Day 1 :
- Wound Care Research | Stemcells and Tissue Regeneration | Skin & Skin Biology | Diabetic Wound Care
Session Introduction
Frantz Dorestant Jr
Long Island Jewish Forest Hills, USA
Title: Protect the Skin from BiPAP Related Pressure injury
Biography:
Frantz Dorestant Jr has completed his BS in Biological Science from NC State University, BSN from NC Central University, CWOCN from Emory University, MSN in Executive Nursing Leadership and Healthcare Systems from Grand Canyon University and is a recent graduate from Adelphi University with an NP in Adult-Gerontology. He is currently the Chief Wound Care Specialist at Long Island Jewish Forest Hills and the Co-Chair of Northwell Health Wound Ostomy Continence. He serves on the Advertising Committee for the Wound Ostomy Continence Certification Board and Marketing Committee for the WOCN Society. He has been in wound care for over 10yrs with multiple accepted evidence-based research projects focusing on wounds, ostomy’s, incontinence, and podiatric specialties.
Abstract:
Pre-Data: We had a significant increase in device related pressure injuries due to BiPAP masks in 2019 (3)
Why Did You Choose This Project? To research best practice in order to determine the best way to provide pressure reduction to the skin, while using a BiPAP device
What Are Your Data Points? Number of hospital acquired pressure injuries due to BiPAP masks, target number of hospital acquired pressure injuries for the year, devices trialed, patient population to be used on, device selected, collaboration with respiratory, barriers (device not staying in place), adjustments due to barriers (adjustment of device to the device and not on patients nose)
Project To Be Implemented: Identify your stakeholders: RN, MD, PCA, RT, and patients that require BiPAP use
Identify Your Interventions: Formation of a committee to address this topic, trial of multiple pressure injury prevention resources, implementation of assessment and intervention by the Respiratory Therapist and RN’s, indication of who is using BiPAP therapy every day through daily email blasts, and weekly audits done by the CWOCN
How Will You Measure Success of Program? Identify your measures: Decrease the number of device related hospital acquired pressure injuries by 25% in a year (Short Term). No device related hospital acquired pressure injuries (Long Term)
Initiation Date: 4/1/19
Proposed Measurement Points: Daily identification of patients requiring BiPAP therapy by the CWOCN or Director of Nursing, daily evaluation of pressure injury prevention device placement by the nurse and/or respiratory therapist, and weekly evaluation of target goal achievement by the CWOCN
Dr. Sangeetha Kalabhairav
Karnataka Institute of Medical sciences, India
Title: Finding the right dressing for management of wounds in diabetic patients from the pandora box
Biography:
Sangeetha Kalabhairav working at Karnataka Institute of Medical sciences, India. She has done her research at Finding the right dressing for management of wounds in diabetic patients from the pandora box. She is a Co-Research worker in a Clinical trial on Total Parenteral nutrition study (2014-17) conducted at MMCRI Mysore by FRESENIUS KABI, USA and Co-research worker for diabetic foot studies at SL Raheja Hospital Mumbai during 2019-20. She completed M.B.B.S. BMCH, Chitradurga RGUHS University, Bangalore, Karnataka
Abstract:
Selection of an appropriate dressing is of prime importance in the successful management of diabetic foot ulcers.
Currently, there are >6000 different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production.
Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances).
Unlike other chronic wounds, the etiology and consequences of a DFU is often complicated by wide-ranging changes starting from blood glucose level, neuropathic changes ,vascular compromise to affecting the social and psychological well being of the patient .
However several studies state that wound care practitioners often find confusion in choosing the right dressing among the wide variety of options available infront of them.
The critical aspects of the wound healing mechanism and host physiological status in patients with diabetes necessitate the selection of an appropriate treatment strategy based on the complexity and type of wound. In addition to systemic antibiotics and surgical intervention, wound care is considered to be an important component of diabetic foot ulcer management.
My talk reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to the latest and innovative therapeutic strategies and delivery approaches.
Paolo Izzo
Sapienza University of Rome, Italy
Title: Monofilaments mechanical in era suturing machines: our experience
Biography:
Paolo Izzo received his MD degree from Sapienza University of Rome in 2011. At the same University, he completed his PhD in the field of advanced technologies in surgery with a project entitled: "New methods in sentinel lymph node research: SentiMag," in collaboration with King's College London.
In 2017 Specialized in General Surgery. Currently teaching from 2019 at Saint Camillus International University of Health and Medical Sciences in the CL Laboratory Techniques.
Since April 2020, he has been a Medical Executive Specialist General Surgery DEA Hospital Asl Roma 6 - Velletri. He has published 51 international papers (Scopus) as an author
Abstract:
The most used threads for tissue synthesis are composed of organic, synthetic, and natural fiber materials.
The most used organic material suture threads are catgut and chromic catgut, which are no longer used due to known complications.
The most widely used synthetic materials are for multifilament polyester and for monofilaments prolene and polypropylene.
The most used natural fibers are linen and silk.
The purpose of this paper is to report the results obtained by using various suture materials in the packing of the anastomoses, performed on patients operated on the digestive system at I Surgical Clinic during 2020-2022, and to report the results obtained in a previous experience of Trimpi and co.
From February 2020 to May 2022, 154 intestinal anastomoses, manual anastomoses were performed including 93 male and 51 female patients. Specifically, 29 right hemicolectomies, 23 anterior sigma resections, 7 sub-total colectomies, 21 left hemicolectomies were performed. In 48 cases the anastomosis was packed in monofilament, while in the other 106 cases traditional materials were used.
The case history used includes Ileocolic anastomoses 29; Colcolic anastomoses 21; Ileorectal anastomoses 7; Colorectal anastomoses 23.
Our results in the 48 anastomoses performed with monofilament the channelization occurred on the third-fourth day on average and the hospital stay was seven to eight days.
In the other 106 anastomoses performed with multifilament, bowel canalization was restored on the fifth to sixth day and patients were discharged in an average of nine to ten days.
The most frequently observed anastomosis-related complications were infection and dehiscence. Regarding dehiscence, six cases of infection and two cases of dehiscence were observed in the first group (monofilament) when suturing was done in monolayer and no cases in double-layer anastomosis.
Marwan Noureldin
New Giza University, Egypt
Title: Comparative study between skin micrografting (Meek technique) and meshed skin grafts in paediatric burns
Biography:
Marwan Noureldin, MD, is a member of the Royal College of Surgeons in England and obtained his MD degree in plastic and reconstructive surgery in 2021 from Cairo University. He is a plastic and hair transplant surgeon at Nour Clinic and Lecturer at Newgiza University – Surgery department, both in Cairo, Egypt.
Abstract:
Globally, burn injuries are the 3rd principal cause of death due to injury among children aged 1–9 years. Yet, the management of paediatric burns is always challenging; due to limited donor sites and the cosmetic appearance that will affect the child later in life, either at the donor or the recipient site. Skin grafts may need to be expanded to minimise donor skin size or in patients with limited donor sites. Multiple techniques were described for graft expansion. A prospective comparative randomised study was done on 40 paediatric burn patients with deep dermal and full-thickness burns. Patients were divided into two groups. The skin graft take, epithelialization time, total time of the surgery and the aesthetic outcomes (using the Patient and observer scar assessment scale) in each group were evaluated at three months postoperatively.
The percentage of take in the Meek group (84.25%) was significantly better than the meshed group (71.5%) (P = 0.006). Epithelialization time was better for the Meek group (27.11 days) compared to the meshed group (33.5 days) (P = 0.176). In addition, infection rates were lower in the Meek group (25%) than in the meshed group (40%) (P = 0.311). Subjectively POSAS scar assessment scale exhibited better results for the Meek group, with a mean score of 3.17 & for the meshed group, was 4.2 (P = 0.048). The observer’s overall score was as well better for the Meek group, with a mean overall opinion score of 2.89 & for the meshed group was 4.1 (P = 0.003). The operative time was longer with the Meek technique than with the traditional mesher (P < 0.001).
The Meek technique for expanding the skin grafts is useful in covering burn wounds with a greater expansion rate, more accessible application, better graft take & a better scar appearance than the traditional mesher.
- Wound Care and Nursing | Skin and Wound care
Session Introduction
Ron Legerstee
Scientific lecturer Erasmus Medical Center Rotterdam Netherlands
Title: Evidence and practical wound care – An all-inclusive approach
Biography:
Ron Legerstee is a Scientific lecturer Erasmus Medical Center Rotterdam, Netherlands. He has done his research at Evidence and practical wound care – An all-inclusive approach. He has done his research based on wound healing & tissue repair.
Abstract:
Aim: Health Care Professionals and patients should be fully informed on the best way care can be provided for the individual patient’s situation. Meta-analyses of randomised controlled trials exclude other forms of evidence, putting patients and carers in hazardous situations1,2,3
Method: Reviewing the literature on wound dressings and evidence based medicine4, ample arguments are found to put forth a critique to the suggestion of a hierarchy in the “pyramid of clinical evidence”. The authors have not found the source, nor justification or validation for this hierarchy. Doubt on a hierarchy was cast as early as in 19895, years before the term EBM was first coined6.
Results / Discussion: Replacing this pyramid by a circular model7, incorporating ALL types of evidence8 at equal value9, the health care professional can appraise the evidence to reach best practice. Modifying an earlier published set of (pre-)clinical evidence types10, the authors propose to expand these with PROM’s and COHORT. The meta-analysis and consensus statement are types of analysis rather than a form of clinical study. They should not be part of the circle (input), but follow (output) on what evidence was found in the circle.
Conclusion: To assist the consideration of as much as possible from the “real life experience” of a patient, the authors put forth an all-inclusive approach to visualise how health care professionals can deal with all available evidence.