Using fat to help wounds heal without scars

fat heal scars adipogenic culture

Philadelphia – Doctors have found a way to manipulate wounds to heal as regenerated skin rather than scar tissue. The method involves transforming the most common type of cells found in wounds into fat cells – something that was previously thought to be impossible in humans. Researchers began this work at the Perelman School of Medicine at the University of Pennsylvania, which led to a large-scale, multi-year study in connection with the Plikus Laboratory for Developmental and Regenerative Biology at the University of California, Irvine. They published their findings online in the journal Science on Thursday, January 5th, 2017.Fat cells called adipocytes are normally found in the skin, but they’re lost when wounds heal as scars. The most common cells found in healing wounds are myofibroblasts, which were thought to only form a scar. Scar tissue also does not have any hair follicles associated with it, which is another factor that gives it an abnormal appearance from the rest of the skin. Researchers used these characteristics as the basis for their work – changing the already present myofibroblasts into fat cells that do not cause scarring. (more…)

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Clinical Notes: Healing SCI Patients, antiseptics on mahout, diabetes

Electrical stimulation

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…)

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Doing it cheaply vs. doing what’s best for patients

Sad but true: Much of what we do as healthcare professionals is based on reimbursement. For nearly all the services and products we use in wound care and ostomy management, Medicare, Medicaid, and insurance companies control reimbursement. For many years, these payers have been deciding which interventions, medications, products, and equipment are the best, and then reimbursing only for those items. If we want to use something not on the list, we—or our patients—will have to pay for it out of pocket. (more…)

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Case study: Maggots help heal a difficult wound

Using maggots to treat wounds dates back to 1931 in this country. Until the advent of antibiotics in the 1940s, maggots were used routinely. In the 1980s, interest in them revived due to the increasing emergence of antibiotic-resistant bacteria.

At Select Specialty Hospital Houston in Texas, we recently decided to try maggot therapy for a patient with a particularly difficult wound. In this case study, we share our experience. (more…)

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Medications and wound healing

Each issue, Apple Bites brings you a tool you can apply in your daily practice. Here are examples of medications that can affect wound healing.

Assessment and care planning for wound healing should include a thorough review of the individual’s current medications to identify those that may affect healing outcomes. Clinicians must then weigh the risks and benefits of continuing or discontinuing the medications. In some cases, the risk of discontinuing the medication outweighs the importance of wound healing, so the goal of the care plan should be adjusted to “maintain a wound” instead of “healing.” (more…)

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Seeing healthcare from a new perspective

By: Donna Sardina, RN, MHA, WCC, CWCMS, DWC, OMS

As healthcare clinicians, our world is full of tasks to be completed. Some are new, but many are tasks we repeat every day and thus have become routine—things we could almost do in our sleep.

But what’s routine for us may not be routine for our patients. For some patients, these routine tasks of ours may be their first encounter with a healthcare situation. (more…)

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Healthcare reform and changes provide opportunities for wound care clinicians

By Kathleen D. Schaum, MS

Qualified healthcare professionals (QHPs), such as physicians, podiatrists, physician assistants, nurse practitioners, and clinical nurse specialists, are taught to diagnose the reasons that chronic wounds aren’t healing and to create plans of care for aggressively managing the wound until it heals. Wound care professionals—nurses and therapists—are taught to implement those plans of care. All of these highly skilled wound care professionals know how to manage chronic wounds from identification through healing. (more…)

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Translating the language of health care

By Catherine E. Chung, PhD, RN, CNE, WCC

As a wound care clinician, you teach patients about medications, wound treatments, the plan of care, symptoms of complications, wound physiology—you teach a lot. And most patients probably smile and nod when you ask, “Do you understand?” However, health literacy research has shown that only 12% of the U.S. population is fluent in the language of health care. As health care has become increasingly complex, it has become increasingly difficult for patients to understand. Fortunately for your patient, you can translate. (more…)

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