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Diabetic Foot Ulcers

 

* MIST Therapy study. In a clinical study entitled "Ultrasound Therapy for Racalcitrant Diabetic Foot Ulcers: A Randomized Double Blinded, Sham-Controlled, Multicenter Study," the incidence of wound closure in diabetic foot ulcers was found to increase when the wounds were treated with the MIST Therapy System (Celleration, Eden Prairie, MN).Participants at hospital-based and private wound care clinics received either active 40 kHz ultrasound delivered by a saline mist or saline mist alone (sham control). After 12 weeks, the proportion of wounds that healed in the active ultrasound therapy device group was significantly higher than in the sham control device group (40.7% vs 14.3%, P = .0366, Fisher exact test).Celleration's MIST technology can be used on a variety of wounds, including acute traumatic, chronic, and dehisced wounds, to promote wound healing.[black up pointing small triangle] Information:http://www.celleration.com

 

* Shear and plantar pressure sensor. Researchers at the University of Washington have developed a shear and plantar pressure sensor based on fiber-optic bend loss that could help prevent foot ulcers in individuals with diabetes. The sensor could be used to create a shoe that would monitor stress changes in the foot and provide the appropriate pressure and shear force to the area to relieve the stress.

 

Details of the invention were reported in the May/June issue of the Journal of Rehabilitation Research & Development. In their study, the researchers used a pressure shear sensor consisting of an array of optical fibers lying in perpendicular rows and columns separated by elastomeric pads. They constructed a map of normal and shear stresses based on observed macrobending through the intensity attenuation from the physical deformation of fibers.

 

Initial results demonstrated that the sensor emits low noise and responds to applied normal and shear loads with good repeatability.

 

Source: Wang WX, Ledoux, WR, Sangeorzan BJ, Reinhall PG. A shear and plantar pressure sensor based on fiber-optic bend loss. J Rehabil Res Dev. 2005:42:315-26.

 

Pressure Ulcers

A study published in the May/June issue of the Journal of Wound, Ostomy and Continence Nursing compared clinical outcomes and nursing labor costs associated with (a) balsam Peru, hydrogenated castor oil, and trypsin (BCT) ointment; (b) BCT + Other; and (c) Other treatments in 2014 wound episodes occurring in 861 patients (mean 2.34 wounds/patient). Treatment with BCT ointment or BCT + Other was associated with a higher healing rate (P < .05). None of the Stage I or II pressure ulcers treated with BCT ointment progressed, compared with 13.8% treated with BCT + Other and 13.4% treated with Other.

 

The reported mean duration of treatment and time to heal were shorter for ulcers treated with the BCT ointment, but differences did not reach significance, possibly because of the variability in reported treatment times. Mean daily nursing labor costs were lower for treatment with BCT than Other ($50.8 vs $61.7, P < .05).

 

According to the researchers, data suggest that treatment of Stage I or II pressure ulcers with BCT may be associated with shorter treatment time and time to heal and a potential reduction in treatment-related nursing labor costs.

 

Source: Narayanan S, Van Vleet J, Strunk B, Ross RN, Gray M. Comparison of pressure ulcer treatments in long-term care facilities: clinical outcomes and impact on cost. J Wound Ostomy Continence Nurs. 2005;32:163-70.

 

Venous Ulcers

An Italian study published in the August 2005 issue of the Journal of Vascular Surgery evaluates the efficacy of treating venous ulcers of the lower limbs with prostaglandin E-1 (PGE-1), which is intended to improve local ischemia. In the randomized, placebo-controlled, single-blind study, 87 patients who had venous leg ulcers of similar size and characteristics were treated for 20 days with an infusion of PGE-1 or placebo, in association with topical therapy. The dimensions and the number of ulcers were determined at the beginning of the treatment and then every 20 days for up to 4 months, or until wound closure.

 

The reduction in ulcer size was faster in the patients treated with PGE-1; all ulcers healed by 100 days. In the placebo group, only 84.2% of ulcers healed by the end of the 120-day observation period.

 

The researchers concluded that PGE-1 demonstrates effectiveness in reducing the healing time of venous ulcers, suggesting that venous ulcers should also be considered ischemic.

 

Source: Milio G, Mina C, Cospite V, Almasio PL, Novo S. Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs. J Vasc Surg. 2005;42:304-8.