An international research team led by Johns Hopkins University School of Medicine is seeking approval from the FDA for a topical gel they have created from oral blood pressure pills that has shown to be effective in the healing of chronic skin wounds in mice and pigs. A report of the team’s findings have been published in the Journal of Investigative Dermatology. Read more.
Read MoreSearch Results for: topical
Doctors Find New Natural Way to Prevent Scars
Scars are a particularly sore subject for most people. Not only are they aesthetically unpleasing, but some of them can prove painful. That’s why research into minimizing the appearance of scars continues to be a central priority of wound care-related research. In the last several months alone, there have been quite a few exciting such breakthroughs. (more…)
Read MoreA new way of healing wounds in the future discovered by scientists
Scientists at Ohio State University have developed a new method that has the capability of changing the body’s existing cells into new cells to promote healing. The method, called Tissue Nanotransfection (TNT), reprograms cells through a device that uses nanotechnology. The way it would work: First, doctors would apply a light electrical stimulation to the surface of the skin. They would then place a small chip about the size of a cuff link onto the site of the wound. In less than a second, this chip would deliver reprogramming factors (pre-programmed DNA or RNA) non-invasively into living skin cells via a high-intensity, focused electric field, converting them into whatever type of cells a scientist or doctor may choose. (more…)
Read MoreAntibiotic use in pressure injury infections
Antibiotic overuse contributes to the problems of antibiotic resistance and healthcare acquired infections, such as Clostridium difficile. Antibiotic stewardship programs improve patient outcomes, reduce antimicrobial resistance, and save money. These programs are designed to ensure patients receive the right antibiotic, at the right dose, at the right time, and for the right duration. (more…)
Read MoreThink a Patient Has Rights? They Left.
by Dr. Michael Miller
There are few absolutes in my universe. I know that my youngest daughter will gleefully and with full malice (but humorously presented) find something to torment me about every time I see her; referrals from family practice docs arrive well marinated in multiple antibiotics with nary a diagnosis in sight (save for the ubiquitous “infection”); and that regardless of what I recommend, offer, beg, plead, or cajole, that the patient has the complete and total power to make their decisions regarding their care and who provides it. Unless they are deemed by multiple authorities to be incapable of making a decision, until the appropriate paperwork or an emergency situation exists mandating immediate lifesaving action, the ball bounces squarely in their court…or so I thought. (more…)
Read MoreCondemning Patients to a Leap of Faith
by Dr. Michael Miller
I have several letters after my name. The two that say “DO” indicate that I have the training of a physician and the requisite education and responsibilities that uphold those letters. They should mean to patients that my ultimate goal is to offer (and provide when the fates allow) the entire spectrum of medical care referable to what I am good at and what they came to seek solace for. Nothing less and if I keep my ego in check, certainly nothing more. Patients run the gamut of their perception of the medical field. But like the old sales nemesis called “Bait and Switch”, what is offered on the sign all too often does not truly match what is seen on the shelves. Arrogant people are that way because they are good at what they do and not afraid to tell others. As a child, we are told to let others brag about us but failing to let people know what we can and can’t do is integral to our patients’ survival and our success. The problem is that the glitz and glamour of being a healer all too often clouds our success. Some time ago, I blogged about the pseudo-utilitarianism of all those so-called “Wound Certification” Exams. At first blush, these seem to be the key to health, wealth, omniscience and outcomes equaled only by those wound care management companies. (more…)
Read MoreBreaking silos: Effective wound healing means treatment across the continuum
Around 6.5 million patients in the U.S. suffer from chronic wounds, such as pressure injuries or ulcers. Treatment costs $25 billion each year, representing a sizable and growing problem. Despite the wide impact of chronic wounds, it’s rare to see specialized, effective wound care delivered across the care continuum.
A chronic non-healing wound is a surrogate marker for illness. These patients require holistic management of their co-morbidities and continuity across care settings.
Despite this, a great deal of emphasis has been placed on treating wounds as singular events, managed topically with expensive dressings and support surfaces. This is only a small part of wound healing.
As a physician focused solely on wound care, I have learned that we must shift the focus from simply treating the wound to treating the wounded patient. The impact in the post-acute care setting in particular is worthy of evaluation and discussion, as up to 29% of patients in long-term care facilities will experience a pressure ulcer, posing serious legal, financial, and staffing implications.
For those providers working outside long-term care, there is little understanding of challenges facing LTC providers. Acute providers do not often ask, for example, how are my LTC partners reimbursed? How are they staffed? What are the requirements and regulatory pressures they face? Asking these questions would facilitate a more productive dialogue with a focus on collaborative prevention, rather than waiting until a chronic wound occurs in the LTC setting.
Creating an integrated wound care community
To address the needs of the present and growing population of patients with chronic wounds, Healogics developed an integrated wound care community model, to coordinate the wound healing process across all care settings. The program utilizes Healogics Specialty Physicians, a subspecialty group of physicians and providers with extensive training solely focused on wound care.
HSPs provide expert inpatient consultation and ensure safe transition of patients out of the hospital into the appropriate care setting. Because HSPs see the patient regardless of post-discharge venue, patients receive the same quality of care whether they are going home, to a skilled-nursing, assisted living, or LTC setting. Because chronic wounds are surrogate markers for illness, we have realized it’s essential to have an integrated, multi-setting, and multi-disciplinary process to treat the patient and their co-morbidities.
Data collected at a pilot IWCC site in the Midwestern U.S. from 2014 to 2016 revealed very positive trends for chronic wound patients. In the acute care setting, the average length of stay decreased from 9.41 days to 5.64 days, and total cost of care per patient was reduced from $10,670 to $7,248.
We’re excited by these promising results, which were revealed at the American College of Wound Healing and Tissue Repair Conference last December. We look forward to refining and expanding the model by helping our partners in acute and LTC settings standardize their practices, use evidence-based clinical guidelines, mobilize technologies and processes, and pay critical attention to patient safety and value-based outcomes.
When it comes to wound healing, no venue of care should operate alone—an integrated solution that creates continuity for the patient is critical. There are four things LTC facilities can do to break down the silos:
Read more at McKnight’s
Read MoreManaging chronic venous leg ulcers — what’s the latest evidence?
Chronic venous leg ulcers (CVLUs) affect nearly 2.2 million Americans annually, including an estimated 3.6% of people over the age of 65. Given that CVLU risk increases with age, the global incidence is predicted to escalate dramatically because of the growing population of older adults. Annual CVLU treatment-related costs to the U.S. healthcare system alone are upwards of $3.5 billion, which are directly related to long healing times and recurrence rates of over 50%.
CVLUs are not only challenging and costly to treat, but the associated morbidity significantly reduces quality of life. That makes it critical for clinicians to choose evidence-based treatment strategies to achieve maximum healing outcomes and minimize recurrence rates of these common debilitating conditions. These strategies, which include compression therapy, specialized dressings, topical and oral medications, and surgery, are used to reduce edema, facilitate healing, and avert recurrence. (more…)
Read MoreSkin substitutes: Understanding product differences
Skin substitutes (also called tissuebased products and dermal replacements) are a boon to chronic wound management when traditional therapies have failed. When selecting skin substitutes for their formularies, wound care professionals have many product options—and many decisions to make.
Repair of skin defects has been a pressing concern for centuries. As early as the 15th century BC, Egyptian physicians chronicled procedures and herbal treatments to heal wounds, including xenografts (skin from another species). The practice of applying allografts (human cadaver skin) to wounds was first documented in 1503. In 1871, autologous skin grafting (skin harvested from the the person with the wound) was tried. Next came epithelial- cell seeding, which involves scraping off the superficial epithelium of healthy skin and transplanting the cells onto the wound. (more…)
Read MoreHerpes zoster: Understanding the disease, its treatment, and prevention
Herpes zoster (HZ, also called shingles) is a painful condition that produces a maculopapular and vesicular rash. Usually, the rash appears along a single dermatome (band) around one side of the body or face.
In most cases, pain, tingling, burning, or itching occurs a few days before the rash. Next, blisters form, scabbing over in 7 to 10 days. In rare cases, the rash is widespread, resembling varicella zoster (VZ, or chickenpox) rash. Pain can range from mild to severe and may be dull, burning, or gnawing. It may last weeks, months, or even years after the blisters heal. Shingles on the face may impair vision or hearing. (more…)
Read More2016 Journal: Best of the Best Vol. 5 No. 5
Clinical Notes: Healing SCI Patients, antiseptics on mahout, diabetes
Electrical stimulation and pressure ulcer healing in SCI patients
A systematic review of eight clinical trials of 517 patients with spinal cord injury (SCI) and at least one pressure ulcer indicates that electrical stimulation increases the healing rate of pressure ulcers. Wounds with electrodes overlaying the wound bed seem to have faster pressureulcer healing than wounds with electrodes placed on intact skin around the ulcer. (more…)
Read More