Advanced Wound Diagnostics: Toward Transforming Wound Care into Precision Medicine

Weigelt, Maximillian A.; Lev‐Tov, Hadar; Tomic‐Canic, Marjana; Lee, W David; Williams, Ryan A.; Strasfeld, David B.; Kirsner, Robert S.; Herman, Ira M.

doi:10.1089/wound.2020.1319

Cited by 21 publications

(20 citation statements)

References 214 publications

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“…In wound care, that desired outcome has historically been a healed wound. However, recent appreciation of other outcomes, either as intermediate, surrogates, or of desired endpoints that by themselves have value, has emerged 104–108 . Outcomes or endpoints have also become a focal point in regulatory aspects of wound care.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians may rely on a variety of quality of life (QOL) tools to assess the impact on QOL and how certain interventions might change QOL. Such tools may measure overall QOL, or may be disease specific (e.g., to venous leg ulcer, diabetic foot ulcer or pressure ulcers) 104–108 . Depending on individual patient needs, QOL assessment may not be needed for every patient; choosing the best assessment tool might differ between patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent appreciation of other outcomes, either as intermediate, surrogates, or of desired endpoints that by themselves have value, has emerged. 104 , 105 , 106 , 107 , 108 Outcomes or endpoints have also become a focal point in regulatory aspects of wound care. Recognition of the impact of wounds and how other fields approach drug and device development led to holistic evaluations of providers' and patients' opinions regarding important outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Such tools may measure overall QOL, or may be disease specific (e.g., to venous leg ulcer, diabetic foot ulcer or pressure ulcers). 104 , 105 , 106 , 107 , 108 Depending on individual patient needs, QOL assessment may not be needed for every patient; choosing the best assessment tool might differ between patients. For example, wound pain may be a critical driver of diminished QOL in patients with venous leg ulcers but less important for a patient with a neuropathic insensate diabetic foot ulcer.…”

Section: Discussionmentioning

confidence: 99%

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Chronic wounds: Treatment consensus

Eriksson

Liu

Schultz

et al. 2022

Wound Repair Regeneration

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139

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The Wound Healing Foundation (WHF) recognised a need for an unbiased consensus on the best treatment of chronic wounds. A panel of 13 experts were invited to a virtual meeting which took place on 27 March 2021. The proceedings were organised in the sub‐sections diagnosis, debridement, infection control, dressings, grafting, pain management, oxygen treatment, outcomes and future needs. Eighty percent or better concurrence among the panellists was considered a consensus. A large number of critical questions were discussed and agreed upon. Important takeaways included that wound care needs to be simplified to a point that it can be delivered by the patient or the patient's family. Another one was that telemonitoring, which has proved very useful during the COVID‐19 pandemic, can help reduce the frequency of interventions by a visiting nurse or a wound care center. Defining patient expectations is critical to designing a successful treatment. Patient outcomes might include wound specific outcomes such as time to heal, wound size reduction, as well as improvement in quality of life. For those patients with expectations of healing, an aggressive approach to achieve that goal is recommended. When healing is not an expectation, such as in patients receiving palliative wound care, outcomes might include pain reduction, exudate management, odour management and/or other quality of life benefits to wound care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Chronic wounds: Treatment consensus

Eriksson

Liu

Schultz

et al. 2022

Wound Repair Regeneration

Self Cite

139

View full text Add to dashboard Cite

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“…Wound healing is a dynamic process consisting of 4 stages—hemostasis, inflammation, proliferation, and remodeling [ 1 , 2 ]. Diagnosing the wound stage is important for developing appropriate treatment and improving wound care [ 3 – 5 ]. In practice, doctors monitor the progression of wounds through visual cues and adjust treatment in correspondence with an individual's response.…”

Section: Introductionmentioning

confidence: 99%

Robust classification of wound healing stages in both mice and humans for acute and burn wounds based on transcriptomic data

et al. 2023

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Background Wound healing involves careful coordination among various cell types carrying out unique or even multifaceted functions. The abstraction of this complex dynamic process into four primary wound stages is essential to the study of wound care for timing treatment and tracking wound progression. For example, a treatment that may promote healing in the inflammatory stage may prove detrimental in the proliferative stage. Additionally, the time scale of individual responses varies widely across and within the same species. Therefore, a robust method to assess wound stages can help advance translational work from animals to humans. Results In this work, we present a data-driven model that robustly identifies the dominant wound healing stage using transcriptomic data from biopsies gathered from mouse and human wounds, both burn and surgical. A training dataset composed of publicly available transcriptomic arrays is used to derive 58 shared genes that are commonly differentially expressed. They are divided into 5 clusters based on temporal gene expression dynamics. The clusters represent a 5-dimensional parametric space containing the wound healing trajectory. We then create a mathematical classification algorithm in the 5-dimensional space and demonstrate that it can distinguish between the four stages of wound healing: hemostasis, inflammation, proliferation, and remodeling. Conclusions In this work, we present an algorithm for wound stage detection based on gene expression. This work suggests that there are universal characteristics of gene expression in wound healing stages despite the seeming disparities across species and wounds. Our algorithm performs well for human and mouse wounds of both burn and surgical types. The algorithm has the potential to serve as a diagnostic tool that can advance precision wound care by providing a way of tracking wound healing progression with more accuracy and finer temporal resolution compared to visual indicators. This increases the potential for preventive action.

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