Bates-Jensen Wound Assessment Tool Research Articles

A domain specific health-related quality of life of omani patients living with chronic wounds

AimChronic wounds, defined as wounds that do not heal in a logical set of stages, impact patients’ quality of life by disrupting their self-esteem, sleep, social interaction, work capacity, and psychological well-being. Chronic wounds are a prevalent problem in Oman due to the high number of patients with diabetes, sickle cell disease, road traffic accidents, and decubitus ulcer. Therefore, it is paramount to analyse the health-related quality of life (HRQOL) of these patients with chronic wounds. Material and methodsAn observational, cross-sectional, descriptive study with a quantitative approach was conducted among 275 adult patients with chronic wounds in three tertiary hospitals of Muscat from June to December 2021 using a self-reported Cardiff life wound impact questionnaire and the Bates-Jensen wound assessment tool. Data were analysed with IBM SPSS version 23 using inferential statistics and chi-square test. ResultsWe found that the majority of participants were men (178; 64.7 %), aged between 41 and 60 years (107; 38.9 %), predominantly with diabetic wounds (80; 29.1 %). Respondents reported poor HRQOL across all domains: well-being (63.24 ± 18.092), physical (53.24 ± 18.387), and social (59.54 ± 19.025). Statistically significant poorer HRQOL was observed among the elderly above 60 years, illiterates, those with traumatic wounds, and those receiving medication and dressing as treatment. ConclusionsOur findings indicate that Omani patients with chronic wounds experience low HRQOL. It is imperative for healthcare providers to offer comprehensive care to these patients. To enhance their quality of life and alleviate suffering, evaluating both the wounds and HRQOL is essential. Such assessments will enable the optimisation of treatment and coping strategies for patients.

The Effect of Ozone Therapy Stimulation on Diabetes Wound Healing Process

<p>Health problems that are currently developing include diabetes mellitus (DM) with various complications including diabetic ulcers. Diabetic ulcers are the main cause of prolonged pain and even amputation in DM patients. Diabetic wounds are a complication of diabetes that often occurs in the extremities, increasing morbidity and lessens the patient's personal satisfaction. Ozone therapy is one method used to speed up the healing process for diabetic ulcers. This study plans to examine the impact of ozone treatment feeling on diabetic injury mending. The exploration strategy utilizes a semi exploratory technique with a pretest and posttest non-identical benchmark group plan. The testing strategy is a non-likelihood inspecting method.The population in this study were all patients suffering from diabetic wounds who received wound care at the Edwcare clinic in Langsa city. The respondents of this study were patients suffering from diabetic wounds who received wound care at the Edwacare wound care center in Langsa City, Indonesia consisting of 28 respondents who received modern wound care dressings and 28 respondents received wound care combined with modern dressings and ozone therapy. The research instrument for assessing wound severity used the Bates-Jensen Wound Assessment Tool. Data analysis used the Friedman and Kruskal Wallis tests. Based on the research results, it was found that there was a more significant effect between wound care using a combination of modern dressings and ozone therapy with a Mean Rank value of 39.75 compared to wound care that only received modern dressing wound care with a Mean Rank value of 17.25 with a value of p -value <0.05. The conclusion is that the effect of ozone stimulation significantly influences the healing process of diabetic wounds and is recommended as a nursing intervention that can be applied in treating diabetic wounds.</p><p><strong><em>Keywords: Diabetes mellitus, diabetic wounds, ozone therapy, stimulation</em></strong></p>

The Use of Silver Oxynitrate Wound Dressings in the Treatment of Chronic Wounds: A Feasibility Pilot Study.

To evaluate the feasibility and effectiveness of a silver oxynitrate (Ag 7 NO 11 ) dressing on wound healing in patients with stalled chronic wounds. A prospective pilot study was conducted to determine the feasibility and effect of using silver oxynitrate dressings within an outpatient setting in Alberta, Canada. A total of 23 patients (12 women and 11 men; mean age, 66.1 ± 13.8 years) with a chronic wound that failed to heal with conventional treatment were included in the study. Wound assessments including the Bates-Jensen Wound Assessment Tool, wound-related pain, wound size, and patient quality of life (QoL) were conducted at baseline, after dressing application for 1 and 2 weeks, and during 4- and 12-week follow-ups. Dressing application at 1 and 2 weeks improved patients' wound healing progression as measured through significantly decreased Bates-Jensen Wound Assessment Tool scores with a more than 10% decrease at 4- and 12-week follow-up ( P < .001). Pain ( P = .004), and QoL psyche subscore ( P = .008) significantly improved at 4-week follow-ups, although wound area, perimeter, and QoL body and everyday subscores were not significantly affected. Wound size was not significantly affected. The silver oxynitrate dressing may improve healing progression in patients with chronic wounds, enhance patient experience by reducing wound-related pain, and improve patients' mental well-being. Further studies are warranted to elucidate the effect of silver oxynitrate dressings on wound area, perimeter, and volume measurements.

The effectiveness of wound cleansing using &lt;i&gt;Cocor Bebek&lt;/i&gt; (&lt;i&gt;Kalanchoe pinnata&lt;/i&gt;) leaves in healing diabetic foot ulcers

This study aimed to evaluate the effectiveness of Cocor Bebek (Kalanchoe pinnata) leaves in wound cleaning for diabetic foot ulcers (DFU) and compare it with the use of NaCl solution. Diabetes mellitus (DM) and its complications, such as DFU, pose a global health problem with increasing prevalence. Given the escalating occurrence of DFU, timely and effective treatment is crucial to prevent severe complications, including amputation. This research employed a quasi-experimental design with a pretest-posttest control group and was conducted at Rumah Luka Surabaya, Indonesia. The sample comprised 40 respondents with DFU, divided into an intervention group (using Cocor Bebek leaves) and a control group (using NaCl solution). Respondents' characteristics, including age, sex, occupation, duration of diabetes, and other factors, were assessed to understand their impact on the response to treatment. The results demonstrated a significant improvement in DFU wound healing in the intervention group after using Cocor Bebek leaves (p&lt;0.05), along with reduced scores on Bates Jensen Wound Assessment Tool (BWAT) indicators such as wound edge, tunnel, and necrotic tissue type. Conversely, the control group using NaCl solution also exhibited significant improvement in wound healing (p&lt;0.05), with decreased scores on indicators such as the amount of necrotic tissue and the quantity of exudate. This study underscores the potential of Cocor Bebek leaves in aiding wound healing in DFU, evident from clinical improvements and reduced BWAT scores. However, further research and clinical trials are needed to comprehensively support these findings and understand the mechanism of action, as well as the safety of using Cocor Bebek leaves in diabetic patients.

Towards an AI-Based Objective Prognostic Model for Quantifying Wound Healing.

Chronic wounds affect millions of people worldwide every year. An adequate assessment of a wound's prognosis is critical to wound care, guiding clinical decision making by helping clinicians understand wound healing status, severity, triaging and determining the efficacy of a treatment regimen. The current standard of care involves using wound assessment tools, such as Pressure Ulcer Scale for Healing (PUSH) and Bates-Jensen Wound Assessment Tool (BWAT), to determine wound prognosis. However, these tools involve manual assessment of a multitude of wound characteristics and skilled consideration of a variety of factors, thus, making wound prognosis a slow process which is prone to misinterpretation and high degree of variability. Therefore, in this work we have explored the viability of replacing subjective clinical information with deep learning-based objective features derived from wound images, pertaining to wound area and tissue amounts. These objective features were used to train prognostic models that quantified the risk of delayed wound healing, using a dataset consisting of 2.1 million wound evaluations derived from more than 200,000 wounds. The objective model, which was trained exclusively using image-based objective features, achieved at minimum a 5% and 9% improvement over PUSH and BWAT, respectively. Our best performing model, that used both subjective and objective features, achieved at minimum an 8% and 13% improvement over PUSH and BWAT, respectively. Moreover, the reported models consistently outperformed the standard tools across various clinical settings, wound etiologies, sexes, age groups and wound ages, thus establishing the generalizability of the models.

Evaluation of a new low-cost negative pressure wound therapy in the treatment of diabetic foot ulcers.

To investigate the effectiveness of a new and low-cost negative pressure wound therapy (LC-NPWT) in the treatment of diabetic foot ulcers (DFUs). In this retrospective cohort study, patients from our inpatient clinic with Wagner grade 3 DFUs were given LC-NPWT or conventional wound dressings. The primary outcome was the wound healing rates. Complete wound healing, defined as complete re-epithelialisation of the wound, was recorded during the two months of follow-up. The definition of complete epidermis of the wound was that the skin was closed (100% re-epithelialisation), with no drainage or dressing. The secondary outcomes were the number of inpatient days and surgical procedures, and outcomes after hospital discharge. The wound score from the Bates-Jensen wound assessment tool and the levels of the inflammation factors procalcitonin (PCT), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were compared between the two groups. The Kaplan-Meier survival estimate was used to examine the cumulative wound healing rate. The study cohort comprised 41 patients. The two-month wound healing rate was higher in patients in the LC-NPWT group than in the control group (15/21 (71.4%) versus 8/20 (40.0%), respectively; p=0.043). At the end of the two-month follow-up period, the cumulative wound healing rate was higher in the LC-NPWT group than in the control group (p=0.032). Patients in the LC-NPWT group had fewer inpatient days (19.3±3.84 versus 25.05±4.81; p<0.001) and shorter duration of antibiotic use (32.14±3.89 days versus 36.10±5.80 days; p=0.014) than those who received conventional wound dressings. There were significant improvements in mean wound score between the LC-NPWT group and the control group (p<0.001). After one week of treatment, the blood levels of PCT (0.03±0.30ng/ml versus 0.07±0.08ng/ml; p=0.039), CRP (14.55±13.40mg/l versus 24.71±18.10mg/l; p=0.047) and ESR (42.05±29.29mm/h versus 61.65±22.42mm/h; p=0.021) were lower in patients who received LC-NPWT than those who received conventional wound dressings. LC-NPWT is effective in the treatment of DFUs and provides a cheaper alternative for patients with DFUs that could potentially alleviate the economic distress these patients endure.

A Randomized, Placebo-controlled, Double-blind Clinical Trial of Bacteriophage Cocktails in Chronic Wound Infections.

Chronic wounds are prevalent globally at endemic proportions. The common features associated with chronic wounds are prolonged inflammatory phase, infection with multidrug-resistant (MDR) bacteria, and subsequent biofilm formation. The present randomized-controlled trial (RCT) study was undertaken on chronic wounds of ≥6 weeks longer duration using customized phages to evaluate the efficacy and safety of bacteriophage therapy. The study was conducted from December 2021 to August 2023. Thirty patients in each of the arms (placebo and bacteriophage) were recruited with chronic wounds. The patients, both arms, received the conventional treatment of wound debridement, local antiseptics, and local and systemic antibiotics at the discretion of the treating surgeon. However, before applying the customized bacteriophage cocktail or placebo, the wound surface was thoroughly washed to remove the residual antiseptics. The phage cocktails or placebo were applied on alternate days. The wounds were evaluated using the Bates-Jensen Wound Assessment Tool for the progress of wound healing. A total of 93.3% of the wound became sterile in 39 days (median sterility time), followed by complete healing by the end of 90 days in the phage group. Contrary to this, 83.3% of those on placebo therapy remained colonized by original bacteria or additional new bacteria without healing for up to 90 days. With the well-designed RCT, we could conclude that customized bacteriophage therapy using bacteriophage cocktails will definitely cure the chronic wound, irrespective of age, sex, diabetes status, and infection by MDR bacteria.

Hyperbaric Oxygen Therapy for Soft Tissue Injury in Open Musculoskeletal Trauma: A Prospective Study.

Background Non-union,chronic pain,functionaldisability, and infectionare all things that have been associated with open fractures with severe soft tissue damage leading to the need for additional hospitalization, and sometimes even subsequent surgeries and weeks or months of rehabilitation. Open fractures and severe musculoskeletal injuries are occasionally treated with hyperbaric oxygen therapy (HBOT) in an effort to reduce the risk of complications and increase the likelihood of a successful recovery. Methods A prospective randomized controlled study was done between January 2019 and August 2022 at a tertiary health care center including 60 patients with a severe soft tissue injury (Grade II and III) divided into two groups - group-CT (30 patients who received conventional treatment) and group HT (30 patients, who received HBOT in addition to conventional treatment). The outcome was measured according to the Bates-Jensen Wound Assessment Tool. Results The wound size, depth, and granulation were significantly reduced in group-HT patients. In the final session, the patient's severity of the wound in group-HT was significantly reduced (P = 0.0001) compared to group-CT. Conclusions Patients who received HBOT reported a significant improvement in their wounds.

EFFECTS OF NURSING INTERVENTIONS ON SELF CARE AND WOUND MANAGEMENT AMONG POST- CORONARY ARTERY BYPASS GRAFTING PATIENTS

Coronary Artery Bypass Grafting (CABG) is a standard cardiac procedure with potential post-operative challenges, including wound management and self-care deficiencies. The role of nursing interventions in improving self-care among these patients remains crucial. This study aimed to determine the effects of nursing interventions on self-care and wound management among post-coronary artery bypass grafting patients. Employing a quasi-experimental design, the study conducted pre-post comparisons in a single group of 36 post-CABG patients. The participants, predominantly middle-aged with a mean age of 61, were profiled based on various demographic and health parameters. Nursing interventions were assessed using pre-defined scales and the Bates-Jensen Wound Assessment Tool to determine the pre- and post-intervention status of the individuals. The interventions revealed significant improvements in several care dimensions: Physical Care improved from a pre-intervention mean score of 51.61 (SD=1.82) to 61.97 (SD=2.55), witnessing a mean difference of -10.36 (95% CI: -10.79 to -9.93, p=0.000). Emotional care experienced a surge from 31.61 (SD=1.82) to 38.72 (SD=2.34), resulting in a mean difference of -7.11 (95% CI: -7.42 to -6.80, p=0.000). Spiritual care enhanced from 43.64 (SD=1.82) to 50.94 (SD=2.70) with a mean difference of -7.31 (95% CI: -7.78 to -6.84, p=0.000). Workplace Self-Care marked an increase from 36.61 (SD=1.82) to 45.06 (SD=2.03), having a mean difference of -8.44 (95% CI: -8.90 to -7.99, p=0.000). Balance scores bettered from 5.06 (SD=0.98) to 7.58 (SD=0.73), showing a mean difference of -2.53 (95% CI: -2.70 to -2.36, p=0.000). In contrast, Psychological Care saw a decline from 51.11 (SD=2.38) to 41.61 (SD=1.82) with a mean difference of 9.50 (95% CI: 9.06 to 9.94, p=0.000). The nursing interventions positively affected several self-care dimensions, aiding in the holistic recovery of post-CABG patients. However, a decrease in psychological care scores suggests the necessity for an integrated approach that equally addresses all care dimensions, including psychological care.

Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery

Abstract Objective Surgical procedures manifest immense risks to patients. One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection (SSI). Although several efforts are being undertaken to determine the proper means to reduce such complications, there is still a high incidence of SSI worldwide. Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site. This study tested the effectiveness of an operating room (OR) bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery. Methods A quasi-experimental pretest and posttest design was utilized to determine its effectiveness. The study was composed of 60 participants divided into two groups: 30 subjects were selected to receive the OR bundle of care, while the other 30 subjects received the usual care. The groupings were determined through a systematic random sampling technique. The OR bundle of care had three interventions, namely: (1) maintaining perioperative normothermia, (2) no pre-operative surgical site hair removal, and (3) changing gloves before abdominal wall closure. These patients were evaluated using the standard instrument, Bates–Jensen Wound Assessment Tool (BWAT) in the post-intervention phases of the wound healing process, which are as follows: hemostasis, inflammatory, and proliferative phases. To describe the difference in the patients’ wound status after implementation of the OR bundle of care in each post-intervention phase, Friedman’s test was used. To describe the difference in the patients’ wound status in both groups after implementation of the OR bundle of care, the Mann–Whitney U test was used. Results The patient’s wound status was lower, indicating a more healing process. Differences between the wound status of the control and the experimental group were observed on the third postoperative day. This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring. A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed. Conclusions The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital, if there is uniform and consistent implementation of the said intervention.

Potential of Honey Hydrogel Modern Dressing in Wound Healing of Patients with Grade II Diabetic Foot Ulcer

Aims: To analyze the potential of honey hydrogel modern dressing in wound healing process in patients with grade II diabetic ulcers. Methods: The research design used a true experiment with a randomized pretest posttestcontrol group design. This study had 36 respondents who were divided into 2 groupsthrough simple random sampling. The intervention group was given honey hydrogel with 4measurements. The first measurement or pretest on day 1, the second measurement orposttest 1 on day 7, the third measurement or posttest 2 on day 14, and the fourthmeasurement or posttest 3 on day 21. The instrument used to measure patient woundhealing using the Bates-Jensen Wound Assessment Tool (BWAT). Results: The increase in the mean wound healing score of patients who were given honeyhydrogel modern dressing from a score of 42.11 on day 1 to 34.56 on day 21 with p = 0.001while the increase in the mean wound healing score of patients who were givenmanufacturer hydrogel modern dressing from a score of 41.67 on day 1 to 37.17 on day 21with p = 0.001. The effect size between the intervention group and the control group is quitestrong with a value of 0.78. Conclusion: Honey hydrogel has the potential to promote wound healing in patients withgrade II diabetic ulcers. Further research is recommended to explore the use of honeyhydrogel by innovating the manufacturing process to ensure consistent dosing in thetreatment of grade II diabetic ulcers.

Effect of oxpecker’s interaction on wounds healing process in calves at Federal Uuniversity of Agriculture cattle production farm, Abeokuta Southwest Nigeria

This study investigated the role of oxpeckers in wound creation and healing in calves at the Cattle Production Venture of the Federal University of Agriculture, Abeokuta. Eleven calves with wounds out of twenty in the herd of 234 animals were randomly recruited for this study. Bates-Jensen wound assessment tool (BWAT) was used to assess the size, depth and edges of the wound, necrotic tissue type and tissue, exudate type and amount, skin colour surrounding wound, peripheral tissue edema and induration, granulation tissue and epithelialization to determine the severity. Descriptive statistics and ANOVA were used to analyse data obtained. Nine (81%) out of the 11 calves had more than one wounds. The score for all wounds decreased on day 15. The highest average score was 38.2 while the lowest was 17.8. The average score for each wound fell under wound status continuum. The highest percentage of reduction was 16.2% while the lowest was 0.9%. All wounds granulated at one stage or the other, except in one calf that did not throughout the study. Three calves had epithelialization above 75% on BWAT score of 2. At the termination of the study, 5 calves showed epithelialization of their wounds, 3 above 75% and 2 less than 50% while one wound did not epithelialize. In conclusion, wounds induced or exacerbated on calves by oxpeckers were under the status of continuum, and none neither regenerated nor degenerated. The activities of oxpeckers contributed to the delay in the wound healing process in the calves.

Validity and reliability of Chinese version of the new diabetic foot ulcer assessment scale.

A specific assessment tool is urgently needed to guide effective wound care for diabetic foot ulcers. However, the tool has not been available in Chinese. We aimed to culturally translate and verify the validity and reliability of the new Diabetic Foot Ulcer Assessment Scale (DFUAS). The original scale was translated into Chinese according to the Brislin guidelines. Patients satisfying the inclusion and exclusion criteria were recruited. Each of the included foot ulcers was evaluated independently by two wound care specialists using the new DFUAS and by the third wound care specialists at the same time using the Bates-Jensen Wound Assessment Tool according to per guidelines. 210 diabetic foot ulcers were included for data analysis. The S-CVI of the Chinese version of the DFUAS was 0.96, and the I-CVIs ranged from 0.89 to 0.98. The total Cronbach's Alpha of the scale was 0.709, and the corrected item-total correlation of the items ranged from 0.4 to 0.872. The DFUAS had high inter-observer reliability of 0.997, and there were weak, moderate, and strong correlations between each pair of the items. The Bland-Altman plots showed a good agreement between the scale and the Bates-Jensen Wound Assessment Tool. We concluded that the Chinese version of the DFUAS showed good validity and reliability and is a reliable instrument for the assessment of diabetic foot ulcers.

Effect of Topical Insulin Versus Normal Saline Dressing on Diabetic Wound Healing: An Experimental Comparative Study

Introduction: Diabetic foot ulcer is one of the most significant and devastating complications and a major cause of hospitalization among patients with diabetes. It leads to severe economic and social burdens. The management of Diabetic foot ulcers remains a major therapeutic challenge. Hence, the present study was conducted to compare the topical insulin and normal saline dressing on wound healing among patients with a diabetic foot ulcers. Methods: An experimental research design was adopted to conduct the study with 60 samples matched with the inclusion criteria in Saveetha Medical College and Hospital. Samples were allocated into experimental group I (n=30) and experimental group II (n=30) by simple random sampling. The baseline outcomes were measured at the beginning of the study. Pre-assessment was done using the Bates-Jensen wound assessment tool in experimental I &amp; II. Experimental group I received topical insulin dressing, and experimental group II received normal saline dressing daily for 14 days. Post-assessment was done on the seventh and fourteenth days using the same tool for both groups. Data were analyzed using SPSS. Results: A significant improvement in the level of wound healing was observed at the level of p&lt; 0.001 within and between a group of pretest, post-test I, and Post-test II by repeated measures ANOVA. The overall comparison of wound healing between experimental groups I &amp; II revealed that the calculated F value of F=12.679 shows a statistically (p

Feasibility and clinical utility of Bates-Jensen wound assessment tool among nurses caring of patients having pressure ulcers

Aims: One of the vital roles of nurses is to perform pressure ulcer risk assessment that enables them to appropriately assess and track healing progress of wound and pressure ulcers among patients. Our aim was to assess the feasibility and clinical utility of the Bates-Jensen Wound Assessment Tool (BWAT) among nurses caring of patients with pressure ulcer.&#x0D; Methods: A descriptive cross-sectional design used to collect data from 177 registered nurses caring of patients who developed or have a risk of developing pressure ulcers working in three hospitals in Jordan.&#x0D; Results: The mean feasibility score of the BWAT was 28.3 out of 36 (SD=3.4) with a median score of 29. Most of nurses reported that the BWAT was easy to use on a scale of 1-4 (best) (M=3.40/4, SD=0.62) and can successfully assess wound characteristics (M=3.40/4, SD=0.59). The mean utility score of the BWAT was 21.3 out of 28 (SD=2.7) with a median of 21. Nurses had a perception that using the BWAT enhances care of patients with wounds (M=3.36/4, SD=0.61) and makes communication easier between nurses and physicians. &#x0D; Conclusion: This study provided evidence that support the use of the Bates-Jensen Wound Assessment Tool for patients with pressure ulcer. Nurses perceived BWAT as easy to use, understandable, and relevant for assessing patients with pressure ulcers.&#x0D; Funding statement: This work was supported by supported and funded by The Deanship of Scientific Research at The University of Jordan, Amman, Jordan [number1953/2017/19].

Effect of oral Calendula officinalis on second-degree burn wound healing.

Treatment of wounds and burn injuries is very important. Nowadays, the tendency to research complementary medicine has increased. In this clinical trial, 60 patients hospitalized in the burn ward who met the inclusion criteria were randomly assigned to two groups: intervention (n = 30) and control (n = 30). In addition to treatments, the intervention group received one capsule (2 g) of Calendula officinalis daily, for two weeks, and the control group received the placebo. Wound status was assessed with the Bates-Jensen Wound Assessment Tool (BWAT) on the 1st, 7th, and 15th days of the study in both groups. The mean total score of wound status using BWAT at the 1st, 7th, and 14th days in the intervention group was 48.23, 35.93, and 22.97, respectively, and in the control group was 48.90, 42.57, and 37.8. Statistically, wound condition on the first day was at the same level for both groups. Wound healing scores in the two groups increased during the 1st to 15th days of the study (P <0.001). However, in the intervention group, the range of wound healing changed on days seven and 15 and was greater than in the control group. Based on the results of this study, C. officinalis may have beneficial healing properties and be effective in accelerating the healing of second-degree burn wounds and can be used as a supplement to treat wounds.

Effect of Honey Dressing on Wound Healing among Patients with Diabetic Foot Ulcer at Al-Ahsa, Saudi Arabia

Background: Diabetic foot ulcer (DFU) is a serious infection in people with diabetes mellitus. DFU is caused by vascular disease with diabetic neuropathy, and severe DFU leads to disability or even death. Mostly, povidone iodine dressing (PID) is used for DFU. The honey dressing (HD) may also improve wound healing in DFU as a complementary therapy. Aim: The study aimed to determine the effect of HD on the wound-healing process for DFU. Materials and Methods: A prospective observational study was conducted in the diabetic centres of selected hospitals in eastern Saudi Arabia. A total of 126 patients with DFU below grade three according to Wagner’s classification were selected by randomization and equally divided into HD (n = 63) and control (n = 63) groups. The patients were followed up with regularity, and 60 from each group were analysed, because the remaining patients lost their follow-up. Demographic variables and clinical parameters including random blood sugar and haemoglobin A1C were measured at the initial visit before intervention. The Bates-Jensen wound assessment tool was used before and after the intervention. Intervention group received HD and control group received PID for 6 weeks. The results are presented using frequency, mean, chi-squared test, independent ‘t’ test and Wilcoxon signed-rank test. Results: Among 120 patients, the demographic variables, and clinical parameters in the HD and control were homogeneous. The overall mean wound score was 41.07 ± 2.95 and 29.78 ± 2.2 before and after the intervention in the HD group respectively which was significant (p &lt; 0.0001). Mean score of control was 41.13 ± 2.43 before intervention and 38.53 ± 3.29 after intervention which was also significant (p = 0.00062). Conclusion: HD is best alternative cost-effective dressing method that promotes faster healing in DFU. It should be further promoted in healthcare settings.

THE EFFECTIVENESS OF MODERN DRESSING WITH A COMBINATION OF AFRICAN LEAF NANOPARTICLE HYDROGEL AND PAPUAN HONEY FOR GRADE II DIABETIC WOUND HEALING

The combination of African leaf nanoparticle hydrogel (Vernonia amygdalina) and Papuan honey in modern dressing to heal wound in grade II diabetic patients can reduce the care day length and amputation risk for upper or lower extremity areas that are often affected and wounded in the event of hyperglycemia. Wound care is performed every 3 days for 20 days based on the physiological process in the proliferative phase of wound healing. The diabetic wound was assessed using the Bates Jensen Wound Assessment Tool (BWAT). The research was experimental with pre- and post-test control group design. The results showed that the 20-day wound care with this combination could reduce the BWAT score by 5.2, a sign of its effectiveness as compared to the control group reduction by 4.33. Conclusively, performing a modern dressing using this combination for 30-45 minutes every 3 days for 20 days was effective in accelerating the healing process of grade II diabetic wounds.

THE EFFECT OF CREAM-BASED APPLICATION OF MORINGA LEAF (MORINGA OLEIFERA) EXTRACT ON THE INCISION WOUND HEALING ON WHITE RAT MANUSCRIPT

Background: High injury incidence is a consideration of wound prevention with the prevalence of iris/torn/puncture injuries 20.1% in 2018. Indonesian people have a high level of confidence in traditional medicine and one of them is Moringa. Moringa phytochemical content has the potential to speed up the healing process of incision wounds. Purpose: This study aims to determine the effect of moringa leaf extract cream with concentrations of 5%, 15%, and 45% on the healing process of white rat incision wounds (Rattus norvegicus) by assessing the healing phase and using the Bates-Jensen Wound Assessment Tool (BWAT). Method: This research is experimental with a post-test-only control group design. Sampling by simple random sampling method and calculated using Federer's formula with the number of samples of 30 white rats divided into five groups, namely two groups of control and three treatment groups with 6 white rats in each group for 21 days. Results: In the analysis of BWAT score data with the MANNOVA test, there were insignificant results on day 1 (p=0.840) and day 7 (p=0.888), then there were significant results on day 14 (p=0.001). Post-hoc results showed significant differences between the negative control group and positive control over the 45% moringa leaf extract creaming group. In the analysis of healing phase data with the Kruskal-Wallis’s test, significant results were obtained in the coagulation phase (p=0.000) and the proliferation phase (p=0.001). The results of the Mann-Whitney test in the coagulation phase showed significant differences between the control and treatment groups while in the proliferation phase there were significant results between the control group and the treatment and there were no meaningful differences between the treatment groups. Conclusion: There is no significant difference in effectiveness between the administration of moringa leaf extract cream to accelerate the healing process of incision wounds.

Comparison of Topical Oxygen with Vacuum Assisted Closure in Wound Healing in a Low Resource Setting.

The aim of this pilot study is to obtain preliminary results comparing topical oxygen therapy (TOT) and vacuum assisted closure (VAC) in terms of its ability to accelerate wound healing. This non-randomised prospective study included patients with age 16-50 years, wound size ≥ 16cm2 and present below knee joint within seven days of occurrence. Bates-Jensen wound assessment tool (BWAT) was used for evaluation at 8-day interval along with percent area reduction at final follow up. Mean number of cycles required in VAC and TOT group were 1.97 (range 1-3) and 2.1 (range 1-3) (each cycle of 5 days) per patient respectively. Percent area reduction was significantly higher in the VAC group (34±9.7%) than TOT (11.3±3.8%) group at final follow up (p<0.05). TOT patients had better improvement in epithelialization compared to VAC at last follow up. More extensive debridement was needed in patients of TOT than VAC. There was no significant difference between final score in both groups. TOT appears to be comparable to well-established VAC in treatment of fresh traumatic wounds below the knee joint. Further large scale, multicentric and randomised studies comparing both these modalities of treatment should be the way forward.