Advances in wound care
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Advances in wound care · Sep 2013
ReviewDisclosure of the Culprits: Macrophages-Versatile Regulators of Wound Healing.
Macrophages are invariably present and tightly regulate all phases of adult wound healing, including inflammation, granulation tissue formation, and matrix deposition with the unavoidable outcome of scar formation. In response to environmental cues, macrophages mount a "classical" pro-inflammatory M1 activation as opposed to the "alternative" M2 phenotype, with wound macrophages having long been viewed as M2 macrophages. ⋯ If characterized in sufficient detail, distinct macrophage subsets and their impaired functions provide ideal targets for improving wound healing.
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Advances in wound care · Oct 2012
ReviewWound Care Specialization: The Current Status and Future Plans to Move Wound Care into the Medical Community.
There has been an explosion of basic science results in the field of wound care over the past 20 years. Initially, wound dressings were the only therapeutic option available to the wound practitioner. With advanced basic science knowledge, technical innovation, and the recent participation of pharmaceutical companies, the wound clinician now has an arsenal of dressings, biological tissue replacements, gene therapy, and cell-based treatment options. What has not, however, kept pace with these changes is the education and practical training for those treating nonhealing wounds. The pace of innovation in wound diagnostic tools has also lagged, creating even more pressure on the clinician to use experience, skill, and training to properly diagnose the root cause for the nonhealing wound. As wound healing is not considered a medical specialty, there is no formal training process for physicians, and subsequently, allied health practitioners are often the only ones available to provide care for these complex patients. Wound care training, however, is also not part of any formal curriculum for these healthcare providers as well, creating confusion for patients, payors, regulators, researchers, and product manufacturers. ⋯ The American College of Wound Healing and Tissue Repair was founded in Illinois as a nonprofit organization whose express function is to organize university-based medical school programs around a common curriculum for physicians who want to specialize in wound healing. Currently, two wound care fellows have graduated from the University of Illinois at Chicago and other programs are under development. The ultimate process will be achieved when certification is accredited by an organization such as the American Board of Medical Specialties. This article outlines the current process in place to achieve this goal within 10 years.
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Infection is a major problem in the health and wellbeing of patients in hospitals, nursing homes, and other medical facilities as well as the homecare patients and the general public. According to Scientia Advisors, wound care costs the healthcare system over $7 billion in 2009. After adding the cost associated with potential complications such as infections, extended physician care, and lengthy hospital stays, the annual wound care expenditures well exceeded over $20 billion.1 There are 20 million reported cases of diabetes per year and more every day. Because of the fact that leg ulcers are the number one health problem of men coupled with the rise in drug resistance of infections, the importance of providing the professional and the public with relatively simple and affordable wound care is of extreme importance. Often the wounds can become chronic wounds, which then result in long-term nursing expense in time and supplies or, worse yet, can result in expensive amputations ranging from $5000 to $40,000 per patient. ⋯ Elasto-Gel™ is not approved for third-degree burns as no dressing has been approved by the FDA for this type of wound.
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Advances in wound care · Feb 2012
PolyMem(®) Wic(®) Silver(®) Rope: A Multifunctional Dressing for Decreasing Pain, Swelling, and Inflammation.
Choosing the most appropriate dressing to meet the complex needs of patients with narrow deep wounds, such as tunnels, fistulas, and cysts, is a daunting task. Such wounds are difficult to cleanse and tend to be extremely painful. Wound patients need a drug-free dressing that handles exudates, decreases the need for traumatic cleansing during dressing changes, and addresses wound pain, inflammation, and swelling. ⋯ PolyMem dressings enhance autolytic debridement, which often results in production of large quantities of pale yellow enzyme- and nutrient-rich wound fluid during the first treatment week. Extra-absorbent PolyMem Max secondary dressings can contain excess fluid.