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International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

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The effect of a combination of 0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol (octenisept®) on wound healing in pigs in vivo and its in vitro percutaneous permeation through intact and barrier disrupted porcine skin

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

A combination of 0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol (octenisept®) is a commonly used disinfectant in human medicine. As porcine skin represents an adequate model for human skin, the effect of octenidine dihydrochloride and phenoxyethanol on wound healing is studied in pigs. Furthermore, the in vitro percutaneous permeation of the test substances is studied. The impact of the test formulations on wound healing is examined (A) under non occlusive conditions and (B) in comparison to another disinfectant based on povidone-iodine under occlusive conditions, while wounds are treated daily with the test substances. The percutaneous permeation of octenidine dihydrochloride and phenoxyethanol is studied in Franz-type diffusion cells with intact skin as well as barrier disrupte...

The role of mast cells in wound healing

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

Mast cells are predominantly found in the vicinity of connective tissue vessels of skin and mucosa. The main immunological functions of mast cells are in IgE-mediated reactions and in helminth infestations. Mast cells respond to tissue injury by releasing inflammatory mediators and have been implicated in diseases of excessive fibrosis of the dermis such as scleroderma. Current evidence suggests that mast cells exert its role during inflammation and cellular proliferation. Animal models have shown that by stabilising mast cells at the early stages of wound healing, wound contraction is reduced. Mast cells are an ideal candidate to play a pivotal role in wound healing due to its location, substances released and clinical associations. (Source: International Wound Journal)

The economics of pressure relieving surfaces: an illustrative case study of the impact of high-specification surfaces on hospital finances

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

Pressure ulcers are associated with a significant economic burden that, in many cases, is recognised as being avoidable. The effectiveness of pressure relieving surfaces is well documented and acknowledged in clinical guidelines on the prevention and management of pressure ulcers. Whilst pressure relieving surfaces are more expensive than traditional hospital mattresses, judicious use, targeted to patients most at risk, can help to reduce the incidence and costs of pressure ulcers in hospital settings. This review paper includes a summary of pivotal clinical evidence on pressure relieving surfaces as well as a suggested approach for modelling their financial impact on hospital budgets. Simple financial modelling suggests that pressure relieving surfaces could lead to financial savings for ...

Improving venous ulcer healing: designing and reporting randomised controlled trials

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

The randomised controlled trial (RCT) is often considered the gold standard for judging the benefits of treatments. The application of randomised controlled clinical trials to treatments of venous ulcer healing has lagged behind that of other areas of medicine. To interpret the results of an RCT, readers must understand a variety of aspects of their design, analysis and interpretation. Venous ulcer disease has a high prevalence and has a significant socioeconomic impact in most parts of the world. The management of venous ulcers causes a considerable strain on the health system and is likely to worsen in future. The multi-layer high compression system is described as the current gold standard for treating venous ulcers. A recent meta-analysis of bandaging systems found that multi-layer com...

Implementation of best practice in the prevention of heel pressure ulcers in the acute orthopedic population

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

To implement and evaluate a heel pressure ulcer prevention program (HPUPP) for orthopaedic patients. Program development of HPUPP involved input from administrators, staff and adult patients on an orthopaedic service in an academic tertiary care facility, located in a small urban centre in Canada. Prospective evaluation was conducted. Consensus exercises with clinical staff and administrators (Delphi and Nominal group) were used to, evaluate current practices, select a heel protective device, and develop key aspects of the HPUPP. HPUPP involved an individualised, bedside, staff education program, a team approach to improve patient mobility and use of a heel protective device. A 2-inch foam wedge covered in washable vinyl was placed at the foot of all beds on the orthopedic service. After t...

The experience of children and families with lymphoedema – a journey within a journey

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

This paper reports on a study in the UK that explored the experience of children suffering with Lymphoedema and that of their families. Qualitative data was collected from 20 children between the ages of 6 and 18 and their respective parents. Single, semi-structured interviews were used in which children and their parents were asked to share how lymphoedema impacted on their family life. Children were asked about their school experience, their dreams and their aspirations. Three categories emerged. Firstly, the negotiation of the health care system. Themes included correct diagnosis, finding robust information and reaching a knowledgeable expert. The second category explored the complex role of the parents as advocates. Themes within this category included the dilemmas of parenting and the...

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International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

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International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

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The emergence of a clinical specialty in wound care

International Wound Journal — Wed, 24 Feb 2010 00:00:00 +0100

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2010 and the International Wound Journal

International Wound Journal — Mon, 01 Feb 2010 00:00:00 +0100

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International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

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A clinical investigation into the microbiological status of 'locally infected' leg ulcers

International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

The objective of this open, prospective pilot study was to quantitatively and qualitatively assess the microbiological status of 'locally infected' venous leg ulcers. Three different sampling techniques were used to recover organisms from 20 venous leg ulcers that had failed to progress towards healing and comparisons made to explore the distribution of colonised flora within the wound. In total, 116 isolates were recovered (mean of 5·8 per ulcer) with highest recovery rates seen with swabs. Greatest agreement of colonisation and counts was found between swabs and absorbent polyvinyl acetate (PVA) foam disc, and also between PVA discs and biopsies. Lowest agreement was between the distribution of anaerobes and coryneforms in swabs and biopsies, suggesting uneven vertical distribution with...

Hypertrophic versus non hypertrophic scars compared by immunohistochemistry and laser confocal microscopy: type I and III collagens†

International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

Oliveira GV, Hawkins HK, Chinkes D, Burke A, Pasqua Tavares AL, Ramos-e-Silva M, Albrecht TB, Kitten GT, Herndon DN. Hypertrophic versus non hypertrophic scars compared by immunohistochemistry and laser confocal microscopy: type I and III collagens. Although dermal collagens appear increased in hypertrophic scars, this has not been tested in tissue samples using objective methods. We compared the expression of types I and III collagen in hypertrophic and non hypertrophic scars at 6[ndash]12 and 18[ndash]24 months after burn using a quantitative method. Among 17 patients with extensive burns, 3 patients had acute scars, 8 had hypertrophic or non hypertrophic scars at 6[ndash]12 months after burn and 6 had hypertrophic or non hypertrophic scars at 18[ndash]24 months after burn. After clinica...

Intra-lesional injections of recombinant human epidermal growth factor promote granulation and healing in advanced diabetic foot ulcers: multicenter, randomised, placebo-controlled, double-blind study

International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

Fernández-Montequín JI, Valenzuela-Silva CM, González Díaz O, Savigne W, Sancho-Soutelo N, Rivero-Fernández F, Sánchez-Penton P, Morejón-Vega L, Artaza-Sanz H, García-Herrera A, González-Benavides C, Hernández-Cañete CM, Vázquez-Proenza A, Berlanga-Acosta J, López-Saura PA, for the Cuban Diabetic Foot Study Group. Intra-lesional injections of recombinant human epidermal growth factor promote granulation and healing in advanced diabetic foot ulcers: multicenter, randomised, placebo-controlled, double-blind study. A multicenter, double-blind, placebo-controlled trial was carried out to evaluate the intra-lesional infiltration of recombinant epidermal growth factor (EGF) in Wagner's grade 3 or 4 diabetic foot ulcers (DFUs). Subjects (149) were randomised to receive EGF (75 or 25 ...

Wound cleansing, topical antiseptics and wound healing

International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

Atiyeh BS, Dibo SA, Hayek SN. Wound cleansing, topical antiseptics and wound healing. Quality of care is a critical requirement for wound healing and 'good' care of wounds has been synonymous with topical prevention and management of microbial contamination. Topical antiseptics are antimicrobial agents that kill, inhibit or reduce the number of microorganisms and are thought to be essential for wounds infection control. However, they have long and commonly been used on wounds to prevent or treat infection, the merits of antiseptic fluid irrigation have received little scientific study. Unlike antibiotics that act selectively on a specific target, antiseptics have multiple targets and a broader spectrum of activity, which include bacteria, fungi, viruses, protozoa and even prions. Although ...

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International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

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International Wound Journal — Fri, 18 Dec 2009 00:00:00 +0100

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The world of wound care loses an inspirational leader! A special editorial – in memory of Donalyn Hyland, RN (1951–2009)

International Wound Journal — Tue, 01 Dec 2009 00:00:00 +0100

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Definition of infection in chronic wounds by Dutch nursing home physicians

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

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International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

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Topical silver-impregnated dressings and the importance of the dressing technology

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

Cutting Keith, White Richard, Hoekstra Hans. Topical silver-impregnated dressings and the importance of the dressing technology. A wide variety of silver-impregnated wound dressings has become available in recent years. This has given the practitioner choice but little evidence by which an appropriate dressing may be selected. In many instances, the ancillary function(s) of the dressing will become differentiating factors that influence choice. For example, the dressing capacity to manage exudate, maintain an optimum moist environment, reduce or avoid maceration, maintain an intimate contact with the wound bed, promote autolytic debridement, sequester bacteria and bind matrix metallo proteases (MMPs) are some of those functions that are of clinical significance and may dictate choice. In t...

Venous leg ulcers: patient concordance with compression therapy and its impact on healing and prevention of recurrence

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

In conclusion, published biomedical literature has documented that non concordance with compression therapy negatively impacts the outcome of VLUs, highlighting the need to improve patient concordance to maximise therapeutic benefits. (Source: International Wound Journal)

Diabetes foot ulceration in a Nigerian hospital: in-hospital mortality in relation to the presenting demographic, clinical and laboratory features

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

Ekpebegh CO, Iwuala SO, Fasanmade OA, Ogbera AO, Igumbor E, Ohwovoriole AE. Diabetes foot ulceration in a Nigerian Hospital: in-hospital mortality in relation to the presenting demographic, clinical and laboratory features. This prospective study assessed in-hospital mortality from diabetic foot ulcer in relation to the demographic, clinical and laboratory features at presentation. Forty-two patients admitted with diabetic foot ulcer were followed up from admission till discharge from hospital. Those who survived or died were compared for any differences in demographic, clinical and laboratory parameters at presentation. The mean age and duration of diabetes for the 42 patients were 56.1 ± 1.9 years and 8.3 ± 1.1 years, respectively. The in-hospital mortality rate amongst the 42 subjects...

Clinician's perspectives on the treatment of venous leg ulceration

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

We present two studies that examine more closely the clinicians' experience of treating VLU and reflect upon how that understanding may further enhance better outcomes for patients in the future. The first of these studies is a qualitative investigation of 49 clinicians treating VLU in the UK and USA. The second is a quantitative, online survey of 304 clinicians' beliefs, attitudes and practices in the UK, Germany and USA. Findings show that the clinicians' experience of treating VLU is often accompanied by frustration and dissatisfaction with treatment challenges and uncertain outcomes. Practices and treatment choices were found to vary widely and differ by countries. We conclude that a key aspect in improving VLU treatment is in listening to the frustrations of the clinician when conside...

A prospective evaluation of lower extremity ulcers in a Zimbabwean population

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

Sibanda M, Sibanda E, Jönsson K. A prospective evaluation of lower extremity ulcers in a Zimbabwean population. Aetiological factors and their frequencies, causes, level and impact of immunosuppression on outcome of lower extremity ulcers were prospectively recorded. A total of 100 patients were evaluated. Consent for HIV testing was given by 68 patients and 31 (46%) of these were HIV infected. Thirty patients were diabetic. CD 4+ T-lymphocyte count was assessed in 41 patients. Eleven were HIV infected with a mean CD 4+ count of 229 ± 137 cells/µl. Six had non insulin-dependent diabetes mellitus (NIDDM) with a mean CD 4+ count 430 ± 308 cells/µl. Five had both HIV infection and NIDDM with a mean CD 4+ count of 299 ± 120 cells/µl. All three groups differed from the normal 707 ± 285 ...

The operative treatment of pressure wounds: a 10-year experience in flap selection

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

This study sought to both assist in the selection of flaps for ischial pressure wound reconstruction and evaluate the overall complication rates associated with reconstruction. A retrospective medical record review was conducted for 78 patients following the surgical reconstruction of an ischial pressure sore. Records were reviewed for demographics, location of sores, methods of reconstruction and flap selection, as well as any complications and recurrences. A total of 72 wounds were reconstructed with an average of 1·4 flaps used per wound. An ischial flap complication rate of 16% was observed in flap follow-up, with a recurrence rate of 7% recorded. The vast majority of complications went on to heal with 15% of patients requiring a second reconstruction. Our relatively large sample of i...

Infections and treatment of wounds in survivors of the 2004 Tsunami in Thailand

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

This report suggests that wounds should be aggressively debrided and suturing postponed if possible. Patients should be given broad spectrum antibiotics to assist with wound healing. (Source: International Wound Journal)

Epidermal growth factor in clinical practice – a review of its biological actions, clinical indications and safety implications

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

Berlanga-Acosta J, Gavilondo-Cowley J, López-Saura P, González-López T, Castro-Santana MD, López-Mola E, Guillén-Nieto G, Herrera-Martinez L. Epidermal growth factor in clinical practice[ndash]a review of its biological actions, clinical indications and safety implications. Chemotaxis, mitogenesis, motogenesis and cytoprotection are common cellular events involved in both tumourigenesis and tissue repair, which appear amplified upon growth factors exposure. Epidermal growth factor (EGF) promotes these events in epithelial and mesenchymal cells through the binding to a specific tyrosine kinase receptor. In experimental oncology settings, EGF does not initiate malignant transformation but exhibits 'tumour promotion'. These observations have raised doubts on the clinical use of EGF despi...

Bandage pressure measurement and training: simple interventions to improve efficacy in compression bandaging

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

Keller A, Müller ML, Calow T, Kern IK, Schumann H. Bandage pressure measurement and training: simple interventions to improve efficacy in compression bandaging. Compression bandaging is a major cornerstone in the treatment of chronic venous insufficiency. Its efficacy considerably depends on the applied pressure and it is therefore largely dependent on the individual applying the system. The sub-bandage pressure was measured under three consecutive compression bandages applied by 21 nurses before and after training and the introduction of a pressure monitor (Kikuhime®, MediTrade, Denmark). A questionnaire was used to evaluate the self-rating before and after the intervention. Before intervention, a questionnaire showed the confidence of the nurses in reaching sufficient sub-bandage press...

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International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

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International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

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Cochrane's legacy and its impact on wound care

International Wound Journal — Fri, 13 Nov 2009 00:00:00 +0100

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The development of wound care as a clinical specialty in Japan

International Wound Journal — Thu, 01 Oct 2009 00:00:00 +0100

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A Clinical Review of Infected Wound Treatment with Vacuum Assisted Closure® (V.A.C.®) Therapy: Experience and Case Series

International Wound Journal — Wed, 30 Sep 2009 23:00:00 +0100

Gabriel A, Shores J, Bernstein B, de Leon J, Kamepalli R, Wolvos T, Baharestani MM, Gupta S. A Clinical Review of Infected Wound Treatment with Vacuum Assisted Closure® (V.A.C.®) Therapy: Experience and Case Series. Over the last decade Vacuum Assisted Closure® (KCI Licensing, Inc., San Antonio, TX) has been established as an effective wound care modality for managing complex acute and chronic wounds. The therapy has been widely adopted by many institutions to treat a variety of wound types. Increasingly, the therapy is being used to manage infected and critically colonized, difficult-to-treat wounds. This growing interest coupled with practitioner uncertainty in using the therapy in the presence of infection prompted the convening of an interprofessional expert advisory panel to determ...

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International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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COCHRANE: HANDS OFF WOUND CARE!–PROF DAVID LEAPER RESPONSE

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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Letter: Evidence-Based Wound Care in the UK: A Response to David Leaper's Editorial in International Wound Journal April 2009 6 (2)

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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Letter: Use of Cotton Cast Padding Instead of Gauze Wrap as a Secondary Dressing for High-Risk Wounds

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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The use of Urgotul™ in the treatment of partial thickness burns and split-thickness skin graft donor sites: a prospective control study

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

Tan PWW, Wong CH, Song C. The use of Urgotul[trade] in the treatment of partial thickness burns and split-thickness skin graft donor sites: a prospective control study. The use of paraffin-impregnated gauze for burns and skin graft donor sites is commonly associated with wound adherence with consequent pain and trauma upon removal. This prospective clinical study was performed to evaluate a new class of lipido-colloid dressings (Urgotul[trade]) in promoting healing and in reducing tissue adherence. In a 6-month period, 25 consecutive patients were recruited. Two separate burn or donor sites on each patient were dressed with tulle-gras (TG) or Urgotul[trade] and covered with standard secondary dressings. Objective assessment of wounds by two reviewers, and patients' subjective assessments w...

Point prevalence of wounds in a sample of acute hospitals in Canada

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

Hurd T, Posnett J. Point prevalence of wounds in a sample of acute hospitals in Canada. To provide new information on wound prevalence and the potential resource impact of non healing wounds in the acute sector by summarising results from wound audits carried out at 13 acute hospitals in Canada in 2006 and 2007. Audits were carried out in each hospital by the same independent team of advanced practice nurses using standard data-collection forms. The results reported here were derived from the summary reports for each hospital. A total of 3099 patients were surveyed (median 259 patients per hospital). In the sample hospitals, the mean prevalence of patients with wounds was 41·2%. Most wounds were pressure ulcers (56·2%) or surgical wounds (31·1%). The mean prevalence of pressure ulcers w...

Case reports on the use of antimicrobial (silver impregnated) soft silicone foam dressing on infected diabetic foot ulcers

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

This article described four patients who had an episode of an infected foot ulcer, and subsequently treated with a novel antimicrobial soft silicone foam dressing together with standard off-loading and antibiotic therapy. Qualitative description of the ulcer-healing process was documented. All four ulcers showed positive wound contraction and reduction in size throughout the follow-up period ranging from 3 to 16 weeks. In addition, clinical signs of infection were absent at the end of the follow-up period. Moreover, surrounding skin maceration and trauma were absent in all wounds. Adequate moisture control was also achieved with the evidence of a healthy red granulating base, and a thin layer of clear light exudate in three out of the four cases. However, these reports had very little evid...

Definition of infection in chronic wounds by Dutch nursing home physicians

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

According to this study, NHPs do not frequently see many chronic wounds. The most frequent type of wounds treated was PU. For NHPs, the identification of infection of all types of chronic wounds is difficult. The use of criteria that is not in line with consensus documents may lead to ineffective treatment and even seriously damage patients: the clinical identification of infection is still dependent on experts' opinion. Further research on triggers for the suspicion of wound infection and the development of an evidence-based guideline is necessary. (Source: International Wound Journal)

Vacuum-assisted closure of laparostomy wounds: a critical review of the literature

International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

Stevens P. Vacuum-assisted closure of laparostomy wounds: a critical review of the literature. Vacuum-assisted closure (VAC) reduces the burden for carers of laparostomy wounds but evidence from randomised trials is lacking. This review analyses the evidence for the VAC® abdominal wound management system (KCI, San Antonio, TX) in the open abdomen. Three prospective studies provide level III evidence that VAC® allows delayed primary fascial closure in the majority of these wounds up to 21 days after occurrence, but not where duration of VAC® was less than 9 days or if vacuum pack techniques were used in place of VAC®. Fistulae occurred in a minority of wounds complicated by multi-organ failure or sepsis and could not be attributed to VAC® itself. Two retrospective analyses suggested VA...

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International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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International Wound Journal — Tue, 25 Aug 2009 23:00:00 +0100

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The double-edged sword of the immune system–a force for good or evil in the wound?

International Wound Journal — Fri, 31 Jul 2009 23:00:00 +0100

(Source: International Wound Journal)

V.A.C.® Therapy in the management of paediatric wounds: clinical review and experience

International Wound Journal — Thu, 09 Jul 2009 11:42:51 +0100

Baharestani M, Amjad I, Bookout K, Fleck T, Gabriel A, Kaufman D, McCord SS, Moores DC, Olutoye OO, Salazar JD, Song DH, Teich S, Gupta S. V.A.C.® Therapy in the management of paediatric wounds: clinical review and experience. Usage of negative pressure wound therapy (NPWT) in the management of acute and chronic wounds has grown exponentially in the past decade. Hundreds of studies have been published regarding outcomes and methods of therapy used for adult wounds. This treatment is increasingly being used to manage difficult-to-treat paediatric wounds arising from congenital defects, trauma, infection, tumour, burns, pressure ulceration and postsurgical complications in children, although relatively few studies have been aimed at this population. Given the anatomical and physiological di...

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International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

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Letter to the Editor

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

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Book review

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

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Malignant transformation of a chronic leg ulcer

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

We report a case of a squamous cell carcinoma arising from a chronic leg ulcer initially diagnosed as venous ulcer. Usually, further diagnostic assessment of chronic ulcers is initiated with considerable delay only in cases when appropriate treatment fails to effect cure. (Source: International Wound Journal)

Transplantation of chronic wounds with epidermal sheets derived from autologous hair follicles—the Leipzig experience

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

Conclusions: Autologous keratinocyte transplantation with EpiDex[trade] can be performed easily and safely in patients with chronic wounds with satisfying results. Our data suggest that patients with small ulcer area < 25 cm2 might profit the most from this method. (Source: International Wound Journal)

Modulation of wound contracture α-smooth muscle actin and multispecific vitronectin receptor integrin αvβ3 in the rabbit's experimental model

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

Kahi CGE, Atiyeh BS, Hussein IAH, Jurjus R, Dibo SA, Jurjus A, Jurjus A. Modulation of wound contracture [alpha]-smooth muscle actin ([alpha]-SMA) and multispecific vitronectin receptor integrin [alpha]v[beta]3 in the rabbit's experimental model The myofibroblast, a major component of granulation tissue, is a key cell during wound healing, tissue repair and connective tissue remodelling. Persistence of myofibroblasts within a fibrotic lesion leads to excessive scarring impairing function and aesthetics. Various wound-healing cytokines can be modulated by topical application of active agents to promote optimal wound healing and improve scar quality. Thus, the myofibroblast may represent an important target for wound-healing modulation to improve the evolution of conditions such as hypertrop...

Defining success in clinical trials of diabetic foot wounds: the Los Angeles DFCon consensus

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

Armstrong DG, Boulton AJM, Andros G, Attinger C, Eisenbud D, Lavery LA, Lipsky BA, Mills JL, Sibbald G, Smith AP, Wukich D, Margolis DJ. Defining success in clinical trials of diabetic foot wounds: the Los Angeles DFCon consensus Regulatory requirements for new products should be guided by clinical trials that protect the public by a thorough evaluation of safety and efficacy, while not creating unnecessary barriers to their development and ultimate approval. While healing a wound is the ultimate goal of treating an individual with a diabetic foot ulcer, achieving this goal is physiologically complex requiring the initiation and interaction of many events and therefore unlikely to be achieved by one compound. We believe that developing new, more meaningful, study outcomes or end points in ...

Use of a new silver barrier dressing, ALLEVYN⋄ Ag in exuding chronic wounds

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

Kotz P, Fisher J, McCluskey P, Hartwell SD, Dharma H. Use of a new silver barrier dressing, ALLEVYN Ag in exuding chronic wounds. Recognising and managing wounds at risk of infection is vital in wound management. ALLEVYN Ag dressings have been designed to manage exudate in chronic wounds that are at risk of infection; are displaying signs of local infection; or where a suspected increase in bacterial colonisation is delaying healing. They combine an absorbent silver sulfadiazine containing hydrocellular foam layer, with a perforated wound contact layer and highly breathable top film. The results presented are from a multi-centre clinical evaluation of 126 patients conducted to assess the performance of ALLEVYN Ag (Adhesive, Non Adhesive and Sacrum dressings) in a range of indications. Clin...

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International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

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Oxford International Wound Healing Foundation

International Wound Journal — Mon, 15 Jun 2009 23:00:00 +0100

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The International Wound Infection Institute—a new global platform for the clinical management of infected wounds

International Wound Journal — Sun, 31 May 2009 23:00:00 +0100

(Source: International Wound Journal)

Diabetic foot ulcers and ethnicity in Tanzania: a contrast between African and Asian populations

International Wound Journal — Fri, 10 Apr 2009 04:00:00 +0100

Abbas ZG, Lutale JK, Archibald LK. Diabetic foot ulcers and ethnicity in Tanzania: a contrast between African and Asian populations. Int Wound J 2009; doi: 10.1111/j.1742-481X.2008.00578.x. To characterise the role of ethnicity in the occurrence of foot ulcer disease in persons with diabetes, we analysed prospectively collected data for persons attending the diabetes clinic at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. A case was defined as any adult presenting to MNH with an ulcer at or below the ankle joint during July 1998[ndash]June 2005. We documented clinical and epidemiologic characteristics, progress, interventions and outcome. Seven hundred and eight persons met the case definition [ndash] 570 (80%) ethnic Africans and 138 (20%) Asian Indians. Ethnic Africans were...

Clinical effectiveness of an acellular dermal regenerative tissue matrix compared to standard wound management in healing diabetic foot ulcers: a prospective, randomised, multicentre study

International Wound Journal — Thu, 02 Apr 2009 04:00:00 +0100

This study supports the use of single-application AM therapy as an effective treatment of diabetic, neuropathic ulcers. (Source: International Wound Journal)

Effect of a water-based no-sting, protective barrier formulation and a solvent-containing similar formulation on skin protection from medical adhesive trauma

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

We report the results of a randomised controlled study comparing a solvent-free (SF) formulation and a solvent-containing (SC) formulation to the skin of 12 healthy volunteers aged 18[ndash]55 years. Treatments were applied at baseline to two of the four test sites on the back of each subject and repeated for 5 days. Measurements of pain, discomfort, erythema and skin water loss were taken 24 hours after each application. The SF formulation is associated with lower mean scores for erythema (day 5, P < 0·05) and lower values for transepidermal water loss (day 5, P < 0·05) and redness (days 4 and 5, P < 0·05) when compared with either no treatment or daily treatment with a SC formulation. There were no significant differences between subject responses when pain on application of the test ...

Bacteriotherapy with Lactobacillus plantarum in burns

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

Peral MC, Huaman Martinez MA, Valdez JC. Bacteriotherapy with Lactobacillus plantarum in burns. Int Wound J 2009;6:73[ndash]81. Bacterial colonisation and infection remain the major causes of delayed healing and graft rejection following burns. Topical treatment is necessary to reduce the incidence of burn wound infection. Silver sulphadiazine (SD-Ag) is an often used microbicidal agent. However, this treatment produces adverse reactions and side-effects. On the basis of experimental data and clinical application of lactobacilli as probiotics, we performed this exploratory study to establish the effectiveness of bacteriotherapy with topical application of the innocuous bacteria Lactobacillus plantarum cultured in De Man, Rogosa and Sharpe medium to provide an alternative method for burn tr...

Intralesional administration of epidermal growth factor-based formulation (Heberprot-P) in chronic diabetic foot ulcer: treatment up to complete wound closure

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

Fernández-Montequín JI, Betancourt BY, Leyva-Gonzalez G, Mola EL, Galán-Naranjo K, Ramírez-Navas M, Bermúdez-Rojas S, Rosales F, García-Iglesias E, Berlanga-Acosta J, Silva-Rodriguez R, Garcia-Siverio M, Martinez LH. Intralesional administration of epidermal growth factor-based formulation (Heberprot-P) in chronic diabetic foot ulcer: treatment up to complete wound closure. Int Wound J 2009;6:67[ndash]72. Previous studies have shown that an epidermal growth factor-based formulation (Heberprot-P) can enhance granulation of high-grade diabetic foot ulcers (DFU). The aim of this study was to explore the clinical effects of this administration up to complete wound closure. A pilot study in 20 diabetic patients with full-thickness lower extremity ulcers of more than 4 weeks of evolution w...

Fixed sporotrichosis as a cause of a chronic ulcer on the knee

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

We present a case of fixed sporotrichosis as the cause of a chronic ulcer in the knee. Although a culture of Sporothrix schenckii could not be obtained, a positive response to the sporotrichin skin test, a skin biopsy showed a suppurative granuloma and an adequate response to oral administration of potassium iodide confirmed the diagnosis. The identification and correction of the underlying aetiology of any chronic wound is the first and most important step to restore wound healing. (Source: International Wound Journal)

Conservative management of ulcerated haemangioma – twenty years experience

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

Pandey A, Gangopadhyay AN, Sharma SP, Kumar V, Gopal SC, Gupta DK. Conservative management of ulcerated haemangioma [ndash] twenty years experience. Int Wound J 2009;6:59[ndash]62. Ulceration is the most common complication of haemangioma and occurs in 5[ndash]15% of cases. The present study was carried out to evaluate the clinical features of ulcerated haemangioma and efficacy of the management protocol adopted by us over a period of 20 years. All patients with ulcerated haemangioma were evaluated on the basis of age at presentation, sex, rural or urban distribution and site of haemangioma. Treatment included application of topical antibiotic and systemic antibiotic and analgesic for pain. The total number of patients was 608. The male to female ratio was 1: 2·28. The rural:urban distrib...

Development of vaginal erosion and vesicocutaneous fistula following midurethral transvaginal tape with PelviLace® for treatment of stress urinary incontinence

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

In this study, we report on a patient with SUI, treated with PelviLace® Biourethral Support, who suffered multiple issues postoperatively. (Source: International Wound Journal)

Haemodynamic effects of −75 mmHg negative pressure therapy in a porcine sternotomy wound model

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

Mokhtari A, Gustafsson R, Sjögren J, Nilsson J, Lindstedt S, Malmsjö M, Ingemansson R. Haemodynamic effects of [minus]75 mmHg negative pressure therapy in a porcine sternotomy wound model. Int Wound J 2009;6:48[ndash]54. Previous research has shown [minus]125 mmHg to be the optimal negative pressure for creating an environment that promotes wound healing, and this has therefore been adopted as a standard pressure for patients with deep sternal wound infection. However, it has not yet been clearly shown that [minus]125 mmHg is the optimal pressure from a haemodynamic point of view. Furthermore, there have been reports of cardiac rupture during [minus]125 mmHg negative pressure therapy. We therefore studied the effects of a lower pressure: [minus]75 mmHg. Twelve pigs were used. After media...

Maggot debridement therapy with Lucilia cuprina: a comparison with conventional debridement in diabetic foot ulcers

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

This study documents outcome in diabetic foot wounds treated with maggot debridement versus those treated by conventional debridement alone. In this series of 29 patients treated with MDT, 14 wounds were healed, 11 were unhealed and 4 were classified under others. The control group treated by conventional debridement had 30 patients of which 18 wounds were healed, 11 unhealed and 1 classified under others. There was no significant difference in outcome between the two groups. The conclusion that can be made from this study is that MDT with L. cuprina is as effective as conventional debridement in the treatment of diabetic foot ulcers. It would be a feasible alternative to those at high risk for surgery or for those who refuse surgery. (Source: International Wound Journal)

Silver resistance in MRSA isolated from wound and nasal sources in humans and animals

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

The objectives of this study were to determine the prevalence of silver-resistance (sil) genes in MRSA and methicillin-resistant coagulase-negative staphylococci (MR-CNS) isolated from wounds and nasal cavities of humans and animals, and also to determine the susceptibility of sil-positive and sil-negative MRSA isolates to a silver-containing Hydrofiber® (SCH) wound dressing, on planktonic silE-positive and silE-negative MRSA. Polymerase chain reaction was used to determine the presence of three silver-resistance (sil) genes, silE, silP and silS in 33 MRSA and 8 methicillin-resistant staphylococci (MR-CNS). SilP and silS genes were absent in all isolates tested; however, two MRSA strains were found to contain the silE gene, together with one isolate of MR-CNS. Phenotypic resistance of the...

Evaluation of the quality and cost-effectiveness of Versajet® hydrosurgery

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

Sainsbury DCG. Evaluation of the quality and cost-effectiveness of Versajet® hydrosurgery. Int Wound J 2009;6:24[ndash]29. Judicious resource allocation to maximise benefits is essential to health care decision-making, particularly with increasingly expensive treatments and rising populations. Accurate wound debridement is important, and while many methods exist, surgical debridement is currently the gold standard with material costs at approximately £140. Versajet®, a hydrosurgical device, is suggested by some to have facilitated a paradigm shift in wound management by allowing debridement of undesirable tissue while accurately preserving viable structures. Its proponents claim that it minimises surgical duration, length of hospital admission, improves wound healing and may be deployed...

Calendar

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

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News and views

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

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The new year brings editorial changes to IWJ

International Wound Journal — Fri, 06 Mar 2009 05:00:00 +0100

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Diabetes and landmine-related amputations: a call to arms to save limbs

International Wound Journal — Sun, 01 Feb 2009 05:00:00 +0100

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Changes in serum and exudate creatine phosphokinase concentrations as an indicator of deep tissue injury: a pilot study

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

This study aimed to investigate the usefulness of CPK levels in wound exudates as an indicator of DTI. Rats were divided into control, 6 hours 10-kg and 6 hours 20-kg loading groups. Serum samples were obtained before wounding, and at 8 and 12 hours, and 1, 2 and 3 days after wounding, while exudate samples were obtained on days 2 and 3. Serum CPK levels were markedly increased in the 10-kg and 20-kg groups at 8 and 12 hours after loading compared with the baseline value and control group, but decreased to the normal level on day 1. In both loading groups, exudate CPK levels were high on day 2 and decreased on day 3. Muscle necrosis was more severe in the 20-kg group than in the 10-kg group by histological examination. This is the first study to indicate the potential of CPK in wound exuda...

Definition of efficiency in vacuum therapy – a randomised controlled trial comparing Redon drains with V.A.C.® Therapy™

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

Wild T, Stremitzer S, Budzanowski A, Hoelzenbein T, Ludwig C, Ohrenberger G. Definition of efficiency in vacuum therapy [ndash] a randomised controlled trial comparing Redon drains with V.A.C.® Therapy[trade]. Int Wound J 2008;5:641[ndash]647. Redon drains are still used to suction wounds for vacuum sealing. Vacuum-assisted closure (V.A.C.®; Kinetic Concepts Inc, San Antonio, TX) is a computer-controlled therapy system for delivering topical negative pressure therapy. The efficiency of V.A.C. in the treatment of pressure ulcers was prospectively studied in a randomised controlled trial in which patients with pressure ulcers were randomly assigned to negative pressure wound therapy (NPWT) using either V.A.C. or Redon bottles. The target parameters were absolute and relative proportion of ...

Comparative analysis of global gene expression profiles between diabetic rat wounds treated with vacuum-assisted closure therapy, moist wound healing or gauze under suction

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

This study is the first to assess wound healing by whole genome interrogation in a diabetic rat model treated with different healing modalities. (Source: International Wound Journal)

Wound care around the world

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

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Antibiotic-resistant gram-negative bacteria in deep tissue cultures

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

(Source: International Wound Journal)

'Woundology'– an emerging clinical specialty

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

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News and views

International Wound Journal — Fri, 09 Jan 2009 05:00:00 +0100

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Calendar

International Wound Journal — Mon, 01 Dec 2008 05:00:00 +0100

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Six-month mortality risks in long-term care residents with chronic ulcers

International Wound Journal — Thu, 02 Oct 2008 04:00:00 +0100

This study evaluated the relationship between wound characteristics and other health predictors with 6-month mortality in nursing home residents. The subjects included were nursing home residents seen by the wound consult service from 1998 to 2007 with an ongoing chronic ulcer. This was a retrospective cohort study. Data were manually and electronically abstracted for each resident. Six-month mortality was collected as the primary outcome. Statistical comparisons were made using logistic regression with a final multivariant model. Four hundred and forty residents were seen with 411 records reviewed. Ulcer area was not associated with mortality; however, chronic ulcer number was associated with 6-month mortality with an odds ratio of 1·32 (95% CI 1·07[ndash]1·63). Other significant risk ...

Correlation between Braden Scale and Palliative Performance Scale in advanced illness

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

This study describes the significant correlation between the Braden Scale (BS) and the Palliative Performance Scale (PPS) in patients with advanced illness that has not been previously reported. The analysis was based on a prospective sequential case series of 664 patients suffering from advanced illness who were referred to a regional palliative medicine programme in Toronto, Canada. Baseline BS and PPS scores assessed within 24 hours of referral were considered for analysis. After controlling for age, gender, consult site and diagnosis (cancer versus non cancer), we observed a significant positive correlation between baseline PPS and BS scores (r = 0·885, P < 0·001). These findings suggest that for patients with advanced illness where BS is not routinely used, PPS could be considered a...

Tubercular infection in the sacrococcygeal pilonidal sinus – a case report

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

We report a case of multiple pus discharging sinuses in the sacrococcygeal region in a 22-year-old man, who had a history of episodes of pain and pus discharge since 8 months. The patient underwent radiofrequency sinotomy using a Ellman radiofrequency device and was treated with antitubercular treatment, which resulted in complete resolution, and healing of the wound. (Source: International Wound Journal)

Chitin membrane for wound dressing application – preparation, characterisation and toxicological evaluation

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

Singh R, Chacharkar MP, Mathur AK. Chitin membrane for wound dressing application [ndash] preparation, characterisation and toxicological evaluation. Int Wound J 2008;doi:10.1111/j.1742-481X.2008.00482.x. Chitin, a unique biopolymer based on the N-acetyl-glucosamine monomer is envisioned to promote rapid dermal regeneration and accelerate wound healing. It has many useful and advantageous biological properties for its application as a wound dressing. Chitin membranes were prepared using lithium chloride/dimethylacetamide solvent system and evaluated for use as a wound dressing. Swelling behaviour, moisture vapour transmission rate, microbial impermeability and antimicrobial efficacy of the dressings was evaluated. The chitin dressing provided an effective barrier to microbial penetration a...

The effects of education and training on clinical practice in wound healing

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

This article considers the effects of two different types of educational programme on community nurse clinical practice in venous ulceration. One group of nurses (the experimental group) attended an educational programme designed to take account of training needs and learning styles. A second group of nurses (the control group) attended a standardised educational programme. A multiple-choice question examination and Objective Structured Clinical Examination were used to measure knowledge and skills. Kolb's Learning Styles Inventory was used to measure learning styles. Findings were that experimental nurses failed to show improved post-intervention clinical practice compared with the control group. (Source: International Wound Journal)

Novel cryoprecipitate for wound healing and skin grafts in rats

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

Scholz T, Waltzman J, Wirth GA, Dyson SW, Owens WJ, Shanbrom E, Evans GRD. Novel cryoprecipitate for wound healing and skin grafts in rats. Int Wound J 2008;0:00[ndash]00. The authors sought to evaluate the ability of locally administered enhanced cryoprecipitate (eCryo) to improve the wound healing of split thickness skin grafts (STSG) and their donor sites. An STSG (5 × 5 cm) was harvested on the back of 30 rats and divided into four areas that were then treated in one of the following groups: A: 'standard' dressing without STSG; B: eCryo without STSG; C: eCryo with STSG coverage and D: STSG alone. Macroscopic and histological assessments (histomorphometric grading scale and cellular composition) were evaluated at days 7, 14, 21 and 28 for wound healing. All wound beds as well as STSGs ...

A comparative study of the in vitro permeation characteristic of sulphadiazine across synthetic membranes and eschar tissue

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

In this study, the permeation of sulphadiazine from aqueous saturated solutions of SSD through human full-thickness burn eschar tissue was studied and compared with permeability through silicone and Carbosil as model membranes. The permeation of sulphadiazine through eschar tissue was significantly higher than that through silicone and Carbosil membranes (P < 0·05). Deconvolution of the data showed that the apparent sulphadiazine diffusion coefficient was much higher in eschar tissue and was comparable to transport through an aqueous protein gel. Further studies on a greater number of compounds are suggested to elucidate the utility of such membranes as predictive models of drug permeability through eschar tissue. (Source: International Wound Journal)

Extracorporeal shock wave therapy suppresses the early proinflammatory immune response to a severe cutaneous burn injury*

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

Davis TA, Stojadinovic A, Anam K, Amare M, Naik S, Peoples GE, Tadaki D, Elster EA. Extracorporeal shock wave therapy suppresses the early proinflammatory immune response to a severe cutaneous burn injury. Int Wound J 2008; doi: 10.1111/j.1742-481X.2008.00540.x. Following severe burn injury, persistent inflammation perpetuated by surface eschar, bacterial colonisation and neutrophil proteolytic activity can impede normal healing and result in further tissue damage. Extracorporeal shock wave treatment (ESWT) has been shown in the clinical setting to promote the healing of burn and difficult-to-heal wounds; however, the mechanism is unclear. We investigated the role of ESWT on the early proinflammatory response using a severe, full-thickness and highly inflammatory cutaneous burn wound in a ...

Hydrocolloid dressings in the management of acute wounds: a review of the literature

International Wound Journal — Wed, 01 Oct 2008 04:00:00 +0100

Thomas S. Hydrocolloid dressings in the management of acute wounds: a review of the literature. Int Wound J 2008; doi: 10.1111/j.1742-481X.2008.00541.x A review of the literature suggests that the application of self-adhesive hydrocolloid dressings, most commonly associated with the treatment of ulcerative conditions such as pressure ulcers and leg ulcers, may also offer benefits in the management of acute wounds of all types, for example decreasing healing times of donor sites by about 40% compared with traditional treatments. Healing times of superficial traumatic injuries and surgical wounds are similarly enhanced but in the treatment of burns, the principal benefit appears to be a reduction in wound pain, an effect that has also been reported in virtually all other wound types. The imp...

Microgravity and the implications for wound healing

International Wound Journal — Sat, 20 Sep 2008 04:00:00 +0100

Farahani RM, DiPietro LA. Microgravity and the implications for wound healing. Int Wound J 2008; doi: 10.1111/j.1742-481X.2008.00438.x. Wound healing is a sophisticated response ubiquitous to various traumatic stimuli leading to an anatomical/functional disruption. The aim of present article was to review the current evidence regarding the effects of microgravity on wound healing dynamics. Modulation of haemostatic phase because of alteration of platelet quantity and function seems probable. Furthermore, production of growth factors that are released from activated platelets and infiltration/function of inflammatory cells seem to be impaired by microgravity. Proliferation of damaged structures is dependent on orchestrated function of various growth factors, for example transforming growth ...

Pressure transduction to the thoracic cavity during topical negative pressure therapy of a sternotomy wound

International Wound Journal — Fri, 19 Sep 2008 04:00:00 +0100

In conclusion during TNP therapy, negative pressure is effectively transmitted to anterior portions of the heart. This may explain our recent findings that TNP increases microvascular blood flow in the myocardium. The pressure difference between the anterior and the posterior portions of the heart causes the right ventricle to be sucked up towards the posterior parts of the sternum, where it might be exposed to the sharp edges of the sternal bone, which may result in heart injury. (Source: International Wound Journal)

Wound dressing components degrade proteins detrimental to wound healing

International Wound Journal — Fri, 19 Sep 2008 04:00:00 +0100

Baskovich B, Sampson EM, Schultz GS, Parnell LKS. Wound dressing components degrade proteins detrimental to wound healing. Int Wound J. 2008; doi: 10.1111/j.1742-481X.2007.00422.x Excessive levels of matrix metalloproteinases (MMPs) are present in chronic wounds preventing wound closure. Reducing detrimental components may be key in healing chronic wounds. Elta Protease-containing wound dressings have been observed clinically to resolve inflammation and appear to aid healing in acute and chronic recalcitrant wounds. To investigate possible mechanisms of action, in vitro tests, zymography, collagenase assays and enzyme-linked immunosorbent assays (ELISAs), were performed to evaluate the effect of the dressing proteases on detrimental and beneficial wound healing components such as MMPs, Tis...

Topical negative pressure wound therapy: a review of its role and guidelines for its use in the management of acute wounds

International Wound Journal — Fri, 19 Sep 2008 04:00:00 +0100

This article provides a qualitative overview of the published literature appertaining to the use of TNP therapy in the management of acute wounds by an international panel of experts using standard methods of appraisal. Particular focus is applied to the use of TNP for the open abdomen, sternal wounds, lower limb trauma, burns and tissue coverage with grafts and dermal substitutes. We provide evidence-based recommendations for indications and techniques in TNP wound therapy and, where studies are insufficient, consensus on best practice. (Source: International Wound Journal)

Telemedicine in wound care

International Wound Journal — Fri, 19 Sep 2008 04:00:00 +0100

We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 × 10 cm) and one on his right leg (9 × 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via emai...

Late complication after tropic storm accident: subcutaneous and intracranial actinomycetoma

International Wound Journal — Fri, 19 Sep 2008 04:00:00 +0100

We report a 53-year-old farmer who developed subcutaneous and cerebral masses 24 years after penetrating trauma during a tropic storm. Computed tomography scans, magnetic resonance imaging and histopathology disclosed actinomycetoma, a disease that rarely develops after trauma and is only occasionally seen with intracranial manifestation. Clinically, the cutaneous manifestation resembled acne keloidalis nuchae or dissecting folliculitis of the scalp. He was treated by neurosurgery and antibiosis. (Source: International Wound Journal)

Warm immersion recovery test in assessment of diabetic neuropathy – a proof of concept study

International Wound Journal — Tue, 02 Sep 2008 04:00:00 +0100

Bharara M, Viswanathan V, Cobb JE. Warm immersion recovery test in assessment of diabetic neuropathy [ndash] a proof of concept study. Int Wound J 2008; doi: 10.1111/j.1742-481X.2008.00455.x. The aim of this article was to present results of warm immersion recovery test in the diabetic foot with neuropathy using a liquid crystal-based contact thermography system. It is intended to provide a 'proof of concept' for promoting the role of supplementary thermal assessment techniques and evidence-based diagnosis of diabetic neuropathy. A total of 81 subjects from the outpatient department of MV Hospital for Diabetes, India, were assessed using a liquid crystal thermography system. Each subject was assigned to one of three study groups, that is diabetic neuropathy, diabetic non neuropathy and non...

Cold immersion recovery responses in the diabetic foot with neuropathy

International Wound Journal — Mon, 01 Sep 2008 04:00:00 +0100

Bharara M, Viswanathan V, Cobb JE. Cold immersion recovery responses in the diabetic foot with neuropathy. Int Wound J 2008; doi: 10.1111/j.1742-481X.2008.00454.x. The aim of this article was to investigate the effectiveness of testing cold immersion recovery responses in the diabetic foot with neuropathy using a contact thermography system based on thermochromic liquid crystals. A total of 81 subjects with no history of diabetic foot ulceration were assigned to neuropathy, non neuropathy and healthy groups. Each group received prior verbal and written description of the test objectives and subsequently underwent a comprehensive foot care examination. The room temperature and humidity were consistently maintained at 24°C and less than 50%, respectively, with air conditioning. The right fo...

Vacuum Assisted Closure: Recommendations for Use

International Wound Journal — Fri, 01 Aug 2008 07:07:04 +0100

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Wound Infection in Clinical Practice

International Wound Journal — Sun, 01 Jun 2008 04:00:00 +0100

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Wound Infection in Clinical Practice. An International Consensus

International Wound Journal — Fri, 16 May 2008 14:01:59 +0100

International Wound Journal, Volume 5, Issue s3, Page iii-11, June 2008. (Source: International Wound Journal)

Would Exudate and the Role of Dressings. A Consensus Document

International Wound Journal — Wed, 19 Mar 2008 02:49:57 +0100

International Wound Journal, Volume 5, Issue s1, Page iii-12, March 2008. (Source: International Wound Journal)

Challenging times in a challenging world

International Wound Journal — Tue, 11 Mar 2008 16:48:18 +0100

International Wound Journal, Volume 5, Issue 1, Page 7, March 2008. (Source: International Wound Journal)

News and views

International Wound Journal — Tue, 11 Mar 2008 16:48:11 +0100

International Wound Journal, Volume 5, Issue 1, Page 6, March 2008. (Source: International Wound Journal)

Five years and counting

International Wound Journal — Tue, 11 Mar 2008 16:48:11 +0100

International Wound Journal, Volume 5, Issue 1, Page 3, March 2008. (Source: International Wound Journal)

Laser in the treatment of hypertrophic burn scars

International Wound Journal — Tue, 11 Mar 2008 16:48:10 +0100

International Wound Journal, Volume 5, Issue 1, Page 87-97, March 2008. Kawecki M, Bernad-Wiśniewska T, Sakiel S, Nowak M, Andriessen A. Laser in the treatment of hypertrophic burn scars. Int Wound J 2008;5:87–97.AbstractThis prospective study looked at the outcome of laser (light amplification by stimulated emission of ... (Source: International Wound Journal)

Vacuum-assisted closure of a large palmar defect after debriding a midpalmar tuberculous abscess

International Wound Journal — Tue, 11 Mar 2008 16:48:03 +0100

International Wound Journal, Volume 5, Issue 1, Page 45-48, March 2008. Kang GCW, Yam A. Vacuum-assisted closure of a large palmar defect after debriding a midpalmar tuberculous abscess. Int Wound J 2008;5:45–48.AbstractA rare case of tuberculous deep palmar abscess of the hand was treated with radical excisional debridement, ... (Source: International Wound Journal)

Neonatal necrotising fasciitis – Varanasi experience

International Wound Journal — Tue, 11 Mar 2008 16:47:42 +0100

International Wound Journal, Volume 5, Issue 1, Page 108-112, March 2008. Gangopadhyay AN, Pandey A, Upadhyay VD, Sharma SP, Gupta DK, Kumar V. Neonatal necrotising fasciitis – Varanasi experience. Int Wound J 2008;5:108–112.AbstractNeonatal necrotising fasciitis (NNF) is a rare and fatal disorder. Successful outcome depends on ... (Source: International Wound Journal)

Society news

International Wound Journal — Tue, 11 Mar 2008 16:47:32 +0100

International Wound Journal, Volume 5, Issue 1, Page 5, March 2008. (Source: International Wound Journal)

The revisit of 2004 tsunami in Thailand: characteristics of wounds

International Wound Journal — Tue, 11 Mar 2008 16:47:08 +0100

International Wound Journal, Volume 5, Issue 1, Page 8-19, March 2008. Prasartritha T, Tungsiripat R, Warachit P. The revisit of 2004 tsunami in Thailand: characteristics of wounds. Int Wound J 2008;5:8–19.AbstractThe name, tsunami that was unknown to most Thai people, had hit west southern coast of Thailand on 26 December ... (Source: International Wound Journal)

Induction of MMP-1, MMP-3 and TIMP-1 in normal dermal fibroblasts by chronic venous leg ulcer wound fluid*

International Wound Journal — Tue, 11 Mar 2008 16:47:02 +0100

International Wound Journal, Volume 5, Issue 1, Page 79-86, March 2008. Subramaniam K, Pech CM, Stacey MC, Wallace HJ. Induction of MMP-1, MMP-3 and TIMP-1 in normal dermal fibroblasts by chronic venous leg ulcer wound fluid. Int Wound J 2008;5:79–86.AbstractIn the wound bed of chronic venous leg ulcers, an imbalance of ... (Source: International Wound Journal)

Calendar

International Wound Journal — Tue, 11 Mar 2008 16:46:53 +0100

International Wound Journal, Volume 5, Issue 1, Page 113, March 2008. (Source: International Wound Journal)

Prospective clinical study of a new adhesive gelling foam dressing in pressure ulcers

International Wound Journal — Tue, 11 Mar 2008 16:46:53 +0100

International Wound Journal, Volume 5, Issue 1, Page 60-67, March 2008. Parish LC, Dryjski M, Cadden S on behalf of the Versiva® XC Pressure Ulcer Study Group. Prospective clinical study of a new adhesive gelling foam dressing in pressure ulcers. Int Wound J 2008;5:60–67.AbstractThis prospective, non comparative study ... (Source: International Wound Journal)

Physiological changes in tissues denervated by spinal cord injury tissues and possible effects on wound healing

International Wound Journal — Fri, 18 Jan 2008 19:10:43 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Rappl LM. Physiological changes in tissues denervated by spinal cord injury tissues and possible effects on wound healing. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00360.x.AbstractThere are many metabolic and physiological changes that happen to ... (Source: International Wound Journal)

Use of chlorhexidine-impregnated patch at pin site to reduce local morbidity: the ChIPPS Pilot Trial

International Wound Journal — Fri, 18 Jan 2008 16:45:52 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Wu SC, Crews RT, Zelen C, Wrobel JS, Armstrong DG. Use of chlorhexidine-impregnated patchat pin site to reduce local morbidity: the ChIPPS Pilot Trial. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00368.x.AbstractPin tract infection is one of the most ... (Source: International Wound Journal)

The use of marrow-derived stem cells to accelerate healing in chronic wounds

International Wound Journal — Thu, 03 Jan 2008 19:13:26 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Rogers LC, Bevilacqua NJ, Armstrong DG. The use of marrow-derived stem cells to accelerate healing in chronic wounds. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00349.x.AbstractAdult bone marrow-derived stem cells may aid the healing of chronic lower ... (Source: International Wound Journal)

The football: an intuitive dressing for offloading neuropathic plantar forefoot ulcerations

International Wound Journal — Thu, 03 Jan 2008 11:58:17 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Rader AJ, Barry TP. The football: an intuitive dressing for offloading neuropathic plantar forefoot ulcerations. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00364.x.AbstractA reproducible, affordable, efficacious and safe modality for offloading ... (Source: International Wound Journal)

Interleukin-6 concentrations in wound fluids rather than serological markers are useful in assessing bacterial triggers of ulcer inflammation

International Wound Journal — Thu, 03 Jan 2008 11:58:13 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Ambrosch A, Lobmann R, Pott A, Preißler J. Interleukin-6 concentrations in wound fluids rather than serological markers are useful in assessing bacterial triggers of ulcer inflammation. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00347.x.Abstract... (Source: International Wound Journal)

The role of the vacuum-assisted closure therapy in the salvage of venous congestion of the free flap: case report

International Wound Journal — Thu, 03 Jan 2008 11:58:12 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Uygur F, Duman H, Ülkür E, Çeiköz B. The role of the vacuum-assisted closure therapy in the salvage of venous congestion of the free flap: case report. Int Wound J 2008; doi: 10.1111/j.1742-481X.2007.00362.x.AbstractIndications for vacuum-assisted closure ... (Source: International Wound Journal)

Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in Pakistan

International Wound Journal — Thu, 03 Jan 2008 11:58:07 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Sangrasi AK, Leghari AA, Memon A, Talpur AK, Qureshi GA, Memon JM. Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in Pakistan. Int Wound J 2008; doi: 10.1111/j.1742-... (Source: International Wound Journal)

When will I see you again? The fate of research findings from international wound care conferences*

International Wound Journal — Thu, 13 Dec 2007 19:22:48 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Dumville JC, Petherick ES, Cullum N. When will I see you again? The fate of research findings from international wound care conferences. Int Wound J 2007; doi: 10.1111/j.1742-481X.2007.00343.x.AbstractMedical conferences provide a forum for the rapid ... (Source: International Wound Journal)

Radiotherapy and wound healing

International Wound Journal — Thu, 13 Dec 2007 09:19:40 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Devalia HL, Mansfield L. Radiotherapy and wound healing. Int Wound J 2007; doi: 10.1111/j.1742-481X.2007.00351.x.AbstractThis review article discusses basic radiation physics and effects of radiation on wounds. It examines various postulated hypothesis on ... (Source: International Wound Journal)

Leg ulceration in Portugal: quality of life

International Wound Journal — Thu, 13 Dec 2007 09:19:38 +0100

This study was undertaken to examine the impact of chronic leg ulceration on patients’ health-related ... (Source: International Wound Journal)

Abdominal wall mucocele: a late complication of colostomy closure

International Wound Journal — Thu, 13 Dec 2007 09:19:37 +0100

We present a case of incisional enteric mucocele formation 10 ... (Source: International Wound Journal)

Neonatal necrotising fasciitis – Varanasi experience

International Wound Journal — Thu, 13 Dec 2007 09:19:36 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, OnlineEarly Articles. Gangopadhyay AN, Pandey A, Upadhyay VD, Sharma SP, Gupta DK, Kumar V. Neonatal necrotising fasciitis – Varanasi experience. Int Wound J 2007; doi: 10.1111/j.1742-481X.2007.00350.x.AbstractNeonatal necrotising fasciitis (NNF) is a rare and fatal disorder. ... (Source: International Wound Journal)

News and views

International Wound Journal — Wed, 12 Dec 2007 14:56:13 +0100

International Wound Journal, Volume 4, Issue 4, Page 367-368, December 2007. (Source: International Wound Journal)

Calendar

International Wound Journal — Wed, 12 Dec 2007 14:56:09 +0100

International Wound Journal, Volume 4, Issue 4, Page 292, December 2007. (Source: International Wound Journal)

Diabetic foot infections in the elderly: primary amputation versus ‘footsparing surgery’. A case report

International Wound Journal — Wed, 12 Dec 2007 14:56:08 +0100

International Wound Journal, Volume 4, Issue 4, Page 325-326, December 2007. (Source: International Wound Journal)

Knowledge and practice of foot care in Iranian people with type 2 diabetes

International Wound Journal — Wed, 12 Dec 2007 14:56:03 +0100

International Wound Journal, Volume 4, Issue 4, Page 298-302, December 2007. Khamseh ME, Vatankhah N, Baradaran HR. Knowledge and practice of foot care in Iranian people with type 2 diabetes. Int Wound J 2007;4:298–302.AbstractThe aim of this study was to determine the knowledge and practice of foot care in people with type 2 ... (Source: International Wound Journal)

Update from the Diabetic Foot Global Conference (DFCon) 2007

International Wound Journal — Wed, 12 Dec 2007 14:56:01 +0100

International Wound Journal, Volume 4, Issue 4, Page 295-297, December 2007. (Source: International Wound Journal)

Guest Editorial: are diabetes-related wounds and amputations worse than cancer?

International Wound Journal — Wed, 12 Dec 2007 14:55:48 +0100

International Wound Journal, Volume 4, Issue 4, Page 286-287, December 2007. (Source: International Wound Journal)

Re-amputation occurrence in the diabetic population in South Wales, UK

International Wound Journal — Wed, 12 Dec 2007 14:55:47 +0100

International Wound Journal, Volume 4, Issue 4, Page 327-330, December 2007. (Source: International Wound Journal)

Diabetic foot infections in the elderly: primary amputation versus ‘foot-sparing surgery’. A case report

International Wound Journal — Wed, 12 Dec 2007 14:55:45 +0100

International Wound Journal, Volume 4, Issue 4, Page 315-321, December 2007. Leon LR Jr, Psalms SB, Walters J. Diabetic foot infections in the elderly: primary amputation versus ‘foot-sparing surgery’. A case report. Int Wound J 2007;4:315–321.AbstractRenal failure diabetic patients who present with lower extremity gangrene ... (Source: International Wound Journal)

Keyword index

International Wound Journal — Wed, 12 Dec 2007 14:55:43 +0100

International Wound Journal, Volume 4, Issue 4, Page 363-364, December 2007. (Source: International Wound Journal)

Challenges for management of the diabetic foot in Africa: doing more with less

International Wound Journal — Wed, 12 Dec 2007 14:55:42 +0100

International Wound Journal, Volume 4, Issue 4, Page 323-325, December 2007. (Source: International Wound Journal)

Guest Editorial: time and place-shifting the physical examination: technologies are converging to allow more detailed evaluations of the foot and wound

International Wound Journal — Wed, 12 Dec 2007 14:55:41 +0100

International Wound Journal, Volume 4, Issue 4, Page 289-290, December 2007. (Source: International Wound Journal)

Author index

International Wound Journal — Wed, 12 Dec 2007 14:55:39 +0100

International Wound Journal, Volume 4, Issue 4, Page 363, December 2007. (Source: International Wound Journal)

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

International Wound Journal — Wed, 12 Dec 2007 14:55:28 +0100

International Wound Journal, Volume 4, Issue 4, Page 330-332, December 2007. (Source: International Wound Journal)

Volume contents

International Wound Journal — Wed, 12 Dec 2007 14:55:08 +0100

International Wound Journal, Volume 4, Issue 4, Page 364-366, December 2007. (Source: International Wound Journal)

Intralesional injections of Citoprot-P® (recombinant human epidermal growth factor) in advanced diabetic foot ulcers with risk of amputation

International Wound Journal — Wed, 12 Dec 2007 14:54:41 +0100

International Wound Journal, Volume 4, Issue 4, Page 326-327, December 2007. (Source: International Wound Journal)

Knowledge and practice of foot care in lranian people with type 2 diabetes

International Wound Journal — Wed, 12 Dec 2007 14:54:39 +0100

International Wound Journal, Volume 4, Issue 4, Page 322-323, December 2007. (Source: International Wound Journal)

What is OnlineEarly?

International Wound Journal — Fri, 16 Nov 2007 19:09:59 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, -Not available-. What is OnlineEarly? OnlineEarly is a Blackwell Synergy service where fully corrected, fully web-functional and complete articles are published online as and when they are ready, prior to their ultimate inclusion in a print issue. This service is a ... (Source: International Wound Journal)

Re-amputation occurrence in the diabetic population in South Wales, UK

International Wound Journal — Thu, 25 Oct 2007 18:25:42 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, -Not available-. Kanade RV, van Deursen RWM, Burton J, Davies V, Harding K, Price P. Re-amputation roccurrence in the diabetic population in South Wales, UK. Int Wound J 2007; doi:10.1111/j.1742-481X.2007.00313.x.AbstractThe incidence of re-amputation following lower ... (Source: International Wound Journal)

Challenges for management of the diabetic foot in Africa: doing more with less

International Wound Journal — Wed, 24 Oct 2007 23:17:28 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, -Not available-. Abbas ZG, Archibald LK. Challenges for management of the diabetic foot in Africa: doing more with less. Int Wound J 2007;doi: 10.1111/j.1742-481X.2007.00376.x.AbstractDiabetes mellitus reached epidemic proportions in much of the less-developed world over ... (Source: International Wound Journal)

Intralesional injections of Citoprot-P® (recombinant human epidermal growth factor) in advanced diabetic foot ulcers with risk of amputation

International Wound Journal — Mon, 22 Oct 2007 18:32:03 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, -Not available-. Fernández-Montequín JI, Infante-Cristiá E, Valenzuela-Silva C, Franco-Pérez N, Savigne-Gutierrez W, Artaza-Sanz H, Morejón-Vega L, González-Benavides C, Eliseo-Musenden O, García-Iglesias E, Berlanga-Acosta J, Silva-Rodríguez R, Betancourt BY, López-Saura ... (Source: International Wound Journal)

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

International Wound Journal — Mon, 22 Oct 2007 08:31:46 +0100

International Wound Journal, Volume 0, Issue 0, Page ???, -Not available-. Martínez-De Jesús FR, Ramos-De la Medina A, Remes-Troche JM, Armstrong DG, Wu SC, Lázaro Martínez JL, Beneit-Montesinos JV. Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections. Int Wound J 2007;doi:10.1111/j.1742-... (Source: International Wound Journal)

To oxygenate or not to oxygenate – that is the question!

International Wound Journal — Sun, 14 Oct 2007 03:45:28 +0100

International Wound Journal, Volume 4, Issue s3, Page 1, September 2007. (Source: International Wound Journal)

To oxygenate or not to oxygenate – that is the question!

International Wound Journal — Mon, 24 Sep 2007 18:06:49 +0100

International Wound Journal Volume 4, Issue s3, Page 1-1, Sep 2007. (Source: International Wound Journal)