Venous stasis ulcers (VSUs) represent both an enormous cost to the healthcare system and significant quality-of-life issue to patients. While certain high-technology products have shown promise, compression bandaging continues to be the gold standard of care. Recently, some regional Medicare carriers suggested that patients with VSUs should be able to perform self-bandaging in an effort to avoid reimbursing caregivers to provide this service. Using a database of 7251 patients from 29 wound care facilities maintained as part of an agreement under the Intellicure Research Consortium for users of Intellicure Inc’s (The Woodlands, Tex) wound care software; activity of daily living (ADL) data was extracted for all patients with a VSU in whom this was collected (547 patients) to examine such an impact. Analysis showed that 55% of these patients required assistance with ADLs—the majority had issues with dressing and toileting. It is unlikely that patients who require assistance with dress

Background. In the authors’ experience re-epithelialization after successful debridement and granulation can be the most difficult part of the wound closure process. Extracellular matrix products represent a possible solution. However, in studies discussing the effectiveness of extracellular wound matrix (porcine-derived small intestine submucosa [SIS], [OASIS® Wound Matrix, Healthpoint Ltd, Fort Worth, Tex]), a long list of exclusion criteria has been presented. The present study was designed to explore the contraindications of OASIS Wound Matrix. Methods. In this study, 32 patients in whom the wounds were fully debrided and granulated were treated with weekly applications of the wound matrix. The exclusion criteria formulated in the reported literature were followed. Seven different outcomes were defined. Various patient and wound characteristics that might influence outcome were recorded. Results. Beneficial outcomes were seen in 80.6 % (n = 25) of the patients. The tw

Open window thoracostomy (OWT) is an invasive treatment option for thoracic empyema that is seldom indicated. These wounds are accompanied with a prolonged hospital stay and significant patient discomfort over an extended period of time. A retrospective report was conducted on patients who underwent OWT at the Academic Medical Center (Amsterdam, The Netherlands) and evaluated if topical negative pressure therapy ([TNP], V.A.C.® Therapy™, KCI Medical BV, Houten, The Netherlands) is a valid treatment option for these wounds. Clinical outcome and applied management methods are analyzed. Between January 1986 and June 2005, 15 patients, with a mean age of 54 years, were treated with OWT. Recently, the authors have used TNP in combination with OWT as a new treatment modality to obtain rapid control over pleural bacterial load and to achieve a well-vascularized wound surface. Good clinical results and a trend toward shorter hospital stays and improved quality of life were seen. Open wi

The benefits of occlusive and/or semi-occlusive dressings to accelerate epidermal wound healing have been documented in experiments on human and animal models, as well as in clinical settings. Their benefits have been generally accepted. However, reports either from experimental or clinical observations suggest that occlusive dressings may occasionally delay wound healing. Methods. Data presented here were reevaluated from experimental models conducted on controlled wounds. Conclusion. Although most human studies document that occlusive dressings facilitate epidermal wound healing, sufficient observations suggest that some experiment factors (latex rather than plastic and species) were not investigated in the earlier occlusive dressing observations, mandating the need for clarification. The differences between the earlier and more recent, significantly different, observations may relate to species (largely mouse rather than human), occlusive materials (latex rather than p

Tissue engineering is described as the application of principles and methods of engineering and biology toward fundamental understanding of structure-function relationships in normal and pathological mammalian tissue. With this in mind, interest in applying tissue engineering in the evolving field of wound healing arose in the nineties of the previous century. This review provides an overview of the history and technique of tissue engineering, current wound healing related research, description of available tissue-engineered wound dressings, and future challenges.