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  • 1
    Electronic Resource
    Electronic Resource
    Social support: some pragmatic implications for health care professionals (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of advanced nursing 23 (1996), S. 0 
    Details
    ISSN: 1365-2648
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The role of social support in promoting recovery from chronic illness has been the focus of a debate within the nursing and social science research communities This paper reviews the literature on this important issue and discusses the implications for patient management In providing holistic patient care, health care professionals need to reflect on the impact of this research for their clinical practice
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2648.1996.tb03138.x
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  • 2
    Electronic Resource
    Electronic Resource
    Use of molecular techniques to study microbial diversity in the skin: Chronic wounds reevaluated (2001)
    Oxford, UK : Blackwell Science, Ltd.
    Wound repair and regeneration 9 (2001), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The skin is colonized by an array of microorganisms which form its natural microflora. Disruption to the normal barrier function of the skin (due to trauma or disease) may result in invasion of the dermis by opportunistic bacteria. To date, these organisms, which may contribute to the chronicity of skin wounds, have been analyzed solely by culture methods. It is increasingly realized that standard culture methods of analysis do not accurately reflect the full diversity of complex microflora. This review discusses the limitations of traditional culture approaches and reviews recent advances in molecular microbiological techniques which facilitate a more comprehensive characterization of the microflora within clinical samples. The currently available technologies and techniques are described, as is their use in clinical practice and their potential for diagnostic screening. Chronic venous ulceration of the lower limbs is an important skin disorder in which the microflora invading the dermal tissues contribute to the observed delayed healing. Using chronic leg ulcers as a working example, we show how strict culture and molecular microbiological techniques may be employed, for the first time in combination, to definitively characterize the invading microbial community of the dermis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1524-475x.2001.00332.x
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  • 3
    Electronic Resource
    Electronic Resource
    Efficacy and safety of the freeze-dried cultured human keratinocyte lysate, LyphoDerm™ 0.9%, in the treatment of hard-to-heal venous leg ulcers (2005)
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: LyphoDermTM (XCELLentis, Belgium) is an end-sterilized, freeze-dried lysate from cultured allogeneic epidermal keratinocytes, formulated into a hydrophilic gel. Its efficacy and safety were evaluated, in combination with standard care (hydrocolloid dressing and compression therapy), in 194 patients suffering from hard-to-heal (lasting more than 6 weeks and not responding to conventional therapy) venous leg ulcers. Two control groups received standard care, with or without vehicle, respectively. Patients had a median age of 67.5 years and the majority were females (61%). The median duration of the ulcer was 43 weeks and in 39% of the subjects it had been present for more than 1 year. Thirty-eight percent of the patients in the standard care + LyphoDermTM group had complete ulcer healing within 24 weeks (primary end point) compared to 27% of patients in the standard care + vehicle pooled groups (P = 0.114) in the “as treated” intent-to-treat cohort (37% vs. 27% in the “as randomized intent-to-treat cohort; p = 0.137). In the subgroup of patients with enlarging ulcers, the difference between the two groups was significant (30% vs. 11%; p = 0.024 in the “as treated” intent-to-treat cohort and 31% vs. 9%; p = 0.005 in the “as randomized” intent-to-treat cohort). LyphoDermTM was well tolerated and safe, and no differences in the frequency of adverse events were noted between the treatment groups. Although the primary objective of the study was not achieved, the exploratory analysis carried out in patients with enlarging ulcers suggests that LyphoDermTM could offer a new prospect for the treatment of patients with venous ulcers that may prove to be a significant adjunct to the overall provision of care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2005.130204.x
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  • 4
    Electronic Resource
    Electronic Resource
    Effect of sharp debridement using curette on recalcitrant nonhealing venous leg ulcers: A concurrently controlled, prospective cohort study (2005)
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The objective of this study was to evaluate the effect of sharp debridement on the progression of recalcitrant chronic venous leg ulcers (CVLU) and to assess the feasibility of performing this procedure in an outpatient setting. We performed a prospective study of 55 CVLU (53 patients) over a 12-month period. The study group, which underwent debridement, contained 28 CVLU whose wound beds had slough, nonviable tissue, and no granulation tissue. The control group was 27 CVLU with minimal (15–20%) granulation tissue, but no slough or nonviable tissue. Treatments were otherwise similar. Age, body mass index, mean ulcer surface area (MSA) and mean ulcer duration were comparable in both groups. Ulcer measurements were taken at 4 weeks before debridement, at the time of debridement, and 4 and 20 weeks post-debridement. There was no change in the MSA from 4 weeks before to the time of debridement in either group. At 4 weeks post-debridement, the study ulcers showed a 6 cm2 reduction in the MSA vs. a 1 cm2 reduction in controls (P = 0.02). By week 20 post-debridement, the study ulcers achieved a 7.4 cm2 reduction in the MSA vs. an increase of 1.3 cm2 in controls (P = 0.008). Between weeks 8 and 20 post-debridement, 16% of study ulcers vs. 4.3% of control ulcers achieved complete healing. Infection rates and antimicrobial usage were similar. We conclude that sharp debridement is effective in stimulating healing of recalcitrant CVLU. It is safe, well tolerated, and can be performed in an outpatient setting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2005.130203.x
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  • 5
    Electronic Resource
    Electronic Resource
    Plantar pressure in off-loading devices used in diabetic ulcer treatment (2005)
    Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Four off-loading devices used for the treatment of diabetic forefoot ulcers were compared: a custom-molded insole shoe, a cast MABAL shoe, a prefabricated pneumatic walking brace, and a bivalved total contact cast (BTCC). It was anticipated that all devices would significantly reduce forefoot plantar pressure compared with a control shoe. Sixteen healthy volunteers participated. Plantar pressures were evaluated using the Pedar system, while walking speed was determined using an optoelectric timer. Peak pressure (PP) of ten plantar areas and pressure–time integral for the first metatarsal area were analyzed statistically using a repeated measures analysis of variance. Forefoot pressures were significantly reduced compared with the control shoe for all devices (p〈0.001). PP was most reduced (by 65.8%) for the BTCC, and pressure–time integral was most reduced for the BTCC and cast MABAL shoe. Small but significant differences between devices in walking speed (p〈0.05) could not explain the substantial PP differences between the different devices. Although all off-loading devices resulted in a significant reduction of forefoot plantar pressure, devices differed significantly in the magnitude of pressure reduction. Further research will have to reveal the level of off-loading sufficient for effective treatment of diabetic ulcers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1524-475X.2005.00075.x
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  • 6
    Electronic Resource
    Electronic Resource
    Comparison of oxidative stress biomarker profiles between acute and chronic wound environments (2004)
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 12 (2004), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Increasing evidence implicates excessive reactive oxygen species (ROS) generation and ROS-derived degradation products in the pathogenesis of many skin diseases. While numerous attempts have been made to identify prognostic biomarkers of wound healing in skin, these have met with limited success. This study examined the profiles of various oxidative stress biomarkers, namely total protein carbonyl content (from protein oxidation), malondialdehyde content (from lipid peroxidation), and the total antioxidant capacities, in acute wound fluid (n= 10) and chronic wound fluid (n= 12), using a rapid, noninvasive collection technique. Protein carbonyl content was quantified spectrophotometrically and by sodium dodecyl sulfate-polyacrylamide gel electrophoresis/Western blotting, following 2,4-dinitrophenylhydrazine derivitization. Malondialdehyde levels were similarly quantified, following N-methyl-2-phenylindole derivitization. Total antioxidant capacity was determined via wound fluid inhibition of cytochrome C reduction by a superoxide radical flux. Acute wound fluid contained higher protein carbonyl content than chronic wound fluid, particularly evident following sodium dodecyl sulfate-polyacrylamide gel electrophoresis/Western blot analysis under nonreducing and reducing conditions (p 〈 0.001 and p 〈 0.02, respectively), related to significantly higher protein levels (p = 0.0005) in acute wound fluid. Human serum albumin (∼66 kDa) was identified as the most prominent protein oxidized in both acute and chronic wound fluid, which may contribute to the reduced albumin and total protein levels in chronic wound fluid. No significant difference (p 〉 0.1) in malondialdehyde levels or total antioxidant capacities were determined between acute and chronic wound fluids, although chronic wound fluid exhibited significantly higher total antioxidant capacities (p 〈 0.005), accounting for variations in wound fluid protein content. These findings suggest an adaptation in the antioxidant profiles of chronic wound fluid to counteract the loss of consumed antioxidants in the chronic wound environment. This study highlights the roles of ROS/antioxidants in skin wound healing, their possible involvement in chronic wounds and the potential value of ROS-induced biomarkers in wound healing prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2004.12406.x
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  • 7
    Electronic Resource
    Electronic Resource
    Potential role of anaerobic cocci in impaired human wound healing (2002)
    Malden, USA : Blackwell Science Inc
    Wound repair and regeneration 10 (2002), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Although more than 80% of infected and 70% of noninfected leg ulcers have been shown to harbor anaerobic organisms, their role in mediating impaired wound healing in the skin is frequently overlooked. There is now increasing evidence that the gram-positive anaerobic cocci play a role (both directly and indirectly) in mediating impaired wound healing in vivo. This article discusses the mechanisms by which these microorganisms may interfere with the inflammation, repair, and remodeling phases of the wound healing process. (WOUND REP REG 2002;10:–353)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1524-475X.2002.t01-1-10602.x
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  • 8
    Electronic Resource
    Electronic Resource
    Prediction of healing time as an aid to the management of open granulating wounds (1983)
    Springer
    World journal of surgery 7 (1983), S. 641-645 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les phénomènes de cicatrisation ont été étudiés chez 2 groupes de malades: 40 qui présentaient une laparotomie laissée ouverte en raison d'une infection péritonéale, et 29 qui avaient subi l'excision d'un sinus pilonidal. La régression linéaire de la durée du temps de cicatrisation en fonction de l'importance de la plaie fut prise en considération en se basant sur sa largeur et sa profondeur. A partir des résultats obtenus, il a été possible de prédire la durée du temps de cicatrisation de chaque plaie en fonction de sa taille. Les modifications constatées en fonction des facteurs étiologiques, par exemple l'infection susceptible de retarder la cicatrisation, ont été aussi statistiquement analysées. La prévision de la durée du temps de cicatrisation pour chaque plaie permet d'informer le malade de l'évolution qu'il est en droit d'espérer. Fait plus important, il est possible de prévoir un retard du processus cicatriciel dès le stade initial et d'analyser les facteurs qui sont susceptibles de retentir sur lui.
    Abstract: Resumen Se estudiaron las tasas de cicatrización en 2 grupos de pacientes. Cuarenta presentaban heridas de laparotomía que fueron dejadas abiertas para granular debido a infección evidente o sospechada, y 29 eran parte de una serie de extirpaciones de quistes pilonidales que fueron dejados sin suturar de acuerdo a una politica pre-establecida. Las regresiones lineares del tiempo de cicatrización contra el tamaño de la herida fueron determinadas; la dimensión escogida para esta última fué el ancho o la profundidad, tomando lo que fuera mayor. Con base en los resultados obtenidos fué posible calcular un tiempo de cicatrización “predecible” para cada herida en correspondencia con su tamaño, y ver cómo éste diferia del tiempo real observado. Las desviaciones halladas fueron utilizadas para el análisis estadistico relativo a posibles factures etiológicos, por ejemplo la significación de la infección como causa de retardo de la cicatrización. La predicción del tiempo de cicatrización para heridas individuales permite dar información al paciente sobre la probable duración de la cicatrización de su herida. Aún más importante, permite reconocer e investigar la demora en la cicatrización de la herida en una etapa temprana, y facilita el análisis de los factores que tienen incidencia probable sobre el proceso.
    Notes: Abstract The healing rates of 2 groups of patients were studied. Forty patients had laparotomy wounds that were left open to granulate because of overt or suspected infection, and 29 were from a series of pilonidal sinus excisions left unsutured as a matter of policy. The linear regressions of healing time against wound size were determined, the dimension chosen for wound size being either the breadth or depth, whichever was greater. From the results obtained, it was possible to calculate a “predicted” healing time for each wound corresponding to its size and to see how this differed from the observed time. The deviations found were used for statistical analysis relating to possible etiological factors; for example, the significance of infection as a cause of delayed healing. Prediction of the healing time for individual wounds allows the patient to be given information about the likely duration of wound healing. More importantly, it enables delay in wound healing to be recognized and investigated at an early stage and facilitates analysis of factors having a possible bearing on the process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01655345
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