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Huang J, Fan C, Ma Y, Huang G. Exploring Thermal Dynamics in Wound Healing: The Impact of Temperature and Microenvironment. Clin Cosmet Investig Dermatol 2024; 17:1251-1258. [PMID: 38827629 PMCID: PMC11144001 DOI: 10.2147/ccid.s468396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/18/2024] [Indexed: 06/04/2024]
Abstract
Exploring the critical role of thermal dynamics in wound healing, this manuscript navigates through the complex biological responses initiated upon wound infliction and how temperature variations influence the healing trajectory. Integrating biothermal physics, clinical medicine, and biomedical engineering, it highlights the significance of thermal management in wound care, emphasizing the wound microenvironment's division into internal and external domains and their collaborative impact on tissue repair. Innovations in real-time wound temperature monitoring, especially through intelligent wireless sensor dressings, are spotlighted as transformative, enabling precise wound condition management. The text underscores the necessity for further research to elucidate thermal regulation's molecular and cellular mechanisms on healing processes. It advocates for standardized protocols for localized heating treatments, integrating them into personalized wound care strategies to enhance therapeutic outcomes, improve patient well-being, and achieve cost-effective healthcare practices. This work presents a forward-looking perspective on refining wound management through sophisticated, evidence-based interventions, emphasizing the interplay between thermal dynamics and wound healing.
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Affiliation(s)
- Jun Huang
- Department of Clinical Medicine, Shandong Second Medical University (Weifang Medical University), Weifang, 261000, People’s Republic of China
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Chunjie Fan
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Yindong Ma
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
| | - Guobao Huang
- Department of Burns and Reconstructive Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, People’s Republic of China
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Jin S, Newton MAA, Cheng H, Zhang Q, Gao W, Zheng Y, Lu Z, Dai Z, Zhu J. Progress of Hydrogel Dressings with Wound Monitoring and Treatment Functions. Gels 2023; 9:694. [PMID: 37754375 PMCID: PMC10528853 DOI: 10.3390/gels9090694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Hydrogels are widely used in wound dressings due to their moisturizing properties and biocompatibility. However, traditional hydrogel dressings cannot monitor wounds and provide accurate treatment. Recent advancements focus on hydrogel dressings with integrated monitoring and treatment functions, using sensors or intelligent materials to detect changes in the wound microenvironment. These dressings enable responsive treatment to promote wound healing. They can carry out responsive dynamic treatment in time to effectively promote wound healing. However, there is still a lack of comprehensive reviews of hydrogel wound dressings that incorporate both wound micro-environment monitoring and treatment functions. Therefore, this review categorizes hydrogel dressings according to wound types and examines their current status, progress, challenges, and future trends. It discusses various wound types, including infected wounds, burns, and diabetic and pressure ulcers, and explores the wound healing process. The review presents hydrogel dressings that monitor wound conditions and provide tailored treatment, such as pH-sensitive, temperature-sensitive, glucose-sensitive, pressure-sensitive, and nano-composite hydrogel dressings. Challenges include developing dressings that meet the standards of excellent biocompatibility, improving monitoring accuracy and sensitivity, and overcoming obstacles to production and commercialization. Furthermore, it provides the current status, progress, challenges, and future trends in this field, aiming to give a clear view of its past, present, and future.
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Affiliation(s)
- Shanshan Jin
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Md All Amin Newton
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Hongju Cheng
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Qinchen Zhang
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Weihong Gao
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Yuansheng Zheng
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Zan Lu
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
| | - Zijian Dai
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai 200051, China
| | - Jie Zhu
- School of Textiles and Fashion, Shanghai University of Engineering Science, Shanghai 201620, China; (S.J.); (M.A.A.N.); (H.C.); (Q.Z.); (W.G.); (Y.Z.); (Z.L.)
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De Marziani L, Boffa A, Orazi S, Andriolo L, Di Martino A, Zaffagnini S, Filardo G. Joint Response to Exercise Is Affected by Knee Osteoarthritis: An Infrared Thermography Analysis. J Clin Med 2023; 12:jcm12103399. [PMID: 37240505 DOI: 10.3390/jcm12103399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/12/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Infrared thermography can be used to evaluate the inflammation characterizing the joint environment of OA knees, but there is limited evidence on the response to physical exercise. Identifying the response to exercise of OA knees and the influencing variables could provide important information to better profile patients with different knee OA patterns. Sixty consecutive patients (38 men/22 women, 61.4 ± 9.2 years) with symptomatic knee OA were enrolled. Patients were evaluated with a standardized protocol using a thermographic camera (FLIR-T1020) positioned at 1 m with image acquisition of an anterior view at baseline, immediately after, and at 5 min after a 2-min knee flexion-extension exercise with a 2 kg anklet. Patients' demographic and clinical characteristics were documented and correlated with the thermographic changes. This study demonstrated that the temperature response to exercise in symptomatic knee OA was affected by some demographic and clinical characteristics of the assessed patients. Patients with a poor clinical knee status presented with a lower response to exercise, and women showed a greater temperature decrease than men. Not all evaluated ROIs showed the same trend, which underlines the need to specifically study the different joint subareas to identify the inflammatory component and joint response while investigating knee OA patterns.
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Affiliation(s)
- Luca De Marziani
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Angelo Boffa
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Simone Orazi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessandro Di Martino
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Derwin R, Patton D, Strapp H, Moore Z. Wound pH and temperature as predictors of healing: an observational study. J Wound Care 2023; 32:302-310. [PMID: 37094930 DOI: 10.12968/jowc.2023.32.5.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE The aim of this study was to measure wound pH, wound temperature and wound size together to gain further understanding of their impact as predictors of wound healing outcomes. METHOD This study employed a quantitative non-comparative, prospective, descriptive observational design. Participants with both acute and hard-to-heal (chronic) wounds were observed weekly for four weeks. Wound pH was measured using pH indicator strips, wound temperature was measured using an infrared camera and wound size was measured using the ruler method. RESULTS Most of the 97 participants (65%, n=63) were male; participant's ages ranged between 18 and 77 years (mean: 42±17.10. Most of the wounds observed were surgical 60%, (n=58) and 72% (n=70) of the wounds were classified as acute, with 28% (n=27) classified as hard-to-heal wounds. At baseline, there was no significant difference in pH between acute and hard-to-heal wounds; overall the mean pH was 8.34±0.32, mean temperature was 32.86±1.78°C) and mean wound area was 910.50±1132.30mm2. In week 4, mean pH was 7.71±1.11, mean temperature was 31.90±1.76°C and mean wound area was 339.90±511.70mm2. Over the study follow-up period, wound pH ranged from 5-9, from week 1 to week 4, mean pH reduced by 0.63 units from 8.34 to 7.71. Furthermore, there was a mean 3% reduction in wound temperature and a mean 62% reduction in wound size. CONCLUSION The study demonstrated that a reduction in pH and temperature was associated with increased wound healing as evidenced by a corresponding reduction in wound size. Thus, measuring pH and temperature in clinical practice may provide clinically meaningful data pertaining to wound status.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | | | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
- School of Nursing & Midwifery, Griffith University, Queensland, Australia
- School of Health Sciences, Faculty of Life and Health Sciences Ulster University, Northern Ireland
- Cardiff University, Cardiff, Wales
- Department of Nursing, Fakeeh College for Medical Sciences, Jeddah, KSA
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- Lida Institute, Shanghai, China
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Takizawa C, Minematsu T, Nakagami G, Kitamura A, Koudounas S, Kunimitsu M, Sanada H. Expression levels of NPPB, ITGB6, CPNE4, EML5, and ITSN1 in fresh exudates swabbed from critically colonised and infected full-thickness wounds in rats. Int Wound J 2023; 20:1088-1097. [PMID: 36307995 PMCID: PMC10031246 DOI: 10.1111/iwj.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/30/2022] [Accepted: 09/11/2022] [Indexed: 11/27/2022] Open
Abstract
Pressure injury management requires reliable identification of critical colonisation due to lack of infection signs. Our research group previously proposed the mRNAs natriuretic peptide B (Nppb), integrin subunit beta 6 (Itgb6), copine 4 (Cpne4), echinoderm microtubule-associated protein like 5, and intersectin 1 as candidate markers in pooled exudates of critically colonised wounds. However, it is unclear whether mRNAs or proteins of the candidate genes would be suitable as biomarkers in fresh exudate. Therefore, this study aimed to evaluate the validity of the mRNAs and proteins as fresh exudate markers for critical colonisation. Three wound models of normal healing, critical colonisation, and infection were created in rats. Fresh swab-collected exudates were collected, and mRNA and protein expression levels were measured. In the fresh wound exudates, the detection frequency of Itgb6 tended to decrease in the critically colonised and infected wounds (P = .067), and those of Cpne4 and Nppb tended to be lower in the infected wounds than in the normal healing and critically colonised wounds (P = .006 and .067, respectively). In contrast, there was no difference in protein expression in the exudates. This study suggests that Itgb6 mRNA in fresh exudates is a promising biomarker for critical colonisation.
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Affiliation(s)
- Chihiro Takizawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sofoklis Koudounas
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mao Kunimitsu
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Derwin R, Patton D, Strapp H, Moore Z. The effect of inflammation management on pH, temperature, and bacterial burden. Int Wound J 2023; 20:1118-1129. [PMID: 36251505 PMCID: PMC10031221 DOI: 10.1111/iwj.13970] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022] Open
Abstract
The aim of this feasibility study was to investigate the impact of inflammation management on wound pH, temperature, and bacterial burden, using the principles of TIME and Wound Bed Preparation. A quantitative non-comparative, prospective, descriptive observational design. Following ethical approval, 26 participants with 27 wounds of varying aetiologies were observed twice weekly for 2 weeks. Wounds were treated with cleansing, repeated sharp debridement, and topical cadexomer iodine. Wound pH (pH indicator strips), temperature (infrared camera), bacterial burden (fluorescence imaging) and size (ruler method) was monitored at each visit. The mean age of all participants was 47 years (SD: 20.3 years), and 79% (n = 19) were male, and most wounds were acute (70%; n = 19) and included surgical and trauma wounds, the remaining (30%; n = 8) were chronic and included vascular ulcers and non-healing surgical wounds. Mean wound duration was 53.88 days (SD: 64.49 days). Over the follow up period, pH values ranged from 6 to 8.7, temperature (centre spot) ranged from 28.4°C to 36.4°C and there was an average 39% reduction in wound size. Inflammation management had a positive effect on pH, temperature, bacterial burden, and wound size. This study demonstrated that it was feasible to practice inflammation management using a structured approach to enhance wound outcomes.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, Faculty of Medicine and HealthRoyal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
| | - Declan Patton
- School of Nursing and Midwifery, Faculty of Medicine and HealthRoyal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
- Department of NursingFakeeh College of Health SciencesJeddahSaudi Arabia
- Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
| | - Helen Strapp
- Department of SurgeryTallaght University HospitalDublinIreland
| | - Zena Moore
- School of Nursing and Midwifery, Faculty of Medicine and HealthRoyal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
- School of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia
- School of Health Sciences, Faculty of Life and Health Sciences Ulster UniversityColeraineUK
- School of Nursing and MidwiferyCardiff UniversityCardiffUK
- Department of NursingFakeeh College for Medical SciencesJeddahKingdom of Saudi Arabia
- Department of Public HealthFaculty of Medicine and Health Sciences, Ghent UniversityGhentBelgium
- Departmnet of NursingLida InstituteShanghaiChina
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Itakura DA, Nakato AM, Hembecker PK, Neves EB, Nohama P. Thermal changes in the sacral region with different mattresses used in the prevention of pressure injuries. J Therm Biol 2022; 110:103366. [PMID: 36462883 DOI: 10.1016/j.jtherbio.2022.103366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/01/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pressure Injury (PI) is a severe health problem that affects millions of people. As a preventive strategy for high-risk ICU patients, the appropriate selection of a support surface is essential for preventing PI, along with risk assessment and repositioning. Increasing skin temperature has been associated with a higher susceptibility to PI development. OBJECTIVE This study aimed to evaluate thermal variations related to skin pressure in the sacral area of healthy individuals lying on three different mattresses models (standard, inflatable air, and egg crate). DESIGN Experimental study. MAIN OUTCOMES Initially, a survey was performed to identify the mattresses models most used in four public university hospitals and preventive strategies adopted. And then, an experimental study was conducted with a non-probabilistic sample involving 28 individuals of both sexes, aged 18-35 years old. The volunteers were immobilized for 2 h, and temperature variations in the sacral region were obtained by acquiring thermal images. RESULTS A significant difference was not found in the temperature recorded on the three mattresses models before the experiment. However, there were significant differences at the 1st and 31st minute (p < 0.001). The lowest temperature values were identified in the air inflatable mattress. Post-hoc comparisons revealed a significant difference between standard or egg crate mattresses and the inflatable air model. CONCLUSION The inflatable air mattress should be considered for preventing pressure injury in ICU patients since the temperature had returned to the initial value (pre-test) after the 31st min. In addition to the appropriate selection surface, risk assessment and positioning are essential to PI prevention strategies.
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Affiliation(s)
- Daniela Akemi Itakura
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Adriane Muller Nakato
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Paula Karina Hembecker
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Universidade Tecnológica Federal do Paraná (UTFPR), Brazil.
| | - Percy Nohama
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
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Hagde P, Pingle P, Mourya A, Katta CB, Srivastava S, Sharma R, Singh KK, Sodhi RK, Madan J. Therapeutic potential of quercetin in diabetic foot ulcer: Mechanistic insight, challenges, nanotechnology driven strategies and future prospects. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nancy GA, Kalpana R, Nandhini S. A Study on Pressure Ulcer: Influencing Factors and Diagnostic Techniques. THE INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS 2022; 21:254-263. [PMID: 35188406 DOI: 10.1177/15347346221081603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pressure ulcer (PU) is one of the most common occurrences in bedridden subjects. Despite the standard of care, there is a huge challenge in monitoring immobile subjects in all the bodily pressure points. This increases the chance of onset of PU which in turn increases the expenditure for treating and managing the PU. Hence, we made a study on the biological and physiological factors that are responsible for the formation of PU and also on various techniques used for diagnosis. Thus, we have summarised the efficacy of various advanced diagnostic procedures with their limitations. Though there are advanced imaging techniques, risk assessment tools based on the visual inspection are widely followed in hospitals. Based on our observation, we here have identified three major areas; one being the development of mathematical modeling, the second is towards the development of non-invasive devices and finally to automate cot facility. We have also provided possible suggestions as to solutions that could be useful to researchers and for society. Thus, this review covers the present difficulty faced by bedridden subjects and respective care-takers along with the knowledge gap and a few suggestions as to future scope.
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Affiliation(s)
- G Annie Nancy
- 382205Loyola-ICAM college of Engineering and Technology, Chennai, India
| | - R Kalpana
- 29862Rajalakshmi Engineering College, Thandalam, Chennai, India
| | - S Nandhini
- 29862Rajalakshmi Engineering College, Thandalam, Chennai, India
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Oohashi F, Ogai K, Takahashi N, Arisandi D, Urai T, Sugama J, Oe M. Increased temperature at the healed area detected by thermography predicts recurrent pressure ulcers. Wound Repair Regen 2022; 30:190-197. [PMID: 35180332 DOI: 10.1111/wrr.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022]
Abstract
Preventing recurrent pressure ulcers is an important challenge in healthcare. One of the reasons for the high rate of recurrent pressure ulcers is the lack of assessment methods for their early detection. Therefore, this study aimed to determine the thermographic characteristics of the healed area and to consider the predictive validity of thermographic images for recurrent pressure ulcers within a 2-week period. This observational study was conducted at a long-term care facility in Japan between July 2017 and February 2019 among patients whose pressure ulcers had healed. Thermographic images of the healed area were recorded once a week until recurrence or until the end of the study. We enrolled 30 participants, among whom 8 developed recurrent pressure ulcers. The generalised estimation equation revealed that the thermographic finding of increased temperature at the healed area compared to that of the surrounding skin was significantly associated with recurrent pressure ulcers (odds ratio: 101.13, 95% confidence interval: 3.60-2840.77, p = .007); the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio for recurrent pressure ulcers within 2 weeks were 0.80, 0.94, 0.62, 0.97, 12.9 and 0.2, respectively. Our thermographic findings revealed that the temperature of the healed area was higher than that of the surrounding skin; this could be a useful predictor of pressure ulcer recurrence within 2 weeks, even in the absence of macroscopic changes.
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Affiliation(s)
- Fumiya Oohashi
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kazuhiro Ogai
- Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Natsuki Takahashi
- Graduate School of Frontier Science Initiative, Kanazawa University, Kanazawa, Japan
| | - Defa Arisandi
- The Nursing Institute of Muhammadiyah Pontianak, Pontianak, Indonesia
| | - Tamae Urai
- Faculty of Nursing, Toyama Prefectural University, Toyama, Japan
| | - Junko Sugama
- Research Center for Implementation Nursing Science Initiative, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Makoto Oe
- Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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Derwin R, Patton D, Avsar P, Strapp H, Moore Z. The impact of topical agents and dressing on pH and temperature on wound healing: A systematic, narrative review. Int Wound J 2021; 19:1397-1408. [PMID: 34931445 PMCID: PMC9493238 DOI: 10.1111/iwj.13733] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
Abstract
To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, Web of Science, and Scopus. Data synthesis and analysis were conducted using a structured narrative synthesis. The quality of the included clinical studies was appraised using the Evidence-Based Literature (EBL) Critical Appraisal Tool. A total of six clinical studies were assessed as eligible for inclusion, A total of six dressings/topical agents were assessed and the types of wounds included non-healing chronic wounds. Of the studies, five explored pH and one explored temperature. The EBL validity of the clinical studies was low (mean quality score was 51.3%). The five clinical studies that explored pH investigated different dressings and topical agents reporting an associated reduction in pH and improved wound outcomes. One clinical study investigated the impact of topical sodium nitrite on temperature and found that sodium nitrite increased peri-wound skin temperature and improved wound outcomes with a reduction in leg ulcer size. Given the low certainty of the evidence, we cannot confidently recommend the use of any particular topical agent or dressing to manipulate pH, or temperature to improve wound outcomes. Thus, there is a need for further research to develop a greater understanding of this topic. Irish Research Council, Enterprise Partnership Scheme.
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Affiliation(s)
- Rosemarie Derwin
- School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- Wounds and Trauma Research Centre, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Pinar Avsar
- Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Helen Strapp
- Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Zena Moore
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,Head of School of Nursing and Midwifery and Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Nursing, Lida Institute, Shanghai, China.,School of Nursing and Midwifery, University of Wales, Cardiff, UK
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Paneysar JS, Barton S, Ambre P, Coutinho E. Novel Temperature Responsive Films Impregnated with Silver Nano Particles (Ag-NPs) as Potential Dressings for Wounds. J Pharm Sci 2021; 111:810-817. [PMID: 34808215 DOI: 10.1016/j.xphs.2021.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/13/2021] [Accepted: 11/13/2021] [Indexed: 12/23/2022]
Abstract
Silver nanoparticles have attracted wide interest in medicine on account of their antibacterial activity. We report in this paper, the antibacterial activity and biocompatibility of a temperature responsive topical film fabricated from pullulan-g-pNIPAM and impregnated with two different concentrations (15 ppm and 30 ppm) of silver nanoparticles (Ag-NPs). The release of silver from the film under the influence of temperature above the LCST has been studied and the in vitro release profile of the films has been compared with a marketed silver nano formulation, 'Meganano gel'. The release of silver from the films has a distinctive profile characterized by a sustained release over a period of 48 hrs, which is comparable to the marketed formulation. The films exhibit excellent swelling properties, making them ideal materials for absorption of exudates from wounds. The antibacterial activity of the films has been established at physiological temperature against gram-positive S. aureus and gram-negative E. coli and compared with the marketed formulation. A cytotoxicity evaluation on HeK293 cells has demonstrated their biocompatibility. The nanocomposite films are thus a new therapeutic device for management of non-healing wounds being constructed from temperature responsive polymers that release Ag-NPs when the temperature of the wound exudate is slightly higher than normal.
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Affiliation(s)
- Joginder Singh Paneysar
- Department of Pharmaceutical Chemistry, Vasvik Research Wing, Bombay College of Pharmacy (Autonomous), Mumbai 400 098, India
| | - Stephen Barton
- School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston-upon-Thames, KT1 2EE, UK
| | - Premlata Ambre
- Department of Pharmaceutical Chemistry, Vasvik Research Wing, Bombay College of Pharmacy (Autonomous), Mumbai 400 098, India.
| | - Evans Coutinho
- Department of Pharmaceutical Chemistry, Vasvik Research Wing, Bombay College of Pharmacy (Autonomous), Mumbai 400 098, India
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13
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Tang N, Zheng Y, Cui D, Haick H. Multifunctional Dressing for Wound Diagnosis and Rehabilitation. Adv Healthc Mater 2021; 10:e2101292. [PMID: 34310078 DOI: 10.1002/adhm.202101292] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Indexed: 12/12/2022]
Abstract
A wound dressing is a sterile pad or compress that is used in direct contact with a wound to help it heal and prevent further issues or complications. Though wound healing is an intricate dynamic process that involves multiple biomolecular species, conventional wound dressings have a limited ability to provide timely information of abnormal conditions, missing the best time for early treatment. The current perspective presents and discusses the design and development of smart wound dressings that are integrated with multifunctional materials, wearable sensors and drug delivery systems as well as their application ranging from wound monitoring to timely application of therapeutics. The perspective also discusses the ongoing challenges and exciting opportunities associated with the development of wearable sensor-based smart wound dressing and provide critical insights into wound healing monitoring and management.
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Affiliation(s)
- Ning Tang
- School of Electronic Information and Electrical Engineering Shanghai Jiao Tong University Shanghai 200240 P. R. China
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Daxiang Cui
- School of Electronic Information and Electrical Engineering Shanghai Jiao Tong University Shanghai 200240 P. R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
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14
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El-Ashram S, El-Samad LM, Basha AA, El Wakil A. Naturally-derived targeted therapy for wound healing: Beyond classical strategies. Pharmacol Res 2021; 170:105749. [PMID: 34214630 DOI: 10.1016/j.phrs.2021.105749] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 02/07/2023]
Abstract
This review summarizes the four processes of wound healing in the human body (hemostasis, inflammatory, proliferation, and remodeling) and the most current research on the most important factors affecting cutaneous wound healing and the underlying cellular and/or molecular pathways. Local factors, including temperature, oxygenation, and infection, and systemic factors, such as age, diabetes, sex hormones, genetic components, autoimmune diseases, psychological stress, smoking and obesity are also addressed. A better understanding of the role of these factors in wound repair could result in the development of therapeutics that promote wound healing and resolve affected wounds. Additionally, natural products obtained from plants and animals are critical targets for the discovery of novel biologically significant pharmacophores, such as medicines and agrochemicals. This review outlines the most recent advances in naturally derived targeted treatment for wound healing. These are plant-derived natural products, insect-derived natural products, marine-derived natural products, nanomaterial-based wound-healing therapeutics (metal- and non-metal-based nanoparticles), and natural product-based nanomedicine to improve the future direction of wound healing. Natural products extracted from plants and animals have advanced significantly, particularly in the treatment of wound healing. As a result, the isolation and extraction of bioactive compounds from a variety of sources can continue to advance our understanding of wound healing. Undescribed bioactive compounds or unexplored formulations that could have a role in today's medicinal arsenal may be contained in the abundance of natural products and natural product derivatives.
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Affiliation(s)
- Saeed El-Ashram
- College of Life Science and Engineering, Foshan University, 18 Jiangwan Street, Foshan 528231, Guangdong Province, China; Faculty of Science, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt.
| | - Lamia M El-Samad
- Zoology Department, Faculty of Science, Alexandria University, Egypt.
| | - Amal A Basha
- Zoology Department, Faculty of Science, Damanhour University, Egypt
| | - Abeer El Wakil
- Biological and Geological Sciences Department, Faculty of Education, Alexandria University, Egypt
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15
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Lin YH, Chen YC, Cheng KS, Yu PJ, Wang JL, Ko NY. Higher Periwound Temperature Associated with Wound Healing of Pressure Ulcers Detected by Infrared Thermography. J Clin Med 2021; 10:jcm10132883. [PMID: 34209633 PMCID: PMC8269037 DOI: 10.3390/jcm10132883] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/25/2022] Open
Abstract
Visual and empirical assessments do not enable the early detection of wound deterioration or necroses. No suitable objective indicator for predicting poor wound-healing is currently available. We used infrared thermography to determine the association between wound temperature and pressure-wound healing. We examined patients with grades 2–4 pressure ulcers from a medical center in southern Taiwan and recorded the temperatures of the wound bed, periwound, and normal skin using infrared thermographic cameras. A total of 50 pressure ulcers and 248 infrared-thermography temperature records were analyzed. Normal skin temperature was not related to pressure ulcer wound healing. In a multivariate analysis, higher malnutrition universal-screening-tool scores were associated with poor wound-healing (p = 0.020), and higher periwound-temperature values were associated with better wound-healing (p = 0.028). In patients who had higher periwound-skin temperature than that of the wound bed, that result was also associated with better wound-healing (p = 0.002). Wound-bed and periwound temperatures differed significantly with the grade of the pressure ulcer, and a high periwound temperature was positively correlated with wound healing. Infrared thermography can objectively serve as indicators for assessing pressure-ulcer healing.
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Affiliation(s)
- Yen-Hsi Lin
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Kuo-Sheng Cheng
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan;
| | - Po-Jui Yu
- Department of Nursing, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Jiun-Ling Wang
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 701, Taiwan
- Correspondence: (J.-L.W.); (N.-Y.K.); Tel.: +886-6-2353535 (ext. 4703) (J.-L.W.); +886-6-2353535 (ext. 5838) (N.-Y.K.)
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, Tainan 701, Taiwan; (Y.-H.L.); (Y.-C.C.)
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: (J.-L.W.); (N.-Y.K.); Tel.: +886-6-2353535 (ext. 4703) (J.-L.W.); +886-6-2353535 (ext. 5838) (N.-Y.K.)
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16
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The Insights of Microbes' Roles in Wound Healing: A Comprehensive Review. Pharmaceutics 2021; 13:pharmaceutics13070981. [PMID: 34209654 PMCID: PMC8308956 DOI: 10.3390/pharmaceutics13070981] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/18/2022] Open
Abstract
A diverse range of normal flora populates the human skin and numbers are relatively different between individuals and parts of the skin. Humans and normal flora have formed a symbiotic relationship over a period of time. With numerous disease processes, the interaction between the host and normal flora can be interrupted. Unlike normal wound healing, which is complex and crucial to sustaining the skin’s physical barrier, chronic wounds, especially in diabetes, are wounds that fail to heal in a timely manner. The conditions become favorable for microbes to colonize and establish infections within the skin. These include secretions of various kinds of molecules, substances or even trigger the immune system to attack other cells required for wound healing. Additionally, the healing process can be slowed down by prolonging the inflammatory phase and delaying the wound repair process, which causes further destruction to the tissue. Antibiotics and wound dressings become the targeted therapy to treat chronic wounds. Though healing rates are improved, prolonged usage of these treatments could become ineffective or microbes may become resistant to the treatments. Considering all these factors, more studies are needed to comprehensively elucidate the role of human skin normal flora at the cellular and molecular level in a chronic injury. This article will review wound healing physiology and discuss the role of normal flora in the skin and chronic wounds.
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17
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Hasan MM, Hossain MM. Nanomaterials-patterned flexible electrodes for wearable health monitoring: a review. JOURNAL OF MATERIALS SCIENCE 2021; 56:14900-14942. [PMID: 34219807 PMCID: PMC8237560 DOI: 10.1007/s10853-021-06248-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
ABSTRACT Electrodes fabricated on a flexible substrate are a revolutionary development in wearable health monitoring due to their lightweight, breathability, comfort, and flexibility to conform to the curvilinear body shape. Different metallic thin-film and plastic-based substrates lack comfort for long-term monitoring applications. However, the insulating nature of different polymer, fiber, and textile substrates requires the deposition of conductive materials to render interactive functionality to substrates. Besides, the high porosity and flexibility of fiber and textile substrates pose a great challenge for the homogenous deposition of active materials. Printing is an excellent process to produce a flexible conductive textile electrode for wearable health monitoring applications due to its low cost and scalability. This article critically reviews the current state of the art of different textile architectures as a substrate for the deposition of conductive nanomaterials. Furthermore, recent progress in various printing processes of nanomaterials, challenges of printing nanomaterials on textiles, and their health monitoring applications are described systematically.
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Affiliation(s)
- Md Mehdi Hasan
- Department of Textile Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
- UNAM – National Nanotechnology Research Center and, Institute of Materials Science and Nanotechnology, Bilkent University, Ankara, 06800 Turkey
| | - Md Milon Hossain
- Department of Textile Engineering, Khulna University of Engineering & Technology, Khulna, 9203 Bangladesh
- Department of Textile Engineering, Chemistry and Science, North Carolina State University, Raleigh, 27606 USA
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18
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Tang N, Zheng Y, Jiang X, Zhou C, Jin H, Jin K, Wu W, Haick H. Wearable Sensors and Systems for Wound Healing-Related pH and Temperature Detection. MICROMACHINES 2021; 12:430. [PMID: 33919752 PMCID: PMC8070747 DOI: 10.3390/mi12040430] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022]
Abstract
Wound healing is a complex tissue regeneration process involving many changes in multiple physiological parameters. The pH and temperature of a wound site have long been recognized as important biomarkers for assessing wound healing status. For effective wound management, wound dressings integrated with wearable sensors and systems used for continuous monitoring of pH and temperature have received much attention in recent years. Herein, recent advances in the development of wearable pH and temperature sensors and systems based on different sensing mechanisms for wound status monitoring and treatment are comprehensively summarized. Challenges in the areas of sensing performance, infection identification threshold, large-area 3-dimensional detection, and long-term reliable monitoring in current wearable sensors/systems and emerging solutions are emphasized, providing critical insights into the development of wearable sensors and systems for wound healing monitoring and management.
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Affiliation(s)
- Ning Tang
- School of Aerospace Science and Technology, Xidian University, Xi’an 710126, China;
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel;
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel;
| | - Xue Jiang
- School of Advanced Materials and Nanotechnology, Xidian University, Xi’an 710126, China; (X.J.); (W.W.)
| | - Cheng Zhou
- Institute of Micro-Nano Science and Technology, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Han Jin
- Institute of Micro-Nano Science and Technology, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Ke Jin
- School of Aerospace Science and Technology, Xidian University, Xi’an 710126, China;
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Xidian University, Xi’an 710126, China; (X.J.); (W.W.)
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel;
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19
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Charkhabi S, Jackson KJ, Beierle AM, Carr AR, Zellner EM, Reuel NF. Monitoring Wound Health through Bandages with Passive LC Resonant Sensors. ACS Sens 2021; 6:111-122. [PMID: 33381967 DOI: 10.1021/acssensors.0c01912] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This paper details a passive, inductor-capacitor (LC) resonant sensor embedded in a commercial dressing for low-cost, contact-free monitoring of a wound; this would enable tracking of the healing process while keeping the site closed and sterile. Spiral LC resonators were fabricated from flexible, copper-coated polyimide and interrogated using external reader antennas connected to a two-port vector network analyzer; the forward transmission scattering parameter (S21) magnitude was collected, and the resonant frequency (MHz) and the peak-to-peak amplitude of the resonant feature were identified. These increase during the healing process as the permittivity and conductivity of the tissue change. The sensor was first tested on gelatin-based tissue-mimicking phantoms that simulate layers of muscle, blood, fat, and skin at varying phases of wound healing. Finite element modeling was also used to verify the empirical results based on the expected variations in dielectric properties of the tissue. The performance of the resonant sensors for in vivo applications was investigated by conducting animal studies using canine patients that presented with a natural wound as well as a controlled cohort of rat models with surgically administered wounds. Finally, transfer functions are presented that relate the resonant frequency to wound size using an exponential model (R2 = 0.58-0.96). The next steps in sensor design and fabrication as well as the reading platform to achieve the goal of a universal calibration curve are then discussed.
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Affiliation(s)
- Sadaf Charkhabi
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Kyle J. Jackson
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Andee M. Beierle
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Adam R. Carr
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Eric M. Zellner
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa 50011, United States
| | - Nigel F. Reuel
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
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20
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Abstract
Hydrogels, swellable hydrophilic polymer networks fabricated through chemical cross-linking or physical entanglement are increasingly utilized in various biomedical applications over the past few decades. Hydrogel-based microparticles, dressings and microneedle patches have been explored to achieve safe, sustained and on-demand therapeutic purposes toward numerous skin pathologies, through incorporation of stimuli-responsive moieties and therapeutic agents. More recently, these platforms are expanded to fulfill the diagnostic and monitoring role. Herein, the development of hydrogel technology to achieve diagnosis and monitoring of pathological skin conditions are highlighted, with proteins, nucleic acids, metabolites, and reactive species employed as target biomarkers, among others. The scope of this review includes the characteristics of hydrogel materials, its fabrication procedures, examples of diagnostic studies, as well as discussion pertaining clinical translation of hydrogel systems.
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21
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Evaluation of pressure ulcer risk in hospitalized patients after metabolic surgery. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.799157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Aloweni FAB, Ang SY, Chang YY, Ng XP, Teo KY, Choh ACL, Goh IHQ, Lim SH. Evaluation of infrared technology to detect category I and suspected deep tissue injury in hospitalised patients. J Wound Care 2020; 28:S9-S16. [PMID: 31825768 DOI: 10.12968/jowc.2019.28.sup12.s9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the use of an infrared thermography device in assessing skin temperature among category I pressure ulcer (PU) and/or suspected deep tissue injuries (SDTI) with intact skin. METHODS An observational cross-sectional study design was used. Adult inpatients (cases) who had a category I PU or suspected deep tissue injury (skin intact) on the sacral or heel during the study period (March to April 2018) were recruited. Patients without a PU were also recruited to act as control. Thermal images of the patient's PU site and non-PU site were taken within 24 hours of PU occurrence. Thermal images of the control patients (no PU) were also taken. Each PU case was matched to three control patients in terms of age, gender, race and anatomical sites. All thermal images were taken using a portable CAT S60 Thermal Imaging Rugged Smartphone (Caterpillar Inc., US) that provided readings of the skin temperature in degrees Celsius. RESULTS A total of 17 cases and 51 controls were recruited. Among the cases, the mean difference in skin temperature between the PU site (mean: 31.14°C; standard deviation [SD]: 1.54) and control site within the cases (mean: 28.93°C; SD: 3.47) was significant (difference: 2.21±3.66°C; p=0·024). When comparing between all cases and controls, the mean temperature difference was non-significant. When comparing between the category I PU and suspected deep pressure injury cases, the mean difference was also non-significant. CONCLUSION Using infrared thermography technology at the bedside to measure skin temperature will support the clinical diagnosis of patients with skin types I to III. However, there is a need for a more accurate and objective measurement to identify and diagnose early category I PU or suspected deep tissue injury in adult patients with darker skin types 4 and above, enabling early initiation of preventive measures in the hospital acute care setting.
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Affiliation(s)
| | - Shin Yuh Ang
- Division of Nursing, Singapore General Hospital, Singapore
| | - Yee Yee Chang
- Division of Nursing, Singapore General Hospital, Singapore
| | - Xin Ping Ng
- Division of Nursing, Singapore General Hospital, Singapore
| | - Kai Yunn Teo
- Division of Nursing, Singapore General Hospital, Singapore
| | | | - Ivy Hui Qi Goh
- Division of Nursing, Singapore General Hospital, Singapore
| | - Siew Hoon Lim
- Division of Nursing, Singapore General Hospital, Singapore
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23
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Lugoda P, Costa JC, Oliveira C, Garcia-Garcia LA, Wickramasinghe SD, Pouryazdan A, Roggen D, Dias T, Münzenrieder N. Flexible Temperature Sensor Integration into E-Textiles Using Different Industrial Yarn Fabrication Processes. SENSORS 2019; 20:s20010073. [PMID: 31877742 PMCID: PMC6982775 DOI: 10.3390/s20010073] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/16/2022]
Abstract
Textiles enhanced with thin-film flexible sensors are well-suited for unobtrusive monitoring of skin parameters due to the sensors' high conformability. These sensors can be damaged if they are attached to the surface of the textile, also affecting the textiles' aesthetics and feel. We investigate the effect of embedding flexible temperature sensors within textile yarns, which adds a layer of protection to the sensor. Industrial yarn manufacturing techniques including knit braiding, braiding, and double covering were utilised to identify an appropriate incorporation technique. The thermal time constants recorded by all three sensing yarns was <10 s. Simultaneously, effective sensitivity only decreased by a maximum of 14% compared to the uncovered sensor. This is due to the sensor being positioned within the yarn instead of being in direct contact with the measured surface. These sensor yarns were not affected by bending and produced repeatable measurements. The double covering method was observed to have the least impact on the sensors' performance due to the yarn's smaller dimensions. Finally, a sensing yarn was incorporated in an armband and used to measure changes in skin temperature. The demonstrated textile integration techniques for flexible sensors using industrial yarn manufacturing processes enable large-scale smart textile fabrication.
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Affiliation(s)
- Pasindu Lugoda
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
- Correspondence:
| | - Julio C. Costa
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
| | - Carlos Oliveira
- Advanced Textiles Research Group, Nottingham Trent University Nottingham NG1 4GG, UK; (C.O.); (T.D.)
| | - Leonardo A. Garcia-Garcia
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
| | - Sanjula D. Wickramasinghe
- Stretchline (Zhongshan) Limited, Goldenbell Section, Fu Zhong Lu, Shunjing Industrial Park, Banfu Town, Zhongshan City 528459, China;
| | - Arash Pouryazdan
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
| | - Daniel Roggen
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
| | - Tilak Dias
- Advanced Textiles Research Group, Nottingham Trent University Nottingham NG1 4GG, UK; (C.O.); (T.D.)
| | - Niko Münzenrieder
- Sensor Technology Research Centre, University of Sussex Falmer, Brighton BN1 9QT, UK; (J.C.C.); (L.A.G.-G.); (A.P.); (D.R.); (N.M.)
- Faculty of Science and Technology, Free University of Bozen-Bolzano, 39100 Bozen, Italy
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24
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Astrada A, Nakagami G, Jais S, Sanada H. Successful treatment of a diabetic foot ulcer with exposed bone using Trigona honey: a case study. J Wound Care 2019; 28:S4-S8. [DOI: 10.12968/jowc.2019.28.sup12.s4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Many studies have shown that honey might improve wound healing. However, its efficacy for large wounds which may be followed by a systemic effect remains unclear. The effectiveness of honey-based dressings in treating large diabetic foot ulcers (DFU) is still unknown. This study presents the case of a 38-year-old female patient presenting with an extensive infected DFU with exposed bone. The DFU was treated with propolis-enriched Trigona honey, used as a single treatment, in a home visit setting. After two months' follow-up, the wound exhibited complete re-epithelialisation despite the patient's initial poor condition.
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Affiliation(s)
- Adam Astrada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- BantuMelangkah.com
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
| | - Suriadi Jais
- Kitamura Clinic, Indonesia
- Muhammadiyah Institute of Nursing Science, Pontianak, Indonesia
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo, Japan
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25
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Cwajda-Białasik J, Mościcka P, Jawień A, Szewczyk MT. Infrared thermography to prognose the venous leg ulcer healing process-preliminary results of a 12-week, prospective observational study. Wound Repair Regen 2019; 28:224-233. [PMID: 31705776 DOI: 10.1111/wrr.12781] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/30/2019] [Accepted: 11/06/2019] [Indexed: 01/19/2023]
Abstract
Venous leg ulcers are complex, and their multifactorial etiology make successful treatment a difficult and long process. Nonhealing ulcers are the greatest challenge because they are resistant to standard therapies. In this study, we analyzed whether monitoring the temperature of the ulcered limb wound area could benefit the diagnosis of the wound's tendency to heal (estimating the presence of a healing or nonhealing wound) in patients with two-sided venous leg ulcers. This prospective, 12-week observational study included 57 adult individuals with chronic venous leg ulcers. The dynamics of wound healing was assessed by planimetry and infrared thermography every two weeks. We analyzed temperatures measured at three marked areas-the wound, the periwound skin, and the reference area. An initial wound area larger than 1 cm2 was associated with a temperature increase of 0.027 °C in the periwound skin. A 1-cm2 decrease in the wound area was associated with a 0.04 °C decrease in the temperature difference between the periwound skin and wound. A strong positive relationship was identified for both the bacteriology variables (the presence of bacteria: temperature increase in the periwound skin of 0.4 °C, p < 0.001; the number of bacterial species in a wound, temperature increase of 0.95 °C, p < 0.001). The temperature in the reference area was significantly correlated with the failure of the superficial and perforating veins (temperature increase of 0.69 °C, p = 0.04). This study reports that the assessment of the temperature a limb may be beneficial in predicting whether an ulcer is a healing or a nonhealing ulcer. The decrease in the temperature differences between the areas referred to as healing wounds was the only beneficial prognostic marker. Other temperature differences in the periwound skin were caused by disorders, such as multibacterial wound infections and superficial venous inflammation.
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Affiliation(s)
- Justyna Cwajda-Białasik
- Department of Perioperative Nursing, Department of Surgical Nursing and Chronic Wound Care, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Outpatient Department for Chronic Wound Management, University Hospital No 1, Bydgoszcz, Poland
| | - Paulina Mościcka
- Department of Perioperative Nursing, Department of Surgical Nursing and Chronic Wound Care, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Outpatient Department for Chronic Wound Management, University Hospital No 1, Bydgoszcz, Poland
| | - Arkadiusz Jawień
- Department of Vascular Surgery and Angiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Maria T Szewczyk
- Department of Perioperative Nursing, Department of Surgical Nursing and Chronic Wound Care, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland.,Outpatient Department for Chronic Wound Management, University Hospital No 1, Bydgoszcz, Poland
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Francesko A, Petkova P, Tzanov T. Hydrogel Dressings for Advanced Wound Management. Curr Med Chem 2019; 25:5782-5797. [PMID: 28933299 DOI: 10.2174/0929867324666170920161246] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/08/2017] [Accepted: 08/25/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Composed in a large extent of water and due to their nonadhesiveness, hydrogels found their way to the wound dressing market as materials that provide a moisture environment for healing while being comfortable to the patient. Hydrogels' exploitation is constantly increasing after evidences of their even broader therapeutic potential due to resemblance to dermal tissue and ability to induce partial skin regeneration. The innovation in advanced wound care is further directed to the development of so-called active dressings, where hydrogels are combined with components that enhance the primary purpose of providing a beneficial environment for wound healing. OBJECTIVE The objective of this review is to concisely describe the relevance of hydrogel dressings as platforms for delivery of active molecules for improved management of difficult- to-treat wounds. The emphasis is on the most recent advances in development of stimuli- responsive hydrogels, which allow for control over wound healing efficiency in response to different external modalities. Novel strategies for monitoring of the wound status and healing progress based on incorporation of sensor molecules into the hydrogel platforms are also discussed.
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Affiliation(s)
| | - Petya Petkova
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Tzanko Tzanov
- Grup de Biotecnologia Molecular i Industrial, Department of Chemical Engineering, Universitat Politècnica de Catalunya, Terrassa, Spain
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Kitamura A, Yoshimura M, Nakagami G, Yabunaka K, Sanada H. Changes of tissue images visualised by ultrasonography in the process of pressure ulcer occurrence. J Wound Care 2019; 28:S18-S22. [DOI: 10.12968/jowc.2019.28.sup4.s18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mine Yoshimura
- Department of Nursing, Tokyo Medical University Hospital, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Yabunaka
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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28
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Derakhshandeh H, Kashaf SS, Aghabaglou F, Ghanavati IO, Tamayol A. Smart Bandages: The Future of Wound Care. Trends Biotechnol 2018; 36:1259-1274. [PMID: 30197225 DOI: 10.1016/j.tibtech.2018.07.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/04/2018] [Accepted: 07/10/2018] [Indexed: 01/16/2023]
Abstract
Chronic non-healing wounds are major healthcare challenges that affect a noticeable number of people; they exert a severe financial burden and are the leading cause of limb amputation. Although chronic wounds are locked in a persisting inflamed state, they are dynamic and proper therapy requires identifying abnormalities, administering proper drugs and growth factors, and modulating the conditions of the environment. In this review article, we discuss technologies that have been developed to actively monitor the wound environment. We also highlight drug delivery tools that have been integrated with bandages to facilitate precise temporal and spatial control over drug release and review automated or semi-automated systems that can respond to the wound environment.
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Affiliation(s)
- Hossein Derakhshandeh
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE 68508, USA
| | - Sara Saheb Kashaf
- The University of Chicago Medical Scientist Training Program, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Fariba Aghabaglou
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE 68508, USA
| | - Ian O Ghanavati
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE 68508, USA
| | - Ali Tamayol
- Department of Mechanical and Materials Engineering, University of Nebraska, Lincoln, NE 68508, USA; Current address: 900 N16th Street, Room NH W332, Lincoln, NE 68508, USA.
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Ajovalasit A, Caccami MC, Amendola S, Sabatino MA, Alotta G, Zingales M, Giacomazza D, Occhiuzzi C, Marrocco G, Dispenza C. Development and characterization of xyloglucan-poly(vinyl alcohol) hydrogel membrane for Wireless Smart wound dressings. Eur Polym J 2018. [DOI: 10.1016/j.eurpolymj.2018.07.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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A Wearable Textile Thermograph. SENSORS 2018; 18:s18072369. [PMID: 30037070 PMCID: PMC6068546 DOI: 10.3390/s18072369] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 01/15/2023]
Abstract
In medicine, temperature changes can indicate important underlying pathologies such as wound infection. While thermographs for the detection of wound infection exist, a textile substrate offers a preferable solution to the designs that exist in the literature, as a textile is very comfortable to wear. This work presents a fully textile, wearable, thermograph created using temperature-sensing yarns. As described in earlier work, temperature-sensing yarns are constructed by encapsulating an off-the-shelf thermistor into a polymer resin micro-pod and then embedding this within the fibres of a yarn. This process creates a temperature-sensing yarn that is conformal, drapeable, mechanically resilient, and washable. This work first explored a refined yarn design and characterised its accuracy to take absolute temperature measurements. The influence of contact errors with the refined yarns was explored seeing a 0.24 ± 0.03 measurement error when the yarn was held just 0.5 mm away from the surface being measured. Subsequently, yarns were used to create a thermograph. This work characterises the operation of the thermograph under a variety of simulated conditions to better understand the functionality of this type of textile temperature sensor. Ambient temperature, insulating material, humidity, moisture, bending, compression and stretch were all explored. This work is an expansion of an article published in The 4th International Conference on Sensor and Applications.
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31
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Bader DL, Worsley PR. Technologies to monitor the health of loaded skin tissues. Biomed Eng Online 2018; 17:40. [PMID: 29650012 PMCID: PMC5897925 DOI: 10.1186/s12938-018-0470-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/24/2018] [Indexed: 01/18/2023] Open
Abstract
There are many situations where the skin and underlying soft tissues are compromised by mechanical loading in the form or pressure, or pressure in combination with shear. If sustained, this can lead to damage in the tissues particularly adjacent to bony prominences, resulting in chronic wounds. An array of bioengineering technologies have been adopted to assess the integrity of loaded soft tissues. This paper aims to review these approaches for the quantification, simulation and early detection of mechanically-induced skin damage. The review considers different measurements at the interface between the skin and support surface/medical device, involving pressure, shear, friction and the local microclimate. The potential of the techniques to monitor the physiological response of the skin to these external stimuli including biophysical measurement devices and sampling of biofluids are critically analysed. In addition, it includes an analysis of medical imaging technologies and computational modelling to provide a means by which tissue deformation can be quantified and thresholds for tissue damage defined. Bioengineering measurement and imaging technologies have provided an insight into the temporal status of loaded skin. Despite the advances in technology, to date, the translation to clinical tools which are robust and cost effective has been limited. There is a need to adapt existing technologies and simulation platforms to enable patients, carers and clinicians to employ appropriate intervention strategies to minimise soft tissue damage.
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Affiliation(s)
- Dan L Bader
- Skin Health Group, Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
| | - Peter R Worsley
- Skin Health Group, Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
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Power G, Moore Z, O'Connor T. Measurement of pH, exudate composition and temperature in wound healing: a systematic review. J Wound Care 2017; 26:381-397. [PMID: 28704150 DOI: 10.12968/jowc.2017.26.7.381] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To assess the potential of measurements of pH, exudate composition and temperature in wounds to predict healing outcomes and to identify the methods that are employed to measure them. METHOD A systematic review based on the outcomes of a search strategy of quantitative primary research published in the English language was conducted. Inclusion criteria limited studies to those involving in vivo and human participants with an existing or intentionally provoked wound, defined as 'a break in the epithelial integrity of the skin', and excluded in vitro and animal studies. Data synthesis and analysis was performed using structured narrative summaries of each included study arranged by concept, pH, exudate composition and temperature. The Evidence Based Literature (EBL) Critical Appraisal Checklist was implemented to appraise the quality of the included studies. RESULTS A total of 23 studies, three for pH (mean quality score 54.48%), 12 for exudate composition (mean quality score 46.54%) and eight for temperature (mean quality score 36.66%), were assessed as eligible for inclusion in this review. Findings suggest that reduced pH levels in wounds, from alkaline towards acidic, are associated with improvements in wound condition. Metalloproteinase-9 (MMP-9), matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase (TIMP), neutrophil elastase (NE) and albumin, in descending order, were the most frequently measured analytes in wounds. MMP-9 emerged as the analyte which offers the most potential as a biomarker of wound healing, with elevated levels observed in acute or non-healing wounds and decreasing levels in wounds progressing in healing. Combined measures of different exudate components, such as MMP/TIMP ratios, also appeared to offer substantial potential to indicate wound healing. Finally, temperature measurements are highest in non-healing, worsening or acute wounds and decrease as wounds progress towards healing. Methods used to measure pH, exudate composition and temperature varied greatly and, despite noting some similarities, the studies often yielded significantly contrasting results. Furthermore, a limitation to the generalisability of the findings was the overall quality scores of the research studies, which appeared suboptimal. CONCLUSION Despite some promising findings, there was insufficient evidence to confidently recommend the use of any of these measures as predictors of wound healing. pH measurement appeared as the most practical method for use in clinical practice to indicate wound healing outcomes. Further research is required to increase the strength of evidence and develop a greater understanding of wound healing dynamics.
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Affiliation(s)
- G Power
- Community Registered General Nurse, HSE Carlow/Kilkenny, Ireland
| | - Z Moore
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T O'Connor
- Royal College of Surgeons in Ireland, Dublin, Ireland
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García-Mayor S, Morilla-Herrera JC, Lupiáñez-Pérez I, Kaknani Uttumchandani S, León Campos Á, Aranda-Gallardo M, Moya-Suárez AB, Morales-Asencio JM. Peripheral perfusion and oxygenation in areas of risk of skin integrity impairment exposed to pressure patterns. A phase I trial (POTER Study). J Adv Nurs 2017; 74:465-471. [DOI: 10.1111/jan.13414] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Silvia García-Mayor
- Department of Nursing; Faculty of Health Sciences; University of Málaga; Málaga Spain
| | - Juan Carlos Morilla-Herrera
- Department of Nursing; Faculty of Health Sciences; University of Málaga; Málaga Spain
- Málaga Nursing-home Unit; Primary Healthcare District; Andalusian Health Service; Málaga Spain
| | - Inmaculada Lupiáñez-Pérez
- Department of Nursing; Faculty of Health Sciences; University of Málaga; Málaga Spain
- Malaga-Guadalhorce Primary Healthcare District; Andalusian Health Service; Málaga Spain
| | | | | | - Marta Aranda-Gallardo
- Department of Nursing; Faculty of Health Sciences; University of Málaga; Málaga Spain
- Department of Nursing; Agencia Sanitaria Costa del Sol; Málaga Spain
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Relative Temperature Maximum in Wound Infection and Inflammation as Compared with a Control Subject Using Long-Wave Infrared Thermography. Adv Skin Wound Care 2017; 30:406-414. [DOI: 10.1097/01.asw.0000522161.13573.62] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Hughes-Riley T, Lugoda P, Dias T, Trabi CL, Morris RH. A Study of Thermistor Performance within a Textile Structure. SENSORS 2017; 17:s17081804. [PMID: 28783067 PMCID: PMC5579833 DOI: 10.3390/s17081804] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 07/31/2017] [Accepted: 08/03/2017] [Indexed: 11/16/2022]
Abstract
Textiles provide an ideal structure for embedding sensors for medical devices. Skin temperature measurement is one area in which a sensor textile could be particularly beneficial; pathological skin is normally very sensitive, making the comfort of anything placed on that skin paramount. Skin temperature is an important parameter to measure for a number of medical applications, including for the early detection of diabetic foot ulcer formation. To this end an electronic temperature-sensor yarn was developed by embedding a commercially available thermistor chip into the fibres of a yarn, which can be used to produce a textile or a garment. As part of this process a resin was used to encapsulate the thermistor. This protects the thermistor from mechanical and chemical stresses, and also allows the sensing yarn to be washed. Building off preliminary work, the behaviour and performance of an encapsulated thermistor has been characterised to determine the effect of encapsulation on the step response time and absolute temperature measurements. Over the temperature range of interest only a minimal effect was observed, with step response times varying between 0.01–0.35 s. A general solution is presented for the heat transfer coefficient compared to size of the micro-pod formed by the encapsulation of the thermistor. Finally, a prototype temperature-sensing sock was produced using a network of sensing yarns as a demonstrator of a system that could warn of impending ulcer formation in diabetic patients.
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Affiliation(s)
- Theodore Hughes-Riley
- Advanced Textiles Research Group, School of Art & Design, Nottingham Trent University, Bonington Building, Dryden Street, Nottingham NG1 4GG, UK.
| | - Pasindu Lugoda
- Advanced Textiles Research Group, School of Art & Design, Nottingham Trent University, Bonington Building, Dryden Street, Nottingham NG1 4GG, UK.
| | - Tilak Dias
- Advanced Textiles Research Group, School of Art & Design, Nottingham Trent University, Bonington Building, Dryden Street, Nottingham NG1 4GG, UK.
| | - Christophe L Trabi
- School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
| | - Robert H Morris
- School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK.
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Medeiros CRD, Brioschi ML, Souza SND, Teixeira MJ. Infrared thermography to diagnose and manage venomous animal bites and stings. Rev Soc Bras Med Trop 2017; 50:260-264. [PMID: 28562767 DOI: 10.1590/0037-8682-0390-2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/06/2016] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Infrared imaging (IR) is a noninvasive technique that quantifies body surface temperature, producing a digital color image. IR has been used to study diseases in which skin temperature can reflect the presence of inflammation. METHODS This was an observational pilot study of eight patients envenomed by snakes, spiders, and scorpions. All patients were examined using a thermal camera. RESULTS In all cases, we obtained infrared images that corroborated clinical findings indicating localized effects of venom, specifically inflammation. CONCLUSIONS IR has potential for use as a research, diagnostic, and monitoring tool for localized effects of animal venoms.
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Affiliation(s)
| | - Marcos Leal Brioschi
- Divisão de Neurologia e Neurocirurgia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, São Paulo, Brasil
| | | | - Manoel Jacobsen Teixeira
- Divisão de Neurologia e Neurocirurgia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP, São Paulo, Brasil
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Oya M, Murayama R, Oe M, Yabunaka K, Tanabe H, Takahashi T, Matsui Y, Otomo E, Komiyama C, Sanada H. Continuous thermographic observation may predict extravasation in chemotherapy-treated patients. Eur J Oncol Nurs 2017; 28:56-61. [PMID: 28478856 DOI: 10.1016/j.ejon.2017.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 02/18/2017] [Accepted: 02/23/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Extravasation, or leakage of vesicant drugs into subcutaneous tissues, causes serious complications such as induration and necrosis in chemotherapy-treated patients. As macroscopic observation may overlook symptoms during infusion, we focused on skin temperature changes at puncture sites and studied thermographic patterns related to induration or necrosis caused by extravasation. METHODS Outpatients undergoing chemotherapy using peripheral intravenous catheters were enrolled in this prospective observational study. We filmed and classified infrared thermography movies of puncture sites during infusion; ultrasonography was also utilized at puncture sites to observe the subcutaneous condition. Multiple logistic regression analysis was performed to examine the association of thermographic patterns with induration or necrosis observed on the next chemotherapy day. Differences in patient characteristics, puncture sites, and infusions were analyzed by Mann-Whitney's U test and Fisher's exact test according to thermographic patterns. RESULTS Eight patients developed induration among 74 observations in 62 patients. Among six thermographic patterns, a fan-shaped lower temperature area gradually spreading from the puncture site (fan at puncture site) was significantly associated with induration. Ultrasonography revealed that catheters of patients with fan at puncture site remained in the vein at the end of infusion, indicating that the infusion probably leaked from the puncture site. Patients with fan at puncture site had no significant differences in characteristics and infusion conditions compared with those with the other five thermographic patterns. CONCLUSION We determined that fan at puncture site was related to induration caused by extravasation. Continuous thermographic observation may enable us to predict adverse events of chemotherapy.
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Affiliation(s)
- Maiko Oya
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Makoto Oe
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Koichi Yabunaka
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hidenori Tanabe
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Terumo Corporation, 2-44-1 Hatagaya, Shibuya-ku, Tokyo 151-0072, Japan
| | - Toshiaki Takahashi
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yuko Matsui
- School of Nursing, Kanazawa Medical University, 1-1 Uchinadamachi, Kahoku-gun, Ishikawa 920-0293, Japan
| | - Eiko Otomo
- Department of Nursing, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Chieko Komiyama
- Department of Nursing, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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Nakagami G, Schultz G, Gibson DJ, Phillips P, Kitamura A, Minematsu T, Miyagaki T, Hayashi A, Sasaki S, Sugama J, Sanada H. Biofilm detection by wound blotting can predict slough development in pressure ulcers: A prospective observational study. Wound Repair Regen 2017; 25:131-138. [DOI: 10.1111/wrr.12505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/17/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Gregory Schultz
- Department of Obstetrics and Gynecology; Institute for Wound Research, University of Florida; Gainesville Florida
| | - Daniel J Gibson
- Department of Obstetrics and Gynecology; Institute for Wound Research, University of Florida; Gainesville Florida
| | - Priscilla Phillips
- Kirksville College of Osteopathic Medicine; AT Still University of Health Sciences; Kirksville Missouri
| | - Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Takeo Minematsu
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology; The University of Tokyo Hospital; Tokyo Japan
| | - Akitatsu Hayashi
- Department of Plastic Surgery; The University of Tokyo Hospital; Tokyo Japan
| | - Sanae Sasaki
- Department of Nursing; The University of Tokyo Hospital; Tokyo Japan
| | - Junko Sugama
- Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core Institute for Frontier Science Initiative, Kanazawa University; Ishikawa Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine; The University of Tokyo; Tokyo Japan
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Kanazawa T, Nakagami G, Goto T, Noguchi H, Oe M, Miyagaki T, Hayashi A, Sasaki S, Sanada H. Use of smartphone attached mobile thermography assessing subclinical inflammation: a pilot study. J Wound Care 2016; 25:177-80, 182. [PMID: 27064366 DOI: 10.12968/jowc.2016.25.4.177] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To verify the reliability and validity of FLIR ONE, a device connected to a smartphone, for the assessment of inflammation based on relative temperature increase compared with the thermography routinely used in pressure ulcer (PU) and diabetic foot assessment. METHOD Participants in this pilot cross-sectional observational study were recruited from the patients in the PU team rounds and the diabetic foot outpatient clinic at the university hospital in January 2015. Cohen's kappa coefficient with its 95% confidence intervals was used to evaluate the criterion-related validity and inter- and intra-rater reliability for the thermal imaging assessment. For assessing criterion-related validity, a hand-held high-end infrared thermography device was used to provide reference data. Comparison of thermal images between the smartphone-connected device and the hand-held device was performed with both a 'predetermined range' and an 'automatically-set range.' For assessing inter-rater reliability, two assessors evaluated the thermal images taken by the mobile thermography. For assessing intra-rater reliability, one assessor evaluated the thermal images twice. The thermal images were shown to the assessors at random. RESULTS Among 16 thermal images obtained from eight patients, kappa coefficients for each value were as follows: for the predetermined range and automatically-set range, respectively, the criterion-related validity was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00); the inter-rater reliability was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00); and the intra-rater reliability was 1.00 (95% confidence interval 1.00-1.00) and 1.00 (95% confidence interval 1.00-1.00). CONCLUSION This pilot study suggests that FLIR ONE can work as an alternative device for assessing subclinical inflammation in PUs and the diabetic foot in clinical settings. Our results may facilitate clinicians in accepting the routine use of thermal imaging assessment at the patients' bedside.
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Affiliation(s)
- T Kanazawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - G Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Goto
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Noguchi
- Department of Life Support Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Oe
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Miyagaki
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Japan
| | - A Hayashi
- Department of Plastic Surgery, Graduate School of Medicine, The University of Tokyo, Japan
| | - S Sasaki
- Department of Nursing, The University of Tokyo Hospital, Japan
| | - H Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kaitani T, Nakagami G, Iizaka S, Fukuda T, Oe M, Igarashi A, Mori T, Takemura Y, Mizokami Y, Sugama J, Sanada H. Cost-utility analysis of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses. Wound Repair Regen 2015; 23:915-21. [PMID: 26284460 DOI: 10.1111/wrr.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
The high prevalence of severe pressure ulcers (PUs) is an important issue that requires to be highlighted in Japan. In a previous study, we devised an advanced PU management protocol to enable early detection of and intervention for deep tissue injury and critical colonization. This protocol was effective for preventing more severe PUs. The present study aimed to compare the cost-effectiveness of the care provided using an advanced PU management protocol, from a medical provider's perspective, implemented by trained wound, ostomy, and continence nurses (WOCNs), with that of conventional care provided by a control group of WOCNs. A Markov model was constructed for a 1-year time horizon to determine the incremental cost-effectiveness ratio of advanced PU management compared with conventional care. The number of quality-adjusted life-years gained, and the cost in Japanese yen (¥) ($US1 = ¥120; 2015) was used as the outcome. Model inputs for clinical probabilities and related costs were based on our previous clinical trial results. Univariate sensitivity analyses were performed. Furthermore, a Bayesian multivariate probability sensitivity analysis was performed using Monte Carlo simulations with advanced PU management. Two different models were created for initial cohort distribution. For both models, the expected effectiveness for the intervention group using advanced PU management techniques was high, with a low expected cost value. The sensitivity analyses suggested that the results were robust. Intervention by WOCNs using advanced PU management techniques was more effective and cost-effective than conventional care.
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Affiliation(s)
- Toshiko Kaitani
- Department of Nursing, Sapporo City University, Sapporo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinji Iizaka
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, Saitama, Japan
| | - Makoto Oe
- Department of Advanced Nursing Technology, Social Cooperation Program Graduate School of Medicine The University of Tokyo, Tokyo, Japan
| | - Ataru Igarashi
- Department of Drug Policy & Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Taketoshi Mori
- Department of Life Support Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukie Takemura
- Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yuko Mizokami
- Department of Courses for Certified Nurses Institute for Graduate Nurses, Japanese Nursing Association, Tokyo, Japan
| | - Junko Sugama
- Department of Clinical Nursing, Institute of Medical, and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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42
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Kanazawa T, Kitamura A, Nakagami G, Goto T, Miyagaki T, Hayashi A, Sasaki S, Mugita Y, Iizaka S, Sanada H. Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study. Int Wound J 2015. [PMID: 26212623 DOI: 10.1111/iwj.12454] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Undermined pressure ulcers (PUs) are troublesome complications that are likely to delay wound healing. Early skin incision and debridement can prevent the deterioration of undermined PUs, thus it is necessary to identify devitalised tissue areas to determine the appropriate timing for such interventions. This retrospective cohort study evaluated whether a lower temperature at the wound edge than the wound bed and periwound skin, detected by thermography, can predict undermining development in PUs 1 week after the assessment. Twenty-two participants with category III, IV, or unstageable PUs who were examined by interdisciplinary PU team and were followed up for at least two consecutive weeks were analysed. We found 9/11 PUs without a lower temperature at the wound edge did not develop undermining development, whereas 8/11 PUs with the lower temperature did develop undermining. The relative risk of undermining development after 1 week in PUs with the lower temperature was 4·00 (95% confidence intervals: 1·08-14·7). The sensitivity, specificity, positive predictive value and negative predictive value were 0·80, 0·75, 0·73 and 0·81, respectively. A thermal imaging assessment focusing on a lower temperature pattern at the wound edge may provide sufficient information to predict undermining development.
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Affiliation(s)
- Toshiki Kanazawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taichi Goto
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akitatsu Hayashi
- Department of Plastic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sanae Sasaki
- Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Mugita
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shinji Iizaka
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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43
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Kruse CR, Nuutila K, Lee CCY, Kiwanuka E, Singh M, Caterson EJ, Eriksson E, Sørensen JA. The external microenvironment of healing skin wounds. Wound Repair Regen 2015; 23:456-64. [PMID: 25857996 DOI: 10.1111/wrr.12303] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/02/2015] [Indexed: 11/28/2022]
Abstract
The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen and carbon dioxide), pH, and anti-microbial treatment on the wound. These factors are well described in the literature and can be modified with treatment methods available in the clinic. Understanding the roles of these factors in wound pathophysiology is of central importance in wound treatment.
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Affiliation(s)
- Carla R Kruse
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
| | - Kristo Nuutila
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cameron C Y Lee
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Kiwanuka
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mansher Singh
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edward J Caterson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elof Eriksson
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jens A Sørensen
- Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark
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44
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Kitamura A, Yoshida M, Minematsu T, Nakagami G, Iizaka S, Fujita H, Naito A, Takahashi K, Mori T, Sanada H. Prediction of healing progress of pressure ulcers by distribution analysis of protein markers on necrotic tissue: A retrospective cohort study. Wound Repair Regen 2015; 23:772-7. [PMID: 25976913 DOI: 10.1111/wrr.12316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 02/10/2015] [Accepted: 05/08/2015] [Indexed: 11/29/2022]
Abstract
Predicting the short-term healing progress of pressure ulcers is important for providing timely and appropriate intervention. Although there are some prediction methods available, these are unsuitable for ulcers with abundant necrotic tissue. We aimed to elucidate the relationship between necrotic tissue alteration and protein distributions on ulcers to establish a new prediction method. Thirty-eight pressure ulcers were retrospectively analyzed. Protein distributions on necrotic tissue were evaluated by the wound blotting at three levels: marker protein positivity, signal patterns (speckled, heterogeneous, or homogeneous), and the occupation of heterogeneous pattern. Peroxidase, alkaline phosphatase, tumor necrosis factor α, and matrix metalloproteinase-2 were used as marker proteins. One-week necrotic tissue alteration was classified as liquefaction or nonliquefaction, and associations with protein distributions were analyzed. The peroxidase positivity was significantly higher in the liquefaction than in the nonliquefaction (p = 0.031). In peroxidase-positive samples, the proportion of nonliquefaction samples was significantly higher in the heterogeneous pattern (p = 0.029). In the heterogeneous-patterned samples, the proportion of samples with an occupation values greater than the median value tended to be higher in the nonliquefaction (p = 0.087). There was no significant relationship between liquefaction and other markers. Peroxidase positivity predicts 1-week liquefaction of necrotic tissue, while a heterogeneous pattern indicates nonliquefaction.
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Affiliation(s)
- Aya Kitamura
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science
| | - Mikako Yoshida
- Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinji Iizaka
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideki Fujita
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Ayumi Naito
- WOC Consultation room, Fujisawa City Hospital, Kanagawa, Japan
| | - Kazuo Takahashi
- Department of Dermatology, Fujisawa City Hospital, Kanagawa, Japan
| | - Taketoshi Mori
- Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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45
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Salvo P, Dini V, Di Francesco F, Romanelli M. The role of biomedical sensors in wound healing. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.wndm.2015.03.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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46
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Chaves MEA, Silva FSD, Soares VPC, Ferreira RAM, Gomes FSL, Andrade RMD, Pinotti M. Evaluation of healing of pressure ulcers through thermography: a preliminary study. ACTA ACUST UNITED AC 2015. [DOI: 10.1590/2446-4740.0571] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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47
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Paul DW, Ghassemi P, Ramella-Roman JC, Prindeze NJ, Moffatt LT, Alkhalil A, Shupp JW. Noninvasive imaging technologies for cutaneous wound assessment: A review. Wound Repair Regen 2015; 23:149-62. [PMID: 25832563 DOI: 10.1111/wrr.12262] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/22/2015] [Indexed: 02/02/2023]
Abstract
The ability to phenotype wounds for the purposes of assessing severity, healing potential and treatment is an important function of evidence-based medicine. A variety of optical technologies are currently in development for noninvasive wound assessment. To varying extents, these optical technologies have the potential to supplement traditional clinical wound evaluation and research, by providing detailed information regarding skin components imperceptible to visual inspection. These assessments are achieved through quantitative optical analysis of tissue characteristics including blood flow, collagen remodeling, hemoglobin content, inflammation, temperature, vascular structure, and water content. Technologies that have, to this date, been applied to wound assessment include: near infrared imaging, thermal imaging, optical coherence tomography, orthogonal polarization spectral imaging, fluorescence imaging, laser Doppler imaging, microscopy, spatial frequency domain imaging, photoacoustic detection, and spectral/hyperspectral imaging. We present a review of the technologies in use or development for these purposes with three aims: (1) providing basic explanations of imaging technology concepts, (2) reviewing the wound imaging literature, and (3) providing insight into areas for further application and exploration. Noninvasive imaging is a promising advancement in wound assessment and all technologies require further validation.
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Affiliation(s)
- Dereck W Paul
- The Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - Pejhman Ghassemi
- Department of Electrical Engineering and Computer Science, The Catholic University of America, Washington, DC
| | - Jessica C Ramella-Roman
- Department of Biomedical Engineering and Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Nicholas J Prindeze
- The Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - Lauren T Moffatt
- The Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - Abdulnaser Alkhalil
- The Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
| | - Jeffrey W Shupp
- The Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC
- Department of Surgery, The Burn Center, MedStar Washington Hospital Center, Washington, DC
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48
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Zhang S, Gnyawali S, Huang J, Ren W, Gordillo G, Sen CK, Xu R. Multimodal imaging of cutaneous wound tissue. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:016016. [PMID: 25604545 PMCID: PMC4300315 DOI: 10.1117/1.jbo.20.1.016016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/08/2014] [Indexed: 06/04/2023]
Abstract
Quantitative assessment of wound tissue ischemia, perfusion, and inflammation provides critical information for appropriate detection, staging, and treatment of chronic wounds. However, few methods are available for simultaneous assessment of these tissue parameters in a noninvasive and quantitative fashion. We integrated hyperspectral, laser speckle, and thermographic imaging modalities in a single-experimental setup for multimodal assessment of tissue oxygenation, perfusion, and inflammation characteristics. Algorithms were developed for appropriate coregistration between wound images acquired by different imaging modalities at different times. The multimodal wound imaging system was validated in an occlusion experiment, where oxygenation and perfusion maps of a healthy subject's upper extremity were continuously monitored during a postocclusive reactive hyperemia procedure and compared with standard measurements. The system was also tested in a clinical trial where a wound of three millimeters in diameter was introduced on a healthy subject's lower extremity and the healing process was continuously monitored. Our in vivo experiments demonstrated the clinical feasibility of multimodal cutaneous wound imaging.
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Affiliation(s)
- Shiwu Zhang
- University of Science and Technology of China, School of Engineering Science, Hefei 230026, China
- The Ohio State University, Department of Biomedical Engineering, Columbus, Ohio 43210, United States
| | - Surya Gnyawali
- The Ohio State University, Department of Surgery, Columbus, Ohio 43210, United States
| | - Jiwei Huang
- The Ohio State University, Department of Biomedical Engineering, Columbus, Ohio 43210, United States
| | - Wenqi Ren
- University of Science and Technology of China, School of Engineering Science, Hefei 230026, China
| | - Gayle Gordillo
- The Ohio State University, Department of Surgery, Columbus, Ohio 43210, United States
| | - Chandan K. Sen
- The Ohio State University, Department of Surgery, Columbus, Ohio 43210, United States
| | - Ronald Xu
- University of Science and Technology of China, School of Engineering Science, Hefei 230026, China
- The Ohio State University, Department of Biomedical Engineering, Columbus, Ohio 43210, United States
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49
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Dreifke MB, Jayasuriya AA, Jayasuriya AC. Current wound healing procedures and potential care. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 48:651-62. [PMID: 25579968 DOI: 10.1016/j.msec.2014.12.068] [Citation(s) in RCA: 291] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 12/05/2014] [Accepted: 12/17/2014] [Indexed: 02/06/2023]
Abstract
In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting microRNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage microenvironment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection - all in the hopes of early detection of complications.
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Affiliation(s)
- Michael B Dreifke
- Department of Orthopaedic Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43614-5807, USA
| | - Amil A Jayasuriya
- Undergraduate Program, Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Ambalangodage C Jayasuriya
- Department of Orthopaedic Surgery, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43614-5807, USA.
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50
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Calibration of sensors for reliable radio telemetry in a prototype flexible wound monitoring device. SENSING AND BIO-SENSING RESEARCH 2014. [DOI: 10.1016/j.sbsr.2014.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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