Wound Management Techniques Research Articles

Total Ankle Arthroplasty Incision Management: What Matters? A Systematic Review

Modern advancements in total ankle arthroplasty techniques and implants have increased the popularity of this treatment for ankle osteoarthritis. The preeminent approach for ankle replacement involves an anterior incision, however, wound complications with this approach provide a persistent challenge to surgeons. The present study was conducted to synthesize current data on ankle replacement wound complications via an anterior approach. A systematic review was completed including studies published from 1993 to present that employed an anterior approach and had precise criteria for wound healing and revisions. Twenty-nine studies, with level 3 to 4 evidence and moderate to serious bias, were included for a total of 6,986 ankle arthroplasties. The rate of wound healing without any complication was 90.38%. Minor dehiscence occurred in 6.00% of cases, while major wounds or infections occurred in 3.62%. Across 2,966 implants, the rate of major wounds or infections decreased from 7.03% before 2013 to 4.75% after 2013 (p = 0.034). Limited comparisons involving simple suture closure to various adjunct wound management techniques including negative pressure wound therapy, 2-octyl cyanoacrylate, platelet-rich plasma, dehydrated human amniotic membrane allograft, non-invasive skin expansion strips, compression wound dressings, tranexamic acid, surgical helmets, tourniquets, ankle arthrodesis, and lateral approach ankle arthroplasty, yielded non-significant differences (p > 0.18). Therefore, contemporary techniques, patient selection, and current implants may be leading to better soft tissue healing. As ankle replacement continues to surge in popularity, further research is needed to evaluate causative factors in successful anterior incision healing. Level of Clinical Evidence3

To close or not to close? Wound management in emergent colorectal surgery, an EAST multicenter prospective cohort study.

This study aimed to determine the clinical impact of wound management technique on surgical site infection (SSI), hospital length of stay (LOS), and mortality in emergent colorectal surgery. A prospective observational study (2021-2023) of urgent or emergent colorectal surgery patients at 15 institutions was conducted. Pediatric patients and traumatic colorectal injuries were excluded. Patients were classified by wound closure technique: skin closed (SC), skin loosely closed (SLC), or skin open (SO). Primary outcomes were SSI, hospital LOS, and in-hospital mortality rates. Multivariable regression was used to assess the effect of wound closure on outcomes after controlling for demographics, patient characteristics, intensive care unit admission, vasopressor use, procedure details, and wound class. A priori power analysis indicated that 138 patients per group were required to detect a 10% difference in mortality rates. In total, 557 patients were included (SC, n = 262; SLC, n = 124; SO, n = 171). Statistically significant differences in body mass index, race/ethnicity, American Society of Anesthesiologist scores, EBL, intensive care unit admission, vasopressor therapy, procedure details, and wound class were observed across groups. Overall, average LOS was 16.9 ± 16.4 days, and rates of in-hospital mortality and SSI were 7.9% and 18.5%, respectively, with the lowest rates observed in the SC group. After risk adjustment, SO was associated with increased risk of mortality (OR, 3.003; p = 0.028) in comparison with the SC group. Skin loosely closed was associated with increased risk of superficial SSI (OR, 3.439; p = 0.014), after risk adjustment. When compared with the SC group, the SO group was associated with mortality but comparable when considering all other outcomes, while the SLC was associated with increased superficial SSI. Complete skin closure may be a viable wound management technique in emergent colorectal surgery. Therapeutic/Care Management; Level III.

Best practices for managing malodorous and infected wounds in advanced cervical cancer.

This cross-sectional study was conducted to examine the most effective strategies for managing malodorous and infected wounds in patients who have been diagnosed with advanced cervical cancer. The research was conducted in Liupanshui, China. The study specifically examined demographic profiles, wound characteristics and effectiveness of wound management approaches. The study incorporated the heterogeneous sample of 289 participants who fulfilled the inclusion criteria. Data collection was conducted via structured questionnaires and medical record evaluations. Descriptive statistics and statistical analyses, such as regression analysis, were utilized to evaluate demographic attributes, wound profiles and effects of different approaches to wound management. The findings unveiled the heterogeneous demographic composition of patients, encompassing differences in socioeconomic standing, educational attainment and age. A wide range of wound characteristics were observed, as 65.7% of lesions during the acute phase with diameter between 2 and 5 centimetres, while 41.5% of lesions had this range. The most prevalent types of infections were those caused by fungi (48.4%), followed by bacterial infections lacking resistance (38.1%). A moderate degree of odour intensity was prevalent, affecting 45.0% of the cases. With maximal odour reduction of 80%, a mean healing time of 25 days and patient satisfaction rating of 4.5 out of 5, Negative Pressure Wound Therapy demonstrated itself to be the most efficacious treatment method. Additional approaches, such as photodynamic therapy and topical antibiotic therapy, demonstrated significant effectiveness, as evidenced by odour reductions of 70% and 75%, respectively, and patient satisfaction ratings of 4.3 and 4.2. Thus, the study determined challenges associated with management of malodorous and infected lesions among patients with advanced cervical cancer. The results underscored the significance of individualized care approaches, drew attention to efficacious wound management techniques and identified critical determinants that impacted patient recuperation. The findings of this study hold potential for advancing palliative care for individuals diagnosed with advanced cervical cancer.

A review on wound management strategies in enhanced recovery after craniotomy: An in-depth analysis of their influence on patient recovery and surgical outcomes.

Craniotomy, an essential neurosurgical operation, poses distinct difficulties in the realm of post-operative care, specifically with regard to the management of wounds. Efficient wound management is critical in order to optimize the surgical outcomes, reduce complications and facilitate a speedier recovery. The purpose of this comprehensive review was to assess contemporary wound management approaches as they pertain to improved recovery following craniotomy. This was achieved by contrasting conventional methods with more recent and innovative techniques and analysing the effects of these approaches on patient recovery and surgical results. An exhaustive literature search was undertaken, comprising narrative reviews, clinical studies, peer-reviewed articles and expert opinions. The emphasis was on the evolution of wound management strategies and techniques utilized after cranial section, as well as their contributions to patient recovery. The analysis reveals that while conventional wound management methods, including suturing and antiseptics, continue to be essential, innovative strategies such as negative pressure wound therapy, skin adhesives and advanced pain management protocols are becoming increasingly recognized. It has been demonstrated that these novel approaches improve recovery by decreasing the incidence of infections, enhancing patient comfort and producing superior cosmetic results. Nevertheless, obstacles continue to endure, including patient-specific variables, technological and financial considerations and the enduring consequences of recovery. Thus the treatment of wounds during craniotomy recuperation necessitates an integrated strategy that incorporates conventional techniques alongside contemporary advancements. Progress in this domain necessitates the customization of approaches to suit the unique requirements of each patient, the resolution of identified obstacles and an emphasis on ongoing investigation and interdisciplinary cooperation. The ever-changing terrain of wound management approaches underscores the ever-changing character of neurosurgical treatment and the continuous endeavour to enhance patient results following cranial resection.

An All‐In‐One Self‐Degradable Flexible Skin Patch with Thermostatic Control and Spontaneous Release of Antibacterial Ions to Accelerate Wound Healing

AbstractSmart wound dressings supply new techniques for wound management. Nevertheless, techniques to combine microenvironment control of the wound beds and spontaneous release of antibacterial agents while reducing secondary injury of the wound due to frequent replacement of wound dressings have not been sufficiently developed. Herein, this work proposes a degradable and flexible skin patch that can assist wound healing through the combined effect of thermostatic control, slow release of antibacterial metallic ions, and humidity control. The skin patch features a degradable zinc‐silver (Zn‐Ag) gird line heater and a Zn temperature sensor fabricated through screen printing and water sintering. The sintered degradable patterns of Zn‐Ag and Zn offer electrical conductivities of 307664.4 and 72400 S m−1, enabling closed‐loop thermostatic control of the wound under a temperature range of 43 ± 2 °C. The gradual degradation of the nanocomposites in a humid environment results in an antibacterial effect with more than 99% antibacterial efficiency (AE) on the wound site due to the release of Ag and Zn ions. The skin patches are demonstrated to improve wound healing in rats and rabbits by 18.35% and 51.57%, respectively. The flexible skin patch revolutionizes the wound treatment procedure by replacing traditional wound dressing with degradable materials and flexible circuits.

Updates in Traumatic Lower Extremity Free Flap Reconstruction.

Lower extremity reconstruction, particularly in the setting of trauma, remains one of the most challenging tasks for the plastic surgeon. Advances in wound management and microsurgical techniques in conjunction with long-term outcomes studies have expanded possibilities for limb salvage, but many aspects of management have continued to rely on principles set forth by Gustilo and Godina in the 1980s. The purpose of this article is to provide a comprehensive update on the various management aspects of traumatic lower extremity microvascular reconstruction based on the latest evidence, with an examination of recent publications.

Effect of vacuum assisted therapy in wound healing

Background: Vacuum assisted closure (VAC) is a new technique developed in the management of contaminated, acute, and chronic wounds. It refers to wound dressing system that continuously or intermittently apply sub-atmospheric pressure to the surface of a wound which accelerates debridement and promote healing. The optimum pressure for VAC is around 125 mmhg below ambient and this negative pressure helps in removing interstitial fluid, decreases localised edema and increases blood flow. This in turn decreases tissue bacterial levels and promotes wound healing.Methods: Hospital based prospective study.Results: Most common etiology for wounds is diabetes i.e., 50%, Most common organism cultured from wound is Staphylococcus aureus, and least is proteus. Surface area of wound is reduced to <40 cm2 in 76% cases and 7% cases had >60 cm2. After applying VAC dressing 91% of patients had bright red granulation tissue. Mean duration hospital stay was reduced to 10days in patients with VAC dressing.Conclusions: VAC or NPWT therapy is an excellent alternative modality of treatment of acute or chronic large non-healing wounds. It reduces the number of changes of dressing and reduces the time of hospital stay before definitive surgery for covering wound can be planned. Based on the data from the present study and other studies available, VAC appear to result in better and rapid healing and thus a better option of wound management technique.

Open and Closed Approaches to Skin Closure After Nonelective Open Colorectal Operations.

Optimal wound management strategies to reduce surgical site infections (SSIs) in nonelective open colorectal surgery (NOCS) remain controversial and variable. Our aim is to describe SSI and other 30-day outcome measures among patients with varying wound management techniques undergoing NOCS. All NOCS patients were extracted from the 2016 to 2018 ACS-NSQIP database. Outcomes of patients managed with all layers closed (ALC) were compared to patients managed with skin open (SO), using propensity score matching (PSM) to control for significant confounding risk factors for SSI. A total of 40,820 patients were included; 4622 patients managed with SO and 36,198 managed with ALC. Patients in the SO group were more likely to have a history of hypertension, renal failure, chronic obstructive pulmonary disease, smoking, obesity, and sepsis on presentation (P < .001). After PSM, no differences in risk factors remained; 4622 and 4344 patients were included in the SO and ALC cohorts, respectively. While ALC patients experienced a higher rate of superficial SSI (1.4% vs 7.3%, P < .001) and any wound complications (6.8% vs 10.8%, P < .001), the SO group had higher wound dehiscence (4.4% vs 2.8%, P < .001). There were no significant differences in deep wound infection. The SO group had longer average length of stay (14.7 vs 13.1days, P < .001), higher non-wound-related complications, discharge to SNF, and in-hospital mortality. Significant differences in SSI rates among NOCS patients with differing wound management techniques were observed. More notably, other important quality measures, such as length of stay, disposition, mortality, and non-wound-related complications were also significantly impacted by wound management strategy.

Biofilm-Associated Infections in Chronic Wounds and Their Management.

Chronic wounds including vascular ulcers, diabetic ulcers, pressure ulcers, and burn wounds show delayed progress through the healing process. Some of their common features are prolonged inflammation, persistent infection, and presence of biofilms resistant to antimicrobials and host immune response. Biofilm formation by opportunistic pathogens is a major problem in chronic wound management. Some of the commonly and traditionally used chronic wound management techniques are physical debridement and cleansing. In recent years, novel techniques based on anti-biofilm agents are explored to prevent biofilm-associated infections and facilitate wound healing. In this chapter, the role of biofilms formed by the ESKAPE pathogens (Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa) and Candida species in delayed wound healing have been discussed. The current and emerging techniques in the detection of biofilms for the management of wounds have been focused. The limitations of the existing therapeutics and novel wound management strategies have been deliberated.

FACIAL WOUND ASSESSMENT KIT

Facial wounds are a frequent reason for emergency room visits. The goals of laceration repair are to achieve hemostasis, avoid infection, restore function to the involved tissues, and achieve optimal cosmetic results with minimal scarring. Therefore, these cases are most appropriately managed by plastic surgeons who have a thorough knowledge of anatomy, aesthetic sense, and meticulous expertise in atraumatic tissue manipulation, combined with the surgical skill to repair any structure. You need to know what to do and what not to do : whether to suture or leave open. What local anesthesia to use and how. What equipment to use (and have it available beforehand). Whether to give antibiotic therapy and what kind. How to avoid aesthetic or functional after-effects. Which dressing to use depending on the state of the wound. This article will serve as an aid to wound management and review repair techniques for high-risk areas of the face.

524 Effectiveness of Burns Wound Cleansing by Comparison of Prewash and Post Wash Swab Reports

Abstract Aim The main aim and objective were to optimise wound healing through infection prevention. This clinical audit aimed to investigate the effectiveness of burn wound cleansing in decreasing bacterial load by comparing pre-wash and post-wash swab results against local burn wound management and aseptic non touch technique (ANTT) guidelines. Method The audit was conducted retrospectively on children admitted to Burns Unit during August 2019, excluding resuscitation burn patients. Pre- and post-wash swabs taken on admission were included and the results obtained from Chameleon database. Data were collected on excel spread sheets including demographic variables such as age, sex, type of injury, percentage total body surface area (TBSA) and mechanism of injury. Data were analysed and results compiled. Results Fifty patients were admitted over a month period; amongst those 60% were male and 40% female of ages ranging from 5 months to 14 years. Scald (50%) was found to be the most common mode of injury followed by contact burn (36%) involving 0.30 to 9% TBSA. Among 50 patients, 30 (60%) showed no growth in pre-wash and 36 (72%) in post-wash swabs. However, 6% post-wash swabs that were initially negative later showed bacillus cereus, staph aureus, Enterobacter, and Acinetobacter. Similarly, another 4% post-wash swabs developed new microorganisms as compared to pre-wash swabs. Conclusions The most common bacteria colonising both pre- and post-wash swabs was staph aureus. Overall, cleansing had reduced the bacterial load significantly around 82% very effective. It is imperative to stick to local guidelines to reduce morbidity and mortality in burn patients.

Use of Cost-effective Vacuum-assisted Closure Technique for Shell Fracture Repair and Coelomic Cavity Rupture Healing in a Chelonia carbonaria

Background: The vacuum-assisted closure (VAC) therapy system has been used as a noninvasive wound management technique for shell damage in Chelonians. These animals are excellent candidates for VAC therapy because of their unique shell anatomyconsists of dermal bones, which make bandage placement easier. Beyond that, they are suited for this technique behaviorally, because they are not inclined to remove the vacuum system intentionally. Considering the possibility of Testudines shell repair with the use of less invasive techniques that result in additional dermal bone lesions, the objective of the present study is to describe the adaptation of a vacuum dressing protocol using low-cost and easily accessible materials for post-traumatic shell healing of a specimen of Chelonoidis carbonaria.Case: A specimen of tortoise (Chelonoidis carbonaria), a male, weighing 630 g, approximately 3-year-old, was received at the Veterinary Hospital - Wild Animals Sector in the Federal University of Pará (UFPA) because of being run over by a vehicle. On physical examination, fractures of the dermal plaques and underlying bone structures were found, with rupture of the coelomic cavity. In addition, there was exposure and incarceration of an intestinal loop, with the presence of bleeding. According to the findings of the physical screening examination, the patient's prognosis was defined as good, as described in the literature that specifically focused on chelonian shell injuries. The animal was sent to the diagnostic imaging sector. Then, drug therapy was provided for pain control, vitamins were administered for nutritional support, and antibiotics and anti-inflammatory drugs were instituted. For the closure of the shell and coelomic cavity, a bandage was used with the VAC therapy system adapted as described for Chelonians in previous reports. After a complete osteosynthesis and closure of the coelomic cavity, repair of the integumentary component of the shell was possible. For this procedure, the animal did not need to be anesthetized. The patient was physically restrained by being placed in suspension on a support with a diameter smaller than the plastron. Complete asepsis of the shell was necessary. On top of the lesion, a polypropylene mesh and color less dental resin were applied. The animal continued to be evaluated after the repair to check for potential complications. This procedure ensured that the repaired plates remained stable. Furthermore, the animal did not seem to have any discomfort with the resin when moving, so the animal was discharged after 25 days of hospitalization.Discussion: Radiography was important to determine the condition of the animal and clinical prognosis, and thus, to perform the proper treatment. The VAC therapy system was successful in assisting the patient's recovery. It enabled the reduction of the healing time since shell injuries usually require four to eighteen months to heal. In this report, the healing process only required 17 days, demonstrating that the VAC therapy system is a beneficial treatment to treat traumatic injuries in Testudines. The restoration protocol of the integumentary component using dental resin is less invasive, and this type of material has been used previously by other authors. Drug treatment with aminoglycosides and sulphonamides administered prophylactically has proven to be effective and has been used successfully in reptiles. These drugs may be combined with maintenance fluid therapy to prevent adverse reactions from aminoglycosides, such as nephrotoxicity. It was concluded that the use of the VAC therapy system reduced the time of post-traumatic healing of the carapace and proved to be an innovative approach to treat traumatic injuries in Testudines in a less invasive way.

Does Wound Management Technique Impact Surgical Site Infection in Open Emergency Colon Procedures?

Emergency open large bowel procedures have higher rates of intraoperative contamination and increased risk of surgical site infection (SSI) than elective colon surgeries. Several wound management strategies have been proposed, such as vacuum-assisted closure (VAC) therapy and delayed primary closure to improve results. The purpose of this study is to evaluate the relationship between wound management technique and SSI and other quality measures. We performed a retrospective review of patients undergoing open emergency colon surgery from January 2017 to December 2018 by our acute care surgery service. The primary outcome measure was incidence of SSI. Secondary outcome measures included length of stay, reoperation, and 30-day readmission. A total of 118 patients were included in the study, with a mean age of 62.8years and mean BMI of 28.8. Overall incidence of SSI was 19.5%. There was no significant difference in incidence of SSI, reoperation, or 30-day readmission when stratifying by wound management technique or procedure type after controlling for confounding variables. Notably, patients managed with VAC therapy had a statistically significant longer average length of stay and higher total postoperative antibiotic days (both P = .001) than other techniques. We conclude from our data that wound management technique does not seem to influence rate of SSI, but wound management may influence length of stay or antibiotic duration. These findings suggest that there may not be an advantage to alternative methods of wound management in this high-risk population. Further prospective evaluation should be performed to confirm these findings.

Management of the Burn Wound

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds. This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis, sloughing, dressing

Management of the Burn Wound

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds. This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis, sloughing, dressing

Fish biowaste gelatin coated phosphate-glass fibres for wound-healing application

Inadequate wound management techniques can result in severe consequences for patients and are a major Health Economic burden worldwide. Currently, biosynthetic scaffolds for wound healing are of interest to address the shortcomings of existing treatment options. Gelatin is a derivative of collagen with similar properties, however, with non-antigenic properties. Fish biowaste gelatin has been recognized as a safer, economical and more widely accepted alternative to gelatin derived from mammalian sources. This study investigated the use of bioresorbable phosphate-based glass fibres (PGFs) coated with fish scale gelatin (FSG - extracted from tilapia fish scales) for potential wound healing application. Assessments of the FSG revealed a high protein content of 89.4%. The bloom gel strength, viscosity, SDS-PAGE molecular pattern and functional groups of FSG were found to be similar to bovine gelatin. FSG was then crosslinked using relatively low concentrations of glutaraldehyde (GTA) to coat PGF surfaces. These GTA-crosslinked coated scaffolds were then evaluated in vitro for their cytocompatibility via HaCaT cell adhesion, migration and proliferation studies. All cells grown on the un-crosslinked coated (UCS) and GTA-crosslinked coated scaffolds (GCS5, GCS10 and GCS15) revealed cells with flat and spreading morphologies along the fibres. However, only GCS15 samples showed a significantly greater number of adhered cells than the uncoated PGFs. GCS10 and GCS15 both revealed accelerated in vitro artificial wound closure via additional 27.4% and 28.5% (µm/µm), respectively in wound scratch test, as compared to the untreated wound within 24 h. Tetrazolium (MTT) assay revealed the highest cell viability in GCS15 among all the scaffolds on day 7. Overall, GCS15 promoted adhesion and proliferation of HaCaT cells and ultimately, accelerated their migration in vitro demonstrating high potential of this material as a wound healing scaffold.

Annual Nationwide Infection Trends for Revision Total Knee Arthroplasty.

Several recent intraoperative and wound management techniques have been developed and implemented in the United States over the past decade; however, it is unclear what the effects of these newer modalities have on reducing surgical site infection (SSI) rates. Therefore, the purpose of this study was to track the annual rate and trends of (1) overall, (2) deep, and (3) superficial SSIs following revision total knee arthroplasty (TKA). The National Surgical Quality Improvement Program database was queried for all revision TKA cases performed between 2011 and 2016, which yielded 9,887 cases. Cases with superficial and/or deep SSIs were analyzed separately and then combined to evaluate overall SSI rates. After an overall 6-year correlation and trends analysis, univariate analysis was performed to compare the most recent year, 2016, with the preceding 5 years. Correlation coefficients and chi-square tests were used to determine correlation and statistical significance. No significant correlations between combined, deep, and/or superficial SSI rates and year were noted (p > 0.05). The lowest overall SSI incidence was in 2012 (1.16%), while the greatest incidence was in 2014 (1.76%). The deep SSI incidence over the 6 years was 0.67% (66 out of 9,887 cases). Deep SSI rate decreased by 10% in 2016 compared with 2011 (0.50 vs. 0.56%, p > 0.05). In this 6-year period, 94 cases out of 9,887 were complicated by a superficial SSI, an incidence of 0.95%. The lowest superficial SSI incidence occurred in 2015 (n = 17, 0.77%). Overall, the incidence of SSIs in revision TKA has remained fairly low with some annual variance, indicating room for improvement. These variations likely as revision surgeries can be more complex and have several associated confounding factors influencing outcomes, when compared with primary cases. Further research is needed to identify revision-specific strategies to reduce the risk of surgical site infections.

Wound dressing techniques and costs at a county hospital

Background: Wound management is one of the commonest procedures conducted in surgical departments across health facilities in Kenya.Objective: This study aimed at exploring wound dressing techniques used at Migori County Referral Hospital (MCRH) and the cost of treatment to patients.Methods: Convenience sampling was used to select inpatients presenting with wounds undergoing treatment at the time of recruitment. Five patients (2 male and 3 female) were enrolled after obtaining informed consents. Wounds were examined during cleaning and dressing and healing process follow-ups made. Selection of wound dressing technique was done by the primary clinicians with no bias from the research team.Results: One patient’s wound was an open fracture resulting from a road traffic accident; three patients had pyomyositis following thorn pricks; and the last patient’s was sustained following a blast injury. Wound management methods employed at MCRH included cleaning with vinegar, irrigation with normal saline, dressing with honey, and improvised negative pressure wound therapy. Total cost incurred was affordable to patients, and ranged between Kenya shillings 100–360 (USD 1–3.60) weekly.Conclusion: Wound management techniques at MCRH were effective and affordable. Additional studies with a larger sample size are recommended.Keywords: Wound dressing, costs, NPWT, vinegar cleaning, honey dressing

Why use manuka honey?

Wound management can be a challenging and confusing subject. With numerous products at our disposal and ever-changing advances in wound management techniques, it can become overwhelming trying to make the best clinical decision to suit patients. With the increasing awareness and concern of antibiotic resistance, and a holistic approach to veterinary medicine being sought by clients, the new and old ways of treating wounds are under scrutiny. Throughout various points in history honey has been linked to wound management, possessing desirable properties that can provide osmotic debridement, anti-inflammatory and antimicrobial effects that are beneficial during the inflammatory phase of healing. This article aims to discuss how manuka honey's properties can best be utilised within modern veterinary practice.

Role of Knit Spacer Fabrics in Treatment of Pressure Ulcers

The article highlights some significant trends in the use of knit spacer fabrics in treatment of pressure ulcers. Healing of pressure ulcer wound is complicated and time consuming. Not only affecting the lives of patients and caretakers, but pressure ulcer also becomes the burden to the government. With the developing wound management techniques, companies have launched different wound dressing designed for pressure ulcer. However, regardless for their high price, it is rare that the wound dressing can provide good wound management and cushioning to the wound. Because of the excellent air permeability and compression performance of weft knitted spacer fabrics, it has been applied in different aspects including medical. A theory has been proposed to design a 3D knit spacer bed sheet that will allow patients with pressure ulcers to be comfortable by ensuring a low friction coefficient between their skin and the material. The friction coefficient will be reduced by not only the structure but by the 70 percent polyester, 22 percent polypropylene and eight percent spandex blend.