A Device to Predict Short-Term Healing Outcome of Chronic Wounds

Abstract

Objective: While myriads of studies have suggested that a survey of wound pH environment could indicate wound healing activities, it is not clear whether wound alkalinity can be used as a prognostic indicator of nonhealing wounds. Currently available systems cannot reliably assess the pH environment across wounds, which is the objective of this study. Approach: A disposable device, DETEC Ò pH, was developed and characterized on its ability to map wound alkalinity by pressing a freshly recovered wound dressing against its test surface. By comparing the wound's alkalinity and size reduction rates (*7 days) following pH measurement, we assessed the capability of wound alkalinity to prognosticate subsequent short-term wound size reduction rates. Results: The device had high accuracy and specificity in determining the alkalinity of simulated wound fluids soaked onto wound dressing. The type of wound dressing type had an insignificant effect on its detection sensitivity. Upon testing discarded wound dressings from human patients, the device quickly determined alkaline and acidic wounds. Finally, statistical analyses of wound size reduction rates in wounds with various alkalinities confirmed that wound alkalinity has a strong influence on, at least, short-term wound healing activity. Innovation: Without directly contacting the patient, this device provides a quick assessment of wound alkalinity to prognosticate immediate and short-term wound healing activities. Conclusion: DETEC Ò pH may serve as a prognosis device for wound care specialists during routine wound assessment to predict wound healing progress. This information can assist the decision-making process in a clinical setting and augur well for chronic wound treatment. DETEC Ò pH can also be used as an aid for home health care nurses or health care providers to screen nonhealing wounds outside clinics.

Synthetic antibacterial minerals: harnessing a natural geochemical reaction to combat antibiotic resistance

“…The surface layers of healthy skin are acidic, with pH values ranging from 4.0 to 6.3, and provide protection against bacterial infections and growth 6 , 16 – 20 . Chronic non-healing wounds shift to alkaline pH (8 to 9) and prevent the release of oxygen from hemoglobin in infected tissues, resulting in localized hypoxia that favors infection 6 , 18 , 21 – 23 . Additionally, the elevated pH and reducing environment (redox potential, Eh < −140 mV) in the wound environment make the respiratory burst of ROS used by macrophages and neutrophils to kill invading pathogens difficult to achieve 7 , 24 .…”

“…Additionally, the elevated pH and reducing environment (redox potential, Eh < −140 mV) in the wound environment make the respiratory burst of ROS used by macrophages and neutrophils to kill invading pathogens difficult to achieve 7 , 24 . There is growing evidence that the acidification of chronic wounds results in improved recovery outcomes 6 , 16 , 18 , 21 , 22 , 25 , 26 . However, the acidification of chronic wounds alone was not shown to effectively eliminate bacterial pathogens and in many cases the buffering capacity of the wound environment exceeded that of the acid solutions applied 6 , 21 , 26 .…”

Nanoparticle-Based Rifampicin Delivery System Development

“…Due to the alkaline environment of chronic nonhealing wounds, which have lower healing rates compared with neutral or acidic wounds [ 46 ] and high stability of the alkaline PENs [ 26 ], the in vitro release profiles of RIF-loaded PENs were evaluated at alkaline (8.5) and physiological (7.4) pHs. As shown in Figure 7 , the in vitro release profiles of RIF-loaded PENs were assigned to a biphasic process, including an initial burst release for about 6 h and a subsequent gradual release for 72 h. The initial burst and diffusion of adsorbed RIF into the media were the result of the high swelling and dissolution rate of the shells.…”

Accelerating skin barrier repair using novel bioactive magnesium-doped nanofibers of non-mulberry silk fibroin during wound healing

“…This acidification of the wound bed will help in wound environment as wound site will be resistant toward bacterial infections. 34 Macroscopic analysis of Mg-NSF/PVA film showed accelerated wound contraction rate and re-epithelization at in vivo study. During wound healing at initial phases number of inflammatory cells must be more with gradual decrease in later phase.…”