Geoffrey Mendes Sussman

Bio: Geoffrey Mendes Sussman is an academic researcher from Monash University. The author has contributed to research in topics: Wound care & Self-healing hydrogels. The author has an hindex of 5, co-authored 7 publications receiving 229 citations. Previous affiliations of Geoffrey Mendes Sussman include Monash University, Parkville campus.

First-Line Interactive Wound Dressing Update: A Comprehensive Review of the Evidence.

Abstract: Wound management is a significant and growing issue worldwide. Knowledge of dressing products and clinical expertise in dressing selection are two major components in holistic wound management to ensure evidence-based wound care. With expanding global market of dressing products, there is need to update clinician knowledge of dressing properties in wound care. Optimal wound management depends on accurate patient assessment, wound diagnosis, clinicians' knowledge of the wound healing process and properties of wound dressings. We conducted a comprehensive review of the physical properties of wound dressing products, including the advantages and disadvantages, indications and contraindications and effectiveness of first-line interactive/bioactive dressing groups commonly used in clinical practice. These include semipermeable films, foams, hydroactives, alginates, hydrofibers, hydrocolloids, and hydrogels. In making decisions regarding dressing product selection, clinicians need to ensure a holistic assessment of patient and wound etiology, and understand dressing properties when making clinical decisions using wound management guidelines to ensure optimal patient outcomes. This review has highlighted there is lack of high quality evidence and the need for future well designed trials.

Wound Dressings Update

Abstract: The availability of different types of wound dressings has increased in the last decade. Wound care practitioners have at their disposal an extensive range of dressings. Emerging dressing types include interactive/bioactive dressings and tissue-engineered skin substitutes. There is no one dressing that is suitable for the management of all types of chronic wounds and few are suited for the treatment of a single wound during all stages of the healing cycle. Successful wound management depends on an understanding of the healing process combined with knowledge of the properties of the various dressings available. Without such knowledge and careful assessment of all the factors that effect healing, dressing selection is likely to be arbitrary and ineffective, wasteful both in terms of time and physical resources. This article is an overview of some of the first-line and second-line interactive/bioactive dressings available. A synopsis of wound assessment and wound bed preparation will aid in choosing the appropriate dressings. It will also touch on advanced technologies including tissue-engineered skin substitutes. J Pharm Pract Res 2006; 36: 318-24.

Cost-effectiveness of multidisciplinary wound care in nursing homes: a pseudo-randomized pragmatic cluster trial

Abstract: Vu T, Harris A, Duncan G, Sussman G. Cost-effectiveness of multidisciplinary wound care in nursing homes: a pseudo-randomized pragmatic cluster trial. Family Practice 2007; 24: 372–379. Objectives. To evaluate the cost-effectiveness of a multidisciplinary wound care team in the nursing home setting from a health system perspective. Methods. Pseudo-randomized pragmatic cluster trial with 20-week follow-up involving 342 uncomplicated leg and pressure ulcers in 176 residents located in 44 high-care nursing homes in Melbourne, Australia in 1999–2000. Twenty-one nursing homes (180 wounds in 94 residents) were assigned to the intervention arm and 23 to the control arm (162 wounds in 82 residents). Residents in the intervention arm received standardized treatment from a wound care team comprising of trained community pharmacists and nurses. Residents in the control arm received usual care. Results. More wounds healed during the trial in the intervention arm than in the control arm (61.7% versus 52.5%, P = 0.07). A Cox regression with shared frailty predicted that the chances of healing increased 73% for intervention wounds [95% confidence interval (CI) 20–150%, P = 0.003]. The mean treatment cost was $A616.4 for intervention and $A977.9 for control patients (P = 0.006). Most cost reduction was obtained from decreases in nursing time and waste disposal. The mean cost saving per wound, adjusted for baseline wound severity and random censoring, was $A277.9 (95% CI $A21.6–$A534.1).

Absorption of blood by moist wound healing dressings

Abstract: An understanding of the various properties of the many dressings on the market enables the clinician to select the appropriate dressing product for the patient’s wound. A comparative analysis of the ability of moist wound healing (MWH) products to absorb blood has not been previously reported. The aim of this study was to compare the rate and the maximal weight of blood absorbed, the ability of the dressings to retain blood within the dressing when under pressure, sheet integrity, and lateral wicking of the blood within the dressing. The MWH dressings tested included 12 ‘fibre’ dressings (alginates and hydrofibre) and 15 ‘absorptive’ (polyurethrane foams, hydroactive and combination products). The most absorbent fibre dressings were Hydroheal Algin Firm, Sorbalgon, Cutinova Alginate, Kaltostat and Restore Calcicare, absorbing greater than 35g of blood per 100cm 2 dressing. The least absorbent was Aquacel with 21.5g/100cm 2 . The integrity of the fibre dressings varied markedly from Sorbsan, which disintegrated, to Curasorb and Seasorb Alginates, which retained full strength. The rate of absorption of all fibre dressings was rapid (<18 seconds). Lateral wicking was least with Aquacel and greatest with Algoderm and Kaltostat. The absorptive dressings showed a wide variation in absorptive capacity, from Flexipore which absorbed only 1.7g/100cm 2 to Allevyn which absorbed 79.9g/100cm 2 and Hydrasorb 79.4 g/100cm 2 . Under pressure, Cutinova Foam retained the greatest amount of blood. Rate of absorption varied dramatically between products, with Polymem Alginate, Polymem, Exu-dry, Biatain and Hydrasorb all taking less than 1 minute to absorb 1ml of blood, whilst seven dressings showed incomplete absorption after

Electrospun Nanofibers as Dressings for Chronic Wound Care: Advances, Challenges, and Future Prospects

Abstract: Chronic non-healing wounds show delayed and incomplete healing processes and in turn expose patients to a high risk of infection. Treatment currently focuses on dressings that prevent microbial infiltration and keep a balanced moisture and gas exchange environment. Antibacterial delivery from dressings has existed for some time, with responsive systems now aiming to trigger release only if infection occurs. Simultaneously, approaches that stimulate cell proliferation in the wound and encourage healing have been developed. Interestingly, few dressings appear capable of simultaneously impairing or treating infection and encouraging cell proliferation/wound healing. Electrospinning is a simple, cost-effective, and reproducible process that can utilize both synthetic and natural polymers to address these specific wound challenges. Electrospun meshes provide high-surface area, micro-porosity, and the ability to load drugs or other biomolecules into the fibers. Electrospun materials have been used as scaffolds for tissue engineering for a number of years, but there is surprisingly little literature on the interactions of fibers with bacteria and co-cultures of cells and bacteria. This Review examines the literature and data available on electrospun wound dressings and the research that is required to develop smart multifunctional wound dressings capable of treating infection and healing chronic wounds.

Alginate: Current Use and Future Perspectives in Pharmaceutical and Biomedical Applications

Abstract: Over the last decades, alginates, natural multifunctional polymers, have increasingly drawn attention as attractive compounds in the biomedical and pharmaceutical fields due to their unique physicochemical properties and versatile biological activities. The focus of the paper is to describe biological and pharmacological activity of alginates and to discuss the present use and future possibilities of alginates as a tool in drug formulation. The recent technological advancements with using alginates, issues related to alginates suitability as matrix for three-dimensional tissue cultures, adjuvants of antibiotics, and antiviral agents in cell transplantation in diabetes or neurodegenerative diseases treatment, and an update on the antimicrobial and antiviral therapy of the alginate based drugs are also highlighted.

Extending the TIME concept: what have we learned in the past 10 years?(*).

Abstract: The TIME acronym (tissue, infection/inflammation, moisture balance and edge of wound) was first developed more than 10 years ago, by an international group of wound healing experts, to provide a framework for a structured approach to wound bed preparation; a basis for optimising the management of open chronic wounds healing by secondary intention. However, it should be recognised that the TIME principles are only a part of the systematic and holistic evaluation of each patient at every wound assessment. This review, prepared by the International Wound Infection Institute, examines how new data and evidence generated in the intervening decade affects the original concepts of TIME, and how it is translated into current best practice. Four developments stand out: recognition of the importance of biofilms (and the need for a simple diagnostic), use of negative pressure wound therapy (NPWT), evolution of topical antiseptic therapy as dressings and for wound lavage (notably, silver and polyhexamethylene biguanide) and expanded insight of the role of molecular biological processes in chronic wounds (with emerging diagnostics and theranostics). Tissue: a major advance has been the recognition of the value of repetitive and maintenance debridement and wound cleansing, both in time-honoured and novel methods (notably using NPWT and hydrosurgery). Infection/inflammation: clinical recognition of infection (and non infective causes of persisting inflammation) is critical. The concept of a bacterial continuum through contamination, colonisation and infection is now widely accepted, together with the understanding of biofilm presence. There has been a return to topical antiseptics to control bioburden in wounds, emphasised by the awareness of increasing antibiotic resistance. Moisture: the relevance of excessive or insufficient wound exudate and its molecular components has led to the development and use of a wide range of dressings to regulate moisture balance, and to protect peri-wound skin, and optimise healing. Edge of wound: several treatment modalities are being investigated and introduced to improve epithelial advancement, which can be regarded as the clearest sign of wound healing. The TIME principle remains relevant 10 years on, with continuing important developments that incorporate new evidence for wound care.