Journal of wound care最新文献

These two case studies describe the use of Octenisept^® in hard-to-heal wounds in a hospital network in the Philippines.

These two case studies describe the use of Octenisept^® in diabetic foot ulcers at a tertiary referral hospital in Singapore.

These two case studies describe the use of Octenisept^® in hard-to-heal wounds at a community hospital in Malaysia.

These two case studies describe the use of Octenisept^® in diabetic foot ulcers at a community hospital in Singapore.

These two case studies describe the use of Octenisept^® in diabetic foot ulcers at a medical centre in the Philippines.

Background: Diabetic foot ulcers (DFUs) are a prevalent and severe complication of diabetes, leading to significant morbidity, impaired health-related quality of life (HRQoL) and economic burden on healthcare systems. The complexity of DFUs often results in prolonged healing and high recurrence rates. Effective management strategies are crucial for improving outcomes and reducing complications.

Aim: This study aimed to review the efficacy of antiseptic solutions in the treatment and care of DFUs.

Method: A literature analysis was conducted to review clinical studies and guidelines on the use and efficacy of antiseptic solutions, particularly Octenisept^® (0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol). The review focused on the antimicrobial properties, biofilm-disruption capabilities and wound healing outcomes associated with the use of antiseptic solutions in DFU management.

Results: Antiseptic solutions have potential to reduce bioburden, disrupt biofilm and modulate healing. There is a need to balance antimicrobial clinical efficacy with tolerability and cytotoxicity. The use and choice of adjunctive antiseptic solutions must be tailored to the patient, as antimicrobial efficacy can vary for antiseptic solutions, particularly for hypochlorous solutions. It is important to use products according to their instructions, with consideration of minimum contact time to maximise clinical efficacy. Low-pressure irrigation is adjunctive, and concurrent wound-bed preparation, including debridement, frequent inspection, infection and moisture control, remain important.

Conclusions: The therapeutic application of antiseptic solutions in DFU care presents a promising approach to enhancing wound healing and reducing infection risks. Integrating these solutions into standard wound care protocols could lower the incidence of complications, improve HRQoL and decrease the economic burden associated with diabetic foot disease. Further large-scale studies are recommended to validate these findings and refine guidelines for antiseptic use in DFU management.

Objective: The purpose of this research was to develop an automatic wound segmentation method for a pressure ulcer (PU) monitoring system (PrUMS) using a depth camera to provide automated, non-contact wound measurements.

Method: The automatic wound segmentation method, which combines multiple convolutional neural network classifiers, was developed to segment the wound region to improve PrUMS accuracy and to avoid the biased decision from a single classifier. Measurements from PrUMS were compared with the standardised manual measurements (ground truth) of two clinically trained wound care nurses for each wound.

Results: Compared to the average ground truth measurement (38×34×15mm), measurement errors for length, width and depth were 9.27mm, 5.89mm and 5.79mm, respectively, for the automatic segmentation method, and 4.72mm, 4.34mm, and 5.71mm, respectively, for the semi-automatic segmentation method. There were no significant differences between the segmentation methods and ground truth measurements for length and width; however, the depth measurement was significantly different (p<0.001) from the ground truth measurement.

Conclusion: The novel PrUMS device used in this study provided objective, non-contact wound measurement and was demonstrated to be usable in clinical wound care practice. Images taken with a regular camera can improve the classifier's performance. With a dataset of 70 PUs for single and multiple (four images per PU) measurements, the differences between length and width measurements of the PrUMS and the manual measurement by nurses were not statistically significant (p>0.05). A statistical difference (p=0.04) was found between depth measurements obtained manually and with PrUMS, due to limitations of the depth camera within PrUMS, causing missing depth measurements for small wounds.

Prepectoral breast reconstruction is a relatively new surgical technique that allows placement of the implant directly over the pectoralis major. It has benefits in terms of patient wellbeing, operative time, postoperative pain and recovery. However, in cases of infection, implant removal is often required and the patient is left with a flat chest. To the authors' knowledge, this is the first case of breast implant infection after breast reconstruction, successfully treated with a combination of both negative pressure wound therapy (NPWT) and photobiomodulation (PBM). A 32-year-old female patient with a BRCA2 mutation had undergone bilateral risk-reducing, nipple-sparing mastectomy for in situ ductal breast carcinoma followed by a prepectoral reconstruction. On the left side, the patient presented with dehiscence of 2.5cm with implant exposure 90 days after surgery. After an initial conservative approach, the patient's condition worsened, and she developed a larger dehiscence and a red breast. She was treated with implant removal. PBM of the cavity and the application of VeraFlo Therapy (3M, US) with a polyurethane-foam filling in the residual cavity were adopted. Pseudomonas aeruginosa was isolated and appropriate antibiotic therapy was started. Every 48-72 hours, she returned to the operating room for a washout, PBM, microbiological swabs, foam exchange and continuing NPWT. After 21 days of this approach and two consecutive negative swabs, the patient underwent breast reconstruction with a subpectoral expander. After six months, a definitive implant of the same size as the contralateral one was positioned. The cosmetic result was good and patient satisfaction was high. The combination of NPWT and PBM may represent a good solution in case of breast implant infection after prepectoral reconstruction with benefits in terms of surgical outcome, patient satisfaction and postoperative quality of life.