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Marques R, de Lopes MVO, Neves‐Amado JD, Ramos PAS, de Sá LO, da Oliveira IMS, da Amado JMC, de Vasconcelos MJM, Salgado PMF, Alves PJP. Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study. Int Wound J 2024; 21:e14339. [PMID: 37667542 PMCID: PMC10781894 DOI: 10.1111/iwj.14339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 09/06/2023] Open
Abstract
Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.
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Affiliation(s)
- Raquel Marques
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | - João Daniel Neves‐Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Paulo Alexandre Silva Ramos
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- Unidade de Saúde Familiar Corino de AndradePortoPortugal
| | - Luís Octávio de Sá
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Irene Maria Silva da Oliveira
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - João Manuel Costa da Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | | | - Paulo Jorge Pereira Alves
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
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Polat B, Okur DT, Çolak A, Okur S, Özkaraca M, Yilmaz K. Comparison of three different dosages of low-level laser therapy on expression of cell proliferation and inflammatory markers following ovariohysterectomy in rats. Cutan Ocul Toxicol 2023; 42:273-282. [PMID: 37624142 DOI: 10.1080/15569527.2023.2252075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
The objective of the current study was to evaluate Low-level laser therapy (LLLT) on the healing of incisional wounds following ovariohysterectomy in rats, by means of subjective histopathological and immunohistochemical analysis. A total of 72 female Wistar rats were categorised into four treatment groups (Group I; sacrification 4 hours following only one LLLT application, Group II; sacrification 7 days following only one LLLT application, Group III; sacrification 4 hours after two LLLT applications, and Group IV; sacrification 7 days after two LLLT applications). Each group was further divided into four different doses subgroups (Group Control [C, off mode LLLT application], L1 [1 J/cm2], L3 [3 J/cm2], and L6 [6 J/cm2]), with equal representation in each subgroup. Ovariohysterectomy was employed using two 2-cm-length midline abdominal incisions in the left and right sides of line alba. The Group C was assigned to the left side incision to each rat in the study. After irradiation, the tissue was subjected to histopathological analysis to determine the extent of mononuclear cell infiltration, edoema, and epithelialization. Additionally, immunohistochemical analysis was performed to evaluate the expression of proliferating cell nuclear antigen (pCNA) and inducible nitric oxide synthase (iNOS). Group L1 and L3 significantly decreased mononuclear cell infiltration compared with Group C in all treatment groups (p < 0.05). Group L3 significantly decreased edoema compared with Group C in all groups except for treatment Group I (p < 0.05). Group L2 and L3 significantly increased epithelization in treatment Group IV (p < 0.05). Moreover, Group L2 and L3 significantly increased pCNA in all groups, while L2 and L3 significantly decreased iNOS expression in treatment Group II, III, and IV (p < 0.05). However, no statistical difference was found between subgroups of treatment Group I in iNOS expiration (p > 0.05). The results of the current examination demonstrated that LLLT can modulate mononuclear cell infiltration and edoema, and improve epithelization, as well as increase pCNA expression, whereas decrease iNOS expression during the wound healing process, therefore enhancing wound healing following ovariohysterectomy in rats.
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Affiliation(s)
- Bülent Polat
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
- Bil-Tek, Ata Teknokent, Erzurum, TR, Turkey
| | - Damla Tuğçe Okur
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
| | - Armağan Çolak
- Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey
| | - Sıtkıcan Okur
- Department of Surgery, Atatürk University, Erzurum, Turkey
| | - Mustafa Özkaraca
- Department of Pathology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Kader Yilmaz
- Celal Oruç Animal Production School, Ağrı İbrahim Çeçen University, Ağrı, Turkey
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Rodrigues AM, Ferreira PL, Lourenço C, Alves PJP, Marques JMND, de Sá LO. Chronic wound assessment: Cultural and linguistic adaptation for European Portuguese of RESVECH-2 scale. J Tissue Viability 2022; 31:783-789. [DOI: 10.1016/j.jtv.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
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van de Vyver M, Boodhoo K, Frazier T, Hamel K, Kopcewicz M, Levi B, Maartens M, Machcinska S, Nunez J, Pagani C, Rogers E, Walendzik K, Wisniewska J, Gawronska-Kozak B, Gimble JM. Histology Scoring System for Murine Cutaneous Wounds. Stem Cells Dev 2021; 30:1141-1152. [PMID: 34130483 DOI: 10.1089/scd.2021.0124] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Monitoring wound progression over time is a critical aspect for studies focused on in-depth molecular analysis or on evaluating the efficacy of potential novel therapies. Histopathological analysis of wound biopsies can provide significant insight into healing dynamics, yet there is no standardized and reproducible scoring system currently available. The purpose of this study was to develop and statistically validate a scoring system based on parameters in each phase of healing that can be easily and accurately assessed using either Hematoxylin & Eosin (H&E) or Masson's Trichrome (MT) staining. These parameters included re-epithelization, epithelial thickness index, keratinization, granulation tissue thickness, remodeling, and the scar elevation index. The initial phase of the study was to (1) optimize and clarify healing parameters to limit investigator bias and variability; (2) compare the consistency of parameters assessed using H&E versus MT staining. During the validation phase of this study, the accuracy and reproducibility of this scoring system was independently iterated upon and validated in four different types of murine skin wound models (Excisional; punch biopsy; pressure ulcers; burn wounds). A total of n = 54 histology sections were randomized, blinded, and assigned to two groups of independent investigators (n = 5 per group) for analysis. The sensitivity of each parameter (ranging between 80% and 95%) is reported with illustrations on the appropriate assessment method using ImageJ software. In the validated scoring system, the lowest score (score:0) is associated with an open/unhealed wound as is evident immediately and within the first day postinjury, whereas the highest score (score:12) is associated with a completely closed and healed wound without excessive scarring. This study defines and describes the minimum recommended criteria for assessing wound healing dynamics using the SPOT skin wound score. The acronym SPOT refers to the academic and scientific institutions that were involved in the development of the scoring system, namely, Stellenbosch University, Polish Academy of Sciences, Obatala Sciences, and the University of Texas Southwestern.
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Affiliation(s)
- Mari van de Vyver
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kiara Boodhoo
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Katie Hamel
- Obatala Sciences, Inc., New Orleans, Louisiana, USA
| | - Marta Kopcewicz
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Benjamin Levi
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michelle Maartens
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sylwia Machcinska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Johanna Nunez
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chase Pagani
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Emma Rogers
- Obatala Sciences, Inc., New Orleans, Louisiana, USA
| | - Katarzyna Walendzik
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Joanna Wisniewska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Barbara Gawronska-Kozak
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Jeffrey M Gimble
- Obatala Sciences, Inc., New Orleans, Louisiana, USA.,Department of Medicine, Structural and Cellular Biology, and Surgery, Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
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