Pub Date : 2023-11-01Epub Date: 2023-11-24DOI: 10.1111/wrr.13126
Nariman Rezaei Kolarijani, Danial Cheraghali, Hossein Khastar, Arian Ehterami, Morteza Alizade, Ahmad Vaez, Seyed Mohammad Amini, Majid Salehi
In this study, gold nanoparticles were loaded into poly (ε-caprolactone) (PCL)/gelatin nanofibrous matrices to fabricate a potential wound dressing. The mats were produced by electrospinning of PCL/gelatin solution supplemented with synthesized gold nanoparticles (200, 400 and 800 ppm). Prepared scaffolds were investigated regarding their chemical properties, morphology, mechanical properties, surface wettability, water-uptake capacity, water vapor permeability, porosity, blood compatibility, microbial penetration test and cellular response. In addition to in vivo study, a full-thickness excisional wound in a rat model was used to evaluate the healing effect of prepared scaffolds. Results showed appropriate mechanical properties and porosity of prepared scaffolds. With L929 cells, the PCL/gelatin scaffold containing 400 ppm gold nanoparticles demonstrated the greatest cell growth. In vivo results validated the favorable wound-healing benefits of the scaffold incorporating gold nanoparticles, which triggered wound healing compared to sterile gauze. Our results showed the capability of nanofibrous matrices containing gold nanoparticles for successful wound treatment.
{"title":"Nanofibrous polycaprolactone/gelatin scaffold containing gold nanoparticles: Physicochemical and biological characterization for wound healing.","authors":"Nariman Rezaei Kolarijani, Danial Cheraghali, Hossein Khastar, Arian Ehterami, Morteza Alizade, Ahmad Vaez, Seyed Mohammad Amini, Majid Salehi","doi":"10.1111/wrr.13126","DOIUrl":"10.1111/wrr.13126","url":null,"abstract":"<p><p>In this study, gold nanoparticles were loaded into poly (ε-caprolactone) (PCL)/gelatin nanofibrous matrices to fabricate a potential wound dressing. The mats were produced by electrospinning of PCL/gelatin solution supplemented with synthesized gold nanoparticles (200, 400 and 800 ppm). Prepared scaffolds were investigated regarding their chemical properties, morphology, mechanical properties, surface wettability, water-uptake capacity, water vapor permeability, porosity, blood compatibility, microbial penetration test and cellular response. In addition to in vivo study, a full-thickness excisional wound in a rat model was used to evaluate the healing effect of prepared scaffolds. Results showed appropriate mechanical properties and porosity of prepared scaffolds. With L929 cells, the PCL/gelatin scaffold containing 400 ppm gold nanoparticles demonstrated the greatest cell growth. In vivo results validated the favorable wound-healing benefits of the scaffold incorporating gold nanoparticles, which triggered wound healing compared to sterile gauze. Our results showed the capability of nanofibrous matrices containing gold nanoparticles for successful wound treatment.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-09-29DOI: 10.1111/wrr.13118
Magnus S Ågren, Boris Hinz, Konstantinos Kalogeropoulos, Christopher M Overall, Hans Smola, Sabine Werner
{"title":"Ulrich auf dem Keller (1974-2023).","authors":"Magnus S Ågren, Boris Hinz, Konstantinos Kalogeropoulos, Christopher M Overall, Hans Smola, Sabine Werner","doi":"10.1111/wrr.13118","DOIUrl":"10.1111/wrr.13118","url":null,"abstract":"","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-12-10DOI: 10.1111/wrr.13128
Masood Mazaheri, Raoul F Crooijmans, Maya Vereen, Eveline M L Corten
This study was aimed to review Virtual Reality's (VR) impact on pain, anxiety, opioid usage, physiological and behavioural responses, and patients' experience during wound care (WC) in adults. We searched multiple databases (Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, Scopus and Google Scholar) from inception until January 27th, 2023. Included studies compared VR alone or as an adjunct to standard WC with standard WC or other distraction methods, in adults with burn or non-burn-related wounds. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomised parallel-group and crossover trials. The review followed PRISMA guidelines for reporting. Fourteen studies were eligible for inclusion. The meta-analysis was limited to studies comprising solely of adult participants. VR reduced pain intensity compared to standard WC in all study designs. Despite not being included in the meta-analysis due to reasons such as mixed population or lack of sufficient statistical data, other studies showed significant pain reduction using VR. Additionally, VR improved patients' experience of WC. No clear effect was found on other outcomes including anxiety, opioid usage and physiological and behavioural responses. VR shows promise in reducing acute pain and enhancing patients' experience of WC. The observed variations in the effects of VR at group and individual levels indicate the need for a personalised treatment plan by selecting the right VR for the right patient given at the right time.
本研究旨在回顾虚拟现实(VR)对成人疼痛、焦虑、阿片类药物使用、生理和行为反应以及伤口护理(WC)期间患者体验的影响。我们检索了多个数据库(Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, Scopus和Google Scholar),从成立到2023年1月27日。纳入的研究比较了VR单独或作为标准WC的辅助方法与标准WC或其他分心方法,用于烧伤或非烧伤相关伤口的成人。使用改进的Cochrane随机平行组和交叉试验的偏倚风险工具评估偏倚风险。审查遵循了PRISMA的报告准则。14项研究符合纳入条件。荟萃分析仅限于仅由成人参与者组成的研究。在所有的研究设计中,与标准WC相比,VR降低了疼痛强度。尽管由于混合人群或缺乏足够的统计数据等原因未被纳入荟萃分析,但其他研究显示使用VR可以显着减轻疼痛。此外,VR改善了患者的WC体验。对焦虑、阿片类药物使用、生理和行为反应等其他结果没有明显影响。VR在减轻急性疼痛和增强患者WC体验方面显示出希望。观察到的VR在群体和个人水平上的效果变化表明,需要通过在正确的时间为正确的患者选择正确的VR来制定个性化的治疗计划。这篇文章受版权保护。版权所有。
{"title":"Clinical efficacy and patients' perception of virtual reality during wound care in adults: A systematic review with meta-analysis of randomised clinical trials.","authors":"Masood Mazaheri, Raoul F Crooijmans, Maya Vereen, Eveline M L Corten","doi":"10.1111/wrr.13128","DOIUrl":"10.1111/wrr.13128","url":null,"abstract":"<p><p>This study was aimed to review Virtual Reality's (VR) impact on pain, anxiety, opioid usage, physiological and behavioural responses, and patients' experience during wound care (WC) in adults. We searched multiple databases (Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, Scopus and Google Scholar) from inception until January 27th, 2023. Included studies compared VR alone or as an adjunct to standard WC with standard WC or other distraction methods, in adults with burn or non-burn-related wounds. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomised parallel-group and crossover trials. The review followed PRISMA guidelines for reporting. Fourteen studies were eligible for inclusion. The meta-analysis was limited to studies comprising solely of adult participants. VR reduced pain intensity compared to standard WC in all study designs. Despite not being included in the meta-analysis due to reasons such as mixed population or lack of sufficient statistical data, other studies showed significant pain reduction using VR. Additionally, VR improved patients' experience of WC. No clear effect was found on other outcomes including anxiety, opioid usage and physiological and behavioural responses. VR shows promise in reducing acute pain and enhancing patients' experience of WC. The observed variations in the effects of VR at group and individual levels indicate the need for a personalised treatment plan by selecting the right VR for the right patient given at the right time.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-10-15DOI: 10.1111/wrr.13120
Stuti P Garg, Tokoya Williams, Iulianna C Taritsa, Rou Wan, Chirag Goel, Raiven Harris, Kristin Huffman, Robert D Galiano
Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL). There is a need for patients of colour to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic and Fitzpatrick skin type (FST) data were extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: mapping assessment of scars (MAPS) and University of North Carolina '4P'. Only four studies included non-White patients or dark-skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale (VSS), modified Patient and Observer Scar Assessment Scale (POSAS), acne QOL and SCAR-Q scales. The patients included in the modified VSS validation were 7% and 13% FST V/VI, 14% African in the modified POSAS and 4.5% FST V/VI in the SCAR-Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark-skinned patients. Given the susceptibility of darker-skinned individuals to have poorer scarring outcomes, it is critical to include patients of colour in the very assessment tools that determine their scar prognosis. Inclusion of patients of colour in scar scale development will improve scar assessment and clinical decision-making.
{"title":"Evaluating skin colour diversity in the validation of scar assessment tools.","authors":"Stuti P Garg, Tokoya Williams, Iulianna C Taritsa, Rou Wan, Chirag Goel, Raiven Harris, Kristin Huffman, Robert D Galiano","doi":"10.1111/wrr.13120","DOIUrl":"10.1111/wrr.13120","url":null,"abstract":"<p><p>Across scar studies, there is a lack of dark-skinned individuals, who have a predisposition for keloid formation, altered pigmentation and poorer quality of life (QOL). There is a need for patients of colour to be included in scar scale development and validation. In this study, we evaluate the racial diversity of patients included in the validation of scar assessment scales. A systematic review was conducted for articles reporting on the validation of a scar assessment tool. Racial, ethnic and Fitzpatrick skin type (FST) data were extracted. Fifteen scar scale validation studies were included. Nine of the studies did not mention FST, race or ethnicity of the patients. Two of the studies that reported FST or race information only included White patients or included no FST V/VI patients: mapping assessment of scars (MAPS) and University of North Carolina '4P'. Only four studies included non-White patients or dark-skinned patients in the validation of their scar scale: the modified Vancouver Scar Scale (VSS), modified Patient and Observer Scar Assessment Scale (POSAS), acne QOL and SCAR-Q scales. The patients included in the modified VSS validation were 7% and 13% FST V/VI, 14% African in the modified POSAS and 4.5% FST V/VI in the SCAR-Q. We highlight the severe lack of diversity in scar scale validation, with only 4 out of 15 studies including dark-skinned patients. Given the susceptibility of darker-skinned individuals to have poorer scarring outcomes, it is critical to include patients of colour in the very assessment tools that determine their scar prognosis. Inclusion of patients of colour in scar scale development will improve scar assessment and clinical decision-making.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-10-27DOI: 10.1111/wrr.13121
Tyler L Coye, Mehmet A Suludere, Gu Eon Kang, P Andrew Crisologo, Matthew Malone, Lee C Rogers, Lawrence A Lavery
The objective of this study was to evaluate the effectiveness of C-reactive protein (CRP)/albumin, erythrocyte sedimentation rate (ESR)/albumin ratio, ESR, CRP and albumin to differentiate bone and soft tissue infection in persons with diabetes. We retrospectively evaluated 242 individuals admitted to hospital with diabetes-related foot infections (DFI). We categorised DFI cases as either bone (OM) or soft tissue infection based on bone culture and/or histology. We evaluated the diagnostic accuracy of CRP, ESR, albumin, CRP/albumin and ESR/albumin as biomarkers to diagnose OM in persons with diabetes. The median age was 53 years (74% male). There were 224 diabetes-related patients of which 125 had been diagnosed with osteomyelitis. The ESR/albumin and CRP/albumin ratios cut-points were >17.84 and >1.83, respectively. ESR/albumin and CRP/albumin ratios had similar diagnostic parameters: AUC (0.71, 0.71), sensitivity (70.0%, 57.0%), specificity (62.0%, 75.0%), positive predictive value (67.0%, 71.0%) and negative predictive value (66.0% and 71.0%). In contrast diagnostic efficiency of CRP and ESR were AUC 0.71 and 0.71, sensitivity (45.6%, 71.2%), specificity (85.5%, 60.7%), positive predictive value (70.0%, 65.9%) and negative predictive value (59.5%, 66.4%), respectively. When comparing area under the curves, the results showed that ESR/albumin was not significantly different to ESR alone (Delong test pvs ESR >0.1). Similarly, CRP/albumin was not significantly different to CRP alone (Delong test pvs CRP >0.1). In conclusion, ESR/albumin and CRP/albumin ratios provided comparable results as using ESR and CRP alone.
本研究的目的是评估CRP/白蛋白、ESR/白蛋白比值、ESR、CRP和白蛋白在糖尿病患者骨和软组织感染鉴别中的有效性。我们回顾性评估了242名因糖尿病相关足部感染(DFI)入院的患者。我们根据骨培养和/或组织学将DFI病例分为骨(OM)或软组织感染(STI)。我们评估了CRP、ESR、白蛋白、CRP/白蛋白和ESR/白蛋白作为诊断糖尿病患者OM的生物标志物的诊断准确性。中位年龄为53岁 年龄(74%为男性)。共有224名糖尿病相关患者,其中125人被诊断为骨髓炎。ESR/白蛋白和CRP/白蛋白比值的分界点为> 17.84和> 1.83。ESR/白蛋白和CRP/白蛋白比值具有相似的诊断参数:AUC(0.71,0.71)、敏感性(70.0%,57.0%)、特异性(62.0%,75.0%)、阳性预测值(67.0%,71.0%)和阴性预测值(66.0%和71.0%),阳性预测值(70.0%,65.9%)和阴性预测值(59.5%,66.4%)。当比较曲线下面积时,结果显示ESR/白蛋白与单独的ESR没有显著差异(德隆检验p vs ESR> 0.1)。同样,CRP/白蛋白与单独的CRP没有显著差异(Delong检验p vs CRP> 0.1)。总之,ESR/白蛋白和CRP/白蛋白比率提供了与单独使用ESR和CRP相当的结果。这篇文章受版权保护。保留所有权利。
{"title":"The infected diabetes-related foot: Comparison of erythrocyte sedementation rate/albumin and C-reactive protein/albumin ratios with erythrocyte sedimentation rate and C-reactive protein to differentiate bone and soft tissue infections.","authors":"Tyler L Coye, Mehmet A Suludere, Gu Eon Kang, P Andrew Crisologo, Matthew Malone, Lee C Rogers, Lawrence A Lavery","doi":"10.1111/wrr.13121","DOIUrl":"10.1111/wrr.13121","url":null,"abstract":"<p><p>The objective of this study was to evaluate the effectiveness of C-reactive protein (CRP)/albumin, erythrocyte sedimentation rate (ESR)/albumin ratio, ESR, CRP and albumin to differentiate bone and soft tissue infection in persons with diabetes. We retrospectively evaluated 242 individuals admitted to hospital with diabetes-related foot infections (DFI). We categorised DFI cases as either bone (OM) or soft tissue infection based on bone culture and/or histology. We evaluated the diagnostic accuracy of CRP, ESR, albumin, CRP/albumin and ESR/albumin as biomarkers to diagnose OM in persons with diabetes. The median age was 53 years (74% male). There were 224 diabetes-related patients of which 125 had been diagnosed with osteomyelitis. The ESR/albumin and CRP/albumin ratios cut-points were >17.84 and >1.83, respectively. ESR/albumin and CRP/albumin ratios had similar diagnostic parameters: AUC (0.71, 0.71), sensitivity (70.0%, 57.0%), specificity (62.0%, 75.0%), positive predictive value (67.0%, 71.0%) and negative predictive value (66.0% and 71.0%). In contrast diagnostic efficiency of CRP and ESR were AUC 0.71 and 0.71, sensitivity (45.6%, 71.2%), specificity (85.5%, 60.7%), positive predictive value (70.0%, 65.9%) and negative predictive value (59.5%, 66.4%), respectively. When comparing area under the curves, the results showed that ESR/albumin was not significantly different to ESR alone (Delong test p<sub>vs ESR</sub> >0.1). Similarly, CRP/albumin was not significantly different to CRP alone (Delong test p<sub>vs CRP</sub> >0.1). In conclusion, ESR/albumin and CRP/albumin ratios provided comparable results as using ESR and CRP alone.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-11-20DOI: 10.1111/wrr.13127
Alexander Paping, Clara Basler, Loreen Ehrlich, Carlo Fasting, Kerstin Melchior, Thomas Ziska, Mario Thiele, Georg N Duda, Sara Timm, Matthias Ochs, Rebecca C Rancourt, Wolfgang Henrich, Thorsten Braun
Uterine rupture during a trial of labor after caesarean delivery (CD) is a serious complication for mother and fetus. The lack of knowledge on histological features and molecular pathways of uterine wound healing has hindered research in this area from evolving over time. We analysed collagen content and turnover in uterine scars on a histological, molecular and ultrastructural level. Therefore, tissue samples from the lower uterine segment were obtained during CD from 16 pregnant women with at least one previous CD, from 16 pregnant women without previous CD, and from 16 non-pregnant premenopausal women after hysterectomy for a benign disease. Histomorphometrical collagen quantification showed, that the collagen content of the scar area in uterine wall specimens after previous CD was significantly higher than in the unscarred myometrium of the same women and the control groups. Quantitative real-time PCR of uterine scar tissue from FFPE samples delineated by laser microdissection yielded a significantly higher COL3A1 expression and a significantly lower COL1A2/COL3A1 ratio in scarred uteri than in samples from unscarred uteri. Histological collagen content and the expression of COL1A2 and COL3A1 were positively correlated, while COL1A2/COL3A1 ratio was negatively correlated with the histological collagen content. Transmission electron microscopy revealed a destroyed myometrial ultrastructure in uterine scars with increased collagen density. We conclude that the high collagen content in uterine scars results from an ongoing overexpression of collagen I and III. This is a proof of concept to enable further analyses of specific factors that mediate uterine wound healing.
{"title":"Uterine scars after caesarean delivery: From histology to the molecular and ultrastructural level.","authors":"Alexander Paping, Clara Basler, Loreen Ehrlich, Carlo Fasting, Kerstin Melchior, Thomas Ziska, Mario Thiele, Georg N Duda, Sara Timm, Matthias Ochs, Rebecca C Rancourt, Wolfgang Henrich, Thorsten Braun","doi":"10.1111/wrr.13127","DOIUrl":"10.1111/wrr.13127","url":null,"abstract":"<p><p>Uterine rupture during a trial of labor after caesarean delivery (CD) is a serious complication for mother and fetus. The lack of knowledge on histological features and molecular pathways of uterine wound healing has hindered research in this area from evolving over time. We analysed collagen content and turnover in uterine scars on a histological, molecular and ultrastructural level. Therefore, tissue samples from the lower uterine segment were obtained during CD from 16 pregnant women with at least one previous CD, from 16 pregnant women without previous CD, and from 16 non-pregnant premenopausal women after hysterectomy for a benign disease. Histomorphometrical collagen quantification showed, that the collagen content of the scar area in uterine wall specimens after previous CD was significantly higher than in the unscarred myometrium of the same women and the control groups. Quantitative real-time PCR of uterine scar tissue from FFPE samples delineated by laser microdissection yielded a significantly higher COL3A1 expression and a significantly lower COL1A2/COL3A1 ratio in scarred uteri than in samples from unscarred uteri. Histological collagen content and the expression of COL1A2 and COL3A1 were positively correlated, while COL1A2/COL3A1 ratio was negatively correlated with the histological collagen content. Transmission electron microscopy revealed a destroyed myometrial ultrastructure in uterine scars with increased collagen density. We conclude that the high collagen content in uterine scars results from an ongoing overexpression of collagen I and III. This is a proof of concept to enable further analyses of specific factors that mediate uterine wound healing.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01Epub Date: 2023-11-22DOI: 10.1111/wrr.13124
Francisco J Álvaro-Afonso, Sebastián Flores-Escobar, David Sevillano-Fernández, Yolanda García-Álvarez, Marta García-Madrid, José L Lázaro-Martínez
The current study aimed to evaluate the dispersal of solution and microbes (aerosol) in the clinical environment during treatment with Low-frequency contact ultrasonic debridement (LFCUD) with or without suction attachment in patients with diabetic foot ulcers (DFUs). We performed 20 treatments in 10 patients divided into two groups to receive the proposed LFCUD modalities. We measured the microbial load of the environment pre-treatment (sample M1), during treatment with each LFCUD modality (sample M2) and post-treatment (sample M3). The use of LFCUD debridement without a suction attachment results in significantly higher immediate contamination of the clinic environment than the suction attachment, particularly during the procedure (1.70 ± 0.98 log 10 CFU/mL versus 0.77 ± 0.85 log 10 CFU/mL, p = 0.035). When suction is not applied, there are statistically significant differences depending on whether the DFUs are neuropathic or neuroischemic, finding a greater number of microorganisms with high loads in neuropathic DFUs. We found a statistically significant positive correlation between wound area (r = 0.450, p = 0.047) and TBI (r = 0.651, p = 0.006) with the bacterial load during the LFCUD. Based on our results, we recommend using the personal protective equipment required to protect staff members and patients during treatment with LFCUD and using a suction attachment where clinically possible to reduce clinic environmental pollution, especially in neuropathic DFUs and those with larger areas.
本研究旨在评估低频接触超声清创(LFCUD)治疗糖尿病足溃疡(DFUs)时溶液和微生物(气溶胶)在临床环境中的扩散情况。我们对10名患者进行了20次治疗,将其分为两组接受拟议的LFCUD模式。我们测量了处理前(样品M1)、处理期间(样品M2)和处理后(样品M3)的环境微生物负荷。使用不带吸引装置的LFCUD清创对临床环境的直接污染明显高于使用吸引装置,特别是在手术过程中(1.70±0.98 log 10 CFU/mL vs 0.77±0.85 log 10 CFU/mL, p = 0.035)。不抽吸时,根据DFUs是神经性还是神经缺血性,差异有统计学意义,在神经性DFUs中发现了更多的高负荷微生物。我们发现伤口面积(r = 0.450, p = 0.047)和TBI (r = 0.651, p = 0.006)与LFCUD期间细菌负荷呈正相关,具有统计学意义。根据我们的研究结果,我们建议在LFCUD治疗期间使用所需的个人防护设备来保护工作人员和患者,并在临床可能的情况下使用吸引附件来减少临床环境污染,特别是在神经性dfu和面积较大的dfu中。这篇文章受版权保护。版权所有。
{"title":"A deeper look at low-frequency contact ultrasonic debridement in the clinical management of patients with diabetic foot ulcers.","authors":"Francisco J Álvaro-Afonso, Sebastián Flores-Escobar, David Sevillano-Fernández, Yolanda García-Álvarez, Marta García-Madrid, José L Lázaro-Martínez","doi":"10.1111/wrr.13124","DOIUrl":"10.1111/wrr.13124","url":null,"abstract":"<p><p>The current study aimed to evaluate the dispersal of solution and microbes (aerosol) in the clinical environment during treatment with Low-frequency contact ultrasonic debridement (LFCUD) with or without suction attachment in patients with diabetic foot ulcers (DFUs). We performed 20 treatments in 10 patients divided into two groups to receive the proposed LFCUD modalities. We measured the microbial load of the environment pre-treatment (sample M1), during treatment with each LFCUD modality (sample M2) and post-treatment (sample M3). The use of LFCUD debridement without a suction attachment results in significantly higher immediate contamination of the clinic environment than the suction attachment, particularly during the procedure (1.70 ± 0.98 log 10 CFU/mL versus 0.77 ± 0.85 log 10 CFU/mL, p = 0.035). When suction is not applied, there are statistically significant differences depending on whether the DFUs are neuropathic or neuroischemic, finding a greater number of microorganisms with high loads in neuropathic DFUs. We found a statistically significant positive correlation between wound area (r = 0.450, p = 0.047) and TBI (r = 0.651, p = 0.006) with the bacterial load during the LFCUD. Based on our results, we recommend using the personal protective equipment required to protect staff members and patients during treatment with LFCUD and using a suction attachment where clinically possible to reduce clinic environmental pollution, especially in neuropathic DFUs and those with larger areas.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic wounds have been confirmed as a vital health problem facing people in the global population aging process. While significant progress has been achieved in the study of chronic wounds, the treatment effect should be further improved. The number of publications regarding chronic wounds has been rising rapidly. In this study, bibliometric analysis was conducted to explore the hotspots and trends in the research on chronic wounds. All relevant studies on chronic wounds between 2013 and 2022 were collected from the PubMed database of the Web of Science (WOS) and the National Center for Biotechnology Information (NCBI). The data were processed and visualised using a series of software. On that basis, more insights can be gained into hotspots and trends of this research field. Wound Repair and Regeneration has the highest academic achievement in the field of chronic wound research. The United States has been confirmed as the most productive country, and the University of California System ranks high among other institutions. Augustin, M. is the author of the most published study, and Frykberg, RG et al. published the most cited study. Furthermore, the hotspots of wound research over the last decade were identified (e.g., bandages, infection and biofilms, pathophysiology and therapy). This study will help researchers gain insights into chronic wound research's hotspots and trends accurately and quickly. Moreover, the exploration of bacterial biofilm and the pathophysiological mechanism of the chronic wound will lay a solid foundation and clear direction for treating chronic wounds.
{"title":"Research hotspot and trend of chronic wounds: A bibliometric analysis from 2013 to 2022.","authors":"Xinghan Chen, Xiujun Shi, Haitao Xiao, Dongqin Xiao, Xuewen Xu","doi":"10.1111/wrr.13117","DOIUrl":"10.1111/wrr.13117","url":null,"abstract":"<p><p>Chronic wounds have been confirmed as a vital health problem facing people in the global population aging process. While significant progress has been achieved in the study of chronic wounds, the treatment effect should be further improved. The number of publications regarding chronic wounds has been rising rapidly. In this study, bibliometric analysis was conducted to explore the hotspots and trends in the research on chronic wounds. All relevant studies on chronic wounds between 2013 and 2022 were collected from the PubMed database of the Web of Science (WOS) and the National Center for Biotechnology Information (NCBI). The data were processed and visualised using a series of software. On that basis, more insights can be gained into hotspots and trends of this research field. Wound Repair and Regeneration has the highest academic achievement in the field of chronic wound research. The United States has been confirmed as the most productive country, and the University of California System ranks high among other institutions. Augustin, M. is the author of the most published study, and Frykberg, RG et al. published the most cited study. Furthermore, the hotspots of wound research over the last decade were identified (e.g., bandages, infection and biofilms, pathophysiology and therapy). This study will help researchers gain insights into chronic wound research's hotspots and trends accurately and quickly. Moreover, the exploration of bacterial biofilm and the pathophysiological mechanism of the chronic wound will lay a solid foundation and clear direction for treating chronic wounds.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Device-related pressure injuries (DRPIs) prevail in the intensive care unit (ICU) and have much to do with medical devices and patients' conditions. This meta-analysis aims to systematically assess the incidence, prevalence and risk factors related to DRPIs among adults in ICU. Web of Science, Cochrane Library, MEDLINE, PubMed and CINAHL were searched from inception to March 2023. Observational studies were included, and the Newcastle-Ottawa scale (NOS) was used to assess literature quality. The primary outcomes were the incidence, prevalence and risk factors regarding DRPIs among adults in ICU. The 19 studies conformed to the criteria for inclusion in the review. The estimated pooled incidence of DRPIs was 14.7% (95% CI: 9.7%-19.6%) in 10 studies (4866 participants). The estimated pooled prevalence of DRPIs was 19.0% (95% CI: 13.6%-24.3%) in 9 studies (5218 participants). The most significant risk factor for DRPIs was using mechanical ventilation. The pooled analysis of the four studies showed that DRPIs were more likely to occur in patients who required mechanical ventilation compared with patients who did not use mechanical ventilation (OR: 9.67, 95% CI: 5.03-18.61, p < 0.001) and using vasopressors, age, length of ICU stays, APACHE II score, Braden score, fever, sex, oedema, diabetes and number of medical devices, SOFA score was also related to pressure injuries risk. The incidence and prevalence of DRPIs in adult ICU were high, and the most significant risk factor for DRPIs was using mechanical ventilation. It is imminent to identify patients of increased risk with DRPIs early.
{"title":"Incidence, prevalence and risk factors of device-related pressure injuries in adult intensive care unit: A meta-analysis of 10,084 patients from 11 countries.","authors":"Yi-Jie Jia, Fei-Hong Hu, Wan-Qing Zhang, Wen Tang, Meng-Wei Ge, Wang-Qin Shen, Hong-Lin Chen","doi":"10.1111/wrr.13112","DOIUrl":"10.1111/wrr.13112","url":null,"abstract":"<p><p>Device-related pressure injuries (DRPIs) prevail in the intensive care unit (ICU) and have much to do with medical devices and patients' conditions. This meta-analysis aims to systematically assess the incidence, prevalence and risk factors related to DRPIs among adults in ICU. Web of Science, Cochrane Library, MEDLINE, PubMed and CINAHL were searched from inception to March 2023. Observational studies were included, and the Newcastle-Ottawa scale (NOS) was used to assess literature quality. The primary outcomes were the incidence, prevalence and risk factors regarding DRPIs among adults in ICU. The 19 studies conformed to the criteria for inclusion in the review. The estimated pooled incidence of DRPIs was 14.7% (95% CI: 9.7%-19.6%) in 10 studies (4866 participants). The estimated pooled prevalence of DRPIs was 19.0% (95% CI: 13.6%-24.3%) in 9 studies (5218 participants). The most significant risk factor for DRPIs was using mechanical ventilation. The pooled analysis of the four studies showed that DRPIs were more likely to occur in patients who required mechanical ventilation compared with patients who did not use mechanical ventilation (OR: 9.67, 95% CI: 5.03-18.61, p < 0.001) and using vasopressors, age, length of ICU stays, APACHE II score, Braden score, fever, sex, oedema, diabetes and number of medical devices, SOFA score was also related to pressure injuries risk. The incidence and prevalence of DRPIs in adult ICU were high, and the most significant risk factor for DRPIs was using mechanical ventilation. It is imminent to identify patients of increased risk with DRPIs early.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01Epub Date: 2023-07-27DOI: 10.1111/wrr.13109
Jennifer M Hahn, Kelly A Combs, Heather M Powell, Dorothy M Supp
Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti-inflammatory, anti-proliferative and pro-differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.
{"title":"A role for vitamin D and the vitamin D receptor in keloid disorder.","authors":"Jennifer M Hahn, Kelly A Combs, Heather M Powell, Dorothy M Supp","doi":"10.1111/wrr.13109","DOIUrl":"10.1111/wrr.13109","url":null,"abstract":"<p><p>Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti-inflammatory, anti-proliferative and pro-differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}