Regenerative Tissue Matrix in Treatment of Wounds

Size: px
Start display at page:

Download "Regenerative Tissue Matrix in Treatment of Wounds"

Transcription

1 Regenerative Tissue Matrix in Treatment of Wounds Learning Objectives Differentiate between reparative and regenerative healing Review surgical techniques for applying a regenerative tissue scaffold to a variety of wound types Discuss the role of biologics in the continuum of wound care Review the evidence to support the use of acellular human dermal matrix for patients with chronic wounds Regenerative Healing Regenerative Tissue Scaffolds: Science and Surgical Applications Regenerative vs reparative 80:20 rule

2 Regeneration of Connective Tissue Only Occurs at 2 Specific Times in Our Life Cycle The Repair Process Is Based on Inflammation and Leads to Scar Formation Stem cells localize and divide Fibrin scaffold Local signals instruct stem cells to replace missing tissue Normal structure/function/physiology Regeneration Intrinsic Tissue Regeneration Process Noninflammatory process driven by mesenchymal stem cells Inflammation and proliferation Fibrosis and remodeling to scar Repair Inflammation Is Important to Health Inflammation is initiated by activation of macrophages Macrophage activation In-growth of white blood cells and other activated inflammatory cells Secrete collagen and ECM to replace the lost tissue with scar Inflammatory cells undergo apoptosis when the process is over Healing wounds (repair process) Fighting infection Protecting against foreign bodies Regeneration May Be Enabled Using Biologic Scaffolds Tissue contains the perfect scaffold for supporting the regenerative process Removing the scaffold from tissue without damage allows integration into the body Matrix damage triggers inflammation (and resorption or encapsulation) ECM = extracellular matrix. Harper J, et al. Wounds. 2007;19(6):

3 Regenerative Tissue Scaffolds The ECM Contains Complex 3-Dimensional Information Cellular Repopulation Revascularization Fibrillar collagens and collagen VI Elastin Hyaluronan Native collagen and key matrix components Matrix capable of supporting cell migration and capillary invasion (no abnormal cross-links) Rich in proteoglycans Transition to Functional Host Tissue Large and small Proteoglycans Fibronectin Vascular Channels Initial biomechanics that support suture retention and high load Harper J, et al. Wounds. 2007;19(6): Regenerative Tissue Scaffolds Regenerative Tissue Scaffolds (continued) Day 2 Day 7 Day 14 Day 21 Internal Data from LifeCell, Inc. Internal Data from LifeCell, Inc.

4 Processing Animal Studies Have Shown That Acellular Regenerative Tissue Scaffolds Are Not Adhesiogenic* Human Tissue Plast. Reconstr. Surg. 114:464, 2004 Remove Cellular Components Retain Biochemical Components Preserve Intact Matrix Plast. Reconstr. Surg. 125:167, 2010 Family of Scaffolds Eliminates Immune Response Guides Revascularization & Cellular Repopulation Avoids Inflammatory Response Regeneration of Normal Tissue *Correlation of these results to results in humans have not been established. Butler CE, et al. Plast Reconstr Surg. 2004;114(2): Burns NK, et al. Plast Reconstr Surg. 2010;125(1): Cross-Linked Porcine ADM Is More Fibrogenic against Healthy Bowel than Noncross-Linked Dermal Matrix Histology of Biologics in Primates Regeneration (Human RTM) Resorption (Porcine Small Intestine SM) Encapsulation (Cross-Linked Porcine Dermis) Cross-Linked PADM Noncross-Linked Primate Abdominal Wall 4-Week Explants ADM = acellular dermal matrix; PADM = porcine acellular dermal matrix. Butler CE, et al. J Am CollSurg. 2010;211(3): RTM = regenerative tissue matrix; SM = submucosa. Sandor M, et al. Tissue Eng Part A. 2008;14(12):

5 Histology of Biologic Explants in Primates Cross-Linked Porcine Dermis Was Infected, Acellular, and Encapsulated Regeneration (Human RTM) Resorption (Porcine Small Intestine SM) Encapsulation (Cross-Linked Porcine Dermis) 100x Primate Abdominal Wall 6-Month Explants Human Abdominal Wall 3-Month Explant Sandor M, et al. Tissue Eng Part A. 2008;14(12): Courtesy of Dr. Patrick Osum, Little Rock, AR. Cross-Linked Porcine Dermis Has Been Shown Not to Integrate: Clinical Example Biochemical Impairment of Chronic Wounds Elevated pro-inflammatory cytokines Elevated proteinase activity MMPs Diminished activity of growth factors Degraded receptor sites (degradation blocked by the addition of MMP inhibitors) Human Abdominal Wall 10-Month Explant Courtesy of Dr. Terry L. Simpson, Phoenix, AZ. MMP = matrix metalloproteinase.

6 Bacterial Biofilm Is a Major Barrier to Wound Healing Comparison of Full-Thickness DFU Prospective, Randomized, Controlled Trials Pivotal Study Study End Point # of Applications % of Wounds Healed Average Time to Complete Healing Reyzelman, et al 12 weeks 1 70% 5.7 weeks Veves, et al 12 weeks % 9.3 weeks Marston, et al 12 weeks 8 30% Not Reported DFU = diabetic foot ulcer. Reyzelman A, et al. Int Wound J. 2009;6(3): Veves A, et al. Diabetes Care. 2001;24(2): Marston WA, et al. Diabetes Care. 2003; 26(6): Clinical Effectiveness of an Acellular Dermal Regenerative Tissue Matrix Compared with Standard Wound Management in Healing DFUs: A Prospective, Randomised, Multicenter Study Clinical Effectiveness of an Acellular Dermal Regenerative Tissue Matrix Compared to Standard Wound Management in Healing DFUs: A Prospective, Randomised, Multicenter Study Patients in Study N = 86 Study Group = 47 Received a single application of 4X4 cm human acellular regenerative tissue matrix Control = 39 Received standard-of-care wound management consisting of moist wound therapy with alginates, foams, hydrocolloids, or hydrogels. Primary End Point: Proportion of ulcers that completely healed at 12 weeks (complete healing defined as 100% epithelialization) Secondary End Point: Mean time to healing Mean age: years Majority were patients with type 2 diabetes Obese Demographic Variable Age (years) Mean Median SD Range Number of patients Body mass index (lbs/in²) Mean Median SD Range Number of patients Diabetes mellitus type Type 1 Type 2 Number of patients Study Group (n=46) (10.9%) 41 (89.1%) 46 Control Group (n-39) (5.1%) 37 (94.9%) 39 ReyzelmanA, et al. Int J Wound. 2009;6(3): SD = standard deviation. Reyzelman A, et al. Int J Wound. 2009;6(3):

7 Demographics Surgical Preparation of Wound Site Followed by Randomization into 1 of 2 Groups Number of Patients Comparison of Index Ulcer Location between Treatment Groups 32.6% Toe Most Common Ulcer Area: Foot 12.8% 32.6% Foot 43.6% 8.7% Heel Wound Location Acellular Matrix Moist Wound Therapy 20.5% 10.9% ReyzelmanA, et al. Int J Wound. 2009;6(3): % Other Pretreatment Ulcer Duration (weeks) Study Group (n=46) Control Group (n=39) Mean Median Standard Deviation Mean Pretreatment Ulcer Duration: ~23 Weeks Range Study Group (n = 47) Single application of acellular dermal regenerative matrix for wounds (fenestrated) scaffold RTM 4x4 applied Secured via suture or staple Silver-based nonadherent dressing applied Secondary dressings (hydrogel bolsters or moist gauze) were applied routinely at the rate determined by the investigator until complete epithelialization was achieved or 12 weeks of care ReyzelmanA, et al. Int J Wound. 2009;6(3): Control Group (n = 39) Received standard of wound care Moist wound therapy with alginates, foams, hydrocolloids or hydrogels at discretion of treating physician Alginates with foam typically used for heavily exudative wounds Hydrocolloids or hydrogels typically used for minimal exudating wounds Dressing changed daily unless recommended otherwise by treating physician Survival Probability Survivorship Analysis to Complete Healing Product Limit Survival Function Estimates AM ACM SOC + Standard of care Time to Healing (weeks) P =.0075 AM = acellular matrix; SOC = standard of care; CI = confidence interval. Reyzelman A, et al. Int J Wound. 2009;6(3): % of AM patients healed by 12 weeks 46% of standard of care patients healed by 12 weeks No. of Subjects Event Censored Median Survival (95% CI) AM 46 70% (32) 30% (14) 7.00 ( ) Standard of care 39 46% (18) 54% (21) (9.00-NA) + + Healing Proportion* Proportion of Healed Ulcers at Weekly Evaluation Intervals Patients that Completely Healed the Mean Time to Complete Healing AM Therapy Moist Wound Therapy 15% Higher vs Control Time to Healing (weeks) *Proportion of patients who completely healed as defined as 100% epithelialization. ReyzelmanA, et al. Int J Wound. 2009;6(3): AM SOC P =.0289 AM group = 5.7 weeks Control group = 6.8 weeks Proportion of healed ulcers between groups was statistically significant

8 Summary Conclusion Efficacy for AM demonstrated in UT Grade 1 and 2 diabetic foot ulcers 70% of AM patients completely healed Healed patients reached 100% epithelialization in 5.7 weeks (mean closure) Human acellular regenerative tissue scaffolds provide an effective treatment option for diabetic lower extremity wounds in a single application The AM is a viable treatment option for the treatment of lower extremity diabetic wounds A multicenter prospective study is underway to further validate the safety and efficacy of the AM UT = University of Texas Classification System. Reyzelman A, Crews RT, Moore JC, et al. Int Wound J. 2009;6: Results from 97 Wounds Results* 97 Wounds from 71 patients 33 females (46.5%) 38 males (53.5%) Mean age 62.2 ( ) Mean wound age is 18.6 weeks Patient Comorbidities Osteomyelitis 37.1% Obesity 52.0% Infection 54.6% Peripheral Vascular Disease Cardiac Disease Neuropathy UT Classification 1B = 1 1A = 15 1C = 0 1D = 2 3D = 33 2A = 18 3C = 3 2B = 8 3B = 7 3A = 3 2C = 4 2D = % 86.8% 87.6% Percent Population (%) Winters CL, et al. Adv Skin Wound Care. 2008;21(8): Time to Graft Incorporation (weeks) Mean ± SD Median Range Time to Graft Incorporation (weeks) Mean ± SD Median Range Time to Graft Incorporation (weeks) Mean ± SD Median Range Study Population (n=97) 1.5 ± ± ± No significant difference between time to graft incorporation, time to 100% granulation, and time to complete healing and UT classification *Complete healing defined as full epithelialization. Winters CL, et al. Adv Skin Wound Care. 2008;21(8): UT Grade 1 (n=18) 1.5 ± ± ± UT Grade 3 (n=33) 1.6 ± ± ± UT Grade 3 (n=46) 1.5 ± ± ±

9 Results Did Not Heal 9.3% Multiple Graft Applications Required 1% Overall Healing Rate Did Not Heal 9.3% 90.7% 89.7% Wounds Healed with Single Graft Application Acellular Human Dermal Matrix for Chronic Wounds Overall graft success rate was 89.7% 1 graft failure-healed 7 weeks post 2nd application Overall wound closure rate was 90.7% (88 of 97) Mean time to heal was 13.7 weeks Complete healing defined as full epithelialization. Winters C, et al. ASWC. 2008;21: Surgical Technique Surgical Technique (continued)

10 Case 1: 58-Year-Old Female with Submetatarsal Wound Present for 1 Month Case 1: Matrix and NPWT 7 Days Postop NPWT = negative pressure wound therapy. Case 1: Matrix and NPWT Therapy (continued) Case 1: Matrix and NPWT Therapy (continued) 15 Days Postop 42 Days Postop

11 Postoperative Scenarios Case 2: 54-Year-Old Male with Full Thickness Wound on Medial Ankle, Exposed Tibia, Noninsulin Dependent Diabetic Case 2: 5 Days Case 2: 3 Weeks

12 Case 2: 4 Weeks Case 2: 6 Weeks Case 3: 37-Year-Old Male with Open Traumatic Amputation with Loss of Lesser Digits and Distal Metatarsals Case 3: Preservation of Distal Tissue Use of ADM to preserve distal tissue for function and patient request

13 Case 3: 2 Weeks Post-Application of ADM Case 3: 7 Weeks Post-Application of ADM Flowable Dermal Scaffold Surgical Technique Micronized dermal scaffold Same physiologic properties without intact vascular channels Use in tunneling wounds

14 Tunneling Wounds? Postoperative Appearance 7 Days Postop Case 4: 87-Year-Old Diabetic Female with Multiple Failed Debridements Case 4: Intraoperative Photo

15 Case 4: Scaffold Placement Case 4: Flowable Scaffold Case 4: 5 Days Post-Application Case 4: 13 Days Post Flowable Application Laterally

16 Case 4: 20 Days Post-Application Case 4: 42 Days Post Flowable Laterally Case 4: 42 Days Post-Application (patient transferred to another facility) Thank You

Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds

Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds D. Heath Stacey, MD Northwest Arkansas Center for Plastic Surgery, Fayetteville, Ark Correspondence: dheathstacey@gmail.com Keywords:

More information

CASE 1: TYPE-II DIABETIC FOOT ULCER

CASE 1: TYPE-II DIABETIC FOOT ULCER CASE 1: TYPE-II DIABETIC FOOT ULCER DIABETIC FOOT ULCER 48 YEAR-OLD MALE Mr. C., was a 48-year old man with a history of Type-II diabetes over the past 6 years. The current foot ulcer with corresponding

More information

In the treatment of partial and full-thickness chronic wounds TRANSFORM YOUR APPROACH TO HEALING: SIGNAL THE BODY, NOT THE WOUND DERMA

In the treatment of partial and full-thickness chronic wounds TRANSFORM YOUR APPROACH TO HEALING: SIGNAL THE BODY, NOT THE WOUND DERMA In the treatment of partial and full-thickness chronic wounds TRANSFORM YOUR APPROACH TO HEALING: SIGNAL THE BODY, NOT THE WOUND DERMA It s time to signal a new direction in chronic wound treatment. WHY

More information

Dressings do not heal wounds properly selected dressings enhance the body s ability to heal the wound. Progression Towards Healing

Dressings do not heal wounds properly selected dressings enhance the body s ability to heal the wound. Progression Towards Healing Dressings in Wound Care: They Do Matter John S. Steinberg, DPM FACFAS Associate Professor, Department of Plastic Surgery Georgetown University School of Medicine Dressings do not heal wounds properly selected

More information

Tissue renewal and Repair. Nisamanee Charoenchon, PhD Department of Pathobiology, Faculty of Science

Tissue renewal and Repair. Nisamanee Charoenchon, PhD   Department of Pathobiology, Faculty of Science Tissue renewal and Repair Nisamanee Charoenchon, PhD Email: nisamanee.cha@mahidol.ac.th Department of Pathobiology, Faculty of Science Topic Objectives 1. Describe processes of tissue repair, regeneration

More information

Jeffrey A. Ross, DPM, MD, FACFAS Associate Professor Baylor College of Medicine Houston, Texas DFCon 2018 Houston, Texas

Jeffrey A. Ross, DPM, MD, FACFAS Associate Professor Baylor College of Medicine Houston, Texas DFCon 2018 Houston, Texas Jeffrey A. Ross, DPM, MD, FACFAS Associate Professor Baylor College of Medicine Houston, Texas DFCon 2018 Houston, Texas A Bridge to Healing S.T.E.P Save The Extremity Program Brooklyn Bridge Abnormal

More information

WOUND CARE UPDATE. -Commonly Used Skin Substitute Products For Wound. -Total Contact Casting. Jack W. Hutter DPM, FACFAS, C. ped.

WOUND CARE UPDATE. -Commonly Used Skin Substitute Products For Wound. -Total Contact Casting. Jack W. Hutter DPM, FACFAS, C. ped. WOUND CARE UPDATE -Commonly Used Skin Substitute Products For Wound Closure -Total Contact Casting Jack W. Hutter DPM, FACFAS, C. ped. Commonly Used Skin Substitute Products for Wound Closure why are they

More information

The Georgetown Team Approach to Diabetic Limb Salvage: 2013

The Georgetown Team Approach to Diabetic Limb Salvage: 2013 The Georgetown Team Approach to Diabetic Limb Salvage: 2013 John S. Steinberg, DPM FACFAS Associate Professor, Department of Plastic Surgery Georgetown University School of Medicine Disclosures: None Need

More information

Faculty. The Chronic Wound Management and Reconstruction Continuum: Strategies to Promote Wound Healing. Accreditation. Faculty Disclosures

Faculty. The Chronic Wound Management and Reconstruction Continuum: Strategies to Promote Wound Healing. Accreditation. Faculty Disclosures The Chronic Wound Management and Reconstruction Continuum: Strategies to Promote Wound Healing Sponsored by North American Center for Continuing Medical Education, LLC, An HMP Communications Holdings Company

More information

Fish Skin Grafts Promote Superior Cell Ingrowth Compared to Amnion Allografts, Human Cadaver Skin and Mammalian Extracellular Matrix (ECM)

Fish Skin Grafts Promote Superior Cell Ingrowth Compared to Amnion Allografts, Human Cadaver Skin and Mammalian Extracellular Matrix (ECM) Fish Skin Grafts Promote Superior Cell Ingrowth Compared to Amnion Allografts, Human Cadaver Skin and Mammalian Extracellular Matrix (ECM) Christopher L. Winters, DPM American Health Network Indianapolis,

More information

The Risk. Background / Bias. Integrating Wound Care into a Limb Preservation Initiative 4/24/2009

The Risk. Background / Bias. Integrating Wound Care into a Limb Preservation Initiative 4/24/2009 Stimulating Wound Granulation: Advances in NPWT and other Measures (Wound Bed Preparation) Charles Andersen MD, FACS, FAPWCA Clinical Prof of Surgery UW, USUHS Chief Vascular/Endovascular/ Limb Preservation

More information

Tissue repair. (3&4 of 4)

Tissue repair. (3&4 of 4) Tissue repair (3&4 of 4) What will we discuss today: Regeneration in tissue repair Scar formation Cutaneous wound healing Pathologic aspects of repair Regeneration in tissue repair Labile tissues rapid

More information

QUICK GUIDE SNAP THERAPY SYSTEM

QUICK GUIDE SNAP THERAPY SYSTEM QUICK GUIDE SNAP THERAPY SYSTEM Clinical Pathway to SNAP System Full holistic assessment of patient and wound Is the wound type indicated for NPWT use without contraindications 1? SNAP System is indicated

More information

CorMatrix ECM Bioscaffold

CorMatrix ECM Bioscaffold CorMatrix ECM Bioscaffold REMODEL. REGROW. RESTORE. CorMatrix ECM Bioscaffold provides a natural bioscaffold matrix that enables the body s own cells to repair and remodel damaged cardio-vascular tissue.

More information

BIOBURDEN-BASED WOUND MANAGEMENT: A NEW PARADIGM. Ryan H. Fitzgerald, DPM, FACFAS

BIOBURDEN-BASED WOUND MANAGEMENT: A NEW PARADIGM. Ryan H. Fitzgerald, DPM, FACFAS BIOBURDEN-BASED WOUND MANAGEMENT: A NEW PARADIGM Ryan H. Fitzgerald, DPM, FACFAS Contamination Presence of non-replicating microorganisms on the wound surface that evoke no clinical host response - All

More information

Clinical Policy: EpiFix Wound Treatment

Clinical Policy: EpiFix Wound Treatment Clinical Policy: Reference Number: PA.CP.MP.140 Effective Date: 03/18 Last Review Date: 04/18 Coding Implications Revision Log Description EpiFix (MiMedx Group) is dehydrated human amniotic tissue that

More information

Emerging Use of Topical Biologics in Limb Salvage Role of Activated Collagen in Multimodality Treatment

Emerging Use of Topical Biologics in Limb Salvage Role of Activated Collagen in Multimodality Treatment 9 th Annual New Cardiovascular Horizons New Orleans September 12, 2008 Emerging Use of Topical Biologics in Limb Salvage Role of Activated Collagen in Multimodality Treatment Gary M. Rothenberg, DPM, CDE,

More information

Healing & Repair. Tissue Regeneration

Healing & Repair. Tissue Regeneration Healing & Repair Dr. Srikumar Chakravarthi Repair & Healing: Are they same? Repair :Regeneration of injured cells by cells of same type, as with regeneration of skin/oral mucosa (requires basement membrane)

More information

Galen ( A.D) Advanced Wound Dressing

Galen ( A.D) Advanced Wound Dressing Galen (120-201A.D) Advanced Wound Dressing Wounds heal optimally in a moist environment นพ.เก งกาจ ว น ยโกศล Wound assessment Ideal wound dressing Type of wound Clinical appearance Wound location Measurement

More information

CLINICAL EVIDENCE Partial and Deep Partial Burns

CLINICAL EVIDENCE Partial and Deep Partial Burns CLINICAL EVIDENCE Partial and Deep Partial Burns Endoform helps to improve re-epithelialization after burn injuries Endoform helps to facilitate tissue granulation and epithelialization in partial and

More information

INTRODUCTION TO WOUND DRESSINGS

INTRODUCTION TO WOUND DRESSINGS WOUND CARE INTRODUCTION TO WOUND DRESSINGS JEC 2017 Wound Care Successfully completed specialized skills training in Wound Management. WOUND CONDITIONS & SYMBOLS BY COLOURS Yellow Black Necrotic tissue

More information

The Use of the. in Clinical Practice

The Use of the. in Clinical Practice The Use of the SNAP Therapy System in Clinical Practice It s an ultraportable, mechanically-powered disposable NPWT. By Animesh Bhatia, DPM, CWS This article is written exclusively for PM and appears courtesy

More information

REPRESENTATIVE REPORTS USING DERMACELL AWM

REPRESENTATIVE REPORTS USING DERMACELL AWM REPRESENTATIVE REPORTS USING DERMACELL AWM Documents available upon request. Clinical Reports using DermACELL AWM in Advanced Wound Management Published & Peer-Reviewed Articles, Posters, & Abstracts from

More information

Scott E. Palmer, V.M.D. Diplomate, A.B.V.P., Eq. Practice New Jersey Equine Clinic

Scott E. Palmer, V.M.D. Diplomate, A.B.V.P., Eq. Practice New Jersey Equine Clinic Scott E. Palmer, V.M.D. Diplomate, A.B.V.P., Eq. Practice New Jersey Equine Clinic spalmer@njequine.com Hemostasis Inflammation Proliferation Remodeling Inflammation Matrix production Angiogenesis Epithelialization

More information

Genadyne A4 and foam to treat a postoperative debridment flank abscess

Genadyne A4 and foam to treat a postoperative debridment flank abscess Genadyne A4 and foam to treat a postoperative debridment flank abscess Michael S. DO, The Wound Healing Center Indianapolis, IN Cynthia Peebles RN D.O.N., Becky Beck RN Heartland at Prestwick NH Avon,

More information

Diabetic Foot Ulcer Treatment and Prevention

Diabetic Foot Ulcer Treatment and Prevention Diabetic Foot Ulcer Treatment and Prevention Alexander Reyzelman DPM, FACFAS Associate Professor California School of Podiatric Medicine at Samuel Merritt University Diabetic Foot Ulcers One of the most

More information

Integra. PriMatrix Dermal Repair Scaffold PATIENT INFORMATION. Questions? Contact us: Clinician: Phone #: In case of emergency, dial 9-1-1

Integra. PriMatrix Dermal Repair Scaffold PATIENT INFORMATION. Questions? Contact us: Clinician: Phone #: In case of emergency, dial 9-1-1 Integra PriMatrix Dermal Repair Scaffold PATIENT INFORMATION Questions? Contact us: Clinician: Phone #: In case of emergency, dial 9-1-1 Your Path to Recovery Your health care provider has chosen to use

More information

Biodesign E NTEROCUTANEOUS FISTULA PLUG

Biodesign E NTEROCUTANEOUS FISTULA PLUG Offer a new alternative to patients who have enterocutaneous fistulas, even after standard treatments have been tried. Illustration by Lisa Clark Biodesign E NTEROCUTANEOUS FISTULA PLUG MEDICAL How is

More information

Consider the possibility of pressure ulcer development

Consider the possibility of pressure ulcer development Douglas Fronzaglia II, DO, MS LECOM Institute for Successful Aging LECOM Institute for Advanced Wound Care and Hyperbaric Medicine Consider the possibility of pressure ulcer development 1 Identify ulcer

More information

Appropriate Dressing Selection For Treating Wounds

Appropriate Dressing Selection For Treating Wounds Appropriate Dressing Selection For Treating Wounds Criteria to Consider for an IDEAL DRESSING Exudate Management Be able to provide for moist wound healing by absorbing exudate or adding moisture Secure

More information

The field of wound care is ever-expanding with. Fish Skin to Heal Wounds. Clinical InnovationS / New Concepts and Studies

The field of wound care is ever-expanding with. Fish Skin to Heal Wounds. Clinical InnovationS / New Concepts and Studies Clinical InnovationS / THE DIABETIC FOOT Fish Skin to Heal Wounds This product shows promise in helping chronic wound patients achieve closure faster. by Christopher L. Winters, DPM, CWS-P 119 Figure 1:

More information

Hemostasis Inflammatory Phase Proliferative/rebuilding Phase Maturation Phase

Hemostasis Inflammatory Phase Proliferative/rebuilding Phase Maturation Phase The presenters are staff members of the CHI Health St. Elizabeth Burn and Wound Center. Many of the products discussed are used in our current practice but we have no conflict of interest to disclose.

More information

Smart Solutions for Serious Wounds. An advanced bilayer dermal regeneration matrix FDA approved for the treatment of diabetic foot ulcers.

Smart Solutions for Serious Wounds. An advanced bilayer dermal regeneration matrix FDA approved for the treatment of diabetic foot ulcers. Smart Solutions for Serious Wounds An advanced bilayer dermal regeneration matrix FDA approved for the treatment of diabetic foot ulcers. A New Approach to Diabetic Foot Ulcer Care Supported by Over Two

More information

Patient Care Information

Patient Care Information Patient Care Information A Guide to Healing Diabetic Foot Ulcers Questions? Contact us: Clinician: Phone #: In case of emergency, dial 9-1-1 Dermal Regeneration Matrix Overview Diabetic foot ulcers are

More information

Strength and Predictability. Zimmer Collagen Repair Patch

Strength and Predictability. Zimmer Collagen Repair Patch Strength and Predictability Zimmer Collagen Repair Patch Durable Reinforcement The Zimmer Collagen Repair Patch is a biological implant consisting of an acellular scaffold of collagen and elastin, derived

More information

Understanding and Managing

Understanding and Managing Understanding and Managing MM s in Wound Bed Brock Liden DM, ABM, FAWCA Learning Objectives Review the four sequential phases of normal wound healing and recognize the BENEFICIAL effects of CONTROLLED

More information

Advancing the science of wound bed preparation

Advancing the science of wound bed preparation Advancing the science of wound bed preparation How Drawtex wound dressing works LevaFiber Technology provides three different types of action. Mechanisms of Action Capillary Action Hydroconductive Action

More information

I ve a drawer full of dressings i don t know how to use!

I ve a drawer full of dressings i don t know how to use! I ve a drawer full of dressings i don t know how to use! Introduction: Originating from battlefield medicine much of what we use today is an evolution of material science combined with our understanding

More information

A New Approach To Diabetic Foot Ulcers Using Keratin Gel Technology

A New Approach To Diabetic Foot Ulcers Using Keratin Gel Technology A New Approach To Diabetic Foot Ulcers Using Keratin Gel Technology Farheen Walid, BA, Shrunjay R. Patel, BSc, Stephanie Wu, DPM, MS Center for Lower Extremity Ambulatory Research (CLEAR), Scholl College

More information

Surgical Wounds & Incisions

Surgical Wounds & Incisions Surgical Wounds & Incisions A Comprehensive Review Assessment & Management Alex Khan APRN ACNS-BC MSN CWCN CFCN WCN-C Advanced Practice Nurse / Adult Clinical Nurse Specialist www.woundcarenurses.org 1

More information

HydroTherapy: A simple approach to Wound Management

HydroTherapy: A simple approach to Wound Management Copyright Paul Hartmann Pty Ltd material may not be reproduced or used without written permission HydroTherapy: A simple approach to Wound Management HARTMANN Education Agenda Agenda Acute vs Chronic wounds:

More information

Venous. Arterial. Neuropathic (e.g. diabetic foot ulcer) Describe Wound Types & Stages of. Pressure Ulcers. Identify Phases of Healing & Wound Care

Venous. Arterial. Neuropathic (e.g. diabetic foot ulcer) Describe Wound Types & Stages of. Pressure Ulcers. Identify Phases of Healing & Wound Care A dressing the situation at hand Describe Wound Types & Stages of Pressure Ulcers Identify Phases of Healing & Wound Care Goals Clarify Referral Protocol Lacerations- The goal is nearest to complete approximation

More information

Biomarker Discovery: Prognosis and Management of Chronic Diabetic Foot Ulcers

Biomarker Discovery: Prognosis and Management of Chronic Diabetic Foot Ulcers Biomarker Discovery: Prognosis and Management of Chronic Diabetic Foot Ulcers Joseph Colasurdo, BS Dr. William M. Scholl College of Podiatric Medicine July 29, 2017 S Disclosure of Conflicts of Interest

More information

MANAGEMENT OF DIABETIC WOUNDS : HEALTH CLINIC SETTING DR NORLIZAH PAIDI FAMILY MEDICINE SPECIALIST KLINIK KESIHATAN BANDAR MAS KOTA TINGGI JOHOR

MANAGEMENT OF DIABETIC WOUNDS : HEALTH CLINIC SETTING DR NORLIZAH PAIDI FAMILY MEDICINE SPECIALIST KLINIK KESIHATAN BANDAR MAS KOTA TINGGI JOHOR MANAGEMENT OF DIABETIC WOUNDS : HEALTH CLINIC SETTING DR NORLIZAH PAIDI FAMILY MEDICINE SPECIALIST KLINIK KESIHATAN BANDAR MAS KOTA TINGGI JOHOR OUTLINE DEFINITION FACTORS CONTRIBUTING TO WOUND DEVELOPMENT

More information

We will dose your Gentamycin. We will dose your Vancomycin

We will dose your Gentamycin. We will dose your Vancomycin We will dose your Gentamycin We will dose your Vancomycin We will dose your Heparin We will dose your Warfarin We will do your wound care Animal models show that wounds, including chronic wounds, heal

More information

Topical antimicrobials (antiseptics) Iodine, Silver, Honey

Topical antimicrobials (antiseptics) Iodine, Silver, Honey Topical antimicrobials (antiseptics) Iodine, Silver, Honey Iodine Honey Silver Enzymatic debridement Proteolytic enzyme, also called Proteinase Proteinase breaks the long chainlike molecules of proteins

More information

Prepares wounds to allow natural healing

Prepares wounds to allow natural healing ADVANCED CARE OF ACUTE AND CHRONIC WOUNDS Prepares wounds to allow natural healing 0373 Medical Device Hyaluronic Acid and Collagenase COMBINED ACTION IN WOUND REPAIR Hyaluronic acid and collagenase promote

More information

Wound Healing Stages

Wound Healing Stages Normal Skin Wound Healing Stages Stages overlap Chronic wounds are stalled in the inflammatory phase COLLAGEN MATURATION MATRIX METALLOPROTEINASES ENDOTHELIAL CELLS EPITHELIAL CELLS MATRIX PROTEINS FIBROBLASTS

More information

1/5. Introduction. Primary endpoint Time to reach readiness for closure by surgical intervention or left for closure by secondary intention

1/5. Introduction. Primary endpoint Time to reach readiness for closure by surgical intervention or left for closure by secondary intention 1/5 Introduction Materials and methods Animal studies show that intermittent NPWT has potential to increase the rate of granulation tissue formation compared with adjustable intermittent (AI) NPWT 1 However,

More information

Human acellular dermal wound matrix: evidence and experience

Human acellular dermal wound matrix: evidence and experience International Wound Journal ISSN 1742-4801 ORIGINAL ARTICLE Human acellular dermal wound matrix: evidence and experience Robert S Kirsner 1, Greg Bohn 2, Vickie R Driver 3, Joseph L Mills Sr 4, Lillian

More information

Equine Pericardium as a Biological Covering for the Treatment of Diabetic Foot Wounds

Equine Pericardium as a Biological Covering for the Treatment of Diabetic Foot Wounds ORIGINAL ARTICLES Equine Pericardium as a Biological Covering for the Treatment of Diabetic Foot Wounds A Prospective Study Jeffery H. Alexander, DPM* David A. Yeager, DPM Dean S. Stern, DPM* Carlo A.

More information

Wound Management. E. Foy White-Chu, MD, CWSP

Wound Management. E. Foy White-Chu, MD, CWSP Wound Management E. Foy White-Chu, MD, CWSP E. Foy White-Chu, MD, CWSP Assistant Professor, OHSU Wound Medical Director, VAPORHCS List the Four Principles of Wound Bed Preparation Determine safe debridement

More information

How Wounds Heal: A Guide for the Wound-care Novice

How Wounds Heal: A Guide for the Wound-care Novice C L I N I C A L P R A C T I C E How Wounds Heal: A Guide for the Wound-care Novice BY Christine Pearson Christine Pearson, RN, IIWCC, is a wound clinician for Vancouver Coastal Health and has worked in

More information

Uncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell

Uncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell Uncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell Objectives Identify the stages of pressure ulcer according to the depth of tissue destruction. Discuss the differences

More information

Categorisation of Wound Care and Associated Products

Categorisation of Wound Care and Associated Products Categorisation of Wound Care and Associated Products Version 9 March 2018 Surgical Dressing Manufacturers Association 2018 TAPES AND TRADITIONAL DRESSINGS Wound Dressings Swabs Taping Traditional Wound

More information

A wide variety of membrane options

A wide variety of membrane options A wide variety of membrane options BOVINE Bovine collagen membrane Neomem is a resorbable collagen membrane derived from highly purified type I collagen fibres from bovine Achilles tendon. The macromolecular

More information

CLINICAL EVIDENCE Negative Pressure Wound Therapy (NPWT)

CLINICAL EVIDENCE Negative Pressure Wound Therapy (NPWT) CLINICAL EVIDENCE Negative Pressure Wound Therapy (NPWT) Endoform forms part of the NPWT strategy Endoform fits seamlessly with NPWT approaches. Utilize Endoform within the wound bed to help stabilize,

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Abdominal compartment syndrome (ACS), acute bowel injury/acute intestinal distress syndrome and, 293 294 definitions of, 277 278 intra-abdominal

More information

Healing and Repair. Dr. Nabila Hamdi MD, PhD

Healing and Repair. Dr. Nabila Hamdi MD, PhD Healing and Repair Dr. Nabila Hamdi MD, PhD 1 ILOs Know the classification of human cells according to their ability for proliferation. Understand the mechanism of cellular regeneration. Identify the types

More information

Acute and Chronic WOUND ASSESSMENT. Wound Assessment OBJECTIVES ITEMS TO CONSIDER

Acute and Chronic WOUND ASSESSMENT. Wound Assessment OBJECTIVES ITEMS TO CONSIDER WOUND ASSESSMENT Acute and Chronic OBJECTIVES Discuss classification systems and testing methods for pressure ulcers, venous, arterial and diabetic wounds List at least five items to be assessed and documented

More information

Human Amniotic Membrane. KFAFH-Jeddah. KSA. Human Amniotic Membrane. Human Amniotic Membrane 3/12/2014

Human Amniotic Membrane. KFAFH-Jeddah. KSA. Human Amniotic Membrane. Human Amniotic Membrane 3/12/2014 بسم هللا الرحمن الرحيم KFAFH-Jeddah. KSA The role of in acute and chronic wounds Tauqeer Ahmad Malik MRCS-Ed Associate Consultant Diabetic Foot & Wound Care 5 March 2014 International spinal cord injury

More information

Single-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft

Single-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft Single-Stage Full-Thickness Scalp Reconstruction Using Acellular Dermal Matrix and Skin Graft Yoon S. Chun, MD, a and Kapil Verma, BA b a Division of Plastic and Reconstructive Surgery, Department of Surgery,

More information

Re-growing the Skeleton: Approaches in Tissue Engineering and Regenerative Medicine

Re-growing the Skeleton: Approaches in Tissue Engineering and Regenerative Medicine Re-growing the Skeleton: Approaches in Tissue Engineering and Regenerative Medicine How we fix things now Total Knee Replacements Fracture Plates Fusing Joints Defining Regenerative Medicine restore form

More information

THE WOUND SOLUTION. (Freeze dried Acellular Dermal Matrix) (Cryopreserved Acellular Dermal Matrix)

THE WOUND SOLUTION. (Freeze dried Acellular Dermal Matrix) (Cryopreserved Acellular Dermal Matrix) (Freeze dried Acellular Dermal Matrix) (Cryopreserved Acellular Dermal Matrix) What is / CGCryoDerm?? /CGCryoDerm are processed by the CGBio co. and is available through Daewoong Bio. /CGCryoDerm are an

More information

Embrace the Call to Wound Prevention and Care

Embrace the Call to Wound Prevention and Care CONCLUSION Embrace the Call to Wound Prevention and Care A challenging career Be part of an interprofessional team Help patients, families, communities Commit to lifelong learning To cure occasionally,

More information

Use of AlloPatch Pliable, a Human Acellular Dermal Matrix, as an Adjunctive Therapy for Chronic Non-Healing Diabetic Foot Ulcers

Use of AlloPatch Pliable, a Human Acellular Dermal Matrix, as an Adjunctive Therapy for Chronic Non-Healing Diabetic Foot Ulcers Use of AlloPatch Pliable, a Human Acellular Dermal Matrix, as an Adjunctive Therapy for Chronic Non-Healing Diabetic Foot Ulcers Case Studies and Clinical Review Charles M Zelen, DPM FACFAS 1, Jarrod Kaufman,

More information

SDMA Categorisation of Wound Care and Associated Products

SDMA Categorisation of Wound Care and Associated Products Version 7 - February 2015 TAPES AND TRADITIONAL DRESSINGS Traditional Wound Dressings Wound Dressings Packs Swabs Swabs Swab Products Adhesive Tapes Taping Sheets Absorbent Wadding Absorbent Dressings

More information

MOVE BEYOND. to new hope for enterocutaneous fistulas. Enterocutaneous Fistula Repair

MOVE BEYOND. to new hope for enterocutaneous fistulas. Enterocutaneous Fistula Repair MOVE BEYOND to new hope for enterocutaneous fistulas. Enterocutaneous Fistula Repair to an alternative treatment option Enterocutaneous fistulas can significantly affect patient health and quality of life.

More information

Case Study. TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis.

Case Study. TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis. Case Study TRAM Flap Reconstruction with an Associated Complication. Repair using DermaMatrix Acellular Dermis. TRAM Flap Reconstruction with an Associated Complication Challenge Insulin-dependent diabetes

More information

Integra. Tissue Technologies. Limit uncertainty with a leader in collagen technology

Integra. Tissue Technologies. Limit uncertainty with a leader in collagen technology Limit uncertainty with a leader in collagen technology Integra Dermal Regeneration Template PriMatrix Dermal Repair Scaffold A Pioneer in Regenerative Medicine Integra LifeSciences, a wordwide leader in

More information

Original Article Tissue engineered skin for diabetic foot ulcers: a meta-analysis

Original Article Tissue engineered skin for diabetic foot ulcers: a meta-analysis Int J Clin Exp Med 2015;8(10):18191-18196 www.ijcem.com /ISSN:1940-5901/IJCEM0014309 Original Article Tissue engineered skin for diabetic foot ulcers: a meta-analysis Xuedong Li 1, Geliang Xu 2, Jianqiu

More information

Wright Medical Technology, Inc Airline Road Arlington, TN phone toll-free

Wright Medical Technology, Inc Airline Road Arlington, TN phone toll-free References 1 Brigido SA, Boc SF, Lopez RC. Effective Management of Major Lower Extremity Wounds Using an Acellular Regenerative Tissue Matrix: A Pilot Study. Orthopedics 2004; 27(1S): pp145-149. 2 Brigido

More information

A comprehensive study on effect of collagen dressing in diabetic foot ulcer

A comprehensive study on effect of collagen dressing in diabetic foot ulcer Original Research Article A comprehensive study on effect of collagen dressing in diabetic foot ulcer Sivakumar 1, S. Shanmugam 2* 1 Associate Professor, 2 Senior Assistant Professor Department of General

More information

DIFFERENT SCARS AND THEIR MANAGEMENT

DIFFERENT SCARS AND THEIR MANAGEMENT DIFFERENT SCARS AND THEIR MANAGEMENT Dr R. Newaj Specialist Dermatologist MBBCh (Wits) FCDerm (SA) Arwyp medical centre, Kemptonpark and Intercare Irene, Centurion COMMON CAUSES OF WOUNDS AND INJURIES

More information

RSM. Indications For Use

RSM. Indications For Use NEXT GENERATION SOLUTIONS RSM PATRIOT-RSM Amniotic Allograft Membrane is a human placental-based tissue product. The membrane forms a protective covering over the wound while providing the key components

More information

Move beyond to Biodesign.

Move beyond to Biodesign. Move beyond to Biodesign. Technology guide Biodesign allows the body to restore itself. Created from porcine small intestinal submucosa, Biodesign acts as a scaffold for the body to regrow healthy, vascularized

More information

Surgical Technique. Achilles Tendon Repair Using Conexa Reconstructive Tissue Matrix. conexatm. Surgical Technique Described by Tom Chang, DPM

Surgical Technique. Achilles Tendon Repair Using Conexa Reconstructive Tissue Matrix. conexatm. Surgical Technique Described by Tom Chang, DPM Surgical Technique Achilles Tendon Repair Using Conexa Reconstructive Tissue Matrix Surgical Technique Described by Tom Chang, DPM conexatm r e c o n s t r u c t i v e t i s s u e m a t r i x Achilles

More information

NovoSorb BTM. A unique synthetic biodegradable wound scaffold. Regenerating tissue. Changing lives.

NovoSorb BTM. A unique synthetic biodegradable wound scaffold. Regenerating tissue. Changing lives. NovoSorb BTM A unique synthetic biodegradable wound scaffold Regenerating tissue. Changing lives. Overview NovoSorb BTM is a unique synthetic biodegradable wound scaffold that delivers good cosmetic and

More information

Lower Extremity Wound Evaluation and Treatment

Lower Extremity Wound Evaluation and Treatment Lower Extremity Wound Evaluation and Treatment Boni-Jo Silbernagel, DPM Describe effective lower extremity wound evaluation and treatment. Discuss changes in theories of treatment in wound care and implications

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Alginate, tooth-shaped, for constructs, encapsulated pulp cells in, 589 590 Antibiotic paste, triple, change in root length and width

More information

What s New in Wound Care? Meet Our Fantastic Four

What s New in Wound Care? Meet Our Fantastic Four What s New in Wound Care? Meet Our Fantastic Four Nadia Din, DPM Kadin Foot & Ankle Center Medford, NJ Presenter Disclosures Dr. Nadia Din Kadin Foot & Ankle Center No relationships to disclose What is

More information

D-WOUND SOLUTION. From the start to completion of wound healing

D-WOUND SOLUTION. From the start to completion of wound healing From the start to completion of wound healing From the start to completion of wound healing Treatment for ALL type of wound Burn, Pressure ulcer Diabetic Foot ulcer Scar prevention 244, Galmachi-ro, Jungwon-gu,

More information

Application Guide for Full-Thickness Wounds

Application Guide for Full-Thickness Wounds Application Guide for Full-Thickness Wounds PriMatrix Dermal Repair Scaffold PriMatrix Ag Antimicrobial Dermal Repair Scaffold Application Guide for Full Thickness Wounds PriMatrix is a unique dermal repair

More information

Interleukin-20 is associated with delayed healing in diabetic wounds

Interleukin-20 is associated with delayed healing in diabetic wounds Interleukin-20 is associated with delayed healing in diabetic wounds Phillip Finley, PhD Integrated and Applied Sciences Program Biology and Statistics/Research Methodology Normal Healing Body s natural

More information

Equine Pericardium Collagen Wound Dressing in the Treatment of the Neuropathic Diabetic Foot Wound

Equine Pericardium Collagen Wound Dressing in the Treatment of the Neuropathic Diabetic Foot Wound ORIGINAL ARTICLES Equine Pericardium Collagen Wound Dressing in the Treatment of the Neuropathic Diabetic Foot Wound A Pilot Study John G. Fleischli, DPM* Terese J. Laughlin, DPM* Jeffery W. Fleischli,

More information

After this presentation and discussion, the participants should be able to:

After this presentation and discussion, the participants should be able to: Tissue Repair Robert F. Diegelmann, Ph.D. OBJECTIVES After this presentation and discussion, the participants should be able to: 1. Define the biochemical responses to tissue injury 2. Describe the mechanisms

More information

Management of Complex Wounds with Vacuum Assisted Closure

Management of Complex Wounds with Vacuum Assisted Closure Management of Complex Wounds with Vacuum Assisted Closure Wendy McInnes Vascular / Wound Nurse Practitioner The Queen Elizabeth Hospital, Adelaide, South Australia Treasurer ANZSVN wendy.mcinnes@health.sa.gov.au

More information

Novel Approaches for Accelerating Wound Healing Negative Pressure Wound Therapy in Accelerating Wound Healing Telemedicine

Novel Approaches for Accelerating Wound Healing Negative Pressure Wound Therapy in Accelerating Wound Healing Telemedicine Novel Approaches for Accelerating Wound Healing Negative Pressure Wound Therapy in Accelerating Wound Healing Telemedicine Dr. Julian Vitse, Montellier University Hospital, France Negative Pressure Wound

More information

INTEGRATED THERAPEUTIC SOLUTIONS TO MANAGE AND PREVENT DIABETIC FOOT ULCERS

INTEGRATED THERAPEUTIC SOLUTIONS TO MANAGE AND PREVENT DIABETIC FOOT ULCERS INTEGRATED THERAPEUTIC SOLUTIONS TO MANAGE AND PREVENT DIABETIC FOOT ULCERS UE REMOVE EXU D R IA ER T C D TISS UIL EB ATE AN DB A REMOVE REBUILD REDUCE Cutimed Siltec Sorbact featuring DACC Technology

More information

My Diabetic Patient Has No Pulses; What Should I Do?

My Diabetic Patient Has No Pulses; What Should I Do? Emily Malgor, MD Assistant Professor of Surgery University of Oklahoma, Oklahoma City My Diabetic Patient Has No Pulses; What Should I Do? There are no disclosures. Background Diabetes affects 387 million

More information

WPS Medicare Policy Primer

WPS Medicare Policy Primer WPS Medicare Policy Primer Medicare Jurisdiction (J5 & J8) NE, KS, IA, MO, IN, & MI Retired skin substitute LCD 3/2016 Indications Apligraf Non-infected partial and full-thickness skin ulcers due to VSU

More information

DO NOT DUPLICATE. Negative pressure wound therapy (NPWT) has revolutionized the

DO NOT DUPLICATE. Negative pressure wound therapy (NPWT) has revolutionized the Original research WOUNDS 2013;25(4):89 93 From the Aesthetic and Plastic Surgery Institute, University of California Irvine, Orange, CA and Long Beach Memorial Medical Center, Long Beach, CA Address correspondence

More information

Chapter 7 Wound Healing

Chapter 7 Wound Healing Chapter 7 Wound Healing 長庚皮膚科 2015.12.11 R2 劉人鳳 CHAPTER SUMMARY Wound healing occurs in orderly, overlapping phases: the inflammatory, the proliferative, and the remodeling phases. The depth of the wound

More information

Multiple Interventions for Diabetic Foot Ulcer Treatment Trial (MIDFUT)

Multiple Interventions for Diabetic Foot Ulcer Treatment Trial (MIDFUT) Multiple Interventions for Diabetic Foot Ulcer Treatment Trial (MIDFUT) Nikki Dewhirst MIDFUT Clinical Co-ordinator, Clinical Trials Research Unit, University of Leeds Senior Vascular Research Nurse, Leeds

More information

Index. Foot Ankle Clin N Am 11 (2006) Note: Page numbers of article titles are in boldface type.

Index. Foot Ankle Clin N Am 11 (2006) Note: Page numbers of article titles are in boldface type. Foot Ankle Clin N Am 11 (2006) 865 869 Index Note: Page numbers of article titles are in boldface type. A Alpha-lipoic acid, in diabetic neuropathy, 764 Amputation(s), lower-extremity, in diabetes, 791

More information

o Venous edema o Stasis ulcers o Varicose veins (not including spider veins) o Lipodermatosclerosis

o Venous edema o Stasis ulcers o Varicose veins (not including spider veins) o Lipodermatosclerosis Wound Care Equipment and Supply Benefits to Change for Texas Medicaid July 1, 2018 Effective for dates of service on or after July 1, 2018, wound care equipment and supply benefits will change for Texas

More information

Surgical Off-loading. Reiber et al Goals of Diabetic Foot Surgery 4/28/2012. The most common causal pathway to a diabetic foot ulceration

Surgical Off-loading. Reiber et al Goals of Diabetic Foot Surgery 4/28/2012. The most common causal pathway to a diabetic foot ulceration Reiber et al. 1999 Surgical Off-loading The most common causal pathway to a diabetic foot ulceration Alex Reyzelman DPM Associate Professor California School of Podiatric Medicine at Samuel Merritt University

More information

TIME CONCEPT AND LOCAL WOUND MANAGEMENT

TIME CONCEPT AND LOCAL WOUND MANAGEMENT TIME CONCEPT AND LOCAL WOUND MANAGEMENT B. BRAUN WOUND CARE INTRODUCTION: TIME is a global care framework used to implement appropriate care plans and promote wound healing Tissue Management Inflammation

More information

JMSCR Vol 06 Issue 03 Page March 2018

JMSCR Vol 06 Issue 03 Page March 2018 www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i3.55 Thesis Paper A Prospective Comparative

More information

NPWT Case Series EXPERIENCES WITH INVIA MOTION. Precious life Progressive care. Invia Motion Negative Pressure Wound Therapy

NPWT Case Series EXPERIENCES WITH INVIA MOTION. Precious life Progressive care. Invia Motion Negative Pressure Wound Therapy NPWT Case Series EXPERIENCES WITH INVIA MOTION Invia Motion Negative Pressure Wound Therapy Precious life Progressive care npwt_case_booklet_a4.indd 1 18.12.13 13:17 Chronic sacral pressure ulcer Case

More information