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The Basic Needs to Achieve Wound Healing
Raj Mani, Luc Téot
1:
The Globalisation of Wounds, Burns, Ulcers and Related Injuries: Threatening the Intactness of the Skin
PREVENTION
FIRST AID
MEASUREMENT
HEALING
MANPOWER
CARE OF THE DISABLED DUE TO WOUNDS AND BURNS
UNIVERSAL TRUTHS
THE FUTURE
2:
Leg Ulcers
INTRODUCTION
EPIDEMIOLOGY
CLINICAL DIAGNOSIS
HISTORY TAKING
CLINICAL EXAMINATION
ANKLE BRACHIAL PRESSURE INDEX (ABPI)
ADDITIONAL EXAMINATIONS
ARTERIAL OR VENOUS COLOUR DUPLEX ULTRASOUND
Venous Duplex Ultrasound
Arterial Duplex Ultrasound
OTHER EXAMINATIONS
Bacteriological Sampling
Patch Tests
Skin Biopsy
Microbiology Tests
DIFFERENTIAL DIAGNOSES OF VASCULAR ULCERS
PROGNOSIS
TREATMENT
VENOUS ULCER
Compression is an Essential Aetiological Treatment
Surgery
ARTERIAL ULCER
SYMPTOMATIC/LOCAL TREATMENT
Cleansing and Debridement
Dressings
Grafts
OTHER TREATMENTS
SYSTEMIC TREATMENTS
PREVENTION
3:
Management of Burns: Step-by-Step Approach to the Burn Wound
INTRODUCTION
EVOLUTION OF BURN WOUND
CLASSIFICATION OF DEPTH OF BURNS (FIGS 3.1A TO D)
FIRST DEGREE
PARTIAL THICKNESS (SECOND DEGREE)
DEEP BURN (THIRD DEGREE)
PATHOPHYSIOLOGICAL AND BIOCHEMICAL CHANGES IN BURNS
EVOLUTION OF THE BURN WOUND
INFLAMMATORY PHASE
Acute Burn Wound
Oedema (Figs 3.21A to D)
Blister Formation (Figs 3.3A and B)
PROLIFERATIVE PHASE
RESTORATION PHASE
MATURATION PHASE
Wound Contraction and Scar
GROWTH FACTORS IN WOUND HEALING
MANAGEMENT OF BURN WOUND
MANAGEMENT OF OEDEMA
MANAGEMENT OF BLISTERS
DEEP PARTIAL THICKNESS AND DEEP BURNS (FIGS 3.5 TO 3.9)
BURNS IN SPECIAL AREAS
BIOLOGICAL DRESSINGSM
ALLODERM™
FULL THICKNESS BURNS
4:
Pressure Ulcer Prevention
REAL LIFE SCENARIO
FREQUENTLY ASKED QUESTIONS (FAQS) ABOUT PRESSURE ULCERS
PREVALENCE
COST
LITIGATION
PRESSURE ULCER AETIOLOGY
EXTRINSIC FACTORS
Pressure
Shear
Friction
INTRINSIC FACTORS
PREVENTION
IDENTIFICATION OF VULNERABLE INDIVIDUALS
PRESSURE REDISTRIBUTION
Repositioning
Use of Equipment
SKIN CARE
GOOD NUTRITION
EDUCATION
CONCLUSION
5:
Chronic Infectious Lower Extremity Wounds
ABSTRACT
TYPES OF CHRONIC INFECTIOUS LOWER EXTREMITY WOUNDS
CLASSIFICATION OF CHRONIC INFECTIOUSLOWER EXTREMITY WOUNDS
AETIOPATHOGENESIS OF CHRONIC WOUNDSIN LOWER EXTREMITY
INFECTION
DIABETIC FOOT INFECTIONS
SURGICAL REVASCULARISATION IN THEMANAGEMENT OF DIABETIC FOOT WOUNDS
CHRONIC VENOUS ULCER
PATHOPHYSIOLOGY
MEDICAL MANAGEMENT
SURGICAL MANAGEMENT
ARTERIAL ULCER
NECROTISING SOFT TISSUE INFECTIONS
PRINCIPLES OF MANAGEMENT
STREPTOCOCCAL INFECTIONS
CLOSTRIDIAL INFECTION
HYPERBARIC OXYGEN
NITRIC OXIDE AND CHRONIC LOWER EXTREMITY WOUNDS
TROPICAL ULCERS
TROPICAL PHAGEDENIC ULCER
BURULI ULCER
VELD SORE
BAZIN'S ULCER
MYCETOMA FOOT
FILARIAL LYMPHOEDEMA AND LEG ULCERS
NECROBIOSIS LIPOIDICA DIABETICORUM (NLD)
LEG ULCERS IN LEPROSY PATIENTS
DEBRIDEMENT OF INFECTED WOUNDS: ALTERNATIVE THERAPIES
BIOTHERAPY
ENZYMATIC DEBRIDEMENT
ABSORPTIVE DEBRIDEMENT
VACUUM ASSISTED CLOSURE (VAC) DEVICE
DRESSINGS FOR LEG WOUNDS
6:
Diabetic Foot Ulcer: Local Management
INTRODUCTION
HOW CAN WE INTERRUPT THE WELL-KNOWN CYCLE OF DAMAGE PROCESS IN DIABETIC FOOT?
MOMENTS AND TYPES OF SURGERY INDIABETIC FOOT ULCERATION (DFU)?
DEBRIDEMENT
PRINCIPLES OF DEBRIDEMENT
TECHNIQUES FOR DEBRIDEMENT
SCORING DEBRIDEMENT
USE OF LARVAE OR MAGGOT DEBRIDEMENT THERAPY (MDT)
MECHANICAL METHODS OF DEBRIDEMENT
Hydrojets
Autolytic Debridement using Hydrogels
INFECTION CONTROL
ANATOMICAL CONSIDERATIONS
HYPERBARIC OXYGEN
INFECTION AND HEALING
AMPUTATION
DIGITAL AMPUTATION
PROMOTION OF GRANULATION TISSUE USING NEGATIVE PRESSURE THERAPY
TOTAL CONTACT CAST (TCC)
AIRCAST
ORTHOTIC WALKER
ORTHOPAEDIC SURGERY OF CHARCOT FOOT DEFORMITIES
TREATING THE CHARCOT FOOT
MICROSURGERY
7:
The Role of Vascular Surgery in Diabetic Foot Disease Management
INTRODUCTION
DIAGNOSIS
MANAGEMENT
ONCE THE VIABILITY OF A DIGIT OR FOOT IS SUSPECT
WOUND MANAGEMENT
8:
Selection of Wound Dressings
INTRODUCTION
ADVANTAGES OF MOIST WOUND HEALING
SELECTION OF WOUND DRESSINGS
CLASSIFICATION OF WOUND DRESSINGS
HYDROCOLLOIDS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
HYDROGELS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
HYDROFIBRES
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
HYDROCELLULARS OR FOAM DRESSINGS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
ALGINATES
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
POLYURETHANE FILMS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
CHARCOAL DRESSINGS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
SILVER DRESSINGS
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
TULLES, INTERFACES
Description
Available Forms
Properties
Indications
Practice Guidelines
Renewal
LARVAL THERAPY
Properties
Available Forms
Indications
Practical Guidelines
Renewal
ALTERNATIVE WOUND DRESSINGS
CONCLUSION
9:
The Role of Physical Therapists in Wound Management
INTRODUCTION
PATIENT AND WOUND EVALUATION
PHYSICAL THERAPIST MANAGEMENT OF PATIENTS WITH PRESSURE ULCERATION
LOW FREQUENCY ULTRASOUND (US) FOR DEBRIDEMENT
PULSED LAVAGE WITH SUCTION (PLWS)
PHYSICAL THERAPIST MANAGEMENT OF PATIENTS WITH DIABETIC FOOT ULCERATION
PHYSICAL THERAPIST MANAGEMENT OF PATIENTS WITH VENOUS INSUFFICIENCY ULCERATIONS
PHYSICAL THERAPIST MANAGEMENT OF PATIENTS WITH ARTERIAL INSUFFICIENCY ULCERATIONS
ELECTRICAL STIMULATION FOR WOUND HEALING
EXERCISE FOR INTERMITTENT CLAUDICATION
10:
A Review on Indian Medicinal Plants for Wound Management
INTRODUCTION
DESCRIPTION OF SOME INDIAN MEDICINAL PLANTSFOR WOUND HEALING ACTIVITY
AZADIRACHTA INDICA A JUSS (MELIACEAE)
CARICA PAPAYA LINN. (CARICACEAE)
CENTELLA ASIATICA (LINN.) URBAN (UMBELLIFERAE)
CURCUMA LONGA LINN. (ZINGIBERACEAE)
OCIMUM SANCTUM LINN. (LAMIACEAE)
PTEROCARPUS SANTALINUS LINN. (PAPILIONACEAE)
CONCLUSION
ACKNOWLEDGEMENTS
11:
The Treatment of Chronic Skin Ulcers with the New Dressings from Traditional Chinese Medicine
INTRODUCTION
CASE 1: DIABETIC FOOT ULCER
GENERAL INFORMATION
MEDICAL HISTORY
DIAGNOSIS
PHYSICAL EXAMINATION
BIOCHEMICAL TEST
ANKLE BRACHIAL INDEX (ABI)
X-RAY EXAMINATION
VASCULAR ULTRASOUND
FOOT EXAMINATION
MICROBIAL CULTURE RESULTS
TREATMENT PRINCIPLE
WOUND HISTORY AND ULCER CARE
2006/1/28 Day 0 Suile Wound Dressing Usage (Fig. 11.1)
2006/2/23 Day 26 (Fig. 11.2)
2006/3/23 Day 54 (Fig. 11.3)
2006/5/8 Day 100 the Wound Heal (Fig. 11.4)
CASE 2: CHRONIC RADIATION ULCER
GENERAL INFORMATION
MEDICAL HISTORY
DIAGNOSIS
WOUND HISTORY AND WOUND CARE
12:
The Use of Honey in the Management of Wounds
INTRODUCTION
THERAPEUTIC PROPERTIES OF HONEY
ANTIMICROBIAL PROPERTIES OF HONEY
ANTIMICROBIAL ACTIVITY OF HONEY
WOUND HEALING CHARACTERISTICS OF HONEY
CLINICAL EVIDENCE FOR THE EFFICACY OF HONEY DERIVED FROM COMPARATIVE STUDIES
CLINICAL EVIDENCE FOR THE ROLE OFHONEY IN ONCOLOGY PATIENTS
CLINICAL EVIDENCE FOR THE USE OFHONEY IN SURGICAL WOUNDS
CLINICAL EVIDENCE FOR THE USE OF HONEYIN THE TREATMENT OF ULCERS
GUIDELINES TO USING HONEY
LIMITATIONS OF HONEY
SOURCES OF FURTHER INFORMATION
CONCLUSION
13:
Wound Bed Preparation 2006: Increased Bacterial Burden and Infection—The Story of NERDS© and STONES©
INTRODUCTION
THE 21ST CENTURY CHANGE IN VIEWING WOUND INFECTION
SIGNS AND SYMPTOMS OF BACTERIA IN CHRONIC WOUNDS (CRITICAL COLONISATION AND INFECTION)
A MATTER OF BALANCE
INFECTION
Identify and Correct the Cause and Cofactors that may Inhibit Healing as Well as Addressing Patient Centered Concerns
Paradigm Shift in Care Planning
Differentiate the Wounds Ability to Heal: Healable, Maintenance, or Non-healable Wound
Use Topical Antiseptics for Non-healable or Maintenance Wounds
Determine, if the Wound is in Bacterial Balance or if Increased Bacterial Burden is in the Superficial Compartment, Infection in the Deep Compartment or Both
Obtain a Bacterial Swab in Selected Patients
Select Appropriate Topical Treatment
Use Appropriate Systemic Agents for Increased Deep and Surrounding Skin Compartment Infection (STONES©) and Benchmark Criteria for Monitoring Response to Treatment
RECOMMENDATIONS ON SYSTEMIC AGENTS
SUMMARY
14:
Basic Needs for Wound Healing Research
INTRODUCTION
GENERAL REQUIREMENTS FOR CLINICAL RESEARCH
PERSONNEL: CLINICIAN OR BASIC RESEARCHER?
STRUCTURE AND ORGANISATION
CLINICAL WOUND HEALING EVALUATIONS
PRESENT STATUS
WOUND BED PREPARATION: CONCEPT OF TIME
CHRONIC WOUND HEALING: CONCEPT OF MEASURE
MEASURE
Exudate
Appearance
Suffering
Undermining
Re-evaluate
Edge
BURN WOUND HEALING AND SCARRING
GUIDELINES
SIMPLE TECHNIQUES TO MEASUREOUTCOME OF WOUND HEALING
PLANIMETRY
COLOUR MEASUREMENTS
OTHER AVAILABLE TECHNIQUES
SUBJECTIVE SCALES
CONCLUSION
15:
The Importance of Multidisciplinary Team Building and Education
INTRODUCTION
DEFINITIONS
TEAM BUILDING
TYPES OF CONCEPTS
STATUS IN THE HEALTH CARE SYSTEM
MODELS OR CONCEPTS
THE OUTPATIENT CLINIC MODEL
THE IN- AND OUTPATIENT DEPARTMENT MODEL (THE DANISH MODEL)
Centre Structure
Copenhagen Wound Healing Centre
University Centre of Wound Healing
Activities of the Centres
EDUCATION
EDUCATIONAL MODELS
EUROPE
NORTH AMERICA
CREATION OF A WOUND ORGANISATION
DEFINITION OF AIM
WHICH MODEL OR CONCEPT?
INTEGRATION IN THE NATIONAL HEALTH CARE ORGANISATION
CREATION OF THE SINGLE ELEMENTS OF THE CONCEPT
Wound Healing Centres
The Multidisciplinary Staff
Centre Elements
The Equipment
The Referral Policy
The Diagnostic Armamentarium
A Registration System for Wound Data
Research Activity
Education
The Multidisciplinary Wound Healing Teams in Primary Care
CONCLUSION
INDEX
TOC
Index
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