Journal of tissue viability最新文献

Scientists investigated probiotic-containing dressings to address the challenges associated with burn injuries, namely infection and antimicrobial resistance. The present investigation sought to evaluate the impact of innovative probiotic-loaded microparticles with in situ gelling characteristics on infected burns. The strain, Lactiplantibacillus plantarum, was selected due to its demonstrated wound-healing potential. Subsequently, a formulation was designed to sustain the growth capacity of probiotics. Polymers with a high moisture absorption capacity were exclusively used to avoid powder dispersion from wounds. The formulation was stabilized through the reduction of water content using the spray-drying process. The ideal composition was identified by analyzing the influence of the spray-drying inlet temperature, polymer type, and concentrations on probiotic viability, process efficiency, swelling ratio, and flow properties of powders. Morphological analysis showed the presence of microparticles with significant exchangeable surface areas. The rheological properties of the formulation demonstrated its ability to withstand high temperatures and mechanical stress. Moreover, FTIR and DCS spectra provided evidence of interconnection between the polymers. Examination of the growth profiles of both formulated and free probiotics revealed a consistent growth rate and an extended lag time. Animal studies have shown that the optimal microparticles exhibited superior efficacy compared to the control groups across all parameters and displayed enhanced effectiveness against Pseudomonas aeruginosa. The proposed delivery method, with its simple application and prevention of normal flora transmission, may have the potential to improve burn wound infection treatments.

Despite extensive clinical studies and therapeutic interventions, addressing significant skin wounds remains challenging, necessitating novel approaches for effective regeneration therapy. In the current review, we analyzed and evaluated the application, advancements, and future directions of biomaterials-based scaffolds for skin tissue construct. In addition, we investigated the role of other biological substitutes in promoting wound healing and skin tissue regeneration. The review highlights the impact of biomaterial-based scaffolds on skin tissue regeneration and wound healing. After presenting the physiological process of skin tissue regeneration, the review emphasizes the different biochemical components significant for skin healing and regeneration. Subsequently, it delves into the role of scaffolds in skin tissue engineering. Recent advancements in nanotechnology are also highlighted with a specific focus on the utilization of nanomaterials for enhancing healing, facilitating tissue regeneration, and promoting skin reconstruction. Biomaterial scaffolds have emerged as a potential intervention for wound healing forming the foundation of skin tissue regeneration. These scaffolds, intricate three-dimensional frameworks, serve as carriers for cells, medications, and genes, facilitating their delivery into the body. The integration of degradable porous scaffolds with biological cells offers a promising avenue for tissue repair. Biomaterials play a crucial role in tissue engineering, providing temporary mechanical support and facilitating cellular processes to augment skin tissue regeneration.

Background: An accurate assessment of pressure injury healing is crucial for the timely implementation of nursing intervention. This study aimed to investigate the accuracy of infrared thermography-based wound temperature measurement in predicting wound outcomes.

Methods: This prospective, 16 days observational study included 156 adults with pressure injury. The temperature of wound bed, periwound skin and normal skin was recorded by using infrared thermography every three days. After that, three relative temperatures of PI were analyzed. The aim was to assess the significance of wound temperature in predicting healing outcomes for pressure injuries.

Results: Relative temperature between periwound skin and normal skin was positively correlated with pressure injury healing (r > 0.64). Particularly the first day of follow up, it was found to be closely related to pressure injury healing (r = 0.687). On the last day and median time (the eighth to ninth day) of follow up, the optimal cutoff values of the indicator were negative values (periwound skin temperature was lower than normal skin). COX proportional hazard regression model analysis showed that relative temperature between periwound skin and normal skin on the first day of follow-up was the most significant predictor of pressure injury healing, and the healing risk increased largest- 8.79 times (95%CI: 4.53, 17.05), when its temperature greater than 0.000 °C.

Conclusion: Relative temperature between periwound skin and normal skin monitoring by infrared thermography better than visual assessment which can objectively serve as an indicator for predicting the healing status of pressure injury.

Background: Diabetic foot ulcers (DFUs) are a prevalent complication of diabetes. Individuals with DFUs can experience wound-related pain, which could be nociceptive and/or neuropathic in origin, which adversely affects health-related quality of life (HRQoL).

Aim: To determine the prevalence and characteristics of DFU-related pain and its impact on HRQoL in community-dwelling individuals with active DFUs.

Methods: A cross-sectional quantitative study was conducted, employing the Short-form McGill Pain Questionnaire (SF-MPQ) and the Cardiff Wound Impact Schedule (CWIS), involving patients with DFU at a Podiatry Clinic in the West of Ireland.

Results: This study evaluated 30 patients with DFUs, of whom 70.0 % (n = 21) were male. Among the participants, 70.0 % (n = 21) reported at least one sensory pain descriptor from the SF-MPQ, and 40.0 % (n = 12) chose descriptors indicative of neuropathic pain. "Tender" emerged as the most frequently selected sensory pain descriptor (n = 11, 36.7 %). The mean Visual Analogue Scale (VAS) score was 23.3 (±30.9) mm. For present pain intensity (PPI), 43.3 % (n = 13) reported pain ranging from mild to horrible pain. Spearman's correlation analysis revealed a significant negative correlation between SF-MPQ, VAS, PPI, and HRQoL, with moderate to strong associations. Patients with multiple DFU locations or neuropathic pain presented poorer HRQoL evaluation. Sensory pain (β = -3.582, P = 0.026) and PPI (β = -2.682, P = 0.020) were identified as independent predictors of HRQoL based on multiple linear regression analysis.

Conclusion: DFU-related pain is prevalent and significantly impacts patients' HRQoL. It is important to prioritise comprehensive and regular assessment of DFU-related pain during patient consultations. A patient-centred and holistic approach should be adopted, guided by the outcomes of pain assessments.

Background: Pressure injury (PI) is a significant health issue and one of the greatest challenges in critical care units. Guidelines adherence to prevent PIs is not always optimal by critical care nurses. To our knowledge, there is no data about adherence to PI preventive guidelines among Jordanian critical care nurses, and this study aimed to fill this gap.

Purpose: To assess the levels of adherence, and factors associated with adherence to PIs prevention guidelines among critical care nurses in Jordan.

Methods: A cross-sectional study was conducted among 269 nurses selected from four hospitals in Amman-Jordan. Multiple socio-demographic and psychosocial factors were collected including nurses' knowledge and attitudes toward PI prevention. A valid and reliable self-reported questionnaire (questionnaire to evaluate nurses' adherence to recommendations for preventing pressure ulcers QARPPU) was used to assess participants' adherence to PIs prevention guidelines. Multiple linear regression was conducted to predict the factors associated with adherence to PI prevention guidelines.

Results: Nurses reported a mean of 58.2 ± 8.2 (90 is the highest score) of the total score of adherence scale indicating 65 % of adherence to PIs prevention guidelines. Factors independently associated with lower adherence were being a male nurse, absence of a policy of PI prevention, and being a nurse in a non-accredited hospital (all p ≤ 0.05).

Conclusion: Critical care nurses in Jordan do not have optimal adherence to PIs prevention guidelines. Implementing healthcare policies about PIs prevention and hospital accreditation seems to be essential to enhance their adherence.

Despite the advances in the development of therapeutic wearable wound-healing patches, lack self-healing properties and strong adhesion to diabetic skin, hindering their effectiveness. We propose a unique, wearable patch made from a 3D organo-hydrogel nanocomposite containing polydopamine, titanium dioxide nanoparticles, and silver quantum dots (PDA-TiO₂@Ag). The designed patch exhibits ultra-stretchable, exceptional-self-healing, self-adhesive, ensuring conformal contact with the skin even during movement. Our patch demonstrated potent antibacterial activity and significantly accelerated wound healing with a high wound closure rate of 99.2 % after 7 days. Remarkably, it enhanced diabetic skin wound healing compared to that achieved by adipose-derived stem cell (ADSC) therapy in a study involving 30 adult male albino rats. Microscopic analysis highlights the promising hierarchical architecture structure of the patch for wound healing applications, suggesting its potential to create a favorable environment for healing and provide long-lasting benefits. Histopathological analysis and immunohistochemical staining revealed faster healing and enhanced cellular response in the patch-treated group compared to both stem cell and control groups. Notably, the patch promoted complete re-epithelization and a significant increase in vascular endothelial growth factor (VEGF) expression on day 7, indicating improved angiogenesis. This self-healing, multifunctional patch offers a promising alternative to stem cell therapy for accelerating diabetic wound healing, showcasing its potential for clinical translation. The combination of durability, biocompatibility, and antibacterial properties makes the patch a promising candidate for advanced wound management and offering faster, more complete restoration than other approaches.

Introduction: Hard-to-heal wounds lead to functional loss, decreased quality of life, and prolonged hospitalization due to delayed healing. The healthcare costs of managing such wounds are substantial. Vibration therapy has been proposed as an alternative treatment for hard-to-heal wounds but no comprehensive reviews have quantitatively analyzed its efficacy.

Materials and methods: Six databases were systematically searched for relevant articles on August 1, 2024. The methodologies of the studies included in the analysis were assessed using Version 2 of the Cochrane Risk of Bias tool for randomized trials and ROBINS-I tool for non-randomized studies. A random-effects model was applied to aggregate the pooled effect size. Heterogeneity was assessed using I². A forest plot was generated for meta-analysis.

Results: Ten studies were included in the meta-analysis. Vibration therapy significantly reduced neuropathy (pooled standardized mean difference [SMD] = -0.79; 95 % CI = -1.51 to -0.07; p = 0.03; I² = 61.40 %) and enhanced the ulcer healing area (pooled SMD = 0.92; 95 % CI = 0.60 to 1.23; p < 0.001; I² = 0.00 %) of patients with hard-to-heal wounds. However, the intervention did not significantly alleviate pain (pooled SMD = -0.51; 95 % CI = -1.38 to 0.36; p = 0.25; I² = 74.15 %). Significant heterogeneity was identified in the pooled result for pain and neuropathy.

Conclusions: Vibration therapy appears to enhance ulcer healing and reduce neuropathy. These results may help researchers and healthcare providers to further develop vibration therapy to address the underlying requirements for bridging the evidence-practice gap in wound care. Future studies should consider the safety and potential adverse outcomes of vibration therapy to ensure its appropriate application for treating hard-to-heal wounds.

Background: Myofascial trigger points (MTrPs) in the lower trapezius have been recognized as an important source of neck pain. This study aims to compare the lower trapezius muscle strength, pressure pain threshold (PPT) and muscle thickness at rest and contraction between participants and painful vs. no-painful side with active and latent MTrPs; and to examine the associations among these variables with pain intensity, duration and disability in patients with neck pain.

Methods: A cross-sectional study was carried out in 64 people with neck pain with active or latent MTrPs (34 Active MTrPs group and 30 Latent MTrPs groups). Muscle strength, pressure pain threshold and muscle thickness at rest and contraction of the lower trapezius was recorded.

Results: No significant differences were found in descriptive data, dominant side, or side of neck pain. However, the Active MTrPs Group had lower pain pressure thresholds (PPT) on the neck pain side compared to the Latent MTrPs Group, indicating greater sensitivity. Muscle thickness and strength showed minor differences between groups. Pain intensity correlated moderately with pain duration and strongly with neck pain disability.

Conclusions: The results of the present study showed differences in PPT on the lower trapezius muscle in active and latent MTrP in neck side pain compared to non-neck side pain. In addition, lower trapezius strength reported differences between the neck side pain compared to non-neck side pain in both active and latent MTrP. Lower trapezius muscle strength showed significant moderate association with muscle thickness at contraction.

Background: Lack of a complete understanding of the pathophysiology of pruritus directs patients to different treatments. There is little data on the effect of aromatherapy on itching in patients receiving hemodialysis treatment. However, the effect of aromatherapy on pruritus in patients receiving hemodialysis treatment remains unclear.

Aim: The aim of this study is to investigate the effect of aromatherapy on pruritus in hemodialysis patients.

Methods: The protocol of this systematic review study was registered with PROSPERO (CRD42024522699) and PRISMA guidelines were followed in reporting the study. The search was conducted in Pubmed, Web of Science and Scopus databases without year restriction. Inclusion and exclusion criteria were established according to the PICOS criteria. Study selection and quality assessment of the reviewed studies were performed by two independent researchers.

Results: A total of eight studies (461 participants), including two randomized controlled trials and six quasi-experimental studies, were included in the systematic review. All included studies concluded that aromatherapy reduces pruritus. The studies reported no adverse effects of aromatherapy.

Conclusion: The studies included in this systematic review found that aromatherapy has a positive effect on reducing pruritus in hemodialysis patients. It is recommended that studies of high methodological quality be conducted to investigate the efficacy of aromatherapy on pruritus in people undergoing hemodialysis treatment.