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1.
A wearable wound moisture sensor as an indicator for wound dressing change: an observational study of wound moisture and status 下载免费PDF全文
Stephen D Milne Ihab Seoudi Hanadi Al Hamad Talal K Talal Anzila A Anoop Niloofar Allahverdi Zain Zakaria Robert Menzies Patricia Connolly 《International wound journal》2016,13(6):1309-1314
Wound moisture is known to be a key parameter to ensure optimum healing conditions in wound care. This study tests the moisture content of wounds in normal practice in order to observe the moisture condition of the wound at the point of dressing change. This study is also the first large‐scale observational study that investigates wound moisture status at dressing change. The WoundSense sensor is a commercially available moisture sensor which sits directly on the wound in order to find the moisture status of the wound without disturbing or removing the dressing. The results show that of the 588 dressing changes recorded, 44·9% were made when the moisture reading was in the optimum moisture zone. Of the 30 patients recruited for this study, 11 patients had an optimum moisture reading for at least 50% of the measurements before dressing change. These results suggest that a large number of unnecessary dressing changes are being made. This is a significant finding of the study as it suggests that the protocols currently followed can be modified to allow fewer dressing changes and less disturbance of the healing wound bed. 相似文献
2.
With an epidemic increase in obesity combined with an ageing population, chronic wounds such as diabetic foot ulcers, pressure ulcers and venous leg ulcers are an increasing clinical concern. Recent studies have shown that bacterial biofilms are a major contributor to wound bioburden and interfere with the normal wound healing process; therefore, rational design of wound therapies should include analysis of anti‐biofilm characteristics. Studies using the combined treatment of bacterial biofilms with the innate immune molecule lactoferrin and the rare sugar‐alcohol xylitol have demonstrated an antimicrobial capacity against a clinical wound isolate. Studies presented here used a colony‐drip‐flow reactor biofilm model to assess the anti‐biofilm efficacy of a lactoferrin/xylitol hydrogel used in combination with commercially available silver‐based wound dressings. Log reductions in biofilm viability are compared with a commercially available wound hydrogel used in combination with the silver‐based wound dressings. For both a single species biofilm and a dual species biofilm, the lactoferrin/xylitol hydrogel in combination with the silver wound dressing Acticoat? had a statistically significant reduction in biofilm viability relative to the commercially available wound hydrogel. This study also demonstrated a statistical interaction between the lactoferrin/xylitol hydrogel and the silver wound dressing. 相似文献
3.
Ryan H Fitzgerald Manish Bharara Joseph L Mills David G Armstrong 《International wound journal》2009,6(2):133-139
This paper discusses the application of Nanoflex powder dressing for management of complex soft tissue wounds. A case report is presented detailing the management of a 43‐year‐old Native American woman with diabetes mellitus who required serial debridements for necrotising fasciitis. Following debridement, the patient was left with a large dorsal foot wound and was transitioned through multiple advanced wound healing modalities. Negative pressure wound therapy (NPWT) was initially utilised in the early postoperative setting to control drainage and to promote granulation tissue; the patient was subsequently transitioned to a Nanoflex powder dressing on postoperative day 4. She reported a decrease in pain associated with dressing changes when transitioned from NPWT to the use of Nanoflex powder dressing. We hypothesise that this pain reduction is the result of a light cooling effect of the exudate‐controlling dressing and subsequent reduction in inflammation as well as the total contact nature of the dressing. Nanoflex powder dressings are a recently developed advanced wound healing modality with promise in the management of complex soft tissue wounds, both as a primary wound dressing as well as a delivery platform for analgesics, antimicrobials and pro‐angiogenic compounds. 相似文献
4.
Jones M Ganopolsky JG Labbé A Gilardino M Wahl C Martoni C Prakash S 《International wound journal》2012,9(3):330-343
The treatment of chronic wounds poses a significant challenge for clinicians and patients alike. Here we report design and preclinical efficacy of a novel nitric oxide gas (gNO)-producing probiotic patch for wound healing. Specifically, a wound healing patch using lactic acid bacteria in an adhesive gas permeable membrane has been designed and investigated for treating ischaemic and infected full-thickness dermal wounds in a New Zealand white rabbit model for ischaemic wound healing. Kaplan-Meier survival curves showed increased wound closure with gNO-producing patch-treated wounds over 21 days of therapy (log-rank P = 0·0225 and Wilcoxon P = 0·0113). Cox proportional hazard regression showed that gNO-producing patch-treated wounds were 2·52 times more likely to close compared with control patches (hazard P = 0·0375, score P = 0·032 and likelihood ratio P = 0·0355), and histological analysis showed improved wound healing in gNO-producing patch-treated animals. This study may provide an effective, safe and less costly alternative for treating chronic wounds. 相似文献
5.
Debridement is a crucial component of wound management. Traditionally, several types of wound debridement techniques have been used in clinical practice such as autolytic, enzymatic, biodebridement, mechanical, conservative sharp and surgical. Various factors determine the method of choice for debridement for a particular wound such as suitability to the patient, the type of wound, its anatomical location and the extent of debridement required. Recently developed products are beginning to challenge traditional techniques that are currently used in wound bed preparation. The purpose of this review was to critically evaluate the current evidence behind the use of these newer techniques in clinical practice. There is some evidence to suggest that low frequency ultrasound therapy may improve healing rates in patients with venous ulcers and diabetic foot ulcers. Hydrosurgery debridement is quick and precise, but the current evidence is limited and further studies are underway. Debridement using a monofilament polyester fibre pad and plasma‐mediated bipolar radiofrequency ablation are both very new techniques. The initial evidence is limited, and further studies are warranted to confirm their role in management of chronic wounds. 相似文献
6.
Hajime Matsumura Ryutaro Imai Niyaz Ahmatjan Yukiko Ida Masahide Gondo Dai Shibata Katsueki Wanatabe 《International wound journal》2014,11(1):50-54
In recent years, adhesive wound dressings have been increasingly applied postoperatively because of their ease of use as they can be kept in place without having to cut and apply surgical tapes and they can cover a wound securely. However, if a wound dressing strongly adheres to the wound, a large amount of stratum corneum is removed from the newly formed epithelium or healthy periwound skin. Various types of adhesives are used on adhesive wound dressings and the extent of skin damage depends on how much an adhesive sticks to the wound or skin surface. We quantitatively determined and compared the amount of stratum corneum removed by eight different wound dressings including polyurethane foam using acrylic adhesive, silicone‐based adhesive dressing, composite hydrocolloid and self‐adhesive polyurethane foam in healthy volunteers. The results showed that wound dressings with silicone adhesive and self‐adhesive polyurethane foam removed less stratum corneum, whereas composite hydrocolloid and polyurethane foam using acrylic adhesive removed more stratum corneum. 相似文献
7.
Akela A Nandi SK Banerjee D Das P Roy S Joardar SN Mandal M Das PK Pradhan NR 《International wound journal》2012,9(5):505-516
A study was conducted to evaluate the potential of autologous bone marrow-derived cells in comparison with buffy coat of autologous blood for rapid cutaneous wound healing in rabbit model. Three square full-thickness skin excisional wounds were created in 15 selected experimental animals (rabbit) divided randomly into three groups. The wound was treated with autologous bone marrow cells in plasma (group 1), buffy coat of blood in plasma (group 2) and autologous plasma as control (group 3). Wounds were observed for 30 days for granulation tissue formation, biochemical, histomorphological and histochemical evaluation. In this study, granulation tissue appeared significantly lesser in wounds of group 3 animals followed by group 2 and 1 animals. Neovascularisation, granulation tissue formation, denser, thicker and better arranged collagen fibres, reticulin fibres and elastin fibres formation was more in group 1 as compared with other groups. It was concluded that the application of bone marrow-derived nucleated cells into the wound margins resulted in early and significantly faster rate of complete healing as compared with buffy coat of autologous blood and autologous plasma (control). This approach may be beneficial in various surface wounds that heal at a slower rate and recommended for healing of various complicated wound in future. 相似文献
8.
Ariane R Brogliato Paula A Borges Janaina F Barros Manuela Lanzetti Samuel Valença Nesser C Oliveira Hélcio J Izário‐Filho Claudia F Benjamim 《International wound journal》2014,11(2):190-197
Silver is used worldwide in dressings for wound management. Silver has demonstrated great efficacy against a broad range of microorganisms, but there is very little data about the systemic absorption and toxicity of silver in vivo. In this study, the antimicrobial effect of the silver‐coated dressing (SilverCoat®) was evaluated in vitro against the most common microorganisms found in wounds, including Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, Methicillin‐resistant Staphylococcus aureus and Klebsiella pneumoniae. We also performed an excisional skin lesion assay in mice to evaluate wound healing after 14 days of treatment with a silver‐coated dressing, and we measured the amount of silver in the blood, the kidneys and the liver after treatment. Our data demonstrated that the nylon threads coated with metallic silver have a satisfactory antimicrobial effect in vitro, and the prolonged use of these threads did not lead to systemic silver absorption, did not induce toxicity in the kidneys and the liver and were not detrimental to the normal wound‐healing process. 相似文献
9.
目的:探讨氟尿嘧啶缓释剂对兔胆肠吻合口组织愈合的影响,为其临床应用的可行性及安全性提供依据。方法:40只健康新西兰兔随机均分为实验组与对照组,两组均行胆管十二指肠侧侧吻合后,实验组于胆肠吻合口旁植入氟尿嘧啶缓释剂,对照组植入空颗粒。两组于术后3、7、14、21 d取胆肠吻合口组织,观察腹腔内及吻合口大体情况,行van der Ham粘连评分,测定吻合口破裂压(ABP),行吻合口组织病理学及胶原结缔组织检测。结果:实验组存活18只,1只死于胆汁漏,1只死于腹腔感染;对照组存活19只,1只死于胆汁漏,两组死亡率差异无统计学意义(P>0.05)。两组吻合口大体愈合情况相似,术后各时间点van der Ham评分与ABP差异均无统计学意义(均P>0.05)。组织病理学检测(HE染色及Mallory三色法)显示两组术后吻合口周围炎症反应、新生毛细血管和胶原纤维增生情况基本相似。结论:氟尿嘧啶缓释剂不影响兔胆肠吻合口的愈合,可作为预防和治疗胆胰恶性肿瘤术后局部复发和转移的一种安全的辅助化疗手段。 相似文献
10.
11.
Tien-Hsiang Wang Hsu MaFa-Lai Yeh Jin-Teh LinBing-Hwei Shen 《Burns : journal of the International Society for Burn Injuries》2010
To evaluate the effect of a new dressing method for clean wound coverage, two kinds of dressing materials are combined together to cover nine wounds in nine patients. All the wounds are split-thickness skin graft donor sites located in the anterior thighs. The size of the wounds ranges from 6 cm × 4 cm to 10 cm × 8 cm (42 cm2 on average). A central fenestration is created in the polyurethane film layer for draining the wound discharge, and a piece of 2.5 cm × 2.5 cm carboxymethyl cellulose dressing is fixed on top of the fenestration for protecting the underlying wound. Dry gauze is used to cover the composite dressing, which is replaced daily. The wound condition is checked and recorded everyday until the patient is discharged. Further management and follow-up for the wound is performed at the outpatient department or by telephone. All wounds healed smoothly on the postoperative 6th to 7th day. No wound infection was noted, including one patient who had diabetes mellitus. Five patients responded to follow-up for at least 5 months and no hypertrophy scar formation was noted. From clinical experiences, we know that this new method is practical and cost-effective for covering small-sized, split-thickness skin graft donor-site wounds. 相似文献
12.
《Injury》2017,48(3):653-658
Estimation of surface for application of wound care is one of the important prognostic factors for wound healing. The objective of this study is to measure a surface area estimation for application of wound care. Non-invasive, 3D surface reconstruction methodology using two monocular cameras was implemented and verified. The measurement environment was setup on 10 patients with different kind of wounds. Phantom measurements, with known dimensions, show accuracy of implemented method below 11 percent The patient’s measurements has the same accuracy. The implemented method use state of art algorithms and the cheap equipment and can be treated as an auxiliary, more objective method to quantify the wound healing process. 相似文献
13.
Plastic wound protectors do not affect wound infection rates following laparoscopic-assisted colectomy 总被引:1,自引:2,他引:1
Kercher KW Nguyen TH Harold KL Poplin ME Matthews BD Sing RF Heniford BT 《Surgical endoscopy》2004,18(1):148-151
Background: Wound protectors are plastic sheaths that can be used to line a wound during surgery. Wound protectors can facilitate retraction of an incision without the need for other mechanical retractors and have been proposed as deterrents to wound infection. The purpose of this study was to define the ability of wound protectors to reduce the rate of infection when used in laparoscopic-assisted colectomy. Methods: We completed a retrospective review of the medical records of patients undergoing nonemergent laparoscopic-assisted colectomy between February 1999 and November 2002. All completely laparoscopic cases were excluded. The wound protector, when used, was applied to the extraction incision during the externalized portion of the procedure (colon and mesentery transection, anastomosis). Outcomes for patients with and without the use of a wound protector were compared. Results: A total of 141 patients underwent laparoscopic-assisted colectomy (98 for benign/malignant tumors, 35 for diverticular disease, and eight for Crohns disease). There were no differences between the wound protector group (n = 84) and the no wound protector group (n = 57) with respect to mean age (55 vs 58 years), average body mass index (27 vs 29 kg/m2), gender, indication for surgery, comorbidities, antibiotics used, or mean operative time (185 vs 173 min). Nine patients in the wound protector group and eight in the no wound protector group developed a wound infection at the colon extraction site (p = 0.42). Patients undergoing resection for Crohns disease or diverticulitis had a higher infection rate (18.6%) than patients undergoing resection for polyps or cancer (9.2%; p < 0.05). No wound recurrence of cancer was observed in either group at a mean follow-up of 23 months (range, 3–48). Conclusions: The wound protector, although useful for mechanical retraction of small wounds, does not significantly diminish the rate of wound infection at the bowel resection/anastomotic site. Patients undergoing elective resection for inflammatory processes have higher infection rates than patients undergoing laparoscopic-assisted colectomy for polyps or cancer. 相似文献
14.
重组人角质细胞生长因子2涂膜剂对家兔损伤创面愈合的影响 总被引:3,自引:0,他引:3
目的观察重组人角质细胞生长因子2(rhKGF-2)涂膜剂对家兔损伤创面愈合的影响。方法用预热至100℃的100 g砝码在家兔背部脱毛部位压烫8 s,造成背部4个直径为2.5 cm 的深Ⅱ度烫伤创面;手术切除家兔背部部分皮肤,制作2个5.5 cm×4.0 cm的全层皮肤缺损创面。伤后第2天将家兔分成对照组、基质组、rhKGF-2溶液组和不同剂量rhKGF-2涂膜剂组,共12个组 (两种创面各6组),每天分别在创面涂抹等渗盐水、涂膜剂基质、rhKGF-2溶液及3种剂量的rhKGF-2 涂膜剂,连续给药15 d。每4天测量1次伤口面积并计算愈合率,第16天切取各组家兔伤口及其周围正常皮肤进行组织形态学观察,利用Masson三色法染色和MOTIC Advanced 3.2形态分析软件统计创面新生上皮面积、厚度和上皮细胞迁移距离。结果 30.0 μg rhKGF-2涂膜剂给药4、12 d时, 家兔的烫伤创面愈合率[(20±4)%、(65±6)%]明显高于对照组[(10±4)%、(56±9)%]和基质组 [(20±5)%、(59±7)%];160.0 μg rhKGF-2涂膜剂给药4、12 d时,家兔的皮肤缺损创面愈合率 [(33±6)%、(71±20)%]明显高于对照组[(23±4)%、(53±6)%]和基质组[(27±11)%、(58± 9)%]。组织形态学定量检测结果显示,rhKGF-2涂膜剂尤其是大剂量组能明显增加两种创面新生上皮面积、平均厚度和上皮细胞移行距离。结论 rhKGF-2涂膜剂能明显加快家兔皮肤烫伤和皮肤全层切除创面周围上皮细胞的增生与迁移,缩短其愈合过程。 相似文献
15.
Atiyeh BS Hayek SN Gunn SW 《Burns : journal of the International Society for Burn Injuries》2005,31(8):944-956
Methods for handling burn wounds have changed in recent decades. Increasingly, aggressive surgical approach with early tangential excision and wound closure is being applied leading to improvement in mortality rates of burn victims. Autografts from uninjured skin remain the mainstay of treatment. Autologous skin graft, however, has limited availability and is associated with additional morbidity and scarring. Severe burn patients invariably lack sufficient adequate skin donor sites requiring alternative methods of skin replacement. The present review summarizes available replacement technologies. 相似文献
16.
Ryan S Constantine Jessica D Bills Lawrence A Lavery Kathryn E Davis 《International wound journal》2016,13(5):614-618
In the treatment and monitoring of a diabetic or chronic wound, accurate and repeatable measurement of the wound provides indispensable data for the patient's medical record. This study aims to measure the accuracy of the laser‐assisted wound measurement (LAWM) device against traditional methods in the measurement of area, depth and volume. We measured four ‘healing’ wounds in a Play‐Doh®‐based model over five subsequent states of wound healing progression in which the model was irregularly filled in to replicate the healing process. We evaluated the LAWM device against traditional methods including digital photograph assessment with National Institutes of Health ImageJ software, measurements of depth with a ruler and weight‐to‐volume assessment with dental paste. Statistical analyses included analysis of variance (ANOVA) and paired t‐tests. We demonstrate that there are significantly different and nearly statistically significant differences between traditional ruler depth measurement and LAWM device measurement, but there are no statistically significant differences in area measurement. Volume measurements were found to be significantly different in two of the wounds. Rate of percentage change was analysed for volume and depth in the wound healing model, and the LAWM device was not significantly different than the traditional measurement technique. While occasionally inaccurate in its absolute measurement, the LAWM device is a useful tool in the clinician's arsenal as it reliably measures rate of percentage change in depth and volume and offers a potentially aseptic alternative to traditional measurement techniques. 相似文献
17.
A. Atabey S. Karademir N. Atabey A. Barutçu 《European journal of plastic surgery》1995,18(2-3):99-102
Helium-neon laser irradiation was applied to the denuded dermis and full-thickness open wounds on rabbit skin and cell cultures of human skin fibroblasts to investigate its effects on the wound healing process. To determine the effects of He-Ne laser radiation on epithelialization rate, 3×3 cm denuded dermis areas on the flank of 16 rabbits were irradiated daily until complete epithelialization occurred. For histopathological evaluation biopsies were taken on the first day and on the day on which epithelialization was complete. As a second part of in vivo study, identical full-thickness skin wounds were created bilaterally on the middle flank area of 12 rabbits. He-Ne laser irradiation was applied daily to the wounds until complete healing occurred to determine the effects of the low-energy laser on the contraction of open wounds. The contralateral wounds were left untreated, serving as controls. In a separate in vitro study, the effect of single or multiple applications of He-Ne laser irradiation on normal human skin fibroblasts in cell cultures was evaluated using growth measurement. The mean epithelialization time was 11±0.63 days for the laser-treated wounds and 12±0.12 days for the control wounds. The difference was not significant. No significant difference was found between the contraction rates of the full-thickness wounds (e.g., on the seventh postoperative day, the average wound area was 70.2±6.75% of original wound area in the laser-treated group and 66.±8.75% in the control group). Histopathologically, epidermal thickening and an increase in dermal vascularity were observed in healed wounds of the laser-treated groups. However, in vitro, this low-energy laser promoted cell growth in human fibroblast cell cultures in 2-and 3-day treated groups (p>0.05). 相似文献
18.
目的 分析透明质酸在创伤愈合过程中的含量变化以及胎儿型愈合和成人型愈合的机理。方法 通过胎兔创伤模型及皮肤均化的方法,提取游离及结合的透明质酸(HA) ,应用透明质酸结合蛋白( HABP) 技术,对胚胎兔、成年兔皮肤在正常及创伤愈合过程中用放射免疫法测定游离、结合及HA 的总量。结果 ⑴不同孕期正常胎兔皮肤的游离HA 及HA 总量的差异均无显著意义,结合HA 有显著的波动,而且均比正常成兔增高( P< 0 .01) ;⑵胎兔皮肤创伤后不同愈合时间的游离HA 及HA 总量的差异均无显著意义,结合HA 的组成亦有显著变化;⑶创伤胎兔与正常胎兔相比,各组分HA 均增高( P< 0 .05) ;⑷创伤成年兔游离HA 及HA 总量均比正常成年兔显著增高( P< 0 .01) ,而在创伤成年兔内部游离HA 及HA 总量呈“山峰型”变化;⑸胎兔、成年兔皮肤创伤后对应比较发现,HA 总量均为胎兔高( P< 0 .01) ,而游离HA 则第2 、3 天差异无显著意义。结论 HA 的增高是胎儿型愈合不可缺少的内部机制,其中游离HA 起主导作用,但结合HA 随孕期的延长以及在创伤后不同愈合时间所发生的显著变化,对于临床控制瘢痕形成具有很重要的意义 相似文献
19.
肝细胞生长因子促进膀胱平滑肌创伤愈合的研究 总被引:1,自引:1,他引:1
目的 用单纯膀胱肌肉损伤模型研究肝细胞生长因子 (HGFs)质粒DNA(pUDKH)在膀胱平滑肌创伤愈合中的作用。方法 用 2 4~ 3 0周新西兰兔制备单纯膀胱前壁肌层缺损创面 3个 ,面积均为 1cm2 大小。分别涂覆单纯溶媒 (A组 ) ,15 μg空载体质粒DNA(pUDK ,B组 )和 15 μgpUDKH(C组 )溶液 ,只涂 1次 ,涂覆次序轮替 ,共 2 0组。术后进行系列创面愈合速度检查 ,影像检查和组织学检查 ,比较肥大指数 (HI)。结果 术后 2 0只兔均存活至实验结束。术后各组平滑肌缺损创面均缩少 ,A ,B和C组创面面积 ,7?d时分别为 ( 4 3 .9± 9.8)mm2 ,( 4 3 .0± 11.1)mm2 和( 2 7.7± 7.5 )mm2 ,14d时分别为 ( 2 4.1± 9.1)mm2 ,( 2 2 .4± 7.4)mm2 和 ( 4 .1± 4.0 )mm2 ,C组与A、B组相比差异显著。膀胱影像检查 ,各组膀胱膀胱形态基本正常。术后组织学显示 ,A ,B组显示上皮层正常 ,粘膜下纤维组织增生加厚而肌层较薄 ;C组显示与自体膀胱具相似的组织学结构。术后 3 0d时 ,A ,B和C组的HI分别为 ( 1.76± 0 .17) ,( 1.83± 0 .18)和 ( 1.11± 0 .18) (P <0 .0 1,CvsAandB)。结论 实验组兔膀胱创面愈合速度快 ,对照组创面膀胱平滑肌再生速度慢 ,再生不完全 ,粘膜下纤维瘢痕增生。提示HGFs能够促进膀胱平滑肌创伤愈合 ,减少瘢痕形成 相似文献
20.
创面修复临床治疗机构现状与展望 总被引:2,自引:2,他引:0
It is essential for the development of modem clinical medicine to establish a professional facility and team for wound healing. There is some successful experience of constructing and running the wound healing center to be mirrored at home and abroad. The construction of the facility and team for wound healing will be promoted by guideline issuing, profession certificating, and others, which would push forward the clinical treatment and basic research of wound healing. 相似文献