Wound healing and TIME; new concepts and scientific applications

Schultz, Gregory S.; Mozingo, D.W.; Romanelli, Marco; Claxton, K

doi:10.1111/j.1067-1927.2005.1304s1.x

Cited by 129 publications

(90 citation statements)

References 66 publications

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“…11 An additional method of MMP control could involve the adjustment of the wound pH. 5,12 In addition to affecting enzymatic activity, pH influences oxygen availability. For example, a lowering of pH by just 0.6 units is reported to enhance the release of almost 50% more oxygen into a wound.…”

Section: Introductionmentioning

confidence: 99%

The Effect of pH on the Antimicrobial Efficiency of Silver Alginate on Chronic Wound Isolates

Slone

Linton

Okel

et al. 2010

The Journal of the American College of Certified Wound Speciali

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BACKGROUND: Nonhealing and stalled chronic wounds are often reported to reside within an alkaline environment. Consequently, a number of researchers have proposed that lowering the pH of a chronic wound environment will enable healing to progress. However, it is not known whether the efficacies of silver-impregnated wound dressings are affected by pH.OBJECTIVE: To investigate whether pH has an effect on the antimicrobial barrier efficacy of a silver alginate wound dressing on wound isolates.METHODS: Twenty-five bacteria and yeasts that had been routinely isolated from chronic wounds were separately exposed to a silver alginate wound dressing with the use of a standardized corrected zone of inhibition (CZOI) assay. RESULTS:The silver alginate dressing demonstrated a broad spectrum of antimicrobial barrier activity within the dressing against all wound isolates. However, at a pH of 5.5, compared with a pH of 7, the antimicrobial barrier activity of the silver alginate dressing significantly increased. For all yeasts the CZOI ranged from 6.25 to 11 mm at a pH of 7. At a pH of 5.5, the CZOI range increased from 8.5 to 12.25 mm. For the Gram-negative isolates, the CZOI ranged from 0.75 to 6.5 mm at a pH 7, compared with a CZOI range of 2.75 to 8 mm at pH 5.5. The CZOI for the Gram-positive isolates, including meticillin-resistant Staphylococcus aureus, ranged from 3 to 7.75 mm at pH 7 and from 4.5 to 11.75 mm at pH 5.5.CONCLUSION: For all isolates tested, excluding one strain of Candida albicans and one vancomycinresistant Enterococcus strain, lowering pH to 5.5 resulted in an improvement in the antimicrobial barrier activity within the silver alginate dressing. Based on these initial in vitro findings, it is possible to suggest that there may be benefits to maintaining an infected or recalcitrant wound in a slightly acid (pH 5.5) environment. In particular, doing so may lead to an enhanced antimicrobial barrier effect of silver, a quicker reduction in the wound microbial bioburden, and therefore a reduction in the need for prolonged antimicrobial use. However, more in vitro and in vivo studies would be warranted to further substantiate these claims.

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Section: Introductionmentioning

confidence: 99%

The Effect of pH on the Antimicrobial Efficiency of Silver Alginate on Chronic Wound Isolates

Slone

Linton

Okel

et al. 2010

The Journal of the American College of Certified Wound Speciali

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“…Ceftriaxone, continued after procedure depending on patient's general condition and local wound. (b) Accurate surgical debridement of crushed or non-viable tissue until reaching a viable and aseptic bed, basing on TIME scheme [20,21]. (c) Dermal substitute application, performed after wound's bed cleaning for several minutes (not more than 5) with saline solution and preparation of the device while preserving 1 mm of margin on each side.…”

Section: Devicesmentioning

confidence: 99%

Soft Tissue Reconstructions with Dermal Substitutes Versus Alternative Approaches in Patients with Traumatic Complex Wounds

Morozzo¹,

Villafañe

Ieropoli

et al. 2015

Indian J Surg

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The use of dermal substitutes is considered an effective treatment in several pathologies involving skin damage, mainly extensive burns and trauma. Treatment alternatives entail performing flaps or autografts. The purpose of this cross-sectional study is to assess the clinical effects and costeffectiveness of dermal substitutes in surgical procedure in complex wound healings of adult trauma patients. The study includes 52 patients who received dermal substitutes (n=25) between 2007 and 2012 and patients treated between 2006 and 2011 who received standard treatment (n=27). All patients presented with posttraumatic soft tissue defects with bone and/or tendon exposure. Differences in costs, mean differences in Euros and Euros per square centimeter, and clinical data were collected as outcome measures. Pearson's correlations were used to assess the relationship between total costs with sociodemographic data and clinical services to different healthcare providers (clinical data and costs were recorded for both groups). No relevant differences on acceptance rates were noticed amongst groups. Surgery costs were shown to be significantly reduced in the dermal substitutes group (P<0.01) even though total costs (surgery+hospitaliza-tion) did not exhibit a significant difference. Surgical time was significantly reduced in the dermal substitutes group (1.81 min/cm 2 lesions) as compared with the standard group (6.08 min/cm 2 lesions). The current study suggests that not only clinical but also possible economic and logistical advantages in choosing dermal substitutes may exist.

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“…An aspect of wound healing can therefore be assessed by measuring the rate of recovery of the skin barrier function using TEWL measurements. It is therefore not surprised that research studies have used the technique extensively when assessing wound healing treatments (Nakamizo et al , 2013) and is being advocated as part of assessment tools in wound and scar management (Brusselaers, Pirayesh, 2010, Schultz et al, 2005.…”

Section: Clinical Application In Wound Healingmentioning

confidence: 99%