Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.11.001
J.A. Caprini MD, MS, FACS, RVT , H. Partsch MD , R. Simman MD, FACS, FACCWS
Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence.
{"title":"Venous Ulcers","authors":"J.A. Caprini MD, MS, FACS, RVT , H. Partsch MD , R. Simman MD, FACS, FACCWS","doi":"10.1016/j.jccw.2013.11.001","DOIUrl":"10.1016/j.jccw.2013.11.001","url":null,"abstract":"<div><p><span><span><span>Venous leg ulcers are the most frequent form of wounds seen </span>in patients<span><span>. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying </span>venous pathology and to treat </span></span>venous refluxes<span><span>. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, </span>malignancies. Patients with superficial </span></span>venous incompetence<span><span> may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy<span>, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the </span></span>ulcer is healed compression therapy should be continued in order to prevent recurrence.</span></p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33891037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.12.002
Richard Simman MD, FACS, FACCWS
{"title":"Letter from the Editor","authors":"Richard Simman MD, FACS, FACCWS","doi":"10.1016/j.jccw.2013.12.002","DOIUrl":"10.1016/j.jccw.2013.12.002","url":null,"abstract":"","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.12.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33891036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.10.001
Barbara J. Marshall DPM, CWS , Rachel E. Johnson RN, DPM
This is a case report of a patient who presented to the wound care center with LE ulcerations that were subsequently diagnosed with calciphylaxis. She was an insulin dependent diabetic with renal disease, but unaware of her critical kidney status. She was treated with local wound care, a partial parathyroidectomy, and started on dialysis. She is currently healed with no recurrence of ulcerations. Her ulcerations were controlled with conservative wound care and no surgical debridement.
{"title":"Case Report on Calciphylaxis: An Early Diagnosis and Treatment May Improve Outcome","authors":"Barbara J. Marshall DPM, CWS , Rachel E. Johnson RN, DPM","doi":"10.1016/j.jccw.2013.10.001","DOIUrl":"10.1016/j.jccw.2013.10.001","url":null,"abstract":"<div><p>This is a case report of a patient who presented to the wound care center with LE ulcerations<span><span> that were subsequently diagnosed with calciphylaxis. She was an insulin dependent diabetic with </span>renal disease<span><span>, but unaware of her critical kidney status. She was treated with local wound care, a partial parathyroidectomy, and started on dialysis. She is currently healed with no recurrence of ulcerations. Her ulcerations were controlled with conservative wound care and no surgical </span>debridement.</span></span></p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33891495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.12.001
Jayesh B. Shah MD, CWS, FACCWS, FAPWCA, UHM, FACHM
{"title":"Ace Your Certification: Venous Stasis Ulcer","authors":"Jayesh B. Shah MD, CWS, FACCWS, FAPWCA, UHM, FACHM","doi":"10.1016/j.jccw.2013.12.001","DOIUrl":"https://doi.org/10.1016/j.jccw.2013.12.001","url":null,"abstract":"","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136601378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.08.001
Aaron J. Wodash RN, WCC
The purpose of this study was to determine if using advanced wound care dressings leads to improved outcomes as compared to wet-to-dry dressings. Based on a review of literature published in the last eight years, with the exception of one landmark article published in 2001, strong support was found that advanced wound care dressings improved outcomes when compared to wet-to-dry dressings. Some of the outcomes compared were healing time, pain, infection rates, and costs; several articles took it a step further stating that the use of wet-to-dry dressings is considered sub-standard practice. The articles provided evidence-based support for the use of moist wound healing.
{"title":"Wet-to-Dry Dressings Do Not Provide Moist Wound Healing","authors":"Aaron J. Wodash RN, WCC","doi":"10.1016/j.jccw.2013.08.001","DOIUrl":"10.1016/j.jccw.2013.08.001","url":null,"abstract":"<div><p>The purpose of this study was to determine if using advanced wound care dressings leads to improved outcomes as compared to wet-to-dry dressings. Based on a review of literature published in the last eight years, with the exception of one landmark article published in 2001, strong support was found that advanced wound care dressings improved outcomes when compared to wet-to-dry dressings. Some of the outcomes compared were healing time, pain, infection rates, and costs; several articles took it a step further stating that the use of wet-to-dry dressings is considered sub-standard practice. The articles provided evidence-based support for the use of moist wound healing.</p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33891039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-09-01DOI: 10.1016/j.jccw.2013.11.002
Christine Miller DPM, CWS, FACCWS
Negative pressure wound therapy (NPWT) is a commonly used modality to facilitate tissue granulation and thus hasten the healing process. While the modern vacuum systems are quite sophisticated, their historic origins can be traced to ancient times. This is a historic review of the precursors to the current negative pressure wound therapy.
{"title":"The History of Negative Pressure Wound Therapy (NPWT): From “Lip Service” to the Modern Vacuum System","authors":"Christine Miller DPM, CWS, FACCWS","doi":"10.1016/j.jccw.2013.11.002","DOIUrl":"10.1016/j.jccw.2013.11.002","url":null,"abstract":"<div><p>Negative pressure wound therapy (NPWT) is a commonly used modality to facilitate tissue granulation and thus hasten the healing process. While the modern vacuum systems are quite sophisticated, their historic origins can be traced to ancient times. This is a historic review of the precursors to the current negative pressure wound therapy.</p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33891038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-06-01DOI: 10.1016/j.jccw.2013.06.004
Michael Moore MD, FACS, FACCWS (Chair, ACCWS)
{"title":"Letter from the Chair","authors":"Michael Moore MD, FACS, FACCWS (Chair, ACCWS)","doi":"10.1016/j.jccw.2013.06.004","DOIUrl":"10.1016/j.jccw.2013.06.004","url":null,"abstract":"","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32115846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-06-01DOI: 10.1016/j.jccw.2013.06.001
Andrea Hoffmann PhD , Jessica Lynn Hoing MD , Mackenzie Newman MS , Richard Simman MD, FACS, FACCWS
Background
Keloids are benign dermal scars characterized by enhanced growth factor signaling, hyperproliferation activity and reduced extracellular matrix (ECM) deposition of hyaluronic acid. Our hypothesis is that high molecular weight HA can be used to replenish HA deposition in keloids thereby normalizing the keloid fibroblast phenotype.
Methods
One normal (NF1) fibroblast culture and five keloid (KF1, KF2, KF3, KF4, KF5) fibroblast cultures were analyzed for changes in hyperproliferation, growth factor production and extracellular matrix deposition following 72 hour treatment with or without 10 μg/ml HA.
Results
Proliferation activity decreased significantly in KF3 following HA treatment. Pro-collagen I expression in KF2 was decreased following HA treatment in association with changes in fiber arrangement to more parallel collagen bundles. In addition, HA demonstrated a downregulation on TGF-b1 growth factor expression in KF3 and KF4 and a decrease in active TGF-b1 release in KF2 and KF5 using ELISA.
Conclusion
Our data demonstrates that HA has the potential to normalize keloid fibroblast characteristic features such as hyperproliferation, growth factor production and ECM deposition depending on the specific genotype of the keloid fibroblast cell line. This study suggests that high molecular weight HA can be used to replenish HA deposition in keloid fibroblasts thereby decreasing fibrosis and ultimately decreasing keloid manifestation.
{"title":"Role of Hyaluronic Acid Treatment in the Prevention of Keloid Scarring","authors":"Andrea Hoffmann PhD , Jessica Lynn Hoing MD , Mackenzie Newman MS , Richard Simman MD, FACS, FACCWS","doi":"10.1016/j.jccw.2013.06.001","DOIUrl":"10.1016/j.jccw.2013.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Keloids<span> are benign dermal scars characterized by enhanced growth factor signaling, hyperproliferation activity and reduced extracellular matrix<span> (ECM) deposition of hyaluronic acid. Our hypothesis is that high molecular weight HA can be used to replenish HA deposition in keloids thereby normalizing the keloid fibroblast phenotype.</span></span></p></div><div><h3>Methods</h3><p>One normal (NF1) fibroblast culture<span> and five keloid (KF1, KF2, KF3, KF4, KF5) fibroblast cultures were analyzed for changes in hyperproliferation, growth factor production and extracellular matrix deposition following 72 hour treatment with or without 10 μg/ml HA.</span></p></div><div><h3>Results</h3><p>Proliferation activity decreased significantly in KF3 following HA treatment. Pro-collagen I expression in KF2 was decreased following HA treatment in association with changes in fiber arrangement to more parallel collagen bundles. In addition, HA demonstrated a downregulation on TGF-b1 growth factor expression in KF3 and KF4 and a decrease in active TGF-b1 release in KF2 and KF5 using ELISA.</p></div><div><h3>Conclusion</h3><p><span>Our data demonstrates that HA has the potential to normalize keloid fibroblast characteristic features such as hyperproliferation, growth factor production and ECM deposition depending on the specific genotype of the keloid fibroblast cell line. This study suggests that high molecular weight HA can be used to replenish HA deposition in keloid fibroblasts thereby decreasing </span>fibrosis and ultimately decreasing keloid manifestation.</p></div>","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32429633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-06-01DOI: 10.1016/j.jccw.2013.06.003
Richard Simman MD, FACS, FACCWS (Editor in Chief, Journal of the ACCWS)
{"title":"Letter from the Editor","authors":"Richard Simman MD, FACS, FACCWS (Editor in Chief, Journal of the ACCWS)","doi":"10.1016/j.jccw.2013.06.003","DOIUrl":"10.1016/j.jccw.2013.06.003","url":null,"abstract":"","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32115845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-06-01DOI: 10.1016/j.jccw.2013.06.005
Jayesh B. Shah MD, CWSP, FACCWS, FAPWCA, FUHM
{"title":"Ace Your Certification Exam","authors":"Jayesh B. Shah MD, CWSP, FACCWS, FAPWCA, FUHM","doi":"10.1016/j.jccw.2013.06.005","DOIUrl":"10.1016/j.jccw.2013.06.005","url":null,"abstract":"","PeriodicalId":90358,"journal":{"name":"The journal of the American College of Clinical Wound Specialists","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jccw.2013.06.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32115800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}