Wound-bed preparation: a vital step in the healing process

Abstract

Non-healing wounds are a significant burden to healthcare systems, where it is estimated that 4-5% of the adult population has a problem wound at any one time ( Guest et al, 2017 ). It is suggested that infection is the most frequent complication in non-healing wounds where it can prolong patient treatment times and increase resource use ( Gottrup et al, 2013 ). Wound infection develops as a result of an imbalance between the patient's immune system and the conditions in the wound, which subsequently can promote bacterial proliferation ( Wounds UK, 2013 ). It can impact on the patient by delaying wound healing, increasing the risk of amputation and life-threatening conditions, and reducing quality of life. The use of antibiotics to treat wound infections has decreased due to the increased risk of antibiotic resistance ( Swanson et al, 2014 ). As a result alternative strategies for preventing and managing wound infection have been adopted, including wound debridement and the use of topical antiseptic/antimicrobial agents.

Contamination of wounds with fecal bacteria in immuno-suppressed mice

“…In order to avoid auto-infections of the wounds with skin-resident bacterial flora, to achieve maximum difference between infected and non-infected wounds and to ensure optimal reproducible conditions, we decided to administer topical wound disinfection with Octenidindihydrochlorid (Octenisept). This recapitulates the current clinical practice given that wound disinfection has become a standard aim to prevent and manage inpatient wound infections as well as to reduce antibiotics and prevent development of antimicrobial resistance 54,55 . The presence/absence of the topical disinfection in control (uninfected) animals did not influence the wound closure speed (data not shown).…”

The Impact of Nipple Repair in the Treatment of Lactating Nipple Injury

“…After the nipple was damaged, the movement of the nipple during lactation was not conducive to the creation of the surface, that is, the chronic wound healing process increased the risk of local infection [11] , and the necrotic tissue in the wound had the functions of preventing angiogenesis, granulation tissue formation, epidermal regeneration, and normal extracellular matrix formation, thus forming a physical barrier for re-epithelialization, preventing local drugs from directly contacting the wound, and affecting the curative effect [13][14][15] . Anghel EL considered that adequate debridement of necrotic tissue is the core of wound healing [16] , and also the basic step to promote chronic wound healing [11] .In this study, for patients with no improvement after etiological treatment, nipple repair was used to remove necrotic tissue, it revealed signi cantly better therapeutic effect than that was not treated with medicine or surgery, suggesting that nipple repair plays an important role in promoting the healing of chronic nipple injury. It not only cleares the wound but also promotes the growth of fresh epithelial cells in the wound, thus speeding up the healing process.…”

Undertaking a person-centred assessment of patients with chronic wounds

“…Li et al (2017) stated that the presence of pre-existing conditions such as diabetes or malnourishment means that it is possible to predict that some wounds are more likely to become chronic. Because early identification of factors that affect wound health can optimise a wound's healing potential, a holistic assessment of the patient is as important as a thorough assessment of the wound itself (Frykberg and Banks 2015, Benbow 2016, Morton and Phillips 2016, Barrett 2017, Gupta et al 2017, Li et al 2017.…”