Wound bed preparation: <scp>TIME</scp> for an update

Harries, Rhiannon L; Bosanquet, David C.; Harding, Keith

doi:10.1111/iwj.12662

Cited by 158 publications

(158 citation statements)

References 65 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…All patients in the study cohort had concurrent histological examination of their wound biopsy to exclude occult neoplastic or autoimmune disease. Wound care was personalized for each patient, with wounds being treated systematically as per the TIME (Tissue, Infection/Inflammation, Moisture, Edge) wound bed preparation approach. Topical antimicrobials or antibiotics were prescribed as required in the event of an episode of clinical wound infection.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a gene expression test to identify hard-to-heal chronic venous leg ulcers

Bosanquet

Sanders

Ruge

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background Chronic venous leg ulcers pose a significant burden to healthcare systems, and predicting wound healing is challenging. The aim of this study was to develop a genetic test to evaluate the propensity of a chronic ulcer to heal. Methods Sequential refinement and testing of a gene expression signature was conducted using three distinct cohorts of human wound tissue. The expression of candidate genes was screened using a cohort of acute and chronic wound tissue and normal skin with quantitative transcript analysis. Genes showing significant expression differences were combined and examined, using receiver operating characteristic (ROC) curve analysis, in a controlled prospective study of patients with venous leg ulcers. A refined gene signature was evaluated using a prospective, blinded study of consecutive patients with venous ulcers. Results The initial gene signature, comprising 25 genes, could identify the outcome (healing versus non‐healing) of chronic venous leg ulcers (area under the curve (AUC) 0·84, 95 per cent c.i. 0·73 to 0·94). Subsequent refinement resulted in a final 14‐gene signature (WD14), which performed equally well (AUC 0·88, 0·80 to 0·97). When examined in a prospective blinded study, the WD14 signature could also identify wounds likely to demonstrate signs of healing (AUC 0·73, 0·62 to 0·84). Conclusion A gene signature can identify people with chronic venous leg ulcers that are unlikely to heal.

show abstract

Section: Methodsmentioning

confidence: 99%

Development and validation of a gene expression test to identify hard-to-heal chronic venous leg ulcers

Bosanquet

Sanders

Ruge

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Dressing choice is vital in managing exudate levels, the choice should provide an appropriate moisture balance, avoid maceration of the skin edges, prevent leakage and be easy to apply and remove [7]. It can be mentioned that active prevention of infection can be achieved, among other techniques, by using silver-containing materials [8].…”

Section: Introductionmentioning

confidence: 99%

Electrospun Fibers and Sorbents as a Possible Basis for Effective Composite Wound Dressings

et al. 2020

View full text Add to dashboard Cite

Skin burns and ulcers are considered hard-to-heal wounds due to their high infection risk. For this reason, designing new options for wound dressings is a growing need. The objective of this work is to investigate the properties of poly (ε-caprolactone)/poly (vinyl-pyrrolidone) (PCL/PVP) microfibers produced via electrospinning along with sorbents loaded with Argovit™ silver nanoparticles (Ag-Si/Al2O3) as constituent components for composite wound dressings. The physicochemical properties of the fibers and sorbents were characterized using scanning electron microscopy (SEM), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR) and inductively coupled plasma optical emission spectroscopy (ICP-OES). The mechanical properties of the fibers were also evaluated. The results of this work showed that the tested fibrous scaffolds have melting temperatures suitable for wound dressings design (58–60 °C). In addition, they demonstrated to be stable even after seven days in physiological solution, showing no macroscopic damage due to PVP release at the microscopic scale. Pelletized sorbents with the higher particle size demonstrated to have the best water uptake capabilities. Both, fibers and sorbents showed antimicrobial activity against Gram-negative bacteria Pseudomona aeruginosa and Escherichia coli, Gram-positive Staphylococcus aureus and the fungus Candida albicans. The best physicochemical properties were obtained with a scaffold produced with a PCL/PVP ratio of 85:15, this polymeric scaffold demonstrated the most antimicrobial activity without affecting the cell viability of human fibroblast. Pelletized Ag/Si-Al2O3-3 sorbent possessed the best water uptake capability and the higher antimicrobial activity, over time between all the sorbents tested. The combination of PCL/PVP 85:15 microfibers with the chosen Ag/Si-Al2O3-3 sorbent will be used in the following work for creation of wound dressings possessing exudate retention, biocompatibility and antimicrobial activity.

show abstract

“…Due to the lack of studies on wound cleansing in SSc, we recommend the same procedures commonly applied in other skin ulcers, including the use of sterile saline solution, sterile water, and in some cases also tap water, for irrigation of the DU. 62 Other procedures may include antiseptic solutions, such as sodium hypochlorite 0.5%, or other irrigation solutions like polyhexanide with betaine. 63 In any case, we suggest the use of povidone-iodine only in the case of severely contaminated lesions.…”

Section: Topical Treatmentmentioning

confidence: 99%

“…Surgical debridement is an invasive method that use a curette or a scalpel. This approach is effective for removal of nonviable tissue, and in routine clinical practice represents the gold standard for debridement 62 and is necessary to reduce bacterial contamination and local infection. 64 This approach requires a skilled practitioner and efficacious local anesthesia and general analgesia.…”

Section: Topical Treatmentmentioning

confidence: 99%

“…Together with wound edges, surrounding skin should be carefully examined to identify dry or macerated skin, in order to modify ulcer management and dressings accordingly. 62 For nonhealing DUs, in addition to correct systemic and topical management, some innovative approaches may be proposed. Digital sympathectomy may be useful to control Raynaud's phenomenon, increase blood flow, and improvhealing, [77][78][79] and may also be used in earlier phases to decrease DU-related pain.…”

Section: Topical Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

<p>Management of digital ulcers in systemic sclerosis</p>

Barsotti¹,

Battista²,

Venturini³

et al. 2019

CWCMR

View full text Add to dashboard Cite

Systemic sclerosis (SSc) is a rare disease characterized by autoimmune pathogenesis, alterations to the vascular system, and fibrosis of the skin and internal organs. Digital ulcers (DUs) are common in SSc patients, and represent a major burden for the patients. The management of DUs in systemic sclerosis is difficult, because it needs a multimodal therapeutic approach, as local treatment alone is usually insufficient and also systemic treatment with vasoactive drugs and modification of the lifestyle are usually required for healing of the wounds. In this review, we describe the optimal management of DUs according to recent literature and our clinical practice for systemic and local treatment of chronic digital wounds in SSc patients.

show abstract

Wound bed preparation: TIME for an update

Cited by 158 publications

References 65 publications

Development and validation of a gene expression test to identify hard-to-heal chronic venous leg ulcers

Development and validation of a gene expression test to identify hard-to-heal chronic venous leg ulcers

Electrospun Fibers and Sorbents as a Possible Basis for Effective Composite Wound Dressings

<p>Management of digital ulcers in systemic sclerosis</p>

Contact Info

Product

Resources

About