Journal of wound care
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Journal of wound care · Dec 2018
Randomized Controlled Trial Multicenter StudyDiabetic foot ulcer treatment with focused shockwave therapy: two multicentre, prospective, controlled, double-blinded, randomised phase III clinical trials.
To investigate the efficacy of focused extracorporeal shockwave therapy (ESWT) as an adjunctive treatment for neuropathic diabetic foot ulcers (DFU) (1A or 2A on the University of Texas grading scheme), compared with sham treatment. ⋯ The outcome of these two trials suggests that ESWT is an effective therapeutic modality in combination with standard care for neuropathic DFU that do not respond to standard care alone.
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Journal of wound care · Feb 2019
Meta AnalysisThe role of collagenase ointment in acute burns: a systematic review and meta-analysis.
A systematic review and meta-analysis was performed to summarise the state of the literature in regard to the efficacy and uses of clostridial collagenase ointment (CCO) in the burn patient. ⋯ CCO may be a safe and effective debridement agent for burn wounds with respect to decreasing wound healing time and minimising pain without increasing the risk of infection. It should be used on a case-by-case basis due to its financial cost, which may be offset by its ability to manage burns non-operatively.
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Journal of wound care · Jul 2016
Randomized Controlled Trial Multicenter StudyEvaluation of tissue engineering products for the management of neuropathic diabetic foot ulcers: an interim analysis.
The objective of this prospective, multicentre clinical study is to assess the application of MatriStem MicroMatrix (MSMM) and MatriStem Wound Matrix (MSWM) (porcine urinary bladder derived extracellular matrix) compared with Dermagraft (DG) (human fibroblast-derived dermal substitute) for the management of non-healing diabetic foot ulcers (DFUs). ⋯ The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs or the United States Government. T.W. Gilbert is employed as the Chief Science Officer and is a stockholder in ACell, Inc., which commercializes MatriStem Wound Matrix and MicroMatrix. None of the other authors have a conflict of interest to declare.
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Journal of wound care · Mar 2017
Review Practice GuidelineEWMA Document: Negative Pressure Wound Therapy.
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.1 NPWT has been described as a effective treatment for wounds of many different aetiologies2,3 and suggested as a gold standard for treatment of wounds such as open abdominal wounds,4-6 dehisced sternal wounds following cardiac surgery7,8 and as a valuable agent in complex non-healing wounds.9,10 Increasingly, NPWT is being applied in the primary and home-care setting, where it is described as having the potential to improve the efficacy of wound management and help reduce the reliance on hospital-based care.11 While the potential of NPWT is promising and the clinical use of the treatment is widespread, highlevel evidence of its effectiveness and economic benefits remain sparse.12-14 The ongoing controversy regarding high-level evidence in wound care in general is well known. There is a consensus that clinical practice should be evidence-based, which can be difficult to achieve due to confusion about the value of the various approaches to wound management; however, we have to rely on the best available evidence. ⋯ However, due to the low evidence level the treatment remains controversial from the policy maker and health-care system's points of view-particularly with regard to evidence-based medicine. In response EWMA has established an interdisciplinary working group to describe the present knowledge with regard to NPWT and provide overview of its implications for organisation of care, documentation, communication, patient safety, and health economic aspects. These goals will be achieved by the following: Present the rational and scientific support for each delivered statement Uncover controversies and issues related to the use of NPWT in wound management Implications of implementing NPWT as a treatment strategy in the health-care system Provide information and offer perspectives of NPWT from the viewpoints of health-care staff, policy makers, politicians, industry, patients and hospital administrators who are indirectly or directly involved in wound management.
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Journal of wound care · Dec 2015
Randomized Controlled Trial Comparative StudyReducing the pathogen burden and promoting healing with polyhexanide in non-healing wounds: a prospective study.
Polyhexamethylene biguanide (PHMB) is a novel wound antiseptic solution that has a broad antimicrobial spectrum and wound healing promoting effect, with minimal side effects. The aim of present study was to demonstrate the efficacy of the PHMB on the bacterial burden of non-healing wounds, the reduction in wound size or closure of the wound in comparison to Ringer's lactate solution (RLS) after 21 days of wound dressing. A second objective was to investigate the differences in the C-reactive protein (CRP) levels and white blood cell (WBC) counts between the two groups. ⋯ The results of this study emphasise that the successful treatment of chronic non-healing wounds require a multidisciplinary team approach under the control of a wound care specialist. Whatever the disinfectant used, consistency in the approach to treatment may be more important. We suggest that increasing the use of PHMB and adoption of this team approach in other cardiac centres or other populations may decrease the healing period, especially in chronic non-healing wounds.