bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of polarised light as a method of pressure ulcer prevention in an adult intensive care unit
Authors: Verbelen J. 
Published: May 2014

Objective: This single-centred randomised pilot study aimed to examine whether the wound-healing properties of polarised light are effective in preventing grade II or above pressure ulcers in patients admitted to an adult intensive care unit. Method: Standard pressure ulcer prevention techniques were applied in both research groups. Patients allocated to the test group received supplementary treatment with polarised light once daily for 10 minutes (sacral area and both heels) starting on the first day after admission. The control group received no polarised light. Results: A control group of 13 patients and an intervention group of 10 patients were included in the study between 1 March and 1 May 2006. There was no statistically significant difference between the groups for composition, standard pressure ulcer prevention or pressure ulcer risk. Observations revealed a statistically significant difference (p=0.019) between the groups when comparing development of grade II or above sacral or heel pressure ulcers. Conclusion: Patients treated with polarised light developed significantly (p=0.019) fewer grade II or above sacral or heel pressure ulcers when compared with a control group receiving no polarised light. Further research is required. Declaration of interest: Two Bioptron light sources were lent by Haromed Wound and Skin Care Solutions and a number of grids for use with a Visitrak system by Smith & Nephew. The supporting sources had no involvement in the study design, data collection or analysis, interpretation of data, writing of the article or the decision to submit the article for publication. None of the contributors received any financial compensation.
Wound healing activity of Matricaria recutita L. extract
Authors: Shivananda Nayak B. , Sivachandra Raju S. , Chalapathi Rao A.V. 
Published: May 2014

Objective: To evaluate the wound healing activity of M. recutita (chamomile) extract in rats. Method: Wound healing activity was determined using excision, incision and dead space wound models. The animals were divided into two groups of six for each model: animals in the test group were treated with the aqueous extract of M. recutita (120mg/kg/day), which was mixed in their drinking water. Animals in the control group were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialisation, wound-breaking strength, granulation tissue weight and hydoxyproline content. Antimicrobial activity of the extract against various microorganisms was assessed. Results: On day 15 animals in the test group exhibited a greater reduction in the wound area when compared with the controls (61% versus 48%), faster epithelialisation and a significantly higher wound-breaking strength (p<0.002). In addition, wet and dry granulation tissue weight and hydroxyproline content were significantly higher. Conclusion: The increased rate of wound contraction, together with the increased wound-breaking strength, hydroxyproline content and histological observations, support the use of M. recutita in wound management. However, this needs to be studied further before it can be considered for clinical use. Declaration of interest: None.
Effect of amelogenin extracellular matrix protein and compression on hard-to-heal venous leg ulcers: follow-up data
Authors: Romanelli M. , Kaha E. , Stege H. , Wnorowski J.W. , Vowden P. , Majamaa H. , Lazaro J.L. 
Published: May 2014

Objective: To undertake a follow-up of patients with hard-to-heal venous leg ulcers (VLUs) who had participated in a randomised controlled trial in which they had been treated with either compression therapy in combination with amelogenin extracellular matrix protein or compression therapy alone for 12 weeks or until their ulcers had healed, whichever occurred first. Method: Patients were randomised to receive either high compression therapy plus amelogenin (n=42) or high compression therapy alone (n=41) for a period up to and including 12 weeks. The method and initial findings are detailed in an earlier paper. Twelve weeks after the final visit, the patients were followed up and the wounds were re-evaluated. Results: The initial results demonstrated clinically and statistically significant benefits for the patients in the amelogenin group. The results of the follow-up showed that the successful healing response had been maintained. Significantly more patients continued to show a reduction in ulcer size from baseline in the amelogenin-treated group versus the control group (p=0.02), and there was a statistically significant (p=0.01) larger reduction in the amelogenin-treated group. This group also had a significantly (p=0.02) higher percentage of patients with decreases in wound size. The overall number of patients with healed wounds was greater (n=9) in the amelogenin-treated group than in the control group (n=3). Pain continued to be significantly reduced in the amelogenin-treated group compared with the control group (p=0.001). Conclusion: Amelogenin therapy in conjunction with high compression therapy was beneficial in the treatment of hard-to-heal VLUs when compared with treatment with high compression alone. These beneficial effects were maintained post-treatment and were identified at follow-up. Declaration of interest: This study was funded by Mölnlycke Health Care, Göteborg, Sweden.
Assessment of the antimicrobial effectiveness of a new silver alginate wound dressing: a RCT
Authors: Trial C. , Darbas H. , Lavigne J-P. , Sotto A. , Simoneau G. , Tillet Y. , Toét L. 
Published: May 2014

Objective: To compare the efficacy and tolerability of a new ionic silver alginate matrix (Askina Calgitrol Ag) with that of a standard silver-free alginate dressing (Algosteril). Method: Patients with locally infected chronic wounds (pressure ulcers, venous or mixed aetiology leg ulcers, diabetic foot ulcers) or acute wounds were eligible for this prospective, open-label, controlled and randomised trial. Patients were randomised to receive one of the two dressings for a two-week period. Criteria of efficacy were based on the evolution, from day 1 to day 15, of local signs of infection using a clinical score ranging from 0 to 18, and the evolution of the bacteriological status for each wound. The latter was determined by (blind) bacteriological examinations of results obtained from two biopsies performed at days 1 and 15. A three-point scale (deterioration, unchanged, improvement) was also used. Acceptability, usefulness and tolerance were also assessed. Results: Forty-two patients (20 women and 22 men, 68.9 ± 18.8 and 66.5 ± 15.7 years old respectively) were randomly assigned to receive either Askina Calgitrol Ag (n=20) or Algosteril (n=22). Most had chronic wounds such as pressure ulcers (57%) or venous or mixed aetiology leg ulcers and diabetic foot ulcers (29%); few had acute wounds (14%). Clinical scores of infection were comparable in both groups at inclusion, 8.9 ± 2.4 and 8.6 ± 3.2 in the Askina Calgitrol Ag group and the Algosteril group respectively (not signifi cant), but decreased signifi cantly in both groups at day 15, 3.8 ± 2.9 in the Askina Calgitrol Ag group (p=0.001) and 3.8 ± 3.4 in the Algosteril group (p=0.007). There was no signifi cant difference between the two groups at day 15. Although there was also no signifi cant difference in bacteriological status between the treatment groups, a trend in favour of Askina Calgitrol Ag was found for the relative risk of improvement, especially in patients who were not treated with antibiotics either at the beginning of the study or during it. No differences between groups were observed regarding local tolerance, acceptability and usefulness of the dressings. Conclusion: The regression of local signs of infection, local tolerance, acceptability and usefulness were similar for the two dressings. However, Askina Calgitrol Ag improved the bacteriological status of the wounds. Further trials are required to show that it has a positive impact on the healing process. Declaration of interest: The study was sponsored by B. Braun Medical SAS.
Prevalence of diabetic foot syndrome and its risk factors in the UK
Authors: Lauterbach S. , Kostev K. , Kohlmann T. 
Published: May 2014

Objective To determine the prevalence of diabetic foot syndrome (DFS) and its risk factors (diabetic neuropathy, peripheral vascular disease, open wounds and mycoses of the feet) at GP practices in the UK in 2008. Method We searched the IMS Disease Analyzer database, which stores representative information on approximately 4.2 million patients. All documented diagnoses of diabetes mellitus in 2008, based on either ICD-10 (international classification of diseases) codes or free text comments from doctors, were analysed. Results Data from 34,198 patients with type 2 diabetes (47.1% female, mean age 66.1 years [SD 15.1], mean diabetes duration 7.4 years [SD 5.1]) and 2,576 patients with type 1 diabetes (43.2% female, mean age 39.2 years [SD: 18.0], diabetes duration 11.0 years [SD: 6.1]) were analysed. DFS was registered in 7.6% (95% CI: 6.6–8.6) of patients with type 1 diabetes and 8.5% (95% CI: 8.2-8.8) with type 2 diabetes. Many more patients were at high risk of developing DFS, with diabetic neuropathy, diabetic angiopathy, foot mycoses and/or open wounds of the feet. Conclusion Results from this analysis of one of the large representative databases show that even though the prevalence of DFS among patients with diabetes mellitus is relatively low, the prevalence of its main risk factors is high. Preventive efforts should target these risk factors. Conflict of interest None.
Use of a silicon microsensor for pressure monitoring inside the wound and outcomes on healing
Authors: Mejzlik J. 
Published: May 2014

• Objective: To ascertain the extent to which pressure within a defined neck compartment could be used as predictor for wound healing. • Method: Thirty patients with various head and neck malignancies that were treated surgically, were considered prospectively. In the course of surgery a pressure microsensor was implanted into the defined neck compartment and data were collected over the first 48 hours postoperatively. logistic regression analysis was used to determine the strength of interfascial pressure (IP) as predictor for wound healing. • Results: Mean IP was 7.45 ± 6.15mmHg (95%Cl 7.13; 7.77). A logistic regression model relating good/disturbed healing outcome revealed that the mean pressure is the key variable, with a major influence on healing outcome. However, this type of model only explains approximately 46% of the total variation in the responses. This implies, that although pressure change contributes significantly in explaining variations in healing, there may be other significant predictors that were not included in the study. • Conclusion: This study demonstrates the feasibility of IP measurement in the neck, verifies it in a human clinical experiment and highlights its potential in the prediction of wound healing complications. The study seems to suggest that for high probability of good wound healing (> 90%) the IP values should be monitored and maintained below 7mmHg. At present, there are no comparator studies, as this kind of measurement in the neck area has not been reported yet. • Declaration of interest: This study received financial support from the Internal Grant Agency, ministry of Health of the czech republic (grant study no. NR8387). The author has no economic or social conflicts of interest to report.
Clinicians' rationale for using a silver dressing: the French OMAg+E observational study
Authors: Truchetet F. , Guibon O. , Meaume S. 
Published: May 2014

• Objective: To describe motivations for using a silicone, silver-releasing dressing and the type of wounds treated with this dressing, and to evaluate its short-term impact on wound characteristics. • Method: A French, prospective, observational study of adult patients prescribed a soft-silicone, silver-releasing dressing (Mepilex Ag; Mölnlycke Health Care) in the community. Each participating physician was asked to include the first two consecutive patients they treated with the silver dressing, reporting patient and wound characteristics, as well as the presence of 10 local signs compatible with wound infection (abscesses, purulent or copious exudate, erythema, increase in local warmth, pain, oedema, lymphangitis or satellite adenitis, malodour and delayed wound healing). Clinicians were also asked to select from a list their rationale for prescribing the silver dressing for each patient, including treating a wound infection, to stimulate granulation tissue formation, to promote wound healing, to reduce wound exudate, and to decrease wound pain. Local and general treatment were also reported. • Results: Overall, 794 patients (58% females), with a mean age of 69.0 ± 15.4 years, were included by 128 general practitioners, 51 dermatologists and 63 vascular specialist. Sixty-seven per cent were venous leg ulcers (VLUs), 26% were acute wounds (post-traumatic, surgical, burn wounds and animal bites) and 6.3% were other chronic wounds (pressure ulcers, diabetic foot ulcers and oncology wounds). On average 3.7 ± 1.5 local signs of infection were present and mean pain intensity (on a visual analogue scale) was 50 ± 24mm. According to prescribers, infection and healing delay were the primary rationale in 82% of cases, with oral antibiotics started concurrently in 19% of these wounds. Patients were followed-up at a median of 19 days, by which time all wound parameters were documented as significantly improved. Tolerability and efficiency of the silver dressing was considered as ‘good'/'very good’ in more than 97% of cases. • Conclusion: While there are some variances with the French reimbursement indication, for the clinicians surveyed in this study, the primary rationale for prescription of a silver dressing was treatment of a possible wound infection. Although this indication might not always be clinically funded, based on wound characteristics, the short-term impact of this prescription in this series was favourable. • Declaration of interest: This study was funded by a grant from Mölnlycke Health Care, France. The authors have no conflicts of interest to declare.
The use of maggot debridement therapy in the treatment of chronic wounds in hospitalised and ambulatory patients
Authors: Gilead L. , Mumcuoglu K.Y. , Ingber A. 
Published: May 2014

Objective: To summarise our experience of the use of medicinal maggots for the debridement of necrotic chronic wounds and to try and identify prognostic factors for debridement success and associated pain. Method: During the years 1996–2009, 723 wounds of 435 patients (180 females and 255 males) were treated with maggot debridement therapy (MDT) in 16 departments and units of the Hadassah Hospital in Jerusalem, Israel. overall, 261 patients were treated during hospitalisation, while 174 were treated as ambulatory patients. In 90.5% of the patients the wounds were located on the leg, but only 48.0% had diabetic foot ulcers. The wound duration range from one to 240 months (mean=8.9; median=4 months). Sterile maggots of the green bottle fly, Lucilia sericata, were used for MDT. In 90.6% of the cases, maggots were placed directly on the wound using a cage-like dressing and left for 24 hours, while in 9.4% of the patients maggots concealed in a tea-bag like polyvinyl netting were used. The concealed maggots were left on the wound for 2–3 days. Results: The number of treatments was 1–48 (mean=2.98; median=2) and the duration of the treatment varied between one and 81 days (mean=4.65; median=3). In 357 patients (82.1%) complete debridement of the wound was achieved, while in 73 patients (16.8%) the debridement was partial and in five (1.1%) it was ineffective. Increased pain or discomfort during MDT were reported in 38% of the patients. Conclusion: MDT is a very safe, simple and effective treatment modality for chronic wounds in ambulatory and hospitalised patients. Declaration of interest: There were no external sources of funding for this study. The authors have no additional conflicts of interest to declare.
Pain related to maggot debridement therapy
Authors: Mumcuoglu K.Y. , Davidson E. , Avidan A. , Gilead L. 
Published: May 2014

Objective: To summarise our experience with maggot debridement therapy (MDT) in relation to pain observed in patients treated in 16 departments and units of the Hadassah Hospital in Jerusalem, Israel. Method: A secondary analysis of data from 435 patients. Maggots were either placed directly on the wound using a cage-like dressing (DA), or they were applied to the wound encased in a previously prepared hermetic tea-bag like pouch (TBA). During each treatment, patients were asked whether they felt any difference in the level of pain before and during MDT treatment. Results: Overall, 165 patients (38%) reported increased pain during MDT. Seventeen patients (41%), who were treated with the TBA technique, and 148 patients (38%), who were treated with the DA technique, reported increased pain and were treated with analgesics before or during MDT. In five patients, the treatment had to be discontinued due to uncontrolled pain during MDT. Pain control measures were undertaken in patients who were already in intense pain prior to the initiation of MDT and in those patients who reported intense pain during DA treatment. The measures included shorter periods of application of maggots, use of the TBA rather than DA technique, and applying relatively small maggots as well as a smaller number of maggots during an MDT session. In patients who continued reporting intense pain, systemic analgesic medications and peripheral nerve blocks were used. Conclusion: Since a full debridement requires an average of 2–3 maggot cycles, which last 3–5 days, and since a large percentage of patients treated with MDT complain of pain that may last throughout the therapy period, it is deemed worthwhile and even essential to titrate analgesics as needed and be prepared to treat patients even with potent analgesics, such as opioids. In cases when pain is intense and uncontrolled with systemic medications, peripheral nerve blocks should be considered. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
Incidence and risk factors of sternal wound infection at site of incision after open-heart surgery
Authors: Hosseinrezaei H. , Rafiei H. , Amiri M. 
Published: May 2014

Objective: To identify the incidence of sternal wound infection and the risk factors before, during and after open-heart surgery in an Iranian critical care unit. Method: A descriptive, analytic study investigating all open-heart surgery patients from March 2010 to March 2011, in terms of the incidence of sternal wound infection and the risk factors before, during, and after surgery. Patients were examined for signs of infection at the site of surgical incision on presentation to the ward, daily during their stay, and on discharge. The same investigator reviewed all wounds, every day. Results: The incidence of sternal wound infection was found to be 10%. Multivariate regression analysis identified the following risk factors: diabetes (OR: 0.439; 95%CI: 0.21–0.95; p=0.04), age (OR: 1.033; 95%CI: 1.003–1.064; p=0.03), hyperlipidaemia (OR: 1.008; 95%CI: 1.005–1.011; p < 0.001), history of respiratory disorders ([COPD] OR: 2.952; 95%CI: 1.3–6.4; p=0.007), female gender (OR: 2.06; 95%CI: 1.40–3.03; p < 0.008), and history of addiction to opiates (OR: 2.33; 95%CI: 1.56–3.49; p < 0.006). Conclusion: This study found a high rate of surgical sternal wound infection in open-heart surgery patients in an Iranian critical care unit, suggesting that the medical and care-giving team in the cardiac intensive care unit need further education. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.
Patients' experiences of negative pressure wound therapy for the treatment of wounds: a review
Authors: Upton D. , Stephens D. , Andrews A. 
Published: May 2014

Objective: To review the research on patients' experiences of undergoing negative pressure wound therapy (NPWT). Method: A literature search was carried out using the following databases: Academic Search Complete, CINAHL, PsychINFO, MEDLINE, PubMed and PsyARTICLES. The search covered the period from 2001 to 2012, using the key words: [‘negative pressure wound therapy’ OR ‘vacuum-assisted closure’ OR ‘topical negative therapy’] AND [‘patients' experiences’ OR ‘psychological’ OR ‘stress’ OR ‘anxiety’ OR ‘wellbeing’ OR ‘pain’ OR ‘quality of life’ OR ‘physical’]. Results: Twenty-five relevant articles were included. NPWT is generally considered to be successful in reducing wound depth and facilitating healing. However, studies have highlighted a number of issues that need to be considered. For example, the type of dressing used during treatment can have a significant effect on patients' experience of pain. Furthermore, the NPWT system can cause patients to feel anxious due to both the patient and the health professional being unfamiliar with this form of treatment. It can also restrict patients' daily care and wider social life, which may result in a negative self-image and low self-esteem. Despite this, some studies have reported positive improvements to patients' quality of life. Additionally, since NPWT can lead to faster healing, any detrimental impact upon patients' wellbeing may be short-term and less prolonged than that of other treatments. Conclusion: Compared with other treatments, there is evidence to show that NPWT can lead to faster wound healing, and a reduced frequency of dressing changes and other treatments. However, there are a number of challenges with the use of NPWT, which need to be explored further so that improvements can be made. Specifically, certain aspects of NPWT may impact negatively on patients' wellbeing, albeit short-term. Therefore, research needs to explore patients' experiences of NPWT throughout the treatment process and to consider how this can be improved to minimise any negative effects. Declaration of interest: There were no external sources of funding for this study. The authors have no commercial or financial conflicts of interest to declare.
Disrupted abdominal laparotomy wounds in gynaecologic oncology patients: benefits of active surgical re-closure
Authors: Peled Y. , Krissi H. , Sabah G. , Levavi H , Eitan R. 
Published: May 2014

Objective: To assess the outcome of active management of disrupted wounds through surgical approximation and re-closure. Method: A prospective, non-comparative study, on all consecutive patients with disrupted laparotomy wounds treated at a tertiary medical centre, from November 2009 to December 2011. Data on patient demographics, diagnosis, type of abdominal incision, initial closure technique, infections and results of secondary re-closure were collected from the medical files. All patients underwent bedside closure with an en bloc mass suture mattress technique, performed by two attending gynaecologic oncologists. Results: Of 197 patients who underwent abdominal laparotomy during the study period, 31 (16%) had a disrupted wound. Following surgical re-closure, 26 wounds (84%) were completely healed or needed only minor additional care by follow up on day 10. Five wounds (16%) failed primary management and required re-suturing; all subsequently healed. There were no long-term complications. Conclusion: Active surgical re-closure of disrupted abdominal laparotomy wounds is safe and effective in patients after treatment surgically for Müllerian malignancies. Declaration of interest: There were no external sources of funding for this study. The authors have no conflicts of interest to declare.