The quest for tissue repair's holy grail: The promise of wound diagnostics or just another fishing expedition?

Armstrong, David G.; Lew, Eric; Hurwitz, Bonnie; Wild, T. Cameron

doi:10.1016/j.wndm.2015.03.010

Cited by 9 publications

(8 citation statements)

References 31 publications

(36 reference statements)

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“…We believe that pairing this with a companion diagnostic for inflammation might prove even more beneficial in the future to assist in clinical decision making about when to start and stop therapy. [5][6][7] We concur with the commentators that economic and quality of life data are important to consider when evaluating wound healing therapies. Non-healing diabetic foot ulcers and other lower-extremity complications of diabetes are associated with significant morbidity and mortality, directly impacting our patient's quality of life.…”

supporting

confidence: 58%

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Comment on “An observational pilot study using a purified reconstituted bilayer matrix to treat non‐healing diabetic foot ulcers”

Armstrong

2020

International Wound Journal

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supporting

confidence: 58%

mentioning

confidence: 99%

Comment on “An observational pilot study using a purified reconstituted bilayer matrix to treat non‐healing diabetic foot ulcers”

Armstrong

2020

International Wound Journal

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“…The developed platform and these studies permit a better understanding of the wound healing process and also suggest the potential use a new evaluation tool to better and more consistently measure what we manage. 9,10,11 We look forward to further works that will confirm or refute these data.…”

Section: Resultsmentioning

confidence: 89%

Quantitative Studies of Diabetic Foot Ulcer Evolution Under Treatment by Digital Stereotactic Photography

Mirabal

Acosta

Montequin

et al. 2019

J Diabetes Sci Technol

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Background: Imaging the lower extremity reproducibly and accurately remains an elusive goal. This is particularly true in the high risk diabetic foot, where tissue loss, edema, and color changes are often concomitant. The purpose of this study was to evaluate the reproducibility of a novel and inexpensive stereotaxic frame in assessment of wound healing. Methods: The main idea is to keep constant and reproducible the relative position of extremities related to the sensor used for the examination during a serial studies by stereotaxic digital photographic sequence. Ten healthy volunteers were evaluated at 10 different time moments to estimate the foot position variations in the stereotaxic frame. The evolution of 40 of DFU patients under treatment was evaluated before and during the epidemical grow factor intralesional treatment. Results: The wound closing and granulation speeds, the relative contribution of the contraction and tissue restauration mechanism were evaluated by stereotaxic digital photography. Conclusions: The results of this study suggest that the stereotaxic frame is a robust platform for serial study of the evolution of wound healing which allow to obtain consistent information from a variety of visible and hyperspectral measurement technologies. New stereotaxic digital photography evidences related to the diabetic foot ulcer healing process under treatment has been presented.

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“…The specialty of wound care developed without the benefit of diagnostic testing for inflammation or bacterial burden [ 5 , 6 , 7 , 8 ]. Today, clinicians rely on clinical signs and symptoms (CSS) to diagnose excessive inflammation and elevated bacterial levels in non-healing wounds; however, CSS are unreliable [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Principles of Best Diagnostic Practice in Tissue Repair and Wound Healing: An Expert Consensus

Armstrong¹,

Bauer

Bohn

et al. 2020

Diagnostics

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Chronic wound treatment currently relies heavily on visual assessment by clinicians; however, the clinical signs and symptoms of infection and inflammation are unreliable in chronic wounds. The specialty of wound care has witnessed the advent of advanced interventions, such as cellular and/or tissue based products (CTP). The success of advanced therapies relies on preparing the wound bed by reducing bacterial burden and inflammation. The lack of diagnostics in chronic wound care leads to uncertainty in the adequacy of wound bed preparation. Recent research suggests that two novel point-of-care diagnostic tests can assist in the detection of chronic inflammation known as elevated neutrophil derived protease activity (EPA) and bacterial pathogenesis known as bacterial protease activity(BPA) in chronic wounds. Despite the evidence, however, clinicians report that incorporating diagnostics into every day practice is challenging and across the globe, they have requested guidance on their use. Methods and Recommendations: A panel of wound care experts, experienced with these tests, met to develop guidelines on their use in wound care practice. The consensus panel concluded that the clinician should test for BPA first. The panel maintained that the risk of invasive infection resulting from the presence of pathogenic bacteria was the greatest threat to the patient’s health. If the BPA test is negative, the panel recommended testing for EPA. In addition, it was suggested that if the wound failed to progress after the elevated BPA was treated and subsequent testing was negative for BPA, the clinician should consider testing for EPA. Conclusions: In this manuscript, the consensus panel suggests pathways for testing, treating, and retesting for EPA and BPA. The panel expects that following the algorithm has the potential to improve healing outcomes, result in more cost-effective use of advanced therapies, and improve antimicrobial stewardship by guiding antimicrobial use.

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The quest for tissue repair's holy grail: The promise of wound diagnostics or just another fishing expedition?

Cited by 9 publications

References 31 publications

Comment on “An observational pilot study using a purified reconstituted bilayer matrix to treat non‐healing diabetic foot ulcers”

Comment on “An observational pilot study using a purified reconstituted bilayer matrix to treat non‐healing diabetic foot ulcers”

Quantitative Studies of Diabetic Foot Ulcer Evolution Under Treatment by Digital Stereotactic Photography

Principles of Best Diagnostic Practice in Tissue Repair and Wound Healing: An Expert Consensus

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