bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensory testing in patients with chronic venous leg ulcers using a 10g Owen Mumford monofilament
Authors: Arseculeratne Y.M. , Cherry G.W. 
Published: May 2014

Objective: Chronic venous insufficiency in the lower legs may directly contribute to tissue damage, and there is increasing evidence that neuronal damage may be involved. This study was carried out to determine the feasibility of using a simple neuropathy screening test in the community to diagnose sensory neuropathy in the feet of patients with chronic venous insufficiency. Method: We tested 15 randomly selected patients with documented chronic venous insufficiency with the 10g Owen Mumford monofilament, in order to ascertain objectively sensory blunting. Results: Forty-seven per cent of the patients had normal sensation in the foot of the ulcerated leg and 53% showed some degree of neuropathy. A recent study comparing the performance of commercially available 10g monofilaments showed that the Owen Mumford filament was one of the most accurate, with 100% buckling within ±1g of 10g. Conclusion: This preliminary study indicates that the 10g monofilament is an easy method of testing the sensory status of patients with chronic venous insufficiency in the community. Declaration of interest: None.
Patients’ perceptions and experiences of larval therapy
Authors: Kitching M. 
Published: May 2014

Objective: To gain an insight into patients’ perceptions and experiences of larval therapy. Method: A phenomenological approach was adopted in which six patients who recently had had larval therapy were interviewed using an open, unstructured approach in two hospital settings. Data analysis was loosely based on Colaizzi’s structured analysis technique. Results: Five themes emerged: past experiences of wounds leads to expectations of recurrence and a reduced quality of life; living with a chronic wound led to feelings of hopelessness; the skills and expertise of the nurse made patients feel hopeful; being informed helped patients to choose whether or not to have the therapy; the experience of larval therapy was not as scary as imagined. Conclusion: The findings suggest that, although initially repellent, larval therapy is acceptable once treatment starts. The nurse-patient relationship was a significant factor in acceptance, along with autonomy and informed choice. Declaration of interest: None.
Colloidal silver as an antimicrobial agent: fact or fiction?
Authors: P. van Hasselt , B.A. Gashe , Ahmad J. 
Published: May 2014

Objective: Colloidal silver preparations are marketed on the internet as omnipotent antimicrobial agents, but scientific support for these claims is lacking. This study reports the results of in vitro tests of colloidal silver’s antimicrobial activity against several pathogenic or non-pathogenic microorganisms. Method: Three samples of colloidal silver were tested: one available commercially on the internet (silver concentration of 22ppm) and two samples (concentrations of 403 and 413ppm) which were prepared in our laboratory using standard chemical methods. Results: In an agar-well diffusion assay none of the three colloidal silver solutions had any effect on the growth of the test organisms. All tested bacterial strains were sensitive to ciprofloxacin. Colloidal silver 22ppm showed no bactericidal activity in phenol coefficient tests. Conclusion: As the tested colloidal silver solutions did not show any antimicrobial effect in vitro on the microorganisms, claims of colloidal silver’s antimicrobial potency are misleading and there is no place for it as an antiseptic. Declaration of interest: None.
Does leg ulcer treatment improve patients’ quality of life?
Authors: Charles H. 
Published: May 2014

Objective:To investigate the impact of ‘disease’ and treatment on quality of life in patients with venous leg ulceration.Method:Sixty-five patients with venous leg ulcers were recruited and treated. At study entry and exit or following complete wound closure, whichever occurred first, each patient was assessed using the SF-36 quality-of-life questionnaire. Data analysis included an investigation of the study population as whole, differences between patients whose ulcers did and did not heal and between gender and age. Health domain means for all patients were compared with age equivalent norms (AENs) at both entry and exit.Results:There was a significant improvement in the SF-36 domains of bodily pain, health transition, mental health and social functioning for all 65 patients. Patients whose ulcers healed also showed a statistically significant improvement in the vitality domain. Patients whose ulcers did not heal had statistically significant improved scores for bodily pain and health transition. At entry all SF-36 values, except for general health, were lower than the AENs. On exit, scores for bodily pain, general health and mental health were comparable with the AEN; values for the remaining five domains increased at exit.Conclusion:The results highlight that good wound management and effective compression therapy can improve quality of life in patients with venous leg ulceration, whether or not the patient’s leg ulcer healed following treatment.Declaration of interest:None.
Information leaflets for venous leg ulcer patients: are they effective?
Authors: Clarke Moloney M. , Moore A. , Adelola O.A. , Burke P.E. , McGee H. , Grace P.A. 
Published: May 2014

Objective: To validate the usefulness of written information for patients with venous leg ulcers and test the hypothesis that patients who receive written information retain more knowledge than those who receive verbal information alone. Method: Twenty patients newly diagnosed with venous leg ulcers were recruited into this prospective trial. Patients were randomised either to the control group (given verbal information on their condition) or the intervention group (same verbal information and an information leaflet). The verbal information was in the same format as in the leaflet. Patients’ knowledge of the condition was ascertained at an initial interview and at follow-up four to six weeks later. Results: At follow-up both groups showed an overall improvement in knowledge, with no statistical difference between them. Conclusion: The results indicate there is limited value in providing information leaflets to this patient group, who were predominantly older patients with low levels of education. The relatively small sample size may explain the disappointing results. Further research may reveal a benefit of providing these leaflets to carers. Declaration of interest: None.
An economic evaluation of the use of TNP on full-thickness wounds
Authors: Mouës C.M. , van den Bemd G-J.C.M , Meerding W.J. , Hovius S.E.R 
Published: May 2014

Objective: Topical negative pressure (TNP) (vacuum therapy) is frequently used in the management of acute, traumatic, infected and chronic full-thickness wounds. This prospective clinical randomised trial compared the costs of TNP with conventional therapy (moist gauze) in the management of full-thickness wounds that required surgical closure. Method: The direct medical costs of the total number of resources needed to achieve a healthy, granulating wound bed that was ‘ready for surgical therapy’ were calculated. Results: Fifty-four patients admitted to a department of plastic and reconstructive surgery were recruited into the trial. Cost analysis showed significantly higher mean material expenses for wounds treated with TNP (₠414 ± ₠229 [SD]) compared with conventional therapy (₠15 ± ₠11; p<0.0001), but significantly lower mean nursing expenses (₠33 ± ₠31 and ₠83 ± ₠58 for TNP and conventional therapy respectively; p<0.0001). Hospitalisation costs were lower in the TNP group (₠1788 ± ₠1060) than in the conventional treatment group (₠2467 ± ₠1336; p<0.043) due to an on average shorter duration until they were ‘ready for surgical therapy’. There was no significant difference in total costs per patient between the two therapies (₠2235 ± ₠1301 for TNP versus ₠2565 ± ₠1384 for conventional therapy). Conclusion: TNP had higher material costs. However, these were compensated by the lower number of time-consuming dressing changes and the shorter duration until they were ‘ready for surgical therapy’, resulting in the therapy being equally as expensive as conventional moist gauze. Declaration of interest: This work was partly supported by the Plastic and Reconstructive Surgery Esser Foundation, and KCI Medical, Houten, The Netherlands. The authors have no conflicts of interest.
Upregulation of inducible nitric oxide synthase (iNOS) expression in faster-healing leg ulcers
Authors: Luk P.P. , Sinha S.N. , Lord R. 
Published: May 2014

Objective: Chronic leg ulcers represent a growing clinical problem in the light of today’s ageing population. Nitric oxide (NO), which is mostly produced by inducible nitric oxide synthase (iNOS) in healing wounds, exerts beneficial effects on many processes of healing, including bactericidal effects, angiogenesis, epithelialisation and ECM formation. This study sought to investigate whether iNOS expression in chronic leg ulcers can be correlated with the healing process. Method: Sixteen patients with chronic leg ulcers were recruited and attempts were made to take punch biopsies at two separate time points (however, a second biopsy could not be obtained on seven patients). A linear healing rate was derived using the obtained ulcer area and perimeter. The iNOS levels in the biopsy samples were assessed using immunoblotting. Results: The mean linear healing rate of patients with high iNOS levels was significantly higher (p<0.01) than that of patients with low iNOS levels. An incidental finding was that the linear healing rate was significantly higher (p<0.05) post-biopsy than before biopsy in the same patients. Conclusion: This study therefore shows for the first time that high iNOS levels are associated with higher healing rates and have the potential to be used in prognostication. This also opens the possibility of augmentation of ulcer healing through the manipulation of wound NO levels. Declaration of interest: This work was supported by a discipline of surgery operating grant from the University of Tasmania, Australia.
Effect of a sustained silver-releasing dressing on ulcers with delayed healing: the CONTOP study
Authors: Munter K.-C. , Beele H. , Russel L. , Gröchenig E. , Basse P. , Crespi A. , Alikadic N. , Fraulin F. , Dahl C.A. , Jemma A.P. 
Published: May 2014

Objective: To compare the effect of the sustained silver-releasing foam dressing Contreet Foam (Coloplast A/S) with local best practice (LBP) on delayed healing ulcers using a real-life setting. Method: A total of 619 patients with ulcers of varying aetiologies were treated for four weeks with either the silver foam dressing or LBP. Results: Wound area was reduced by 50% with the silver foam and 34% with LBP. Less slough and maceration, a faster reduction in exudate level and more positive wound progress was achieved with the silver foam. In addition, exudate handling, ease of use, odour and pain improved. Less time was spent on dressing changes, and mean wear time was longer for the silver foam (3.1 days) than for LBP (2.1 days). All differences were statistically significant (p<0.05). The silver foam dressing outperformed all of the other dressing categories including moist wound healing products and other silver dressings. Conclusion: This large-scale comparative real-life study shows that the silver foam dressing supports faster healing of delayed healing wounds. Declaration of interest: The study was financially supported by Coloplast A/S, Humlebaek, Denmark.
Evaluation of a self-adherent soft silicone dressing for the treatment of hypertrophic postoperative scars
Authors: Colom Maján J.I. 
Published: May 2014

Objective: The primary objective was to compare the efficacy of a self-adherent soft silicone dressing (Mepiform) with ‘left-alone’ management of hypertrophic scars using the Vancouver Scar Scale. Secondary objectives were to follow photographs of the scars, patients’ opinions of the scars, and doctors’ and patients’ assessments of the overall dressing performance, safety and tolerance. Method: An exploratory open randomised controlled clinical investigation was undertaken on 11 female patients aged 21–43 years with postoperative scars (nine following breast surgery, two following lower abdominal-glutealplasty). Treatment was initiated between two weeks and two months (mean 4.7 weeks) after surgery. Ten patients completed the 12-month investigation; one patient in the treatment group discontinued for personal reasons. Results: All parameters in the Vancouver Scar Scale improved in both groups, although patients treated with the soft silicone dressing showed greater and more rapid improvements compared with the non-treated patients, while their assessments of the condition of the scar were more favourable. Medical staff rated the overall dressing performance as ‘very good’ or ‘good’. One adverse event was reported – local skin irritation at the site of the scar. Conclusion: The results suggest that patients treated with the soft silicone dressing experienced greater and more rapid improvements compared with non-treated patients. These results concur with those of previous studies. The fact that Mepiform is self-adhesive and causes limited damage to the stratum corneum on removal gives it an added value compared with non-adhesive silicone gel dressings. Declaration of interest: This study was supported by Mölnlycke Health Care AB, Gothenburg, Sweden.
Use of topical negative pressure with a lipidocolloid dressing: results of a clinical evaluation
Authors: Téot L. , Lambert L. , Ourabah Z. , Bey E. , Steenman C. , Wierzbiecka E. , Malikov S. , Charles J.P. , Vives F. , Bohbot S. 
Published: May 2014

Objective:To evaluate the protection and acceptability of Urgotul wound dressing in the local management of acute or chronic wounds receiving topical negative pressure (TNP) therapy.Method:This was a prospective multicentre non-comparative open-label trial. At each dressing change the investigating physician clinically evaluated and photographed the wound. Planimetric measurement was undertaken and wound depth was assessed at the start and end of the treatment. Follow-up was undertaken until deemed clinically unnecessary by the investigator.Results:Sixty-six patients were included (42 acute wounds and 24 chronic wounds) and followed up for an average of 17 days. Dressing changes were deemed entirely painless in 52% of cases (compared with 18% at baseline) and pain between two consecutive dressing changes was absent in 66% of cases (34% at baseline). Removal of the TNP-interface dressing combination was considered ‘very easy’ or ‘easy’ in 94% of cases and adherence to the wound was recorded as ‘absent’ in 88%. On average, the dressings were changed every 3.8 ± 1.1 days (all wounds were considered), and wound area and depth were reduced by 19% and 54% respectively by the end of the follow-up period.Conclusion:Use of the interface dressing in combination with TNP substantially reduced the pain caused by dressing changes. It therefore makes more acceptable the use of this technique, which aims to optimise the management of wounds that are sometimes considered to be in a therapeutic impasse.Declaration of interest:This study was sponsored by Laboratoires Urgo, Dijon, France.
A point prevalence survey of wounds in north-east England
Authors: Srinivasaiah N , Dugdall H , Barrett S , Drew P.J 
Published: May 2014

Objective: To review current wound-care practice and the standard of wound care in Hull and East Yorkshire; obtain information on prevalence, treatment and outcomes; provide a basis for estimating the extent of the problem, treatment modalities used, service provision and future needs; highlight areas of care in need of improvement; highlight areas with excellent wound practices and gain information for future research projects within the population of the region. Method: Point prevalence interface audit of community and acute trusts. Results: The cumulative wound prevalence for the region was 12%. Community nurses were involved in caring for 70.1% of patients with wounds, with 52.7% of wounds being treated in the patient’s home. The largest proportion of wounds were surgical wounds (n=699, 41.5%), followed by leg and foot ulcers (n=629, 37.3%) and pressure ulcers (n=294, 17.4%). Diabetes and cancer were related to 15.1% and 9.7% of the wounds respectively. 41.9% of the wounds were on the lower leg. The primary and secondary dressings used the most were low/non-adherent dressings at 25.9% and 27.3% respectively. Almost half of the patients with a venous leg ulcer (46%) did not receive multilayer compression and 7% of patients with an arterial ulcer did; 23.6% of the leg and foot wounds were not assessed with a Doppler. Conclusion: Wounds represent a significant cause of morbidity in the general population. A systematic focus is necessary on effective and timely diagnosis, on ensuring treatment is appropriate to the cause and condition of the wound and on active measures to prevent complications. A number of initiatives have commenced in order to provide a effective and efficient wound care. Declaration of interest: None.
Pilonidal sinus: healing rates, pain and embarrassment levels
Authors: Stewart A. , Donoghue J. , Mitten-Lewis S. 
Published: May 2014

Objective: To identify the healing rates, wound hygiene practices, types of primary wound dressings used, antibiotics prescribed, pain intensity and embarrassment levels in patients with pilonidal sinus. Method: A prospective descriptive design was used. We followed 55 patients for three months following excision of pilonidal sinus. Digital photographs were taken and the wound area was calculated using the Alfred and Medseed Wound Imaging System on the first postoperative day, at 2–3 weeks and again at 12 weeks. Data were collected from the nurses and patients using piloted questionnaires. Results: Sixty per cent of the participants had closed wounds within 12 weeks of surgery. Various dressing types were used. There was no significant correlation between dressing type and healing, or wound size and healing. There was no significant association between antibiotic usage and faster healing rates. A mean pain intensity score of 4.8 on a 0–10 scale was reported at the first dressing change for saline gauze dressings, which was the most painful experience with this wound. Average levels of embarrassment were low and decreased over time. Conclusion: Forty per cent of participants who had unhealed wounds at 12 weeks had other factors involved, which were not measured in this study. Declaration of interest: None.
Effect of an ibuprofen-releasing foam dressing on wound pain: a real-life RCT
Authors: Domenech R. Palao i , Romanelli M. , Tsiftsis D.D. , Slonkov V. , Jortikka A. , Johannesen N. , Ram A. , Persson L.M. , Altindas M. , Orsted H. , Schäfer E. 
Published: May 2014

Objective: To compare an ibuprofen-releasing foam dressing (Biatain Ibu, Coloplast A/S) with local best practice in the treatment of painful exuding wounds. Method: In this large-scale randomised comparative study, 853 patients were randomised to either ibuprofen-releasing foam (test) dressing (n=467) or local best practice (n=386). Primary endpoint was wound pain relief from day 1–7, assessed by the patients twice daily using a five-point verbal rating scale. Secondary endpoints were reduction in pain intensity from day 0–7 (assessed using an 11-point numeric box scale), quality of life (assessed using the WHO-5 well-being index and effect on health-related activities of daily living) and the incidence of adverse events. Results: After seven days significantly more patients in the experimental group experienced relief from temporary and persistent pain and a reduction in pain intensity, when compared with patients in the local best practice group (p<0.0001). They also experienced a greater improvement in quality of life. The number of adverse events in both groups was low. Conclusion: The test dressing provided an appropriate wound healing environment, relieved temporary and persistent wound pain, and decreased pain intensity. It was also associated with an improvement in quality of life. Declaration of interest: This study was partly funded by Coloplast A/S, Humlebaek, Denmark. Data analysis were performed by an external consultant using validated SAS Macro (SN Lophaven, Roskilde, Denmark).
Identification of yeast in chronic wounds using new pathogen-detection technologies
Authors: Leake J.L. , Dowd S.E. , Wolcott R.D. , Zischkau A.M. , Sun Y. 
Published: May 2014

Objective: To evaluate the ability of two new diagnostic methods to detect and accurately identify yeast associated with chronic wound infections. Method: Fungal tag-encoded FLX amplicon pyrosequencing (fTEFAP), a universal fungal identification method, bacterial tag-encoded FLX amplicon pyrosequencing (bTEFAP), a universal bacterial identification method, and a new quantitative polymerase chain reaction (qPCR) wound pathogen panel were used to evaluate three chronic wounds suspected to contain yeast. Results: Forty wound samples were analysed in addition to the three samples suspected of containing yeast. The qPCR panel, which targets Candida albicans, detected this yeast in two of the three wound samples. In contrast, fTEFAP detected yeast in each of the three samples: two showed Candida albicans and the third Candida parapsilosis. fTEFAP also identified a lower level of Candida tropicalis in one of the wounds that was positive for Candida albicans. The qPCR wound panel results were returned within two hours, while the fTEFAP results were returned within 24 hours. Conclusion: Two new molecular methods have been developed to aid wound pathogen diagnostics. The quantitative PCR wound panel is rapid but is limited to major wound-associated bacteria and yeasts. The universal fTEFAP and bTEFAP methods take 24 hours to return results but are able to detect the relative contribution of any bacteria of yeast in a chronic wound diagnostic sample. Declaration of interest: Southwest Regional Wound Care Center is a clinical wound-care provider seeking to improve the ability of wound care practitioners to help patients. The Research and Testing Laboratory develops molecular methods including fTEFAP, bTEFAP and the quantitative PCR wound panel.
Effect of TNP on the microbiology of venous leg ulcers: a pilot study
Authors: Khashram M. , Huggan P. , Ikram R. , Chambers S. , Roake J.A. , Lewis D.R. 
Published: May 2014

Objective: To investigate the effect of topical negative pressure, delivered using Vacuum Assisted Closure (VAC, KCI), on the microbiology of chronic, non-infected venous leg ulcers (VLUs). Method: Patients receiving compression therapy for a chronic VLU were recruited into this prospective pilot study. The ulcer was swabbed and VAC was applied at 125mmHg continuous subatmospheric pressure on day 1 for six days. Standard methods for bacteriological sampling and measuring the wound surface area were applied at baseline and at the VAC dressing changes on days 3 and 6. Log median colony forming units (CFUs) per cm2 were used for statistical analyses. The bacterial species were identified. Results: Seven patients were recruited into and completed the study. The median log10 CFU/cm2 on days 1, 3 and 6 were 3.5, 4.7 and 5.1 respectively. There was a significant increase in bacterial colonisation between days 1 and 6 (p<0.02). No change was observed in the identified microbiological species during therapy with VAC. Conclusion: This pilot study suggests that VAC therapy increases absolute numbers of bacteria colonising non-infected leg ulcers. Declaration of interest: KCI supplied the VAC equipment and ARANZ the SilhouetteMobile, but both had no other infl uence on the study.