Easy and cheap way to prepare skin extenders
Abstract Skin extender is a very useful method to repair wounds when oedema and skin retraction make a direct suture impossible. We have developed a new, simple and cheap way to prepare skin extenders based only on elastic vessel loops and metal clips stapler commonly used for skin suture and available in any operating room. This simple method can be performed both in the operating room and at the patient bedside, even under local anaesthesia, causes no bleeding and appears to be inexpensive and rapidly usable and should be made readily available in any hospital. (Source: International Wound Journal)
Source: International Wound Journal - March 19, 2015 Category: Surgery Authors: Antonio Stanizzi, Caterina Tartaglione, Elisa Bolletta, Matteo Gioacchini, Manuela Bottoni, Davide Talevi, Giovanni Di Benedetto Tags: ORIGINAL ARTICLE Source Type: research

The nested graft acts by inducing the process of de ‐senescence of the fibroblasts in chronic venous ulcers
In this study, we introduce full‐thickness micro skin grafts in the ulcer, a surgical technique known as a ‘nested graft’, which gave encouraging results leading to complete wound healing in all patients. The assessment of fibroblast cultures taken from the wound before and after treatment and comparison with fibroblasts from healthy skin showed that the fibroblasts taken from the ulcer after the nested graft treatment acquire morpho‐functional characteristics overlapping those of fibroblasts from healthy skin. This surgical approach is, therefore, able to lead to the healing of chronic ulcers through the d...
Source: International Wound Journal - March 18, 2015 Category: Surgery Authors: Giulio Gualdi, Silvia Crotti, Paola Monari, Piergiacomo Calzavara ‐Pinton, Massimiliano Vitali, Manuela Baronio, Vassilios Lougaris Tags: ORIGINAL ARTICLE Source Type: research

Identifying relationships between symptom clusters and quality of life in adults with chronic mixed venous and arterial leg ulcers
The objective of this study was to identify symptom clusters and their effect on quality of life (QOL) of adults with chronic leg ulcers of mixed venous and arterial aetiology. A secondary analysis of data from four existing prospective longitudinal studies conducted by a wound healing research group in Australia was undertaken. A total of 110 patients who met the inclusion criteria were selected for this study. Exploratory factor analysis (EFA) was used to identify symptom clusters and correlational analyses to examine relationships between the identified symptom clusters and QOL. The EFA identified two distinct symptom c...
Source: International Wound Journal - March 16, 2015 Category: Surgery Authors: Hien Thi Thu Do, Helen Edwards, Kathleen Finlayson Tags: ORIGINAL ARTICLE Source Type: research

A novel way to treat skin tears
Abstract Skin tears are one of the most commonly treated wounds in the elderly population. In their most basic form, they are essentially traumatic random pattern flaps. We postulate that the injured blood flow to these skin flaps should be ignored and the tissue should be treated as a skin graft. A case report is presented of an 86‐year‐old female with an 8 × 3·5 cm skin tear to her right upper extremity after a hip fracture. In addition to conventional wound closure strips re‐approximating the tissues, a disposable negative pressure wound therapy device was placed to act as bolster. Upon its removal on...
Source: International Wound Journal - March 10, 2015 Category: Surgery Authors: Scott Moradian, Andrew M Klapper Tags: CASE REPORT Source Type: research

Feasibility of an electrostimulation system treatment for wound healing: a case series of patients with chronic ulcers in Barbados
Abstract Major advances have been made in the development of new therapies for chronic wounds. Fenzian™, an electrostimulation system (ES), has been clinically used for a variety of conditions. The ES was recently tested in the Barbadian population for tolerability and acceptability by asthma patients, with encouraging results. Barbados has an estimated 170 people with diabetes having some form of lower‐extremity amputation annually. Here, we describe a case series of 21 chronic ulcer patients with diabetes recruited as inpatients (n = 10) and outpatients (n = 11) in a pilot study to evaluate the feasibility and ac...
Source: International Wound Journal - March 10, 2015 Category: Surgery Authors: Nkemcho Ojeh, Angela Rose, Selma Jackman, Morvillia Applewhaite, Veronica Webster Tags: ORIGINAL ARTICLE Source Type: research

Comment on Obsessive‐compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations
(Source: International Wound Journal)
Source: International Wound Journal - March 8, 2015 Category: Surgery Authors: Sinan Ozturk, Huseyin Karagoz Tags: LETTER TO THE EDITOR Source Type: research

Topical simvastatin promotes healing of Staphylococcus aureus ‐contaminated cutaneous wounds
Abstract Cutaneous wounds are prompt to be contaminated by bacteria, but the clinical benefits of applying antibiotics and antiseptics in wound management have not been proven. Statins are 3‐hydroxy‐3‐methylglutaryl‐coenzyme A (HMG‐CoA) reductase inhibitors commonly used to lower cholesterol levels. Studies indicated that statins, especially simvastatin, promote wound healing in experimental models. As Staphylococcus aureus is one of the most important microorganism responsible for wound infections, the aims of this study were to characterise the anti‐staphylococcal activity of simvastatin and to evaluate the a...
Source: International Wound Journal - March 7, 2015 Category: Surgery Authors: Chia ‐Chi Wang, Po‐Wei Yang, Sheau‐Fang Yang, Kun‐Pin Hsieh, Sung‐Pin Tseng, Ying‐Chi Lin Tags: ORIGINAL ARTICLE Source Type: research

Comment on Obsessive ‐compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations
(Source: International Wound Journal)
Source: International Wound Journal - March 7, 2015 Category: Surgery Authors: Sinan Ozturk, Huseyin Karagoz Tags: LETTER TO THE EDITOR Source Type: research

Comparing the Meggitt‐Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter‐observer analyses
In this study, 95 clinicians judged digital photographs of diabetic foot ulcers in various stages of healing. Wound depth was classified along the grades of the MW and the UT systems. IOA of the MW and UT systems was only moderate among the clinicians. This moderate agreement demonstrates that the MW and the UT systems appear not to be useful as single instrument and should always be used in combination with additional clinical information to avoid erroneous interpretations. (Source: International Wound Journal)
Source: International Wound Journal - February 26, 2015 Category: Surgery Authors: Trientje B Santema, Ellie A Lenselink, Ron Balm, Dirk T Ubbink Tags: ORIGINAL ARTICLE Source Type: research

Assessment of vacuum ‐assisted closure therapy on the wound healing process in cardiac surgery
Abstract Postoperative deep sternal wound infection (DSWI) is a serious complication in cardiac surgery (1–5% of patients) with high mortality and morbidity rates. Vacuum‐assisted closure (VAC) therapy has shown promising results in terms of wound healing process, postoperative hospital length of stay and lower in‐hospital costs. The aim of our retrospective study is to report the outcome of patients with DSWI treated with VAC therapy and to assess the effect of contributory risk factors. Data of 52 patients who have been treated with VAC therapy in a single institution (study period: September 2003–March 2...
Source: International Wound Journal - February 25, 2015 Category: Surgery Authors: Agamemnon Pericleous, Georgios Dimitrakakis, Renos Photiades, Ulrich O von Oppell Tags: ORIGINAL ARTICLE Source Type: research

Comparing the Meggitt ‐Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter‐observer analyses
In this study, 95 clinicians judged digital photographs of diabetic foot ulcers in various stages of healing. Wound depth was classified along the grades of the MW and the UT systems. IOA of the MW and UT systems was only moderate among the clinicians. This moderate agreement demonstrates that the MW and the UT systems appear not to be useful as single instrument and should always be used in combination with additional clinical information to avoid erroneous interpretations. (Source: International Wound Journal)
Source: International Wound Journal - February 25, 2015 Category: Surgery Authors: Trientje B Santema, Ellie A Lenselink, Ron Balm, Dirk T Ubbink Tags: ORIGINAL ARTICLE Source Type: research

Rare Varicella zoster virus infection in an ALT free flap
(Source: International Wound Journal)
Source: International Wound Journal - February 17, 2015 Category: Surgery Authors: Jun Ho Lee, Hwan Jun Choi Tags: LETTER TO THE EDITOR Source Type: research

Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study
In conclusion, PU incidence rate was higher than that reported in other international studies. This indicates that urgent attention is required for PU prevention strategies in this setting. (Source: International Wound Journal)
Source: International Wound Journal - February 9, 2015 Category: Surgery Authors: Nahla Tayyib, Fiona Coyer, Peter Lewis Tags: ORIGINAL ARTICLE Source Type: research

Reduction in wound healing times, cost of consumables and number of visits treated through the implementation of an electronic wound care system in rural Australia
This study reports on wound healing and cost of wounds collected from a larger project using the mobile wound care (MWC) electronic documentation system, which has been described elsewhere. The study involved 2350 clients from four health service districts in the Gippsland region in rural Australia who received treatments as part of the MWC research project (2010–2012), with a total of 3726 wounds identified (so an average of 1·6 wounds per client). By the end of the data collection period, 81% of these wounds had healed. A significant drop in healing time, cost of consumables and number of visits was found ac...
Source: International Wound Journal - February 9, 2015 Category: Surgery Authors: Hanan Khalil, Marianne Cullen, Helen Chambers, Matthew Carroll, Judi Walker Tags: ORIGINAL ARTICLE Source Type: research

Tadalafil therapy and severe chronic foot wound resolution
We report an unanticipated medication effect resulting in near‐complete wound healing in a patient after beginning tadalafil therapy of 20 mg thrice daily. This patient was treated for 50 years with state‐of‐the art acute and then chronic wound interventions after a traumatic farm machinery accident which resulted in a devascularised foot wound. This infection was both life‐ and limb‐threatening. The patient had undergone multiple vascular and plastic surgeries and antimicrobial therapies in addition to hospitalisations for sepsis. Limb amputation was being considered, when his urologist placed him on dail...
Source: International Wound Journal - February 3, 2015 Category: Surgery Authors: Claire Davenport, Andrew Dubin Tags: CASE REPORT Source Type: research

Ecthyma gangrenosum in a preterm infant
(Source: International Wound Journal)
Source: International Wound Journal - February 3, 2015 Category: Surgery Authors: Kadir Ş Tekgündüz, Yaşar Demirelli, İbrahim Caner, Mustafa Kara Tags: LETTER TO THE EDITOR Source Type: research

Systemic sclerosis chronic ulcers: preliminary results of treatment with allogenic skin grafting in a cohort of Italian patients
(Source: International Wound Journal)
Source: International Wound Journal - February 3, 2015 Category: Surgery Authors: Simone Barsotti, Vincenzo Mattaliano, Anna d'Ascanio, Giovanni Mosti, Alessandra Della Rossa, Chiara Mattaliano, Dilia Giuggioli, Enzo Giraldi, Clodoveo Ferri, Marta Mosca Tags: LETTER TO THE EDITOR Source Type: research

Effect of enzymatic debridement with two different collagenases versus mechanical debridement on chronic hard‐to‐heal wounds
This study was designed in order to compare two types of collagenases with mechanical debridement alone. It was thus possible to evaluate their differences in terms of pain and debridement efficacy. Patients were divided into three groups: 30 patients were daily dressed using an ointment based on collagenase produced by Vibrio alginolyticus (B group), 30 patients were daily dressed using an ointment based on a collagenase preparation derived from Clostridium histolyticum (N group) and 30 patients underwent classical mechanical debridement (M group). Complete wound healing over a period of 8 weeks occurred in 24 pati...
Source: International Wound Journal - February 3, 2015 Category: Surgery Authors: Maria Giuseppina Onesti, Paolo Fioramonti, Pasquale Fino, Valentina Sorvillo, Sara Carella, Nicolò Scuderi Tags: ORIGINAL ARTICLE Source Type: research

The nested graft acts by inducing the process of de‐senescence of the fibroblasts in chronic venous ulcers
In this study, we introduce full‐thickness micro skin grafts in the ulcer, a surgical technique known as a ‘nested graft’, which gave encouraging results leading to complete wound healing in all patients. The assessment of fibroblast cultures taken from the wound before and after treatment and comparison with fibroblasts from healthy skin showed that the fibroblasts taken from the ulcer after the nested graft treatment acquire morpho‐functional characteristics overlapping those of fibroblasts from healthy skin. This surgical approach is, therefore, able to lead to the healing of chronic ulcers through the d...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Giulio Gualdi, Silvia Crotti, Paola Monari, Piergiacomo Calzavara‐Pinton, Massimiliano Vitali, Manuela Baronio, Vassilios Lougaris Tags: ORIGINAL ARTICLE Source Type: research

Nursing staff induced repositionings and immobile patients' spontaneous movements in nursing care
Abstract The aim of this study was to investigate nursing staff induced repositionings and the patients' spontaneous movements during the day and night among older immobile patients in nursing care. Furthermore, the aim was to identify factors associated with the nursing staff induced repositionings and the patients' spontaneous movement frequency. An observational cross‐sectional design was used. Spontaneous movements among patients (n = 52) were registered continuously using the MovinSense monitoring system. The nursing staff documented each time they repositioned the patient. Patients spontaneous movements were compar...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Ulrika Källman, Sara Bergstrand, Anna‐Christina Ek, Maria Engström, Margareta Lindgren Tags: ORIGINAL ARTICLE Source Type: research

Evaluation of angiogenesis, epithelialisation and microcirculation after application of polyhexanide, chitosan and sodium chloride in rodents
Abstract The purpose of this study was to investigate the effect of polyhexanide and a new developed chitin‐based wound dressing on skin microcirculation, epithelialisation and angiogenesis. A full‐thickness dermal layer extending to the underlying cartilage was excised on the dorsal side of hairless mice (n = 27; 2·3 ± 0·3 mm2). A polyhexanide ointment, a chitosan solution and a sodium chloride group as control were analysed using intravital fluorescence microscopy. Angiogenesis, epithelialisation and microcirculatory standard parameters were measured over a time period of 20 days. The non‐perfu...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Ole Goertz, Henrik Lauer, Tobias Hirsch, Adrien Daigeler, Kamran Harati, Ingo Stricker, Marcus Lehnhardt, Leon Lohe Tags: ORIGINAL ARTICLE Source Type: research

Topical simvastatin promotes healing of Staphylococcus aureus‐contaminated cutaneous wounds
Abstract Cutaneous wounds are prompt to be contaminated by bacteria, but the clinical benefits of applying antibiotics and antiseptics in wound management have not been proven. Statins are 3‐hydroxy‐3‐methylglutaryl‐coenzyme A (HMG‐CoA) reductase inhibitors commonly used to lower cholesterol levels. Studies indicated that statins, especially simvastatin, promote wound healing in experimental models. As Staphylococcus aureus is one of the most important microorganism responsible for wound infections, the aims of this study were to characterise the anti‐staphylococcal activity of simvastatin and to evaluate the a...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Chia‐Chi Wang, Po‐Wei Yang, Sheau‐Fang Yang, Kun‐Pin Hsieh, Sung‐Pin Tseng, Ying‐Chi Lin Tags: ORIGINAL ARTICLE Source Type: research

Assessment of vacuum‐assisted closure therapy on the wound healing process in cardiac surgery
Abstract Postoperative deep sternal wound infection (DSWI) is a serious complication in cardiac surgery (1–5% of patients) with high mortality and morbidity rates. Vacuum‐assisted closure (VAC) therapy has shown promising results in terms of wound healing process, postoperative hospital length of stay and lower in‐hospital costs. The aim of our retrospective study is to report the outcome of patients with DSWI treated with VAC therapy and to assess the effect of contributory risk factors. Data of 52 patients who have been treated with VAC therapy in a single institution (study period: September 2003–March 2...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Agamemnon Pericleous, Georgios Dimitrakakis, Renos Photiades, Ulrich O von Oppell Tags: ORIGINAL ARTICLE Source Type: research

A comparative study to evaluate the effect of limited access dressing (LAD) on burn wound healing
In this study, the effect of newer intermittent negative‐pressure wound therapy in combination with moist environment [limited access dressing (LAD)] on burn wound healing is studied. Various biochemical parameters like hydroxyproline, hexosamine and total protein, and antioxidants like reduced glutathione (GSH), glutathione peroxidase (GPx) and oxidative biomarker malondialdhyde (MDA) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing. A total of 55 patients were d...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Thittamaranahalli M Honnegowda, Pramod Kumar, Echalasara G Padmanabha Udupa, Anurag Sharan, Rekha Singh, Hemanth K Prasad, Pragna Rao Tags: ORIGINAL ARTICLE Source Type: research

A review of the surgical management of heel pressure ulcers in the 21st century
Abstract Heel ulceration, most frequently the result of prolonged pressure because of patient immobility, can range from the trivial to the life threatening. Whilst the vast majority of heel pressure ulcers (PUs) are superficial and involve the skin (stages I and II) or underlying fat (stage III), between 10% and 20% will involve deeper tissues, either muscle, tendon or bone (stage IV). These stage IV heel PUs represent a major health and economic burden and can be difficult to treat. The worst outcomes are seen in those with large ulcers, compromised peripheral arterial supply, osteomyelitis and associated comorbidities. ...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: David C Bosanquet, Ann M Wright, Richard D White, Ian M Williams Tags: INVITED REVIEW Source Type: research

Zosteriform pemphigoid after zoster: Wolf's isotopic response
We report a case of 79‐year‐old woman who have bullous pemphigoid (BP) with dermatomal distribution that developed at the site of previously healed herpes zoster. Based on clinical, histological and immunofluorescence findings, the patient was diagnosed with localized BP in a site of prior herpes zoster. BP developing at the site of healed herpes zoster is the first reported case. Recognition of this phenomenon is important for correct clinicopathologic diagnosis and may improve our understanding of the underlying pathophysiologic processes. (Source: International Wound Journal)
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Mehmet S Gurel, Sevil Savas, Fusun Bilgin, Duygu Erdil, Cem Leblebici, Ebru Sarikaya Tags: CASE REPORT Source Type: research

Combined use of fenestrated‐type artificial dermis and topical negative pressure wound therapy for the venous leg ulcer of a rheumatoid arthritis patient
We report a case of circumferential venous leg ulcer in a rheumatoid arthritis patient. Mesh skin grafting was performed in another hospital, but the graft failed and the patient was referred to our hospital. This ulcer was treated by the combination therapy of a fenestrated‐type artificial dermis with negative pressure wound therapy (NPWT) and secondary mesh grafting using our ‘grip tape technique’. NPWT was started at −100 mmHg and continued until the formation of dermis‐like tissue. A section stained using haematoxylin and eosin and an anti‐αSMA (α smooth muscle actin) immunohi...
Source: International Wound Journal - February 1, 2015 Category: Surgery Authors: Naoki Morimoto, Atsuyuki Kuro, Takashi Yamauchi, Ai Horiuchi, Natsuko Kakudo, Michiharu Sakamoto, Kenji Suzuki, Kenji Kusumoto Tags: CASE REPORT Source Type: research

Bilirubin provides perforator flap protection from ischaemia‐reperfusion injury in a rat model: a preliminary result
Abstract The use of bilirubin, a well‐known and powerful antioxidant, has gained popularity in recent years because of its role in the prevention of ischaemic heart disease in patients with Gilbert's syndrome. We investigate the effects of bilirubin on ischaemia‐reperfusion (I/R) injury using a rat perforator flap model. Forty‐eight rats were randomly divided into two groups: experimental (bilirubin) group (n = 24) and control group (n = 24). In each group, elevated bilateral deep inferior epigastric perforator (DIEP) flaps were created. The right (no ischaemia side) and left (ischaemia si...
Source: International Wound Journal - January 26, 2015 Category: Surgery Authors: Sung Yong Kim, Dong Kyun Rah, Yosep Chong, Song Hyun Lee, Tae Hwan Park Tags: ORIGINAL ARTICLE Source Type: research

Non‐contact low‐frequency ultrasound therapy compared with UK standard of care for venous leg ulcers: a single‐centre, assessor‐blinded, randomised controlled trial
Abstract ‘Hard‐to‐heal’ wounds are those which fail to heal with standard therapy in an orderly and timely manner and may warrant the use of advanced treatments such as non‐contact low‐frequency ultrasound (NLFU) therapy. This evaluator‐blinded, single‐site, randomised controlled trial, compared NLFU in addition to UK standard of care [SOC: (NLFU + SOC)] three times a week, with SOC alone at least once a week. Patients with chronic venous leg ulcers were eligible to participate. All 36 randomised patients completed treatment (17 NLFU + SOC, 19 SOC), and baseline demograph...
Source: International Wound Journal - January 25, 2015 Category: Surgery Authors: Judith White, Nicola Ivins, Antony Wilkes, Grace Carolan‐Rees, Keith G Harding Tags: ORIGINAL ARTICLE Source Type: research

Bilirubin provides perforator flap protection from ischaemia ‐reperfusion injury in a rat model: a preliminary result
Abstract The use of bilirubin, a well‐known and powerful antioxidant, has gained popularity in recent years because of its role in the prevention of ischaemic heart disease in patients with Gilbert's syndrome. We investigate the effects of bilirubin on ischaemia‐reperfusion (I/R) injury using a rat perforator flap model. Forty‐eight rats were randomly divided into two groups: experimental (bilirubin) group (n = 24) and control group (n = 24). In each group, elevated bilateral deep inferior epigastric perforator (DIEP) flaps were created. The right (no ischaemia side) and left (ischaemia side) DIEP flaps were separate...
Source: International Wound Journal - January 24, 2015 Category: Surgery Authors: Sung Young Kim, Dong Kyun Rah, Yosep Chong, Song Hyun Lee, Tae Hwan Park Tags: ORIGINAL ARTICLE Source Type: research

Non ‐contact low‐frequency ultrasound therapy compared with UK standard of care for venous leg ulcers: a single‐centre, assessor‐blinded, randomised controlled trial
Abstract ‘Hard‐to‐heal’ wounds are those which fail to heal with standard therapy in an orderly and timely manner and may warrant the use of advanced treatments such as non‐contact low‐frequency ultrasound (NLFU) therapy. This evaluator‐blinded, single‐site, randomised controlled trial, compared NLFU in addition to UK standard of care [SOC: (NLFU + SOC)] three times a week, with SOC alone at least once a week. Patients with chronic venous leg ulcers were eligible to participate. All 36 randomised patients completed treatment (17 NLFU + SOC, 19 SOC), and baseline demographics were comparable between ...
Source: International Wound Journal - January 24, 2015 Category: Surgery Authors: Judith White, Nicola Ivins, Antony Wilkes, Grace Carolan ‐Rees, Keith G Harding Tags: ORIGINAL ARTICLE Source Type: research

Calendar
(Source: International Wound Journal)
Source: International Wound Journal - January 21, 2015 Category: Surgery Tags: CALENDAR OF EVENTS Source Type: research

News and views
(Source: International Wound Journal)
Source: International Wound Journal - January 21, 2015 Category: Surgery Tags: NEWS Source Type: research

Can 2015 be a transformative year for diagnostics in wound care?
(Source: International Wound Journal)
Source: International Wound Journal - January 21, 2015 Category: Surgery Authors: Keith Harding, Douglas Queen Tags: EDITORIAL Source Type: research

The impact of foot ulceration and amputation on mortality in diabetic patients. I: From ulceration to death, a systematic review
Abstract A great deal of emphasis, clinical and financial, is placed on limb salvage efforts in diabetic patients suffering from lower extremity ulceration. This is because of the impression that amputation in such patients may be a proximal cause of death. While amputation is certainly a negative clinical outcome, it is not entirely clear that it causes death. In this systematic review, we examine the available literature to attempt to understand the role that the ulceration itself may play in mortality. In brief, we searched for human studies in OVID, CINAHL and the COCHRANE CENTRAL DATABASE from 1980 to 2013, looking fo...
Source: International Wound Journal - January 20, 2015 Category: Surgery Authors: Daniel C Jupiter, Jakob C Thorud, Clifford J Buckley, Naohiro Shibuya Tags: ORIGINAL ARTICLE Source Type: research

Malignant degeneration of scars in elderly people (Marjolin's ulcers)
(Source: International Wound Journal)
Source: International Wound Journal - January 20, 2015 Category: Surgery Authors: Piotr Brzezinski, Caius Solovan, Anca Chiriac Tags: Letter to the Editor Source Type: research

Achieving competency in wound care: an innovative training module using the long ‐term care setting
Abstract Structured academic teaching on wound care was developed, based on the long‐term care (LTC) setting, with the goal of ensuring that postgraduate family medicine residents attain competency in assessment and treatment of wounds and pressure ulcers (PUs). The curriculum for the 1‐month learning module was based on clinical practice guidelines for the prevention, assessment, and treatment of PUs and wounds. The learning techniques used include a learners' needs assessment, a small‐group didactic session, interdisciplinary bedside case discussions and a toolkit. The curriculum is delivered in four weekly, 90‐m...
Source: International Wound Journal - January 19, 2015 Category: Surgery Authors: Evelyn M Williams, Susan Deering Tags: ORIGINAL ARTICLE Source Type: research

Inflammatory reaction to brown pigment in a tattoo
(Source: International Wound Journal)
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Antonella Tammaro, Veronica Giulianelli, Giorgia Cortesi, Claudia Abruzzese, Alessandra Narcisi, Francesca R Parisella, Severino Persechino Tags: LETTER TO THE EDITOR Source Type: research

Biobrane™ and skin staples: beware of necrotic ulceration
We report two cases of necrotic ulceration associated with the use of Biobrane™ with skin staples. We suggest securing Biobrane™ with alternatives such as adhesive tapes and glue to prevent the occurrence of this adverse outcome. (Source: International Wound Journal)
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Ela J Hyland, Deborah Maze, Torey Lawrence, John G Harvey, Andrew JA Holland Tags: ORIGINAL ARTICLE Source Type: research

Chronic ischaemia does not appear to hinder healing with Integra®: implementation at a tibial artery bypass site
We report a case of a 73‐year‐old man who presented with grade IV peripheral arterial disease necessitating salvage of the lower limb using artery bypass surgery. Immediate exposure of femorotibial artery secondary to skin necrosis following the bypass led us to propose an innovative means of wound coverage using Integra®, a well‐known dermal regeneration template. The wound healed uneventfully with an appearance similar to that of the adjacent skin. Integra® seems to be less demanding in terms of the vascular wound bed and the degree of oxygenation than a conventional skin graft. This finding could support f...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Audrey Michot, Benoit Chaput, Fabienne Gobel, Tiphaine Menez, Guillaume de Bonnecaze, Philippe Pelissier Tags: CASE REPORT Source Type: research

Obsessive‐compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations
In this report, we present two cases of self‐inflicted severe wounds that were diagnosed as secondary to obsessive‐compulsive behaviour. Patients were middle‐aged females who presented with deep cutaneous ulcers that were acknowledgedly maintained through repetitive manipulation. Obsessive‐compulsive‐related cutaneous disease is better treated with serotonin reuptake inhibitor antidepressants in higher dosages than those used to treat depression. Both patients were treated with fluoxetine 60–80 mg that resulted in adequate healing of the ulcers; relapses were observed during attempts to taper fluoxet...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Marcello MS Nico, Silvia V Lourenço Tags: ORIGINAL ARTICLE Source Type: research

Changes in fibrillin‐1 expression, elastin expression and skin surface texture at sites of cultured epithelial autograft transplantation onto wounds from burn scar excision
This study investigated the recovery process during which grafted cultured epithelium generated skin elasticity and skin surface microarchitecture. The subjects were 18 patients whose burn scars were excised at a depth not exposing the fat layer and who subsequently received cultured epithelial autografts. A total of 24 samples were obtained from the grafted sites: 6 samples within 6 weeks (stage 1), 5 samples after 6 weeks and within 6 months (stage 2), 6 samples after 6 months and within 18 months (stage 3) and 7 samples beyond 18 months (stage 4) of transplantation. These sample...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Kuniko Kadoya, Satoshi Amano, Toshio Nishiyama, Shinji Inomata, Makoto Tsunenaga, Norio Kumagai, Kyoichi Matsuzaki Tags: ORIGINAL ARTICLE Source Type: research

The utility of the surgical safety checklist for wound patients
Abstract The purpose of this study was to determine the frequency of changes in patient care resulting from the use of a surgical safety checklist. Data were retrospectively obtained from 233 patients. The number and types of changes made to the patients' intra‐operative management, based on the use of the checklist, were recorded. The number of patients whose management was modified as a result of the checklist was 113 (48%) out of 233. The total number of changes made was 132, and 18 patients had more than one modification made to their care plan. Further stratification was identified: among the 132 changes made, antib...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Joseph W Myers, Brent A Gilmore, Kelly A Powers, Paul J Kim, Christopher E Attinger Tags: ORIGINAL ARTICLE Source Type: research

Ozonated saline shows activity against planktonic and biofilm growing Staphylococcus aureus in vitro: a potential irrigant for infected wounds
Abstract Infections associated with deep wounds require extensive surgical and medical care. New adjunctive treatments are required to aid in the eradication of the bacterial biofilms found on infected wounds and, in particular, any underlying hardware. Ozone has been used as a safe and efficient disinfectant in water treatment plants for many years. The purpose of this study is to investigate the anti‐biofilm potential of ozonated saline against biofilms of Staphylococcus aureus, a microorganism commonly implicated in wound infections. A custom‐made bacterial biofilm bioreactor was used to grow S. aureus biofilms on d...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Hayder Al‐Saadi, Inga Potapova, Edward TJ Rochford, Thomas F Moriarty, Peter Messmer Tags: ORIGINAL ARTICLE Source Type: research

Increased expression of endosomal members of toll‐like receptor family abrogates wound healing in patients with type 2 diabetes mellitus
The objective of this study was to analyse the differential expression of endosomal TLRs in human diabetic wounds compared with control wounds. We analysed the differential expression of TLR7 and TLR9 both at transcriptional and translational levels in wounds of 84 patients with type 2 diabetes mellitus (T2DM) and 6 control subjects without diabetes using quantitative real‐time polymerase chain reaction (RT‐PCR), western blot and immunohistochemistry. TLR7 and TLR9 were significantly up‐regulated in wounds of the patients with T2DM compared with the controls and were dependent on the infection status of the diabetic ...
Source: International Wound Journal - January 14, 2015 Category: Surgery Authors: Kanhaiya Singh, Neeraj K Agrawal, Sanjeev K Gupta, Gyanendra Mohan, Sunanda Chaturvedi, Kiran Singh Tags: ORIGINAL ARTICLE Source Type: research

Chronic ischaemia does not appear to hinder healing with Integra ®: implementation at a tibial artery bypass site
We report a case of a 73‐year‐old man who presented with grade IV peripheral arterial disease necessitating salvage of the lower limb using artery bypass surgery. Immediate exposure of femorotibial artery secondary to skin necrosis following the bypass led us to propose an innovative means of wound coverage using Integra®, a well‐known dermal regeneration template. The wound healed uneventfully with an appearance similar to that of the adjacent skin. Integra® seems to be less demanding in terms of the vascular wound bed and the degree of oxygenation than a conventional skin graft. This finding could support f...
Source: International Wound Journal - January 13, 2015 Category: Surgery Authors: Audrey Michot, Benoit Chaput, Fabienne Gobel, Tiphaine Menez, Guillaume de Bonnecaze, Philippe Pelissier Tags: CASE REPORT Source Type: research

Increased expression of endosomal members of toll ‐like receptor family abrogates wound healing in patients with type 2 diabetes mellitus
The objective of this study was to analyse the differential expression of endosomal TLRs in human diabetic wounds compared with control wounds. We analysed the differential expression of TLR7 and TLR9 both at transcriptional and translational levels in wounds of 84 patients with type 2 diabetes mellitus (T2DM) and 6 control subjects without diabetes using quantitative real‐time polymerase chain reaction (RT‐PCR), western blot and immunohistochemistry. TLR7 and TLR9 were significantly up‐regulated in wounds of the patients with T2DM compared with the controls and were dependent on the infection status of the diabetic ...
Source: International Wound Journal - January 13, 2015 Category: Surgery Authors: Kanhaiya Singh, Neeraj K Agrawal, Sanjeev K Gupta, Gyanendra Mohan, Sunanda Chaturvedi, Kiran Singh Tags: ORIGINAL ARTICLE Source Type: research

Internal pudendal perforator artery –based gull wing flap for vulvovaginal 3D reconstruction after tumour excision: a new flap
Abstract Various skin tumours such as squamous cell carcinoma and extramammary Paget's disease can occur in the vulval area, and reconstruction of the vulval area can be a very challenging task. A retrospective analysis of vulvar reconstruction using the new method ‘internal pudendal perforator artery–based gull wing flap’ was performed from April 2012 to December 2013. A perforator vessel from the internal pudendal artery was detected with a portable Doppler and marked, and this was the pivot point around which the flap was rotated. The flap was rotated by more than 150°–180° internally, an...
Source: International Wound Journal - January 13, 2015 Category: Surgery Authors: Hyun H Han, Daiwon Jun, Bommie F Seo, Suk ‐Ho Moon, Deuk Y Oh, Sang T Ahn, Jong‐Won Rhie Tags: ORIGINAL ARTICLE Source Type: research

Biobrane ™ and skin staples: beware of necrotic ulceration
We report two cases of necrotic ulceration associated with the use of Biobrane™ with skin staples. We suggest securing Biobrane™ with alternatives such as adhesive tapes and glue to prevent the occurrence of this adverse outcome. (Source: International Wound Journal)
Source: International Wound Journal - January 13, 2015 Category: Surgery Authors: Ela J Hyland, Deborah Maze, Torey Lawrence, John G Harvey, Andrew JA Holland Tags: ORIGINAL ARTICLE Source Type: research

Obsessive ‐compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations
In this report, we present two cases of self‐inflicted severe wounds that were diagnosed as secondary to obsessive‐compulsive behaviour. Patients were middle‐aged females who presented with deep cutaneous ulcers that were acknowledgedly maintained through repetitive manipulation. Obsessive‐compulsive‐related cutaneous disease is better treated with serotonin reuptake inhibitor antidepressants in higher dosages than those used to treat depression. Both patients were treated with fluoxetine 60–80 mg that resulted in adequate healing of the ulcers; relapses were observed during attempts to taper fluoxetine dos...
Source: International Wound Journal - January 13, 2015 Category: Surgery Authors: Marcello MS Nico, Silvia V Louren ço Tags: ORIGINAL ARTICLE Source Type: research