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Fulltext Antibacterial-Integrated Collagen Wound Dressing for Diabetes-Related Foot Ulcers: An Evidence-Based Review of Clinical Studies

N Amirrah I, Mohd Razip Wee MF, Tabata Y, Bt Hj Idrus R, Nordin A, Fauzi MB

Polymers (Basel), 2020 Sep 22;12(9).
PMID: 32972012 DOI: 10.3390/polym12092168

Diabetic foot ulcer (DFU) is a chronic wound frequently delayed from severe infection. Wound dressing provides an essential barrier between the ulcer and the external environment. This review aimed to analyse the effectiveness of antibacterial collagen-based dressing for DFU treatment in a clinical setting. An electronic search in four databases, namely, Scopus, PubMed, Ovid MEDLINE(R), and ISI Web of Science, was performed to obtain relevant articles published within the last ten years. The published studies were included if they reported evidence of (1) collagen-based antibacterial dressing or (2) wound healing for diabetic ulcers, and (3) were written in English. Both randomised and non-randomised clinical trials were included. The search for relevant clinical studies (n) identified eight related references discussing the effectiveness of collagen-based antibacterial wound dressings for DFU comprising collagen impregnated with polyhexamethylene biguanide (n = 2), gentamicin (n = 3), combined-cellulose and silver (n = 1), gentian violet/methylene blue mixed (n = 1), and silver (n = 1). The clinical data were limited by small sample sizes and multiple aetiologies of chronic wounds. The evidence was not robust enough for a conclusive statement, although most of the studies reported positive outcomes for the use of collagen dressings loaded with antibacterial properties for DFU wound healing. This study emphasises the importance of having standardised clinical trials, larger sample sizes, and accurate reporting for reliable statistical evidence confirming DFU treatment efficiency.

Matched MeSH terms: Bandages
Biomedical applications of chitosan electrospun nanofibers as a green polymer - Review

Kalantari K, Afifi AM, Jahangirian H, Webster TJ

Carbohydr Polym, 2019 Mar 01;207:588-600.
PMID: 30600043 DOI: 10.1016/j.carbpol.2018.12.011

This review outlines new developments in the biomedical applications of environmentally friendly ('green') chitosan and chitosan-blend electrospun nanofibers. In recent years, research in functionalized nanofibers has contributed to the development of new drug delivery systems and improved scaffolds for regenerative medicine, which is currently one of the most rapidly growing fields in all of the life sciences. Chitosan is a biopolymer with non-toxic, antibacterial, biodegradable and biocompatible properties. Due to these properties, they are widely applied for biomedical applications such as drug delivery, tissue engineering scaffolds, wound dressings, and antibacterial coatings. Electrospinning is a novel technique for chitosan nanofiber fabrication. These nanofibers can be used in unique applications in biomedical fields due to their high surface area and porosity. The present work reviews recent reports on the biomedical applications of chitosan-based nanofibers in detail.

Matched MeSH terms: Bandages
Delayed Onset Sciatic Nerve Palsy Secondary to Wound Hematoma following Anticoagulant Therapy Post-Bipolar Hemiarthroplasty - an Uncommon Complication: A Case Report

Balaji G, Sriharsha Y, Sharma D

Malays Orthop J, 2019 Jul;13(2):49-51.
PMID: 31467653 DOI: 10.5704/MOJ.1907.010

A 58-year old female patient presented to us with a three months' old fracture of the neck of femur. She underwent bipolar hemiarthroplasty. In the immediate postoperative period, she developed deep vein thrombosis for which she was started on anticoagulant therapy. Patient had persistent discharge from the wound since then and underwent regular dressings. On the eighth post-op day, she developed sciatic nerve palsy secondary to wound haematoma. The haematoma was decompressed immediately and she had a dramatic improvement in pain but her neurological deficit persisted. The wound healed completely without any complications. At three months follow up, she had recovered completely with grade 5/5 power in ankle and foot and full sensory recovery in the sciatic nerve distribution. She was ambulating comfortably with a walker. At final follow up around 20 months post-operation, she was pain-free and walking without any support. The wound had healed completely.

Matched MeSH terms: Bandages
Fulltext The effect of Piper betle on wound healing in male Sprague Dawley rats

Nur Ain, J., Ainaa Diyana, S., Nur Hazirah, R., Nur Fathiah, A.S., Fairus, A., Teoh, S.l., et al.

Medicine & Health, 2018;13(1):165-174.
MyJurnal

Piper betle (PB) leaves have been traditionally used in many Asian countries for the healing of wounds and other ailments. The aim of this study was to examine the wound healing effect of PB on skin injury-inflicted Sprague-Dawley rats. Eighteen male Sprague-Dawley rats were inflicted with wounds and then divided into three groups consisting of a control (normal wound healing without dressing), saline (wound healing aided by gauze soaked in saline) and PB (gauze impregnated with PB paste) dressings. Wounds were created on the back of rats with 6-mm sterilized punch biopsy needle. Wounds were examined on days 3, 5, 7, 9, 11 and 13 for dryness, exudation, and scar formation. Rats were sacrificed on day 14 and the granulation tissue formed on the wound was then excised for histological examination using Hematoxylin and Eosin staining. The formation of granulation tissue in rats treated with PB showed higher progress to wound closure with shorter days (on day 3) compared to the control and saline group (on day 5). PB dressing minimized the formation of scar tissue significantly (p

Matched MeSH terms: Bandages
Fulltext Development and validation of a personal care modules for older adults with more significant disabilities

Nor Afifi Razaob, Masne Kadar, Kah, Jolene Ee Koay, Siti Noraini Asmuri

Jurnal Sains Kesihatan Malaysia, 2020;18(2):83-92.
MyJurnal

Older adults residing in community, as well as those who are residing in institutional or care home may experience various cognitive, health and physical impairments that may affect their independence. Continuous supports are needed to manage most of their personal care activities which are usually managed by their family members, often without proper training or guidance. To date, there is no personal care module that can be used as a guideline by family members and paid caretakers. Therefore, this study aims to develop and validate a personal care module as a guideline in assisting older adults with more significant disabilities. This study was a three-phase study, involving (1) development of the personal care module, (2) focus group discussion with healthcare experts and (3) face and content validity by the expert reviewers. A total of 10 older adults participated in semi structured interview in phase one and 13 occupational therapists were involved as experts in evaluating the module in phase two and three, having between 5 to 25 years of working experiences. The finding reported a high content validity in the developed module ranging from 0.88 to 1.00 on six domains of personal hygiene, bathing, dressing, feeding, bed mobility and stairs climbing. This study provides a preliminary support for the developed personal care module as a valid instrument to be used as a guideline in managing personal care activities of older adults with more significant disabilities.

Matched MeSH terms: Bandages
Fulltext Economic impact of managing acute diabetic foot infection in a tertiary hospital in Malaysia

Lam AWC, Zaim MR, Helmy HH, Ramdhan IMA

Malays Orthop J, 2014;8(1):46-49.
MyJurnal

Diabetic foot disease is the leading cause of non-traumatic amputations of the lower limb, hence a major health care and socioeconomic burden. It has been found that most of the costs occur in the inpatient setting; therefore this study is to quantify the costs of managing inpatient diabetic foot infections (DFI). We treated 182 inpatients from May 2012 till April 2013 and analysed the cost of antibiotic usage, wound dressing, surgical procedure, admission and basic investigation costs. The total cost was ~ USD 11,000 (2013). This number, however, only reflects the cost for managing an acute infection. The price for follow-up care as an outpatient, rehabilitation and indirect costs (emotional suffering, reduced productivity) is estimated to be much more.
Study site: Diabetic Inpatient Registry, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia

Matched MeSH terms: Bandages
Fulltext Electrospun polyurethane nanofibrous composite impregnated with metallic copper for wound-healing application

Jaganathan SK, Mani MP

3 Biotech, 2018 Aug;8(8):327.
PMID: 30073112 DOI: 10.1007/s13205-018-1356-2

In this study, a wound dressing based on polyurethane (PU) blended with copper sulphate nanofibers was developed using an electrospinning technique. The prepared PU and PU nanocomposites showed smooth fibers without any bead defects. The prepared nanocomposites showed smaller fiber (663 ± 156.30 nm) and pore (888 ± 70.93 nm) diameter compared to the pristine PU (fiber diameter 1159 ± 147.48 nm and pore diameter 1087 ± 62.51 nm). The interaction of PU with copper sulphate was evident in the infrared spectrum through hydrogen-bond formation. Thermal analysis displayed enhanced weight residue at higher temperature suggesting interaction of PU with copper sulphate. The contact angle measurements revealed the hydrophilic nature of the prepared nanocomposites (71° ± 2.309°) compared with pure PU (100° ± 0.5774°). The addition of copper sulphate into the PU matrix increased the surface roughness, as revealed in the atomic force microscopy (AFM) analysis. Mechanical testing demonstrated the enhanced tensile strength behavior of the fabricated nanocomposites (18.58 MPa) compared with the pristine PU (7.12 MPa). The coagulation assays indicated the enhanced blood compatibility of the developed nanocomposites [activated partial thromboplastin time (APTT)-179 ± 3.606 s and partial thromboplastin time (PT)-105 ± 2.646 s] by showing a prolonged blood clotting time compared with the pristine PU (APTT-147.7 ± 3.512 s and PT-84.67 ± 2.517 s). Furthermore, the hemolysis and cytotoxicity studies suggested a less toxicity nature of prepared nanocomposites by displaying low hemolytic index and enhanced cell viability rates compared with the PU membrane. It was observed that the fabricated novel wound dressing possesses better physicochemical and enhanced blood compatibility properties, and may be utilized for wound-healing applications.

Matched MeSH terms: Bandages
Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections

Ng SF, Leow HL

Drug Dev Ind Pharm, 2015;41(11):1902-9.
PMID: 25758412 DOI: 10.3109/03639045.2015.1019888

It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection.

Matched MeSH terms: Bandages
Use of a portable negative pressure wound therapy device on a hard-to-heal wound with exposed bone: a case study

Wen CWY, Nasir FABM, Charl MK, Jane CA, Abdullah NSKH, Ping LB, et al.

J Wound Care, 2023 Oct 01;32(Sup10a):S16-S20.
PMID: 37830842 DOI: 10.12968/jowc.2023.32.Sup10a.S16

This case study examines the effectiveness of using negative pressure wound therapy (NPWT) in the management of a hard-to-heal (chronic) wound with exposed ankle bone to reduce associated wound exudate and promote production of granulation tissue. A 60-year-old male patient who was able to attend wound follow-up diligently twice weekly for eight weeks, and weekly thereafter, was selected from a private hospital to take part. During each dressing change, the wound was cleansed with superoxidised cleansing solution, and minimal sharp debridement was performed. In the authors' opinion, the NPWT device used in this study is light and convenient for use in the community or home care setting. The NPWT wound dressing was connected to the NPWT machine via a connecting tube and the device then switched on using the default setting of a negative pressure of 125mmHg. Following the application of the NPWT device, the exposed ankle bone was successfully covered with healthy granulation tissue and healed within 20 weeks with minimal exudate formation in the wound. In the authors' opinion, NPWT is able to promote progress to wound healing; to minimise unnecessary dressing changes and, based on feedback from the patient, is comfortable to wear and when in use.

Matched MeSH terms: Bandages
Fulltext Approaches for Mitigating Microbial Biofilm-Related Drug Resistance: A Focus on Micro- and Nanotechnologies

Rao H, Choo S, Rajeswari Mahalingam SR, Adisuri DS, Madhavan P, Md Akim A, et al.

Molecules, 2021 Mar 26;26(7).
PMID: 33810292 DOI: 10.3390/molecules26071870

Biofilms play an essential role in chronic and healthcare-associated infections and are more resistant to antimicrobials compared to their planktonic counterparts due to their (1) physiological state, (2) cell density, (3) quorum sensing abilities, (4) presence of extracellular matrix, (5) upregulation of drug efflux pumps, (6) point mutation and overexpression of resistance genes, and (7) presence of persister cells. The genes involved and their implications in antimicrobial resistance are well defined for bacterial biofilms but are understudied in fungal biofilms. Potential therapeutics for biofilm mitigation that have been reported include (1) antimicrobial photodynamic therapy, (2) antimicrobial lock therapy, (3) antimicrobial peptides, (4) electrical methods, and (5) antimicrobial coatings. These approaches exhibit promising characteristics for addressing the impending crisis of antimicrobial resistance (AMR). Recently, advances in the micro- and nanotechnology field have propelled the development of novel biomaterials and approaches to combat biofilms either independently, in combination or as antimicrobial delivery systems. In this review, we will summarize the general principles of clinically important microbial biofilm formation with a focus on fungal biofilms. We will delve into the details of some novel micro- and nanotechnology approaches that have been developed to combat biofilms and the possibility of utilizing them in a clinical setting.

Matched MeSH terms: Bandages
Fulltext Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing

Mohd Zohdi R, Abu Bakar Zakaria Z, Yusof N, Mohamed Mustapha N, Abdullah MN

Evid Based Complement Alternat Med, 2012;2012:843025.
PMID: 21941590 DOI: 10.1155/2012/843025

A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P < 0.05) wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P < 0.05). Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P < 0.05) suppressed the expression of proinflammatory cytokines (IL-1α, IL-1β, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing.

Matched MeSH terms: Bandages, Hydrocolloid
Fulltext Necrotizing fasciitis of the head and neck: surgical outcomes in three cases

Shaariyah MM, Marina MB, Mohd Razif MY, Mazita A, Primuharsa Putra SH

Malays J Med Sci, 2010 Apr;17(2):51-5.
PMID: 22135538 MyJurnal

Necrotizing fasciitis of the head and neck is a rare, rapidly progressive infection involving the skin, subcutaneous tissue and fascia. We report three cases of necrotizing fasciitis that differ in their presentation and outcome. The first case involves a patient who presented with progressively enlarging anterior neck swelling that was later complicated by dehydration and reduced consciousness. The second case is a patient with neck swelling and ipsilateral otorrhea. The third case concerns a patient with a buccal ulcer complicated by ipsilateral facial swelling. All of them underwent a fasciotomy with wound debridement with the addition of a cortical mastoidectomy in the second case. Two of these patients recovered well. Unfortunately, the third case succumbed to death due to airway compromise and septicaemia. We advocate the importance of eradicating the source of infection followed by frequent, meticulous wound dressing and strict blood sugar control to obtain better outcomes in managing necrotizing fasciitis of the head and neck. However, involvement of the airway carries a grave prognosis despite aggressive treatment.

Matched MeSH terms: Bandages
Benefit of triple-strap abdominal binder on voluntary cough in patients with spinal cord injury

Julia PE, Sa'ari MY, Hasnan N

Spinal Cord, 2011 Nov;49(11):1138-42.
PMID: 21577218 DOI: 10.1038/sc.2011.53

STUDY DESIGN: A cross-sectional experimental study.
OBJECTIVE: The purpose of this study is to examine the benefit of elastic abdominal binders on voluntary cough in persons with spinal cord injury.
SETTING: Spinal rehabilitation unit in a teaching hospital.
METHODS: We measured voluntary cough peak expiratory flow rate (in 21 subjects with spinal cord injury, (18 tetraplegia, 3 paraplegia) under three conditions: without abdominal binder as the baseline, with single-strap abdominal binder and triple-strap abdominal binder.
RESULTS: The results showed that the mean cough peak expiratory flow rate in all subjects without abdominal binder was 277.1 l per min. There was a significant increase in flow rate with the use of abdominal binders: 325.7 l per min with single-strap abdominal binder and 345.2 l per min with triple-strap abdominal binder (P<0.05, paired t-test). The mean cough peak expiratory flow rate in tetraplegic subjects using triple-strap abdominal binders was significantly higher compared with those using single-strap abdomina
l binders (322.1 l per min and 299.4 l per min, respectively).
CONCLUSION: Abdominal binders can be used as an effective method to improve cough ability in spinal cord injured patients, with triple-strap abdominal binder achieving greater cough peak expiratory flows.

Comment in: Frisbie JH. Question of stamina for the diaphragm. Spinal Cord. 2012 Jun;50(6):480. doi: 10.1038/sc.2011.164. Epub 2012 Jan 17. PubMed PMID: 22249332.

Matched MeSH terms: Compression Bandages*
Poly (3-hydroxyalkanoates)-co-(6-hydroxyhexanoate) hydrogel promotes angiogenesis and collagen deposition during cutaneous wound healing in rats

Gumel AM, Razaif-Mazinah MR, Anis SN, Annuar MS

Biomed Mater, 2015 Aug;10(4):045001.
PMID: 26154416 DOI: 10.1088/1748-6041/10/4/045001

Wound management and healing in several physiological or pathological conditions, particularly when comorbidities are involved, usually proves to be difficult. This presents complications leading to socio-economic and public health burdens. The accelerative wound healing potential of biocompatible poly(3-hydroxyalkanoates)-co-(6-hydroxyhexanoate) (PHA-PCL) composite hydrogel is reported herein. The biosynthesized PHA-PCL macromer was cross-linked with PEGMA to give a hydrogel. Twenty-four rats weighing 200-250 g each were randomly assigned to four groups of six rats. Rats in group I (negative control) were dressed with sterilized gum acacia paste in 10% normal saline while PEGMA-alone hydrogel (PH) was used to dress group II (secondary control) rats. Group III rats were dressed with PHAs-PCL cross-linked PEGMA hydrogel (PPH). For the positive control (group IV), the rats were dressed with Intrasite(®) gel. Biochemical, histomorphometric and immunohistomorphometric analyses revealed a significant difference in area closure and re-epithelialization on days 7 and 14 in PPH or Intrasite(®) gel groups compared to gum acacia or PEGMA-alone groups. Furthermore, wounds dressed with PPH or Intrasite(®) gel showed evident collagen deposition, enhanced fibrosis and extensively organized angiogenesis on day 14 compared to the negative control group. While improvement in wound healing of the PH dressed group could be observed, there was no significant difference between the negative control group and the PH dressed group in any of the tests. The findings suggested that topical application of PPH accelerated the rats' wound healing process by improving angiogenesis attributed to the increased microvessel density (MVD) and expressions of VEGF-A in tissue samples. Thus, PPH has been demonstrated to be effective in the treatment of cutaneous wounds in rats, and could be a potential novel agent in the management and acceleration of wound healing in humans and animals.

Matched MeSH terms: Bandages*
Benefits of sucrose octasulfate (TLC-NOSF) dressings in the treatment of chronic wounds: a systematic review

Nair H, Venkateshwaran N, Seetharaman S S, Deng W, Uthaipaisanwong A, Galea E

J Wound Care, 2021 Apr 01;30(Sup4):S42-S52.
PMID: 33856929 DOI: 10.12968/jowc.2021.30.Sup4.S42

OBJECTIVE: Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients are receiving the best treatment proven to reduce healing time and improve outcomes, including economic benefits and patients' health-related quality of life (HRQoL). Due to recent restrictions because of the COVID-19 pandemic, including closure of wound care centres within hospitals and a drop in patient volume, chronic wound management needs simple-to-use dressings which are still effective and evidence-based solutions. This systematic review was conducted to identify the clinical evidence available on a sucrose octasulfate dressing (TLC-NOSF, UrgoStart dressing range, Laboratoires Urgo, France) to explore its efficacy in the management of chronic wounds, particularly lower limb ulcers, diabetic foot ulcers and pressure ulcers.
METHOD: A literature search of PubMed, Cochrane Library and Google Scholar was conducted based on the PICO model (patient/population, intervention, comparison and outcomes) to retrieve publications of different levels of evidence in order to evaluate outcomes of the use of TLC-NOSF dressings.
RESULTS: A total of 21 publications of different levels, ranging from double-blind randomised control trials to case reports, involving over 12,000 patients, were identified through PubMed, with a further eight publications through Google Scholar and two publications through Cochrane Library. A total of seven results were omitted due to the lack of relevance or repetition.
CONCLUSION: All the evidence provided suggest that these dressings provide clinicians with an evidence-based option for the management of chronic wounds; that the TLC-NOSF dressings are beneficial in promoting the healing process, reducing healing times, enhancing patients' HRQoL, and in allowing a more cost-effective procedure.

Matched MeSH terms: Bandages, Hydrocolloid*
Sea cucumber (Stichopus hermanii) based hydrogel to treat burn wounds in rats

Zohdi RM, Zakaria ZA, Yusof N, Mustapha NM, Abdullah MN

J Biomed Mater Res B Appl Biomater, 2011 Jul;98(1):30-7.
PMID: 21504052 DOI: 10.1002/jbm.b.31828

Malaysian sea cucumber was incorporated into hydrogel formulation by using electron beam irradiation technique and was introduced as novel cross-linked Gamat Hydrogel dressing. This study investigated whether Gamat Hydrogel enhanced repair of deep partial skin thickness burn wound in rats and its possible mechanism. Wounds were treated with either Gamat Hydrogel, control hydrogel, OpSite® film dressing or left untreated. Skin samples were taken at 7, 14, 21, and 28 days post burn for histological and molecular evaluations. Gamat Hydrogel markedly enhanced wound contraction and improved histological reorganization of the regenerating tissue. Furthermore, the dressing modulated the inflammatory responses, stimulated the activation and proliferation of fibroblasts, and enhanced rapid production of collagen fiber network with a consequently shorter healing time. The level of proinflammatory cytokines; IL-1α, IL-1β, and IL-6, were significantly reduced in Gamat Hydrogel treated wounds compared with other groups as assessed by reverse transcription-polymerase chain reaction (RT-PCR). In summary, our results showed that Gamat Hydrogel promoted burn wound repair via a complex mechanism involving stimulation of tissue regeneration and regulation of pro-inflammatory cytokines. The resultant wound healing effects were attributed to the synergistic effect of the hydrogel matrix and incorporated sea cucumber.

Matched MeSH terms: Bandages, Hydrocolloid*
Effects of pressure garment on spasticity and function of the arm in the early stages after stroke: a randomized controlled trial

Ooi HK, Chai SC, Kadar M

Clin Rehabil, 2020 Apr;34(4):515-523.
PMID: 32037862 DOI: 10.1177/0269215520905050

OBJECTIVE: To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke.
DESIGN: A randomized controlled trial.
SETTING: Occupational therapy unit of a public hospital.
SUBJECTS: A total of 46 adults with stroke.
INTERVENTION: After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove).
MAIN MEASURES: Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention.
RESULTS: There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline.
CONCLUSION: Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.

Matched MeSH terms: Compression Bandages*
Wound dressings functionalized with silver nanoparticles: promises and pitfalls

Kalantari K, Mostafavi E, Afifi AM, Izadiyan Z, Jahangirian H, Rafiee-Moghaddam R, et al.

Nanoscale, 2020 Jan 28;12(4):2268-2291.
PMID: 31942896 DOI: 10.1039/c9nr08234d

Infections are the main reason why most people die from burns and diabetic wounds. The clinical challenge for treating wound infections through traditional antibiotics has been growing steadily and has now reached a critical status requiring a paradigm shift for improved chronic wound care. The US Centers for Disease Control have predicted more deaths from antimicrobial-resistant bacteria than from all types of cancers combined by 2050. Thus, the development of new wound dressing materials that do not rely on antibiotics is of paramount importance. Currently, incorporating nanoparticles into scaffolds represents a new concept of 'nanoparticle dressing' which has gained considerable attention for wound healing. Silver nanoparticles (Ag-NPs) have been categorized as metal-based nanoparticles and are intriguing materials for wound healing because of their excellent antimicrobial properties. Ag-NPs embedded in wound dressing polymers promote wound healing and control microorganism growth. However, there have been several recent disadvantages of using Ag-NPs to fight infections, such as bacterial resistance. This review highlights the therapeutic approaches of using wound dressings functionalized with Ag-NPs and their potential role in revolutionizing wound healing. Moreover, the physiology of the skin and wounds is discussed to place the use of Ag-NPs in wound care into perspective.

Matched MeSH terms: Bandages*
Emerging Trends in Therapeutic Algorithm of Chronic Wound Healers: Recent Advances in Drug Delivery Systems, Concepts-to-Clinical Application and Future Prospects

Shao M, Hussain Z, Thu HE, Khan S, de Matas M, Silkstone V, et al.

Crit Rev Ther Drug Carrier Syst, 2017;34(5):387-452.
PMID: 29256838 DOI: 10.1615/CritRevTherDrugCarrierSyst.2017016957

Chronic wounds which include diabetic foot ulcer (DFU), pressure ulcer, and arterial or venous ulcers compel a significant burden to the patients, healthcare providers, and the healthcare system. Chronic wounds are characterized by an excessive persistent inflammatory phase, prolonged infection, and the failure of defense cells to respond to environmental stimuli. Unlike acute wounds, chronic nonhealing wounds pose a substantial challenge to conventional wound dressings, and the development of novel and advanced wound healing modalities is needed. Toward this end, numerous conventional wound-healing modalities have been evaluated in the management of nonhealing wounds, but a multifaceted approach is lacking. Therefore, this review aims to compile and explore the wide therapeutic algorithm of current and advanced wound healing approaches to the treatment of chronic wounds. The algorithm of chronic wound healing techniques includes conventional wound dressings; approaches based on autografts, allografts, and cultured epithelial autografts; and recent modalities based on natural, modified or synthetic polymers and biomaterials, processed mutually in the form of hydrogels, films, hydrocolloids, and foams. Moreover, this review also explores the promising potential of advanced drug delivery systems for the sustained delivery of growth factors, curcumin, aloe vera, hyaluronic acid, and other bioactive substances as well as stem cell therapy. The current review summarizes the convincing evidence for the clinical dominance of polymer-based chronic wound healing modalities as well as the latest and innovative therapeutic strategies for the treatment of chronic wounds.

Matched MeSH terms: Bandages/trends
In vivo evaluation of bacterial cellulose/acrylic acid wound dressing hydrogel containing keratinocytes and fibroblasts for burn wounds

Mohamad N, Loh EYX, Fauzi MB, Ng MH, Mohd Amin MCI

Drug Deliv Transl Res, 2019 04;9(2):444-452.
PMID: 29302918 DOI: 10.1007/s13346-017-0475-3

The healing of wounds, including those from burns, currently exerts a burden on healthcare systems worldwide. Hydrogels are widely used as wound dressings and in the field of tissue engineering. The popularity of bacterial cellulose-based hydrogels has increased owing to their biocompatibility. Previous study demonstrated that bacterial cellulose/acrylic acid (BC/AA) hydrogel increased the healing rate of burn wound. This in vivo study using athymic mice has extended the use of BC/AA hydrogel by the addition of human epidermal keratinocytes and human dermal fibroblasts. The results showed that hydrogel loaded with cells produces the greatest acceleration on burn wound healing, followed by treatment with hydrogel alone, compared with the untreated group. The percentage wound reduction on day 13 in the mice treated with hydrogel loaded with cells (77.34 ± 6.21%) was significantly higher than that in the control-treated mice (64.79 ± 6.84%). Histological analysis, the expression of collagen type I via immunohistochemistry, and transmission electron microscopy indicated a greater deposition of collagen in the mice treated with hydrogel loaded with cells than in the mice administered other treatments. Therefore, the BC/AA hydrogel has promising application as a wound dressing and a cell carrier.

Matched MeSH terms: Bandages*

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