https://cmapspublic3.ihmc.us/rid=1266358861321_2027852911_13457/Wound%20Healing%20Dressings%20and%20Drug%20Delivery%20Systems.pdf

Wound healing dressings and drug delivery systems: a review.

Significance: Injury to the skin provides a unique challenge, as wound healing is a complex and intricate process. Acute wounds have the potential to move from the acute wound to chronic wounds, requiring the physician to have a thorough understanding of outside interventions to bring these wounds back into the healing cascade. Recent Advances: The development of new and effective interventions in wound care remains an area of intense research. Negative pressure wound therapy has undoubtedly changed wound care from this point forward and has proven beneficial for a variety of wounds. Hydroconductive dressings are another category that is emerging with studies underway. Other modalities such as hyperbaric oxygen, growth factors, biologic dressings, skin substitutes, and regenerative materials have also proven efficacious in advancing the wound-healing process through a variety of mechanisms. Critical Issues: There is an overwhelming amount of wound dressings available in the market. This implies the lack o...

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Wound Dressings and Comparative Effectiveness Data.

Over the past 30 years as caregivers, clinicians have been exposed to a plethora of new advanced wound dressings. The moist wound care revolution began in the 1970s with the introduction of film and hydrocolloid dressings, and today these are the traditional types of dressings of the advanced dressing categories. Wound-healing science has progressed significantly over the same period, as a result of intense clinical and scientific research around these product introductions. Today, the clinician understands moist wound healing, occlusion, cost effectiveness, wound bed preparation and MMP activity to name but a few of the many concepts in wound care that have flourished as a result of technology and product advancement. This review article presents a condensed history of dressing development over the past 30 years. However, in addition, such advancement is discussed in respect to its adoption in different parts of the world. The largest single markets of the world are generally the United States of America and Europe; as such, the development of both practice and technology generally begins there. Much has been written about these markets in previous review articles. For the purposes of this review, the development of wound care and the maturing of practice is discussed in respect to Canada, Japan and Australia representing smaller geographical areas where the development has been more recent but nonetheless significant.

A dressing history.

IntroductionClinical practice guidelines can improve healthcare processes and patient outcomes, but are often of low quality Guideline appraisal tools aim to help potential guideline users in assessing guideline quality We conducted a systematic review of publications describing guideline appraisal tools in order to identify and compare existing tools MethodsAmong others we searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from 1995 to May 2011 for relevant primary and secondary publications We also handsearched the reference lists of relevant publications On the basis of the available literature we firstly generated 34 items to be used in the comparison of appraisal tools and grouped them into thirteen quality dimensions We then extracted formal characteristics as well as questions and statements of the appraisal tools and assigned them to the items ResultsWe identified 40 different appraisal tools They covered between three and thirteen of the thirteen possible quality dimensions and between three and 29 of the possible 34 items The main focus of the appraisal tools were the quality dimensions “evaluation of evidence” (mentioned in 35 tools; 88%), “presentation of guideline content” (34 tools; 85%), “transferability” (33 tools; 83%), “independence” (32 tools; 80%), “scope” (30 tools; 75%), and “information retrieval” (29 tools; 73%) The quality dimensions “consideration of different perspectives” and “dissemination, implementation and evaluation of the guideline” were covered by only twenty (50%) and eighteen tools (45%) respectively ConclusionsMost guideline appraisal tools assess whether the literature search and the evaluation, synthesis and presentation of the evidence in guidelines follow the principles of evidence-based medicine Although conflicts of interest and norms and values of guideline developers, as well as patient involvement, affect the trustworthiness of guidelines, they are currently insufficiently considered Greater focus should be placed on these issues in the further development of guideline appraisal tools

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Appraisal Tools for Clinical Practice Guidelines: A Systematic Review

Aims and objectives.  The aim of this article is to investigate the way malignant fungating wounds affect femininity, sexuality and daily life in women with progressive breast cancer. Malignant wounds occur when the underlying localized tumour filtrates into the skin, blood capillaries and/or lymph vessels.

Design.  The study was a prospective and exploratory intervention study. The intervention was tested on 12 consecutively selected women with progressive breast cancer and malignant fungating wounds.

Methods.  The 12 women participated in a 4-week wound care intervention programme that comprised evidence-based wound care principles and psychosocial support. Data were generated by means of interviewing prior to and following the intervention period.

Results.  The women described how malodorous and oozing wounds trigger anxiety about seepage, prevent them from wearing feminine attire and cause them to suppress the need for physical closeness and sexual activity. The results showed that by using modern wound care products, the patients could be secured against seepage and odour. The women experienced a sense of comfort, were able to dress again as they wished, no longed felt caged in and isolated and were given a sense of freedom which they had not felt for a long time.

Conclusions.  The intervention succeeded in increasing breast cancer patients’ psychosocial well-being and reducing social isolation.

Relevance to clinical practice.  There is a lack of standard methods of practice for care of malignant wounds in women with breast cancer. This article describes an intervention for wound care which could improve daily live in women with progressive breast cancer.

Young T

Papers

The challenge of managing fungating wounds.

Maggot therapy in wound management.

Fungating wounds: their diagnosis and management.

Matching the dressing to the wound.

Reaping the benefits of foam dressings.