Lounge has an opinion, and discussions can become spirited, whether in agreement or not.

My colleagues (Rhonda Crowe, Randy Cook, Rick Zollinger and Dael Waxman) and I recently … read more

Unsalvageable: Preventable Amputations Rise During COVID

Leafer Miller didn’t hear much after the doctor told him they had to “sacrifice the leg.”

Lying on the emergency room gurney, the self-proclaimed video game nerd and former athlete struggled to comprehend life without the leg that had propelled him on the track and to the turf for tackles on the soccer field.

“It was always in the back of my mind as a worst-case scenario,” the 35-year-old Fresno, CA, native says. “But I wasn’t expecting that to be the case.”

The amputation was the result of a recurring American narrative: A diabetes diagnosis in his early 20s; a sequence of layoffs and hirings that left his insurance status in flux; missed primary care visits when providers went out of network; and skipped insulin doses due to unaffordable price tags.

“Sometimes, it would come down to insulin or rent,” Miller says, “I felt like my hands were tied.” … read more

Prioritizing Foot Ulcers During Lockdown Paid Off in Belgium

Belgium’s efforts to prioritize care at its diabetic foot ulcer clinics during the COVID-19 pandemic lockdown minimized both delays in care and adverse outcomes, new data suggest … The country has had a national diabetic foot care program in place since 2005, with 34 multidisciplinary clinics recognized by the Belgium Ministry of Health for the treatment of diabetic foot ulcers (DFUs) … The system has resulted in a decline in lower-limb amputations in the country … And while all nonurgent medical care in Belgium was postponed during the national COVID-19 lockdown period March 14-May 3, 2020, the clinics followed advice from professional associations to consider all active DFUs as urgent … read more

Are Restaurants Exacerbating the Obesity Epidemic?

Since the COVID-19 pandemic began, almost all discussion of restaurant-related health has centered on one topic: how to protect diners and staff from the virus. But another health issue has been largely overlooked: how restaurants compromise Americans’ health by selling fare that is high in caloric density, fat, added sugars, and sodium, but low in essential fiber. And during a pandemic where obesity and other pre-existing health conditions have been risk factors for severe disease, this discussion couldn’t be more relevant.

It’s common knowledge that fast food sold by chains such as McDonald’s, Burger King, Wendy’s, and the like has a poor nutritional profile. But the appetizers, entrees, and desserts sold at full-service restaurants aren’t much better … read more

What COVID-19 taught us: New opportunities and pathways from telemedicine and novel antiseptics in wound healing

The COVID-19 pandemic deeply impacted the capacity of the health systems to maintain preventive and curative services, especially for the most vulnerable populations. During the pandemic, the wound healing centres in Italy assisted a significant reduction of the frequency of their hospital admission, since only urgencies, such as severe infections or wound haemorrhagic complications, were allowed to the hospital. The aim of this multidisciplinary work is to highlight the importance of a new pathway of wound care with patient-based therapeutic approach, tailored treatments based on the characteristics of the wound and fast tracks focused on the outpatient management, reserving hospital assessment only for patients with complicated or complex wounds. This analysis highlights the point that patients with chronic wounds need to be critically evaluated in order to find the best and most appropriate care pathway, which should vary according to the patient … read more

The Challenges and Advantages of Office-Based Wound Care

Change in health care is in the winds these days. The current pandemic has allowed us to explore different ways of delivering health care, both in how we see patients and where we see patients.1 Although telemedicine might not be ideal for wound care patients, it opened the door to an option of remote supervision of wound care, which was previously inconceivable. Likewise, the shuttering of hospital outpatient departments deemed “non-essential” as the pandemic raged made office-based wound care look more promising. After all, podiatrists have been doing it for years.2

This article will explore some of the advantages and challenges for those in the practice of office-based wound care. Physician office-based wound care is the new frontier—well, new to the folks who are accustomed to providing these services in a hospital outpatient department … read more

Study shows how management of serious diabetic foot ulcers was possible during the COVID-19 lockdown

New research being presented at the European Association for the Study of Diabetes (EASD), held online this year (27 Sept-1 Oct), reveals how Belgium’s efforts to maintain a diabetic foot care programme during the COVID-19 pandemic can offer valuable lessons to the rest of the world.

“Thanks to the great efforts of diabetic foot clinics, continued availability of diabetic foot ulcer services during lockdown, although in a limited capacity, were really helpful, and may be the reason why we didn’t see late presentation and the impact on the severity of ulcers was limited to slightly larger wounds”, says lead author Dr An-Sofie Vanherwegen from Sciensano, Brussels, Belgium. “Our findings will hopefully guide diabetic foot clinics in serving their patients using innovative strategies … read more

Hyperbaric oxygen therapy for paediatric patients: an unintended consequence of the COVID-19 pandemic

Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients … read more

Managing the Surge: Delayed Chronic Wound Care During COVID-19

A growing body of research, as well as first-hand accounts from clinicians on the ground, indicate that a significant percentage of patients with chronic wounds have delayed preventative and emergent wound care during the COVID-19 pandemic.1 While it will take time to assess the full impact of these trends, existing evidence suggests delayed wound care can result in more severe infections, increased hospital admissions, and lead to more amputations.2 Therefore, it will be critical for providers, hospitals, outpatient departments, payers and policymakers to understand and plan for a surge in patients with untreated and unmanaged non-healing wounds and related acute-on-chronic complications as a result of delayed care during the COVID-19 pandemic … read more

Swift Medical’s new imaging platform expands the digital wound care company into decentralized trials

Digital wound care company Swift Medical launched Swift Scientific, a digital imaging platform to support decentralized clinical trials.

The platform allows for large-scale image collection and management so researchers can monitor the effects of medical interventions at a multisite trial or from study participants’ homes.

Swift’s product, Swift Skin and Wound, is an AI-enabled platform that lets patients or providers capture high-precision images of skin conditions or injuries with a smartphone. It tracks disease progression and healing, and allows for remote communication and data sharing … read more

Challenges faced by doctors and nurses in wound care management during the COVID-19 pandemic in Turkey and their views on telehealth

AIM: This study aimed to determine the problems faced by physicians and nurses dealing with chronic wound care during the COVID-19 pandemic and their views on telehealth.

MATERIALS AND METHODS: A descriptive and cross-sectional design was used in this study. The sample comprised physicians (n = 74) and nurses (n = 271) interested in chronic wound care. Data were collected through a questionnaire form consisting of open- and closed-ended questions … read more

Tele Wound Care Navigation for Wound Care Providers

The digital age is upon us, like it or not, ready or not. For the past few years, payers have incentivized, encouraged, reimbursed, and adopted various digital, remote monitoring systems and devices as a way to encourage providers to adopt more digital, remote methods. Although complete telehealth services were not reimbursed in all care settings in all Zip Codes by all payers throughout the United States at the beginning of 2020, many of the restrictions and barriers to provide nearly complete digital services were suddenly released in response to the needs of a nation in the throes of a pandemic … read more

A report of 12 months’ of data collected from a diabetic foot clinic at a public hospital in Phnom Penh, Cambodia

This report interprets data gathered from a diabetic foot ulcer clinic in an outpatient department of a public hospital in Phnom Penh, Cambodia. The data were gathered between September 2019 and August 2020 and were entered into a Microsoft Excel™ spreadsheet. It gives basic demographic information of Cambodian patients with diabetic foot ulceration and provides data that can be used to measure any future research or audit. The data collection timeframe … read more

Scenes From the COVID Resurgence in Wound Clinics

Physicians weathered the first wave of COVID-19 over a year ago, coping with challenges such as a lack of personal protective equipment, providing care via telehealth, and a lack of vaccines. With the Delta variant, many hospitals may be swamped with patients with the coronavirus. Several physicians spoke to Today’s Wound Clinic about their challenges.

“We are busier than ever,” says Matthew Regulski, DPM, ABMSP, CMET, FAPWH(c), the medical director of the Wound Care Institute of Ocean County, New Jersey. “We have so many wound patients. Our wound centers are jam-packed.” … read more

Wound care and dressing selection for pharmacy teams

Pharmacists play a key role and are often the first point of contact for people with wounds, both chronic and acute. During the COVID-19 pandemic, this has only become more apparent.

The burden of wound care is increasing through the ageing population, growing comorbidities and increased skin integrity issues (Guest et al, 2015; Guest et al, 2020), with the annual prevalence of wounds increasing by 71% between 2012/2013 and 2017/2018 (Guest et al, 2020) – and with many people being reluctant to go into the hospital or primary care setting, the key role of the pharmacist will continue to develop and grow … read more

The legacy of the COVID-19 pandemic and potential impact on persons with wounds

COVID-19 has dramatically disrupted the practice of managing individuals with wounds.1 Care has moved onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts,2 redefining what treatments patients with wounds can receive (eg, debridement). Since the start of the pandemic in early 2020, there has been considerable emphasis placed on the implications for patients with wounds in terms of their vulnerability to the virus and potential exposure in health care settings. Many of these are not surprising since most persons with wounds are in the high-risk age groups for COVID-19 … read more

Multicentre clinical trial to explore efficacy of hyperbaric oxygen for preventing ICU admission, morbidity and mortality in adult patients with COVID-19

INTRODUCTION: COVID-19 may cause severe pneumonitis and trigger a massive inflammatory response that requires ventilatory support. The intensive care unit (ICU)-mortality has been reported to be as high as 62%. Dexamethasone is the only of all anti-inflammatory drugs that have been tested to date that has shown a positive effect on mortality. We aim to explore if treatment with hyperbaric oxygen (HBO) is safe and effective for patients with severe COVID-19. Our hypothesis is that HBO can prevent ICU admission, morbidity and mortality by attenuating the inflammatory response. The primary objective is to evaluate if HBO reduces the number of ICU admissions compared with best practice treatment for COVID-19, main secondary objectives are to evaluate if HBO reduces the load on ICU resources, morbidity and mortality and to evaluate if HBO mitigates the inflammatory reaction in COVID-19 … –

Why We Depend on One Another in Wound Care

July means different things to different people for different reasons. Prior to the COVID-19 pandemic, the month of July represented the first real month of summer. It signaled the end of the school year, and it was time to have fun. After college graduation, the first day of July for medical students correlates with the first day of medical school classes, and for senior medical students, the beginning of most medical residency programs. This first day of summer can be wrought with both excitement and fear … Prior to starting medical school, I spent the month of June shadowing an emergency room physician at the Pennsylvania State University School of Medicine at the Hershey Medical Center … read more

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

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

Tips for providing diabetes foot care through telemedicine

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

Pandemic Underlines Importance of Alternative Support Surfaces in Pressure Wound Care

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