Showing papers in "Advances in Skin & Wound Care in 2010"
TL;DR: The results of this study demonstrate that incorporating quantitative skin temperature measurement into routine wound assessment provides a timely and reliable method for a wound care practitioner to quantify the heat associated with deep and surrounding skin infection and to monitor ongoing wound status.
Abstract: PURPOSE:To enhance the clinician's knowledge about the relationship between increased periwound skin temperature and local wound infection in patients with chronic leg ulcers.TARGET AUDIENCE:This continuing education activity is intended for physicians and nurses with an interest in skin and wound c
150 citations
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options.
Abstract: Purpose To enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options. Target audience This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. Objectives After participating in this educational activity, the participant should be better able to: 1. Differentiate lipedema from other similar diagnoses. 2. Tell patients with lipedema and their caregivers about treatment of this condition. 3. Construct assessments, treatment plans, and management options for patients with lipedema.
112 citations
TL;DR: In this paper, a continuing education activity for physicians and nurses with an interest in skin and wound care is presented to enhance the learner's competence with knowledge of Skin Changes at Life's End (SCALE).
Abstract: PURPOSE:To enhance the learner's competence with knowledge of Skin Changes at Life's End (SCALE).TARGET AUDIENCE:This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.OBJECTIVES:After participating in this educational activity, the participa
95 citations
TL;DR: The survey data indicate that a decrease in overall prevalence of PrU, as well as hospital-acquired PrUs, may have occurred in 2009, and suspected deep tissue injuries have become more commonly identified, which may be secondary to education of staging definitions.
Abstract: OBJECTIVE:Suspected deep tissue injury (sDTI) was identified in 2001 and added as a staging definition by the National Pressure Ulcer Advisory Panel in 2007 Clinical data on sDTI are sparse This article reports the overall prevalence data and describes the demographics of subjects with sDT
94 citations
TL;DR: The authors' data demonstrate the ability of the combination of PRP and autologous adipose graft to regenerate tissue and epithelialization with wound closure, with a significant healing-time reduction.
Abstract: BACKGROUND:Platelet-rich plasma (PRP) induces wound regeneration and tissue repair through cell proliferation and differentiation, promoting tissue healing and also acting as an autologous scaffold. With a small quantity of blood, it is possible to obtain the necessary optimal volume of PRP to treat
79 citations
TL;DR: It is imperative to develop such effective measures as active and passive immunization to control multidrug-resistant and tenacious A baumannii infections and to prevent nonhealing wounds.
Abstract: OBJECTIVE: Multidrug-resistant Acinetobacter baumannii is associated with a wide spectrum of infectious diseases ranging from nosocomial, community-acquired infections to those acquired following war or natural disaster. Especially to military personnel with war wounds, Acinetobacter infection is a formidable threat. The treatment has become exceedingly difficult, not only because the bacterium can develop extensive antimicrobial resistance but because it also forms biofilms that are resistant to host defense and antimicrobial treatment. Such causative factors as biofilm formation and resistance are highly likely to lead to nonhealing wounds. This review, although focused on A baumannii infections, aims to summarize what is known about immunization protection against wound biofilm infections and to apply such understanding in exploring the unknown area of war-wound infection protection. DATA SOURCES AND STUDY SELECTION: Publications were searched and selected through http://www.pubmed.gov by using the key words Acinetobacter baumannii, bacteria, war wounds, burn wounds, wound infections, biofilms, vaccines, and immunization. The literature selected was categorized according to the subheadings within this article. CONCLUSIONS: It is imperative to develop such effective measures as active and passive immunization to control multidrug-resistant and tenacious A baumannii infections and to prevent nonhealing wounds. The authors’ understanding in immunization against burn wound–related infections by the model bacteria will facilitate research progress in the poorly explored area of immunization against war-wound biofilm infections. ADV SKIN WOUND CARE 2010;23:169–74
68 citations
TL;DR: Overall, the biological extracellular matrix was more beneficial than moist wound dressings for the treatment of patients with mixed arterial/venous or venous ulcers.
Abstract: OBJECTIVE:In this study, a biological extracellular matrix was compared with a moist wound dressing to determine its effectiveness in the treatment of mixed arterial/venous and venous ulcers.METHODS:Patients were evaluated for complete wound healing, time to dressing change, and formation of
65 citations
TL;DR: The importance of collecting PrU prevalence and incidence data as an effective measure of nursing care and patient outcomes is supported and to identify facility trends is supported.
Abstract: OBJECTIVE:The objectives of the study were to identify the incidence and prevalence of pressure ulcers (PrUs) in acute-care patients, including the major contributing factors, and to modify existing policy and practices to align with the Institute for Healthcare Improvement recommendations f
64 citations
TL;DR: A moderately sufficient informed clinical consensus does exist to support a variety of care approaches for the palliative individual with a PrU, and the recommendations presented are those included in the 2009 National Pressure Ulcer Advisory Panel (NPUAP)–European Pressure Ulcers Prevention and Treatment Guidelines.
Abstract: INTRODUCTION About 300 million individuals, or 3% of the world’s population, need palliative or end-of-life care each year. Palliative care is designed to provide relief from suffering and enhance the quality of both the living and dying processes for the patient and family, while neither hastening nor prolonging death. Many professionals concur that pressure ulcers (PrUs) occurring at the end of life are often not preventable and that efforts to prevent them are complicated because of the patient’s frail condition. Many professionals also agree that it may be impossible to eradicate PrUs in the terminally ill because of the multiple risk factors and comorbid conditions. PrU development, however, can decrease quality of life physically, emotionally, socially, and mentally. A systematic review of research on PrUs and quality of life reported that PrUs had significant impact in all aspects of life. Usual care of a PrU is designed to promote healing; however, healing or closing the ulcer in patients receiving palliative care is often improbable. Therefore, the focus of care is better directed to reduce or eliminate pain, odor, and infection and allow for an environment that can promote ulcer closure, as well as improve self-image to help prevent social isolation. Healthcare providers also need to advocate for and develop products that control complications and deliver symptomatic relief to promote a desirable quality of life of the patient and family. The purpose of this white paper is to review and summarize the current scientific evidence for prevention and care of a PrU in a palliative care patient. Although randomized controlled studies are few, a moderately sufficient informed clinical consensus, as well as less rigorous scientific studies, does exist to support a variety of care approaches for the palliative individual with a PrU. Gaps in the literature will be identified, and current recommendations for practice will also be reviewed. The recommendations presented are those included in the 2009 National Pressure Ulcer Advisory Panel (NPUAP)–European Pressure Ulcer Advisory Panel (EPUAP) International Pressure Ulcer Prevention and Treatment Guidelines.
62 citations
TL;DR: Prevention of PrUs showed a trend of improvement in facilities that fully integrated tools to identify high-risk residents into day-to-day practice and promote staff working together in multidisciplinary teams impacted clinical outcomes.
Abstract: OBJECTIVE:To design and facilitate implementation of practice-based evidence changes associated with decreases in pressure ulcer (PrU) development in long-term-care (LTC) facilities and promote these practices as part of routine care.DESIGN:Pre/post observational study.SETTINGS AND PARTICIPANTS:Frai
58 citations
TL;DR: Experimental evidence suggests a significant role of endogenous EFs in cell migration in wound healing, and electric stimulation offers a novel approach to achieve better and accelerated wound healing.
Abstract: BACKGROUND: Effective wound healing has been a lasting and challenging topic in health care. Various strategies have been used to accelerate and perfect the healing process. One such strategy has involved the application of an exogenous electrical stimulus to chronic wounds with the aim of stimulating healing responses. THE PROBLEM: The biology of electric stimulation to instigate healing, however, is very poorly understood. How does electric stimulation induce healing responses? BASIC/CLINICAL SCIENCE ADVANCES: Recent research shows that the electric fields (EFs) activate multiple signaling pathways that are critical for wound healing. Importantly, the EFs provide a powerful, sometimes an overriding, directional signal for cell migration in wound healing. Unlike other stimuli, EFs have the intrinsic property of being directional. The EF-directed cell migration (electrotaxis/galvanotaxis) appears to be a consequence of EF-induced polarized signaling of epidermal growth factor receptors, integrins, and phosphoinositide 3 kinase/Pten, and may be mediated by protein kinase C, intracellular Ca(2+), and cyclic adenosine monophosphate (cAMP). Because directional cell migration is a key component in wound healing, galvanotaxis may represent an important mechanism of wound healing. CLINICAL CARE RELEVANCE: With the constantly enlarging diabetic and aging population, chronic or nonhealing wounds pose increasing health and economic problems, and currently there is no effective therapy available. Electric stimulation activates important intracellular signaling pathways that are polarized in the EF direction, resulting in enhanced and stimulated directional cell migration. Electric stimulation offers a novel approach to achieve better and accelerated wound healing. CONCLUSION: Experimental evidence suggests a significant role of endogenous EFs in cell migration in wound healing. Most importantly, EFs are a very powerful signal to direct cell migration. Electric stimulation therefore may represent a promising and unique strategy to induce cell and tissue growth in a directional manner, to enhance wound healing, and to achieve better wound healing.
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to enhance the clinician's competence in providing local wound care for malignant and palliative wounds.
Abstract: PURPOSE:To enhance the clinician's competence in providing local wound care for malignant and palliative wounds.TARGET AUDIENCE:This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.OBJECTIVES:After participating in this educational activity
TL;DR: This poster explains why pressure ulcers are a significant problem across all healthcare settings in the United States and some patients are 3 times more likely to be discharged to a long-term-care facility than those with PrUs.
Abstract: WHY DO WE CARE?Pressure ulcers (PrUs) are a significant problem across all healthcare settings in the United States. Annually, 2.5 million patients are treated in acute-care facilities for PrUs. Patients with PrUs are 3 times more likely to be discharged to a long-term-care facility than those with
TL;DR: The use of the vibrator may facilitate the healing of Stage I pressure ulcers in older adults according to PrU care guidelines.
Abstract: Objective The present study investigated whether vibration therapy using a vibrator could facilitate the healing of Stage I pressure ulcers (PrUs) in older adults Methods The study had a nonrandomized, blinded, controlled design The subjects were hospital patients in long-term-care facilities with Stage I PrUs In the experimental group, a vibrator (RelaWave; Matsuda Micronics Corp, Chiba, Japan) was used to apply vibration (frequency: 47 Hz; time: 10 seconds; amplitude modulation cycle: 15 seconds) for 15 minutes 3 times a day for up to 7 days, until Stage I PrUs healed Apart from the vibration therapy, the experimental and control groups received the same care, which was provided according to PrU care guidelines The number of healed ulcers was compared between 2 groups Results The experimental group consisted of 16 patients with 20 Stage I PrUs; the control group consisted of 15 patients with 21 Stage I PrUs In the experimental group, 8 (400%) PrUs healed; in the control group, 2 (95%) PrUs healed The number of healed ulcers was significantly higher in the experimental group than in the control group (P = 033) The healing rate during the study period was significantly higher in the experimental group than in the control group (P = 018, logrank test) The hazard ratio adjusted for baseline risk factors was 0031 (95% confidence intervals: 0002-0594, P = 021) The mean relative changes per day in wound area and intensity of redness were significantly greater in the experimental group than in the control group (P = 007, and P = 023, respectively) Conclusion Based on these results, the use of the vibrator may facilitate the healing of Stage I PrUs
TL;DR: Skin and fabric interactions, which have not received much attention in relation to PrUs, have been more closely investigated by Gerhardt et al under the umbrella of a science called tribology.
Abstract: BACKGROUND Friction is blamed for a number of untoward events of the skin. In particular, it is known to be a causative factor in falls, blisters, dermatitis, skin tears, injuries during patient transfers, airbag deployment injuries, and marathon runners’ skin irritations, as well as PrUs. Friction-induced injuries also can be caused by patient skin rubbing on starched bed linens, primarily affecting the elbows, heels, and knees and, less often, the sacral areas. Increasing the likelihood of PrU development, friction/shear injuries can occur during the positioning of patients in the bed, during the placement of a bedpan, during a transfer to another bed surface or wheelchair, and when moving patients up in bed. The mechanism of injury is that the underlying skin layers move with the patient, while the epidermal/dermal layers adhere to the bed or chair surface because of friction, causing shearing of tissues under the skin. Friction may induce the injury, but the resultant damage is shear to the underlying tissue layers, in this case. Although friction against the skin is rarely noticed until it results in an injury, it is present nonetheless. As an example, consider the difference between wearing a tight, chafing garment for jogging versus wearing a smooth, stretchy material. Most individuals would likely select the latter but may not be aware that it is friction they are avoiding. And when a person sleeps on a bed that has high-thread-count linens and notices that he/she has a better night’s sleep, it might be a lack of friction that accounts for the improvement. This kind of friction might seem inconsequential to wound care and PrUs, but consider patients in hospitals who rarely choose the thread counts in linens on which they sleep or in the bed on which they lie. Their quality of life is impacted by friction 24 hours a day when they are confined to a bed, wearing starched-cotton clothing and sliding against linen washed with harsh detergents. Skin and fabric interactions, which have not received much attention in relation to PrUs, have been more closely investigated by Gerhardt et al under the umbrella of a science called tribology. Tribology, as stated by Gerhardt et al, is the ‘‘study of friction, wear and lubrication, the science and technology of interacting surfaces in relative motion.’’ Tribological studies may help clinicians to understand the role of friction in causing PrUs and how to reduce friction when attempting to prevent PrUs.
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to enhance the clinician's competence in using nutrition as an integral part of wound healing.
Abstract: PURPOSE:To enhance the clinician's competence in using nutrition as an integral part of wound healing.TARGET AUDIENCE:This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.OBJECTIVES:After participating in this educational activity, the part
TL;DR: Hyperbaric oxygen therapy continues to be discussed as another adjunctive therapy in the continuum of wound care, but there is a dearth of evidence from randomized clinical trials on HBO therapy.
Abstract: Hyperbaric oxygen therapy continues to be discussed as another adjunctive therapy in the continuum of wound care. There is a dearth of evidence from randomized clinical trials on HBO therapy. For evidence-based practice, more randomized, controlled studies need to be conducted with HBO therapy to determine its efficacy in treating other chronic wounds besides those of patients with diabetes.
TL;DR: Overall, the authors' testing found that collagenase was observed to be more tolerant when used with the dressings tested than papain, and these findings merit further exploration in clinical wounds to confirm clinical validity.
Abstract: OBJECTIVE: To understand the compatibility between the debriding enzymes collagenase and papain, and various wound dressings. DESIGN: The extracts from a silver dressing (Acticoat; Smith & Nephew, St Petersburg, Florida), iodine dressings (Iodoflex and Iodosorb; Smith & Nephew), a pigment-complexed polyvinyl alcohol (PVA) dressing (Hydrofera Blue; Healthpoint, Ltd, Fort Worth, Texas), and collagen dressings (Hydrofera Blue and FibraCol Plus; Systagenix Wound Management, Quincy, Massachusetts) were examined in vitro with collagenase and papain (papain was used in papain-urea debriding agents, no longer available on today’s US market). SETTING: All testing was in vitro and performed at Healthpoint, Ltd. PATIENTS: Testing was not performed using human or animal subjects. All in vitro testing was conducted in the lab using artificial wound eschar substrate and other lab equipment. MAIN OUTCOME MEASURES: The main outcome measure was percent collagenase and papain activity lost when combined with each type of dressing tested. MAIN RESULTS: The results demonstrated that the pigment-complexed polyvinyl alcohol dressing and the collagen dressing were compatible with collagenase, whereas the iodine dressings inhibit the activity of collagenase. The nanocrystal silver dressing (Acticoat) caused more than a 50% loss in activity when combined with collagenase. Papain displayed varying levels of inhibition with all dressings tested with the enzyme. The iodine dressings significantly inhibit papain activity, whereas the other dressings exhibited inhibitory activity ranging from 10% to 30%. CONCLUSION: Antimicrobial dressings are widely used for management of wound bioburden. Frequently, they are used in combination with other topical therapeutic drugs, such as enzymatic debriding agents for the removal of wound necrotic tissues. Such combined applications may have greater potential to achieve multiple healing activities simultaneously, including exudate and bioburden management, debridement, and tissue regeneration. Overall, the authors’ testing found that collagenase was observed to be more tolerant when used with the dressings tested than papain. These findings merit further exploration in clinical wounds to confirm clinical validity.
TL;DR: Vashe Wound Therapy is a valuable contribution to standard protocols of wound care, and the average size of reduction in nonhealed wounds was 47%.
Abstract: OBJECTIVE:To analyze if Vashe Wound Therapy (PuriCore, Malvern, Pennsylvania) is a valuable contribution to standard protocols of wound careDESIGN:Open, noncomparative studySETTING:Outpatient clinicPATIENTS:Thirty-one patients, primarily with venous or mixed venous/arterial leg ulcersINT
TL;DR: The strategies to attain these objectives were to formulate and devise standard diagnostic, preventive, and therapeutic methods for DF care; launch clinics and educational workshops for physicians, other clinicians, and patients; create opportunities for conducting multicenter projects in various aspects of diabetic foot ulcers.
Abstract: BACKGROUND Diabetic foot (DF) is prevalent in Iran and thus requires appropriate programs aimed at its prevention and management. To that end, the Endocrinology and Metabolism Research Center (EMRC) of Tehran University of Medical Sciences of Iran established the Diabetic Foot Research Network in 2005 (IDFRN) with the primary goals of expanding knowledge and reforming practice in all aspects of diabetic foot care, facilitating the translation of evidence-based knowledge into practice through forging active cooperation between the network members, and finally organizing diabetic foot care programs for the general population, patients, and healthcare providers. The strategies to attain these objectives were to formulate and devise standard diagnostic, preventive, and therapeutic methods for DF care; launch clinics and educational workshops for physicians, other clinicians, and patients; create opportunities for conducting multicenter projects in various aspects of diabetic foot ulcers (DFUs); design a software registration system for diabetic foot patients; train podiatrists; and design appropriate diabetic footwear. This article describes some of the most salient activities of this network.
TL;DR: In SCI patients with Stage III/IV pelvic PrUs, NPWT did not significantly influence the rate of healing, and in malnourished individuals (albumin <3.0 mg/dL), NPWT was not efficacious.
Abstract: OBJECTIVE:To assess the efficacy of negative-pressure wound therapy (NPWT) for healing of pressure ulcers (PrUs) in individuals with spinal-cord injury (SCI).DESIGN:Multicenter, 28-day observational study.SETTING:Ten Veterans Affairs Medical Center SCI centers.PATIENTS:Eighty-six SCI inpatie
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to enhance the learner's competence with knowledge of biopsy techniques and when to perform biopsies on specific chronic wounds.
Abstract: PURPOSE To enhance the learner's competence with knowledge of biopsy techniques and when to perform biopsies on specific chronic wounds. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After participating in this educational activity, the participant should be better able to: 1. Distinguish between different types of chronic wounds that require biopsies. 2. Apply knowledge of biopsy techniques to obtain quality results. 3. Analyze various types of chronic wounds to determine the appropriate type of biopsy needed.
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to enhance the learner's competence in treating burn patients in primary care.
Abstract: PURPOSE: To enhance the learner's competence in treating burn patients in primary care. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to:
TL;DR: The Qoustic Wound Therapy System, using the Qoustic Qurette, kills planktonic bacteria and reduces bacterial biofilms in vitro.
Abstract: Objective The purpose of this study was to determine whether the Qoustic Wound Therapy System (Arobella Medical, LLC, Minnetonka, Minnesota) kills planktonic bacterial cells and/or removes bacterial biofilms. Design The Qoustic Wound Therapy System was evaluated against Pseudomonas aeruginosa, Staphylococcus epidermidis, and Staphylococcus aureus planktonic cells and biofilms in vitro. Main results P aeruginosa, S epidermidis, and S aureus planktonic cells decreased by a mean of 5.10, 4.99, and 5.22 log10 colony-forming units/mL, respectively, with 4 Qoustic Wound Therapy System treatment minutes. After 10 minutes of treatment, P aeruginosa, S epidermidis, and S aureus biofilms decreased by a mean of 1.34, 1.46, and 1.02 log10 colony-forming units/cm, respectively. Conclusion The Qoustic Wound Therapy System, using the Qoustic Qurette, kills planktonic bacteria and reduces bacterial biofilms in vitro.
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to provide information about the impending changes in the Minimum Data Set (MDS) Section M on skin conditions and its implications for practice.
Abstract: PURPOSE:To provide information about the impending changes in the Minimum Data Set (MDS) Section M on skin conditions and its implications for practice.TARGET AUDIENCE:This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.OBJECTIVES:After pa
TL;DR: These studies suggest that potent local antibacterial activity can be achieved with several antimicrobials in this wound dressing, thus diminishing morbidity, mortality, and cost to the healthcare system.
Abstract: OBJECTIVE: Antibiotic resistance is increasing among organisms that commonly cause wound infections. Therefore, it becomes increasingly desirable to prevent wound infections as systemic antibiotic treatment of established wound infections becomes more difficult, more expensive, and potentially more toxic. The ability to incorporate antimicrobial compounds into modern wound dressings provides an opportunity to prevent wound infections without the risk of systemic toxicity, thus diminishing morbidity, mortality, and cost to the healthcare system. DESIGN: In these studies, the authors tested 16 antimicrobial agents in a unique composite wound dressing (TheraGauze; Soluble Systems, LLC, Newport News, Virginia) against clinical methicillin-resistant Staphylococcus aureus isolates and Gram-negative organisms commonly associated with wound infections and antibiotic resistance. Disk diffusion susceptibility testing is used to quantify antimicrobial activity. RESULTS: Broad-spectrum antimicrobial activity was found for the following agents in the composite wound dressing: hydrogen peroxide, tobramycin, chlorhexidine digluconate, chlorhexidine gluconate, levofloxacin, and silver. CONCLUSION: These studies suggest that potent local antibacterial activity can be achieved with several antimicrobials in this wound dressing.
TL;DR: Chronic trauma-induced limb ulceration is the leading risk factor for Marjolin's ulcer and health education, early detection, and proper management of chronic wounds would improve outcome.
Abstract: OBJECTIVE: This study was to evaluate the current pattern and risk factors of Marjolin's ulcer in the authors' setting. SETTINGS AND PARTICIPANTS: Twenty-one patients with histological diagnosis of skin malignancy at the University of Calabar Teaching Hospital, Calabar, Nigeria. METHODS: Presented are patients with histologic diagnosis of Marjolin's seen in the University of Calabar Teaching Hospital, Calabar, Nigeria from January 2007 through December 2007. RESULTS: Five patients (3 men and 2 women) with Marjolin's ulcer whose ages ranged from 32 to 70 years (mean 46.6 years) accounted for 45.5% of squamous cell carcinoma. All the patients suffered traumatic injuries (4 lower limb injuries from road traffic accidents and 1 puncture wound of the upper limb) and the latency was 21.4 years. CONCLUSIONS: Chronic trauma-induced limb ulceration is the leading risk factor for Marjolin's ulcer. Health education, early detection, and proper management of chronic wounds would improve outcome.
TL;DR: It is suggested that the biggest differences between many antimicrobial dressings on the market may be more in cost than in antimicrobial efficacy.
Abstract: Purpose Antimicrobial wound dressings are becoming more popular and are routinely used in the treatment of chronic and problematic wounds. Despite the ever-growing number and types of these antimicrobial products, many practitioners often do not report significant clinical differences between various common antimicrobial wound dressings despite wide variations in cost. Although these dressings use different active ingredients or different presentations of a particular active ingredient, all attempt to protect the wound from bacterial colonization and promote wound repair. With so many topical antimicrobial dressings to choose from in the clinical setting (many having already fallen into disfavor due to their cytotoxic characteristics) it was of prime interest to determine if there was a substantial difference between some of the more commonly used antimicrobial dressings, with silver versus an antimicrobial wound dressing using Oakin (oak extract [Amerx Health Care Corporation, Clearwater, Florida]) as the active ingredient. Methods This article compares the antimicrobial efficacy of 4 commonly used wound dressings in vitro, utilizing a corrected zone of inhibition test followed by a cost analysis. Results In vitro testing demonstrated that there were no substantial differences in the corrected zone of inhibition measurements between the silver wound dressings and the less expensive Oakin-impregnated gauze dressing. Conclusion Despite obvious limitations of this study, these results suggest that the biggest differences between many antimicrobial dressings on the market may be more in cost than in antimicrobial efficacy. The differences in cost are due to variances in cost per application and frequency of applications per week.
TL;DR: It is suggested that differences in cell cycle distribution and p53 protein expression may partly account for the biologic mechanism of 595-nm PDL in treating keloid disease.
Abstract: OBJECTIVE:Clinical observations indicate that the irradiation of pulsed-dye laser (PDL) can inhibit keloid growth; however, the mechanism of this process is unknown. The aim of this study was to explore the molecular mechanism of the action of PDL on keloid fibroblasts.METHODS:Twenty patient
TL;DR: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care to provide the wound care practitioner with information about how chronic wound healing differs in the older adult population.
Abstract: PURPOSE: To provide the wound care practitioner with information about how chronic wound healing differs in the older adult population. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to: 1. Compare chronic wound healing processes and outcomes in older adults with those in younger persons. 2. Explain the relationships between wound healing, comorbidities, and adverse drug events. 3. Apply known relationships among wound healing, comorbid medical conditions, and functional decline to care of the older adult.