Local management of diabetic foot ulcers with a polyabsorbent TLC-NOSF dressings — a real-life pilot study in real life from Kuwait

Authors (clockwise from top left): Naser Alhumaidi, Mariam Alessa, Abdul Aziz Alshahe and Emilio Galea

Naser Alhumaidi is Senior Specialist in General Surgery, Head of Diabetic Foot Unit Department of Surgery, Farwaniya Hospital, Kuwait; Mariam Alessa is Diabetes Specialist Podiatrist, Diabetic Foot Unit Department of Surgery, Farwaniya Hospital, Kuwait; Abdul Aziz Alshaheen is General Practitioner Surgery, Diabetic Foot Unit Department of Surgery, Farwaniya Hospital, Kuwait; Emilio Galea is International Medical Director, Urgo Medical

Chronic wounds are an international and regional concern affecting many patients, demanding substantial resources from healthcare systems. Managing patients with these wounds is costly in terms of time and resources required, not forgetting the detrimental impact on the quality of life of these individuals. Moreover, diabetic foot problems are very common throughout the world, and their recurrence is high. In 2016, the World Health Organization (WHO, 2022)reported that 14.7% of the population of Kuwait are suffering from diabetes, with very high percentages of overweight, obese and inactive individuals. It is inevitable that many of these individuals suffer and/or will suffer in the future from diabetes-related foot ulcers and complications, and the management of these wounds is complex. The authors reviewed the evidence behind a local treatment indicated for chronic wounds and specific in neuropathic diabetic foot ulcers. In view of the high level of evidence regarding this local treatment, a pilot study was conducted in 2021 to analyse the feasibility of a larger-scale observational study. The article highlights the results of the initial pilot and discusses the feasibility of conducting further research to justify implementation of technology lipido-colloid nano oligosaccharide factor(TLC-NOSF) dressings in the local management of patients with diabetic foot ulcers in Kuwait.

Surgical incision care — negative pressure wound therapy and advanced dressings

Authors: Rhidian Morgan-Jones (Chair), Amit Gefen and Kylie Sandy-Hodgett

Rhidian Morgan-Jones (Chair) is Consultant Orthopaedic Surgeon, Cardiff Knee Clinic, University Hospital Llandough, Cardiff, UK; Amit Gefen is Professor of Biomedical Engineering and the Herbert J. Berman Chair in Vascular Bioengineering, Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel; Kylie Sandy-Hodgetts is Associate Professor, Centre of Molecular Medicine & Innovative Therapeutics, Murdoch University; Senior Research Fellow, Director Skin Integrity Research Institute, School of Biomedical Sciences, University of Western Australia, Perth, Australia

      This meeting report is based on the Mölnlycke-sponsored workshop held at the sixth World Union of Wound Healing Societies (WUWHS) Congress on March 1–5, 2022, in Abu Dhabi, United Arab Emirates. The workshop, titled ‘Surgical incision care — negative pressure wound therapy and advanced dressings: what to use and when’, included presentations from Kylie SandyHodgetts, Rhidian Morgan-Jones and Amit Gefen. The topics of surgical dressings, risk assessment and requirements of closed-incision negative pressure wound therapy (ciNPWT) were all explored.

Treatment of chronic wounds with a single-use negative pressure wound therapy system: a case series

Authors: Harikrishna KR Nair, Sylvia SY Chong, Mohd Hasbullah Bin Husain

 Abstact: Negative pressure wound therapy (NPWT), is a wound dressing system that continuously or intermittently applies subatmospheric pressure to the surface of the wound, and provides a positive pressure to the surface of the wound to aid healing. The aim of this study was to assess the healing of chronic wounds treated by single-use NPWT. Study participants were selected by simple random sampling from a pool of patients who were attending their routine follow-up visits in Wound Care Unit in Hospital Kuala Lumpur. During each dressing change, the wound was assessed and cleansed with distilled water. Debridement was performed as necessary. The application of NPWT was a simple 3-steps procedure, removing the release paper from the dressing and positioning it over the wound bed, connecting the tubing from the pump to the dressing and providing negative pressure treatment through the swing. There were five patients with chronic wounds of various size and aetiologies, including a two pressure ulcers/injury (PU), two carbuncles and post-motor-vehicle accident wound, enrolled in the study, all showed complete wound healing. The two abscesses healed on week 6 and 8 with the single use NPWT and the traumatic wound healed in 10 weeks. Both the sacral and gluteal PUs healed on week 28 and week 14. Case 3, the gluteal PU, healed at week 14 due to the good standard of care, 2-hourly repositioning, proper support surface and good nutritional diet. Meanwhile, the sacral PU took double the time i.e. 28 weeks as the wound area is larger and poor adherence to standard of care. NPWT pressure between −75 and −125mmHg would provide moist environment that is suitable for wound healing. It aids healing by improving the rate of angiogenesis, endothelial proliferation, capillary blood flow, reducing oedema and bacterial burden within the wound. The limitation of this study was the small number of patients and might not represent the population at large. A much larger study would be needed to show the significance of these findings.

Key words: ■ Chronic wounds ■ Negative pressure wound therapy (NPWT) ■ Pressure ulcer ■ Wound healing

Wound management with Technology Lipido-Colloid Silver Non-Adherent dressing: a case series from Chinese clinicians

      Prevention and appropriate management of wound infection is central to promote the healing process. While not all wounds will necessitate use of systemic antibiotics, some may benefit from the use of topical antimicrobials as part of a holistic standard of care. This article describes five different cases, from China, where the clinicians used Technology Lipido-Colloid Silver Non-Adherent (TLC-Ag) dressings as part of their holistic multidisciplinary wound management strategy. The wounds discussed were mainly chronic, including two venous leg ulcers and lymphoedema ulcer, a post-amputation wound as well as a case of pyoderma gangrenosum. Managing these wounds with TLC-Ag as a part of the standard holistic multidisciplinary care provided resulted in positive outcomes for the patients.

Key words: ■ Acute wounds . ■ Chronic wounds . ■ Silver antimicrobial . ■ UrgoTul Ag . ■ Wound infection

Self-care foot assessment and e-Health services for diabetic foot ulcer patients: a mobile phone app

Foot complications from diabetes mellitus are one of main causes of lower limb amputation, however, public awareness of diabetic foot care is low. A mobile app “Happy Feet” was developed,s targeting patients with diabetic foot ulcers (DFU). Patients foot awareness substantially increased after three and six months of using the application. Mean total scores between baseline and three months were significantly increased (baseline versus three months, 22.80 versus 25.54; p<0.01), and between three and six months in “examining between the toes” and “breaking in new shoes slowly” (p<0.01). Policymakers and medical professionals benefit from the mobile app by providing accurate and precise information from this group of patients.

Key words: Diabetic foot 、Mobile phone application 、   Self-care 、  Self-assessment

Multi-centre, international practicebased evidence using PICO™ singleuse negative pressure wound therapy: challenging current behaviours in wound care practice

Hard-to-heal wounds are challenging to treat and the associated costs consistently fall on outpatient, community and home care budgets. There is a growing body of evidence that suggests the use of PICO™ single-use negative pressure wound therapy (sNPWT) can potentially help improve healing rates of wounds that are deemed as not healing and reduce associated nursing resources and costs. A 323-patient service evaluation was conducted across 17 sites in Denmark, Ireland, Sweden and the United Kingdom between 2016 and 2022. The results are presented in this article.

Authors:

Jane Hampton, Helen Meagher, Andrew Sharpe, Tim Styche and Jacqui Hughes

Jane Hampton is a Wound Consultant in Aarhus, Denmark; Helen Meagheris a Registered Advanced Nurse Practitioner in Tissue Viability, Ireland; Andrew Sharpe is Advanced Podiatrist, Salford Care Organisation, Part of the Northern Care Alliance, UK; Tim Styche is Market Access & Healthcare Economics Manager at Smith+Nephew; Jacqui Hughes is Senior Healthcare Outcomes Manager at Smith+Nephew