Measurement and prediction of progress in delayed wound healing.

Journal of the Royal Society of Medicine (Impact Factor: 1.72). 05/1987; 80(4):210-2.
Source: PubMed

ABSTRACT Thirty chronic leg ulcers have been studied under controlled conditions until complete healing occurred. Measurement was performed weekly using a computer-linked stereocamera which is capable of measuring skin defects noninvasively with errors of less than 2%. There was a significant difference in healing rate for the first two weeks between clean ulcers entering the trial directly and ulcers admitted first for cleansing before joining the trial. The difference suggests that the weekly healing rate of an ulcer may take up to 2 weeks to respond to a new form of treatment. Absolute ulcer size, change in ulcer size and rate of epithelial migration did not correlate well with time to complete healing, but percentage change in area in the third week was found to be the parameter which gave the earliest close correlation with time to complete healing. Using this parameter, on the data available it was found that time to complete healing could be predicted to within one week for 50% of the ulcers, making this a simple and useful early predictor of treatment efficiency.

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    ABSTRACT: : The purpose of the study was to evaluate the benefit of using pulsed radiofrequency energy (PRFE) therapy in the treatment of chronic pressure ulcers. : A retrospective analysis was performed using case series data from the Provant Wound Registry, which consists of demographic characteristics and wound healing outcomes for patients treated with the Provant Therapy System. : The analysis subset consisted of data from 39 distinct centers, including both residential and ambulatory care facilities. : The analysis included data from 89 patients. The majority of patients (89%) were cared for in residential facilities, whereas 11% of patients were cared for in ambulatory care facilities. : Specific outcomes that assessed wound healing between the initial time point and at the 4-week follow-up were as follows: percent wound surface area reduction (PWAR), proportion of wounds achieving 50% reduction or greater in wound surface area (50% PWAR), and the rate of wound healing (wound healing trajectory in centimeters squared per day). : Overall, there was a 51% median reduction in wound surface area (PWAR) after 4 weeks of PRFE therapy for wounds in the study, with 51% of wounds (56/110) achieving 50% reduction or greater in wound surface area (50% PWAR). Rate of healing measurements for the overall study group showed a median wound healing trajectory of 0.13 cm/d at 4 weeks. : Compared with historical controls and other studies using similar surrogate wound healing markers, these results suggest PRFE therapy is a beneficial adjuvant treatment option for healing chronic pressure ulcers.
    Advances in skin & wound care 06/2012; 25(6):253-60.
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    ABSTRACT: bjective: To compare the efficacy and safety of negatively-charged polystyrene microspheres (NCM) with controls (saline soaks) in the treatment of hard-to-heal wounds of various aetiologies. Method: Patients with one or more hard-to-heal wounds, defined as refractory to healing for at least 4 weeks, or those with exposed bone, tendon or ligament, were eligible for inclusion and were randomised to either NCM (PolyHeal; MediWound Ltd.) or controls, both applied twice daily for 4 weeks. Patients were monitored bi-weekly for an additional 8 weeks, while treated by standard wound care, at the investigators’ discretion, and were re-evaluated 2 years after inclusion. The primary endpoint was defined as coverage of > 75% of the wound area by light-red granulation tissue after 4 weeks of treatment. Results: Fifty-eight patients completed the study, 32 in the NCM group and 26 in the control group. The two most common wound types were those with primary etiologies of venous insufficiency and post operative/post trauma. In the NCM group 47% of patients achieved > 75% light red granulation tissue after 4 weeks compared with 15% of patients in the control group (p=0.01). The mean wound surface area in the NCM group was reduced by 39.0% after 4 weeks compared with 14.9% in the control group (p=0.02). The achievement of > 75% light red granulation tissue and reduction of mean wound surface area was also observed in the two main sub-groups (venous insufficiency and postoperative/post trauma), although it was not statistically significant, possibly due to the small sample size in each sub-group. Conclusion: This study demonstrates that compared to control treatment, NCM treatment of hardto-heal and chronic wounds improves formation of healthy granulation tissue and reduces wound size thus in fact ‘kick-starting’ the healing process and ‘dechronifying’ chronic wounds.
    Journal of Wound Care 03/2013; 22(3):144-155. · 1.91 Impact Factor
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    ABSTRACT: The effect of acute herpes simplex virus type 1 (HSV-1) infection on the healing process of intraoral wounds and tooth extraction sockets in the rat was studied. A standardized size of the buccal mucosa was excised and molars were extracted and a HSV-1 suspension was topically applied. The virus infected wounds were clinically characterized by erythema and swelling and histologically by heavy inflammation cell infiltrate and abscesses during the first week. The acute HSV-1 infection was found to significantly delay healing of both types of wounds by 3 days. Antiviral treatment with acyclovir (ACV) decreased the degree of inflammation and improved healing of the infected wounds. The present results indicate a delayed and disturbed healing of wounds in the oral cavity in the presence of HSV-1. The findings may have a clinical significance for primary or latent HSV-1 infections in conjunction with surgical intervention in the oral cavity.
    Journal of Oral Pathology and Medicine 12/1990; 19(10):471-6. · 2.06 Impact Factor


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