BioPad eBook Treatment of Hard-to-Heal Wounds with Collagen-Based Dressings

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Cervical Biopsy more efficient, less painful via new method

Can new tool make cervical biopsy more efficient, less painful

Physicians evaluate new device to test for cervical cancer. Comparison of Tissue Yield Using Frictional Fabric Brush Versus Sharp Curettage For Endocervical Curettage.

Women undergoing cervical biopsies might have lower odds of repeat tests with a rotating fabric brush than a sharp instrument because the soft device may capture more cells for analysis, a recent study suggests. Furthermore, biopsies with the softer tool may be less painful, researchers say. Cervical biopsies sometimes fail to collect enough cells from the cervix to accurately test for cancer, in which case another biopsy is needed. (more…)

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Crawford bags FDA clearance for wound dressing that will ‘save limbs’

fda wound dressing save limb

Crawford Healthcare, one of the biggest makers of advanced wound-care products in the UK, has won clearance from US regulators for a medical dressing that it says will “save limbs”.

The product, called KerraCel AG, soaks up fluid and bacteria from nasty, oozing wounds and locks it away as a gel. It is also the only dressing of its kind to contain silver at a special concentration to kill all bacteria – even those resistant to antibiotics – that prevent chronic wounds, such as diabetic ulcers and pressure sores, from healing.  (more…)

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Dragon blood may help wounds heal faster

synthetic peptide heal komodo dragon

A new study has identified a peptide, derived from the Komodo dragon, called VK25, which can be synthesized and used as an antimicrobial peptide to promote wound healing.

The new research has identified (see below) a peptide found from the Komodo dragon (Varanus komodoensis), called VK25, which appears to be useful as a cationic antimicrobial peptide (CAMP). There is currently considerable interest in antimicrobial peptides in a world where antibiotic effectiveness is in decline. These peptides are potent, broad spectrum antibiotics which demonstrate potential as novel therapeutic agents. (more…)

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Meeting the nutritional needs of elderly cancer patients

nutritional needs elderly cancer patients food vegetables apple

Although it is described as “one of society’s greatest achievements,” with the aging population, cancer incidence is expected to accelerate rapidly, as 50% of cancer occurs within this age group.(1)

Nutrition therapy is a crucial component of cancer care. Early and continuous nutrition management is necessary to avoid malnutrition, as this is associated with poor clinical outcomes.(2) Often, the elderly already face chronic comorbid conditions, such as high blood pressure, heart disease, lung disease, diabetes, kidney disease, bone disease and arthritis, further complicating their care.(3) (more…)

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Fish Skin for Human Wounds: Iceland’s Pioneering Treatment

Fish Skin for Human Wounds

The FDA-approved skin substitute reduces inflammation and transforms chronic wounds into acute injuries.

Six hours north of Reykjavik, along a narrow road tracing windswept fjords, is the Icelandic town of Isafjordur, home of 3,000 people and the midnight sun. On a blustery May afternoon, snow still fills the couloirs that loom over the docks, where the Pall Palsson, a 583-ton trawler, has just returned from a three-day trip. Below the rust-spotted deck, neat boxes are packed with freshly caught fish and ice. “If you take all the skins from that trawler,” says Fertram Sigurjonsson, the chairman and chief executive officer of Kerecis Ltd., gesturing over the catch, “we would be able to treat one in five wounds in the world.” (more…)

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Wound care technology invented at S&T hits marketplace

Wound care technology invented at S&T

A glass-based wound care product that emerged from research by a doctoral student at Missouri University of Science and Technology has been approved by the U.S. Food and Drug Administration for human use and is now available on the commercial market.

Steve Jung laid the groundwork for the Mirragen Advanced Wound Matrix while earning a master’s degree in ceramic engineering and a Ph.D. in materials science and engineering at Missouri S&T. Jung is now chief technology officer at Mo-Sci Corp., a Rolla specialty glass manufacturer that continued the product’s development in collaboration with ETS Wound Care, also of Rolla. (more…)

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Covenant Health Wound Care Experts Earn National, Regional Recognition

Covenant Health

LUBBOCK, TX (NEWS RELEASE) – The Covenant Center for Wound Care & Hyperbaric Medicine has been honored as a Wound Care Center® of the Year by Healogics, Inc., the nation’s leading and largest wound care management company. The center also was awarded Center of Distinction and the President’s Circle Award.

The center has achieved patient satisfaction rates higher than 92 percent, a healing rate of at least 91 percent in less than 31 median days and healed almost 90 percent of its patients in less than 14 weeks. Out of the 630 Centers eligible in 2016, only seven centers across the country received this prestigious award. Covenant’s center was awarded as Center of the Year for the southwest region, which includes Texas, Oklahoma, Louisiana and New Mexico. (more…)

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Revealing Advanced Wound Care Market Growth Factors

Revealing Advanced Wound Care Market Growth Factors

At a time when governments are under pressure to reduce healthcare costs, the global advanced wound care market is growing, driven by an aging population and rising incidences of chronic wounds.

Advanced wound care products are typically used to manage complex wounds, including burns, chronic wounds and complex trauma and surgical wounds. Chronic and complex wounds represent one of the predominant challenges to global healthcare systems because they are hard to heal and expensive to treat. (more…)

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eBooks

Creating an Ideal Microenvironment for Wound Cleansing

[Sponsored by Angelini Pharma, Inc.]

With so much focus on dressing choices, it’s easy to forget the importance of wound cleansing. Wound cleansing can help achieve the goals of wound bed preparation by removing microorganisms, biological and environmental debris to create an environment beneficial to healing as well as facilitating wound assessment by allowing clear visualization of the wound.

Preventing Infections in Patients with Wounds eBook

[Sponsored by Angelini Pharma, Inc.]

Proper wound care is essential to preventing infections for patients in all practice settings, and healthcare providers should stay informed about the most current and effective treatments out there.

Recognizing factors that increase patients’ susceptibility to infection allows providers to identify risks and take measures to prevent infection from occurring or worsening.

eBook: Treatment of Hard-to-Heal Wounds with Collagen-Based Dressings

[Sponsored by Angelini Pharma, Inc.]

Receive a free BioPad Sample and a free eBook with more details.

BioPad Wound Dressing with Collagen: BioPad, is a 100% equine Type-1 collagen primary wound dressing used to treat hard to heal wounds.

The BioPad collagen dressing has the highest collagen content on the market up to 5 times the amount of collagen. 

BioPad™ is the perfect dressing for wounds.

eBook: Caring for Wounds eBook Series: Pressure Injuries

[Sponsored by Angelini Pharma, Inc.]

Learn how your healthcare team can provide better patient care.

Patient care teams rely on the wound care nurse alone to implement a pressure ulcer prevention program; however, a successful program requires involvement from the entire care team and is a 24/7 endeavor.

eBook: Skin Damage Associated with Moisture and Pressure

[Sponsored by Convatec]

Tips on how to differentiate and goals for protection and management.

* Identify how wounds are classified according to wound depth and etiology.
* Describe the etiology of a pressure injury (PI) and incontinence-associated skin damage (IAD).
* Discuss evidence-based protocols of care of prevention and management if IAD and PIs.
* Describe the NPUAP-EPUAP Pressure Injury Classification System.
* Identify appropriate products that can be used for preventioin and treatment of IAD and PIs.

eBook: Needlestick Risks: Defense and Rescue Strategies for Nurses

[This e-book has been developed through an educational grant from CM&F Group]

Learn more about: 
A Continuing Risk for Healthcare Workers, Sharps Injuries: Facts and Figures, Proactive Steps for Yourself and Your Colleagues, A Preventable Injury, A Downloadable Workbook from the CDC, The Case for Coverage, If You are Exposed.

Needlesticks and other sharps-related exposures to bloodborne pathogens (including HIV, hepatitis B virus, and hepatitis C virus) continue to pose a significant occupational risk for healthcare workers

 

Safe Biopsies eBook: Protect yourself and your patients.

[This e-book is brought to you by BiopSafe]

Safe biopsy handling
One of the most common problems in connection with biopsy handling is the risk of being exposed to formalin either through touch or inhalation. A risk that doctors, veterinarians, laboratory technicians and nurses are exposed to every day.

With BiopSafe the problem is finally solved.

receive a free BiopSafe Sample and a free eBook PDF with more information and details.

 
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One Doctor Exploring Wound Care on Earth and in Space

In laboratories all across the globe, scientists are uncovering new and exciting breakthroughs in the realm of wound healing.

For instance, a team out of Texas is blinding bacteria to prevent their spread. Meanwhile, a collective of doctors from the U.K. recently developed some intriguing new vacuum tech to treat chronic ulcers. There’s even been research into drug treatments, like how opioids may actually prevent proper wound care.

Each team has taken a different approach or tackled a unique situation or medical ailment, and that ensures a more well-rounded coverage that helps a larger pool of patients. However, few scientists have a more grand scope than Ronke Olabisi, a professor of biomedical engineering at Rutgers University.

Reaching for the stars

As the university explained in a recent press release, Olabisi is hard at work on several projects aimed at improving wound healing both on earth and during manned space missions. During space travel, especially as astronauts spend months at a time in stations, the lack of gravity has a huge impact on the human body. Muscle and bones will actually start to deteriorate, and tissues will lose much of their elasticity. Olabisi’s main goal is to study in-depth why this occurs and how to fix, and she believes she can apply much of the same knowledge to wound care on Earth.

Read more at Advanced Tissue

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Lymphedema and lipedema: What every wound care clinician should know

Imagine you have a health condition that affects your life every day. Then imagine being told nothing can be done about it; you’ll just have to live with it. Or worse yet, your physician tells you the problem is “you’re just fat.”

Many people with lymphedema or lipedema have no idea their condition has a name or that many other people suffer from the same thing. Although lymphedema and lipedema can’t be cured, proper management and resources can help patients cope. This article improves your grasp of these conditions, describes how to recognize and manage them, and explains how to support your patients.

To understand lymphedema and lipedema, first you need to understand how the lymphatic system functions. It makes lymph, then moves it from tissues to the bloodstream. It also plays a major role in the immune system, aiding immune defense. In addition, it helps maintain normal fluid balance by promoting fluid movement from the interstitial tissues back to the venous circulation. (See Lymphatic system: Four major functions.)

If the lymphatic system is impaired from a primary (hereditary or congenital) condition or a secondary problem, lymphedema can result. In this chronic, potentially progressive, and incurable condition, protein-rich fluid accumulates in the interstitial tissues.

Lymphedema basics

Lymphedema occurs in four stages.

Stage 0. During this stage (also called the subclinical or latency stage), transport capacity of the lymphatic system decreases but remains sufficient to manage normal lymphatic loads. Signs and symptomsaren’t evident and can be measured only by sensitive instruments, such as bioimpedance spectroscopy and optoelectronic volumetry. Without such instruments to quantify volume changes, diagnosis may rest on subjective complaints.

In this stage, limited functional reserve of the lymphatic system leads to a fragile balance between subnormal transport capacity and lymphatic loads. Added stress on the lymphatic system (as from extended heat or cold exposure, injury, or infection) may cause progression to stage 1.

Providing appropriate patient information and education, especially after surgery, can dramatically reduce the risk that lymphedema will progress to a more serious stage.

Stage 1. Considered the spontaneously reversible stage, stage 1 is marked by softtissue pliability without fibrotic changes. Pitting can be induced easily. In early stage 1, limb swelling may recede over – night. With proper management, the patient can expect the extremity to decrease to a normal size compared to that of the uninvolved limb. Otherwise, lymphedema is likely to progress to stage 2.

Stage 1 lymphedema may be hard to distinguish from edemas from other causes. Clinicians must rely on the patient history and monitor for swelling resolution with conventional management, such as compression and elevation, or note if swelling persists despite these standard interventions.

Stage 2. Sometimes called the spontaneously irreversible stage, stage 2 is identified mainly from tissue proliferation and subsequent fibrosis (called lymphostatic fibrosis). The fluid component can be removed spontaneously, but removal of the increased tissue proliferation (initially irreversible) takes more time. Tissue proliferation stems from long-standing accumulation of protein-rich fluid; over time, the tissue hardens and pitting is hard to induce. In many cases, swelling volume increases, exacerbating the already compromised local immune defense.

Consequently, infections (particularly cellulitis) are common; these, in turn, increase the volume of the affected area. Proper treatment can reduce volume.

With proper care (complete decongestive therapy [CDT]), lymphedema can stabilize during stage 2. But patients with chronic or recurrent infections are likely to progress to stage 3.

Stage 3. Also called lymphostatic elephantiasis, this stage is marked by further fluid volume increases and progression of tissue changes. Lymphostatic fibrosis becomes firmer and other skin alterations may occur, including papillomas, cysts, fistulas, hyperkeratosis, fungal infections, and ulcers. Pitting may be present. Natural skinfolds deepen (especially those of the dorsum of the wrist or ankle) and, in many cases, cellulitis recurs.

If lymphedema management starts during this stage, reduction can still occur. Even in extreme cases, with proper care and patient adherence to treatment, lymphostatic elephantiasis can be reduced so the leg is a normal or near-normal size.

Assessment and diagnosis

A thorough physical examination is the gold standard for diagnosing lymphedema. A complete patient history, body-systems review, inspection, and palpation can help determine if edema is lymphedema.

Clinically, the only test with proven reliability and validity in diagnosing lymphedema is the Stemmer sign. Fibrotic changes associated with lymphedema can lead to thickened skin over the proximal phalanges of the toes or fingers. If you can’t tent or pinch the skin on the involved extremity, lymphedema is present (a positive Stemmer sign). However, a negative finding (soft, pliable tissue) doesn’t rule out  lymphedema because the condition may be in an early stage, before tissue proliferation and fibrosis have set in.

Management

Although incurable, lymphedema can be managed successfully through CDT. This approach involves proper identification of lymphedema, manual lymph drainage, skin and nail care, patient education, compression, and exercise.

CDT has two phases:

Phase I, the intensive phase, continues until the extremity has decongested or reached a plateau. The clinician provides treatments and educates the patient about all aspects of CDT to prepare him or her for phase II. Phase I can last several weeks to several months depending on lymphedema severity.

Phase II, the maintenance phase, begins once the extremity has decongested or plateaued. This phase still focuses on CDT, but now the patient, not the clinician, is responsible for all care. The goal is to reduce limb size while enabling the patient to become self-sufficient in managing lymphedema. Although CDT can bring significant improvements in limb size, skin quality, and function, patients must remember that phase II continues lifelong. Be sure to provide education about ongoing self-management strategies.

Lipedema: The disease they call “fat”

Lipedema is a painful disorder of fat deposition. Pathologic deposition of fatty tissue (usually below the waist) leads to progressive leg enlargement. Like lymphedema, lipedema is incurable but manageable. Unless managed properly, lipedema can reduce mobility, interfere with activities of daily living, and lead to secondary lymphedema. (See Lipedema stages.)

Lipedema commonly is misdiagnosed as lymphedema. However, lymphedema involves protein-rich fluid, whereas lip edema is a genetically mediated fat disorder. Because lipedema resists diet and exercise, it can lead to psychosocial complications. Lipedema occurs almost exclusively in women; typically, onset occurs between puberty and age 30. One unpublished epidemiologic study puts lip edema incidence in females at 11%. Some patients have a combination of lipedema and lymphedema. (See Viewing lipolymphedema.)

Assessment and diagnosis

As with lymphedema, lipedema diagnosis rests on clinical presentation. Lipedema characteristics include bilateral and symmetrical involvement, absence of pitting (because lipedema isn’t a fluid disorder), soft and pliable skin, and filling of the retromalleolar sulcus (called the fat pad sign.)

Key signs and symptoms include:

• feeling of heaviness in the legs (aching dysesthesia)

• easy bruising

• sensitivity to touch (called “painful fat syndrome”)

• orthostatic edema

• oatmeal-like changes to skin texture.

Nearly half of lipedema patients are overweight or obese, but many appear of normal weight from the waist up. Essentially, the upper and lower extremities don’t match. The lower extremities typically show fatty deposits extending from the iliac crest to the ankles, sparing the feet. (See Lipedema patterns.)

Management

Lipedema is best  managed through weight control, as additional weight gain through adipose tissue tends to deposit in the legs. For patients with concomitant lymphedema (lipolymphedema), modified CDT helps reduce and manage lymphatic compromise. To address excess fat deposition, newer “wet” liposuction techniques have proven beneficial. These techniques gently detach adipose cells from the tissue, helping to preserve connective tissue and lymphatic vessels.

Know what to look for

In both lymphedema and lipedema, early identification and proper diagnosis are key. (See Differentiating lymphedema and lipedema.) A thorough history and physical exam will likely lead to an accurate diagnosis, if clinicians know what to look for. Proper diagnosis and treatment can prevent expensive and ineffective interventions, which can negatively affect both the patient’s condition and psychological well being.

Heather Hettrick is an associate professor at Nova Southeastern University, Department of Physical Therapy in Fort Lauderdale, Florida.

Selected references

Fat Disorders Research Society. Lipedema description.

Fife CE, Maus EA, Carter MJ. Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv Skin Wound Care. 2010;23(2):81-92

Herbst KL. Rare adipose disorders (RADS) masquerading as obesity. Acta Pharmacol Sin. 2012;33(2):155-72.

Lipedema Project.

National Lymphedema Network. Position papers.

Schmeller W, Hueppe M, Meier-Vollrath I. Tumescent liposuction in lipoedema yields good long-term results. Br J Dermatol. 2012;166(1):161-8.

Zuther J. A closer look at lipedema and the effects on the lymphatic system. December 13, 2012. lymphedemablog.com/2012/12/13/a-closer-look-at-lipedema-and-the-effects-on-the-lymphatic-system/

Zuther J. Stages of lymphedema. October 3, 2012.

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