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T.I.M.E wound assessment

T.I.M.E wound assessment

Injuries are considered to be acute if they are new while more than 3 or 4 weeks old wounds are chronic. TIME Wound Assessment is a unique and significant systematic approach to wound healing that involves eliminating non-viable tissue, restoring moisture balance, controlling infection, and promoting epithelial advancement. It is not a sequential process since every wound is different. The ‘TIME’ acronym, consisting of tissue debridement, infection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management.

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Negative Pressure Wound Therapy With Instillation and a Reticulated Open Cell Foam

Negative Pressure Wound Therapy With Instillation and a Reticulated Open Cell Foam

Wound healing can be impaired by systemic factors and local factors. Dr W Cole conducted a retrospective assessment of 10 patients (N = 10) with complex lower extremity wounds treated with either advanced wound dressings (control group; n = 5) or NPWTi-d using ROCF-CC dressings (treatment group; n = 5) that was performed between June 2015 and October 2017 at Cleveland center – Ohio.

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Hidradenitis Suppurativa: a Cochrane systematic review

Hidradenitis Suppurativa: a Cochrane systematic review

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects apocrine gland-bearing skin in the axillae, groin, and under the breasts. It is characterised by persistent or recurrent boil-like nodules and abscesses that culminate in a purulent discharge, sinuses, and scarring

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Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus

Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus

Foot ulcers in people with DM have a serious impact on health, related with the quality of life, particularly with respect to physical functioning and role-limitations due to physical and emotional issues. Any intervention that promotes healing makes an important difference. The Cochrane review about the use of Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus make analysis about the use of it.

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Advances of Stem Cell Therapeutics in Cutaneous Wound

Advances of Stem Cell Therapeutics in Cutaneous Wound

The skin wound might be of different nature and varies from surgical to accidental lacerations, burns, pressure ulcers, diabetic ulcers, and venous ulcers. Mesenchymal stromal cells, also known as mesenchymal stem cells (MSCs), are adult stem cells capable of self-renewal and multipotential differentiation. MSC transplantation led to accelerated cutaneous wound closure. the mechanisms by which these stem cells contribute to the healing process have yet to be elucidated

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Skin Condition in Elderly and Geriatric Patient

Skin Condition in Elderly and Geriatric Patient

As we age, our epidermis undergoes several changes. The key characteristics of geriatric sufferers are advanced age, a decrease in physical performance, care dependency, and multimorbidity. In addition, this stage of life leads either directly or indirectly, to a wide range of skin as well as tissue problems.

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Hyaluronic Acid and Re-epithelialization

Hyaluronic Acid and Re-epithelialization

Hyaluronic acid (hyaluronan, HA) is a large glycosaminoglycan and an essential extracellular component of skin It is active throughout the entire process of wound healing being involved in proliferation, migration, and tissue remodelling. Erika Nyman published on 2019 this interesting study in which he investigated the influence of exogenous HA on re-epithelialization, erythema, and protein expression. Nyman and Coll concluded that exogenous intradermal HA accelerates re-epithelialization and alters protein expression in human in vivo deep dermal skin wounds.

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PRP Application prior to Resurfacing with Split Thickness Skin Graft Vs Conventional Mechanical Fixation Using Sutures and Staples

PRP Application prior to Resurfacing with Split Thickness Skin Graft Vs Conventional Mechanical Fixation Using Sutures and Staples

A split-thickness skin graft is generally done for soft skin coverage. The healing process is undertaken through three stages anchorage, inosculation and maturation. Subha Dhua and colleagues conducted this Randomized control study on 40 patients for 24 months from October 2015 to September 2017. The application of autologous platelet-rich plasma (PRP) to the split-thickness skin graft sites is considered and theorized to provide immediate skin graft anchorage.

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Biobrane dressing for pediatric burns in Singapore. A retrospective review

Biobrane dressing for pediatric burns in Singapore. A retrospective review

Cong Fan and colleagues conducted a retrospective review about pediatric burns patients admitted to the pediatric burns unit from January 2014 to April 2015 at Singapore General Hospital, Singapore. This study aimed to compare the results of Biobrane dressing with conventional silver foam dressing. In the Biobrane group, the length of hospital stay was significantly shorter and the infection rate was significantly lower

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The benefit of debridement

The benefit of debridement

The scope is to remove the damaged and dead tissue to remove the death tissue and bacteria from the wound, minimising infection risk and encouraging healthy granulation tissue.

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Chronic Wound. What you have to know

Chronic Wound. What you have to know

A chronic wound is an injury that doesn’t heal in six weeks. Factors that contribute to chronic wounds include increased bacterial load, inappropriate treatment, trauma, lower extremity wounds, senescent/aberrant cells and so on

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Edema of the skin. Cause and treatment

Edema of the skin. Cause and treatment

Edema is swelling that occurs in different areas of the body when too much fluid gets trapped in the tissues. It often takes place in the epidermis, particularly on the legs, feet, ankles, arms, and hands.

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Dressings and topical agents to treat the pressure ulcers

Dressings and topical agents to treat the pressure ulcers

Bedsores (also called pressure ulcers or decubitus ulcers) are injuries of the skin and underlying tissue, resulting from prolonged pressure on the skin. Westby MJ and Coll have successfully conducted a network meta-analysis of dressings and topical agents for healing pressure ulcers. This review includes 51 RCTs involving a total of 2964 participants, comparing 39 different dressings or topical agents for the healing of pressure ulcers.

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Prevention of diabetic wound ulcer

Prevention of diabetic wound ulcer

Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.

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Silver foam dressing and zinc-hyaluronic gel for the treatment of partial thickness hand burn injuries

Silver foam dressing and zinc-hyaluronic gel for the treatment of partial thickness hand burn injuries

The hydrofiber dressing consists of a superficial polyurethane waterproof layer and a multilayered absorbent surface containing 1.2% ionized silver. Zinc-hyaluronic acid promotes cell regeneration.
Gergo Jozsa conducted this study in which 37 children were treated conservatively with a special dressing at first intervention containing Hydrofiber dressing with silver foam and Zn-hyaluronic gel to determine their effectiveness on partial-thickness hand burns.

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Dressings for the prevention of surgical site infection (Review)

Dressings for the prevention of surgical site infection (Review)

In the UK it has been estimated that 4% to 5% of patients undergoing a surgical procedure contract an SSI. Dumville JC and Coll conducted this review, including 29 trials (5718 participants). The scope of the work was to compare Dressings for the prevention of surgical site infection.

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Smoking and wound healing

Smoking and wound healing

Oxygen is the basis for wound healing, and it begins at the cellular level. Smoking deprives the body of the oxygen it needs to repair wounds and build new tissue. not many people know that smoking also slows down the healing process.

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Lymphatic System and Wounds

Lymphatic System and Wounds

The ‘Lymphatic System’ is a complex network of tissues & organs that play an imperative role in homeostasis of extracellular space. Patients suffering from lymphedema have increased the risk of wound formation.

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Dehydrated human amnion/chorion membranes and wound healing

Dehydrated human amnion/chorion membranes and wound healing

Wound healing is a well-coordinated sequence of events in which signalling and remodelling of the extracellular matrix (ECM) are integral components. dehydrated human amnion/chorion membrane (dHACM) has demonstrated clinical efficacy in the enhancement of wound repair compared with standard compression therapy.

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Comparison of Efficacy and Complications Between Negative Pressure Wound Therapy and Conventional Mechanical Fixation in Skin Grafts: A Retrospective Analysis.

Comparison of Efficacy and Complications Between Negative Pressure Wound Therapy and Conventional Mechanical Fixation in Skin Grafts: A Retrospective Analysis.

Negative-pressure wound therapy (NPWT) is a therapeutic technique using a suction dressing to remove excess exudation and promote healing in acute or chronic wounds and second-and third-degree burns. Negative pressure could be utilized to secure a skin graft, improving the drainage. Shen X and Coll conducted this retrospective study in which they evaluated 186 patients

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Most Common Chronic Wound

Most Common Chronic Wound

A chronic wound is an injury type that develops when an acute wound fails to heal in the expected time. It might be a couple of weeks or six weeks in a few cases. The conditions that stop or slow the healing process may lead to similar illnesses are infection, weak immune system, poor blood supply & low oxygen and so on.

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Bioresorbable scaffold as a dermal substitute

Bioresorbable scaffold as a dermal substitute

Burns, trauma, chronic and complex wounds can result in complete loss of skin, leading to infection, increased insensible water loss, hypothermia, difficulties in patient management. Lenon Cardoso and Coll performed this study to assess the efficiency of a porous bioresorbable membrane Poly (L-co-DL lactic acid)-co-trimethylene carbonate, PL-co-DLA-co-TMC, as a dermal substitute associated with partial skin graft in rats.

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Wound Care and peri wound area

Wound Care and peri wound area

A chronic wound is a lesion that doesn’t heal in a specific time but shows delayed wound healing. Many factors could lead an acute wound to become a chronic wound such as diabetes with its complications, low blood flow, soft tissue infection and so many other conditions.

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Silver Dressing

Silver Dressing

Silver has broad-spectrum antimicrobial properties against a wide spectrum of gram-positive and gram-negative bacteria. The use of Silver dressings is recommended for acute or chronic wounds with, or at risk of, a high level of bioburden or local infection.

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Skin Assessment

Skin Assessment

The skin has various significant functions including prevention of loss of body water, temperature control, protection from harmful microbes & substances, and temperature control. Skin Assessment is a process in which the entire skin of a sufferer is examined for abnormalities.

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Ingrowing toenails in children and adolescents

Ingrowing toenails in children and adolescents

An ingrown toenail, also known as onychocryptosis, occurs when the nail plate grows into the adjacent periungual skin and acts as a foreign body, causing inflammation and infection. Sumanth Kumar Gera conducted this study to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents. This study aimed to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents.

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Hyperbaric Oxygen Therapy Effects on Chronic Wounds

Hyperbaric Oxygen Therapy Effects on Chronic Wounds

Hyperbaric oxygen therapy (HBOT) delivers 100% inspired oxygen to individuals at 2.0 to 2.5 absolute atmospheres (ATA) of pressure for a typical total duration of 60-120 minutes during 1-2 daily sessions inside a hyperbaric chamber. Laura Bolton conducted a systematic review of randomized clinical trials (RCTs) comparing HBOT effects on chronic wounds to those of another therapeutic regimen.

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Complication of Venous Ulcers

Complication of Venous Ulcers

Ulcers are open skin sores that can affect any area of the epidermis and they most often occur on the legs due to problems with blood circulation in the veins.

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Cells involved in regeneration dermis

Cells involved in regeneration dermis

The dermis is the mesenchymal component of the skin, separated from the epidermis by the basement membrane. . The dermis comprises two structurally different layers named the papillary and reticular layer. Alexandra L. Rippa and Coll published this scientific article about the different steps of the wound healing and which cells are involved in the healing process.

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Bone infection: Osteomyelitis

Bone infection: Osteomyelitis

A Bone Infection can result when fungi or bacteria invade a bone. It can either develop suddenly or over a long period. The first and foremost Symptom of the same is pain at the infection site.

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Contact Dermatitis

Contact Dermatitis

Contact dermatitis is an itchy and red rash that crops up on your epidermis when you touch or have a reaction to a few substances. Contact Dermatitis is caused by a substance you are exposed to which either irritates your skin or triggers an allergic reaction.

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Burns

Burns

A burn is tissue damage that results from scalding, overexposure to the sun or other radiation, contact with flames, chemicals or electricity, or smoke inhalation.

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Prevention of Postoperative Wound infection

Prevention of Postoperative Wound infection

Surgical site infection (SSI) may occur in 5–20% after surgery. Up to 60% of SSI can be prevented. Bjørg Marit Andersen made an interesting scientific article about the prevention of postoperative wound infection.

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Human Amniotic Membrane and Wound Healing

Human Amniotic Membrane and Wound Healing

Human amniotic membranes (hAMs) have shown promising results in recent studies aimed at improving wound healing. Ben Samuel John and Coll conducted a study on the 2019 full-thickness skin defects in 4 groups of 6 rats with one wound each.

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Bacterial Wound Colture

Bacterial Wound Colture

Wound assessment of a wound is a breakdown in the protective function of the epidermis. If it becomes infected, it can get worsen instead of better. Bacterial Wound Colture is a test to identify harmful bacteria that may be growing in the injury. the type(s) of germ detected is afterwards subjected to sensitivity/susceptibility testing. the final outcome allows clinicians to make a wise decision about the appropriate therapy to inhibit the growth of the bacterium.

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Surgical Site Infection

Surgical Site Infection

SSI stands for Surgical Site Infection, an infection that occurs after surgery in the part of the body where the surgery took place. About 1 to 3 out of every 100 patients develop some infection after the surgical intervention.

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Pressure Injury and Oral Supplement

Pressure Injury and Oral Supplement

Pressure Injury is an area of the injured epidermis. It happens when force is applied to the outermost layer of the skin, especially over the bony body parts. The inadequate diet intake, low body mass index, and presence of malnutrition have been acknowledged as the pivotal risk factors for both the delayed wound recovery and development of pressure injuries. An adequate amount of right supplements could be required for these patients.

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The use of Extracorporeal Shockwave Therapy for Chronic Diabetic Foot Ulcers

The use of Extracorporeal Shockwave Therapy for Chronic Diabetic Foot Ulcers

Etiologies of chronic diabetic foot ulcers (DFUs) are multifactorial. They are caused by angiopathy and poor skin sensation due to peripheral neuropathy.
Chou WY conducted this study at Kaohsiung Chang Gung Memorial Hospital (Kaohsiung, Taiwan). During the course of study, a total of 21 patients were screened. Extracorporeal shockwave therapy was shown to induce neovascularization and increase angiogenic and osteogenic growth factors that lead to improvement in blood flow perfusion and tissue regeneration.

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Deep Venous Thrombosis And Doppler Ultrasound

Deep Venous Thrombosis And Doppler Ultrasound

Deep Venous Thrombosis is a condition where blood clots form in the vein deep in your body, often in your legs. Oedema, leg pain, the warmth of the skin over the area of thrombosis are the most common clinical sign and symptoms.

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Collagen Dressing in Burn

Collagen Dressing in Burn

A discussion about the use of dermal substitutes collagen made for the treatment of burn. Have a look of my contents in the Al Das Medical Clinic web site

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Bandage the Leg Ulcers

Bandage the Leg Ulcers

Leg Ulcer is an open wound or a sore on the legs. they are more common in females but can affect both women and men of any age. It is necessary to have assessment before performing the bandage. Several clinical conditions could cause leg ulcers. Usually a graduated external compression plays a major role in the successful treatment for lower limb open wounds, especially for the treatment of venous ulcers.

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Biofilm and Wound Healing: An Overview, Causes, and Treatment Methods

Biofilm and Wound Healing: An Overview, Causes, and Treatment Methods

Biofilms are dynamic communities of bacterias. Biofilm in injury is a type of contamination made up of living microorganisms which are capable of forming colonies. If a patient has treated for the non-healing chronic wound which failed to progress, they are most likely dealing with a Biofilm. Topical agents including Creams, Methylene Blue, and Cadexomer iodine also help eradicate the Biofilm.

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Managing Wounds as a Team

Managing Wounds as a Team

Only minor injuries can be treated at home through medications & natural remedies. But, in case of wounds which involve skin and subcutaneous tissues, muscular fascia or bones, you need to look for immediate medical attention.

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Topical Antibiotic in the Wound

Topical Antibiotic in the Wound

“Topical Antibiotics” are medicines in the form of cream & ointment applied directly to the skin for destroying or inhibiting the growth of susceptible bacteria. The primary role of “Topical Antibiotic” is to reduce the microbial contaminant exposure after the surgery.

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Modalities of wound Debridement

Modalities of wound Debridement

This is my last presentation at the 5th Emirates Plastic Surgery Congress in Dubai in January 2020. Debridement as the first step for wound healing.

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Innovation in wound care

Innovation in wound care

This is the second of three presentations that I had at the 5th Emirates Plastic Surgery Congress in Dubai in January 2020. It describes the use of dermal substitutes and tissue engineering in wound healing.

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Beauty in wound care

Beauty in wound care

This is the first of three presentations and it describes the use of advanced dressing in the clinical practice.

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HBOT Symposium 2019

HBOT Symposium 2019

I had my talk during 2nd Al Zahra Hyperbaric Oxygen therapy Symposium. Many thanks to Al Zahra Hospital Dubai for the opportunity and the continuous support!

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Major Vitamins That Facilitates the Wound Healing Process

Major Vitamins That Facilitates the Wound Healing Process

Nutritional status of patients at the time of trauma influences the biochemical processes necessary for the phases of normal healing to occur
To heal them properly, all you need is to undergo an effective treatment method. Also, it’s pivotal to maintain healthy levels of “Vitamins” like A, B, C, E and other nutrients.

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An Overview on Wound Bed Preparation and the TIME Framework

An Overview on Wound Bed Preparation and the TIME Framework

“Wound Bed Preparation” has become a standard model that allows physicians to identify and breakdown local barriers for healing the injury. It’s a complex process that can be impacted by an array of significant factors. In addition, it usually progresses through various phases…

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Arianna Fallacara  2018 – Hyaluronic Acid in the Third Millennium

Arianna Fallacara 2018 – Hyaluronic Acid in the Third Millennium

Hyaluronic acid is a natural polymer. In the human body, it is distributed around cells and in the extracellular matrix (ECM). A Fallacara and Coll conducted an interesting overview, describing the history, physicochemical, structural and hydrodynamic of hyaluronic acid. They evaluated also the different applications of the HA in medicine, pharmaceutical and cosmetic fields.

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Venous Ulcers

Venous Ulcers

Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. Venous ulcers develop mostly along the medial distal leg and can be painful with negative effects on quality of life.

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Hyperbaric Oxygen Therapy as an Adjunctive Therapy for Wound Care

Hyperbaric Oxygen Therapy as an Adjunctive Therapy for Wound Care

Hyperbaric oxygen therapy (HBOT) is an of treatment in which a patient breathes 100% oxygen at a pressure greater than 1 atmospheric pressure (ATA) in a chamber. The aim of the treatment is to increase the O2 level dissolved in the plasma up to 15 times the normal amounts, which helps in the treatment of many diseases.

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