Wound Healing Southern Africa - latest Issue
Volume 9, Issue 2, 2016
Author Nick KairinosSource: Wound Healing Southern Africa 9, pp 4 –4 (2016)More LessThis interesting issue of WHSA has been delayed somewhat by a few factors, the first being because of our attendance of the 5th World Union of Wound Healing Societies (WUWHS) meeting, held in Florence. We wanted to give our readers some feedback regarding this. There was a record attendance, in excess of 4 000 delegates, the largest number for this congress to date. Although we heard many interesting things, the most significant thing I noted was that our wound care in South Africa is of an extremely high standard, with our private sector being on par with most countries. Although there are many fantastic wound services in our state sector too, there are of course some challenges due to lack of resources and training.
The prevalence of incontinence-associated dermatitis in a South African sample : the impact of a preventative protocolSource: Wound Healing Southern Africa 9, pp 6 –10 (2016)More Less
Background: Incontinence-associated dermatitis (IAD) has been globally accepted as the new terminology to be used when incontinent patients’ skin is exposed to urine and/or faeces – causing skin redness, with/without oedema or, in more severe cases, erosion (vesicles/bullae) and secondary skin infection. Currently we do not have data on the prevalence of IAD in a South African sample. It is necessary to establish the magnitude of the problem in South Africa, implement preventative strategies and measure the impact of education and preventative care on the prevalence of IAD.
Method: A point prevalence study was conducted in two hospitals in two different regions of South Africa before and after a simple skin care preventative protocol was implemented.
Results: The prevalence of IAD in Hospital 1 decreased from 36% in December 2015 to 0% in February 2016 and pressure injuries reduced from 5% to 0.5%. In Hospital 2 the prevalence of IAD decreased from 43% in May 2016 to 5% in August 2016 and no pressure injuries were found in August 2016 compared to 5% in May 2016.
Conclusions: Following best practice principles of (a) managing incontinence and (b) implementation of a simple protocol to prevent skin breakdown, can result in a 100% reduction of IAD in the hospital setting as well as improving quality patient care and reducing costs.
Source: Wound Healing Southern Africa 9, pp 15 –17 (2016)More Less
Background: Negative pressure wound therapy (NPWT) is considered as an innovative technique in wound management. The commercial VACR Therapy system is not available in Togo. We established NPWT using local materials. We present our technique and results.
Methods: We conducted a retrospective cross-sectional study based on 15 patients whose wounds were treated with NPWT in the wound care department of Sylvanus Olympio Teaching Hospital between March 2014 and March 2015. We analysed the materials used for the NPWT and the wound outcomes.
Results: 15 patients were included, with an average age of 22.5 years, ranging between 16 and 60 years, and a sex ratio of 1.5 for men. Traumatic wounds and complications of orthopaedic surgery were the most encountered lesions, followed by leg ulcers. Gauze was used as an interface for all patients and the main source of the vacuum was an electric surgical suction machine (9 of 15). The average duration of treatment was 10 days, with a range between six days and 18 days. Ten skin grafts, a fasciocutaneous flap, and two muscle flaps were performed after the NPWT. None of our patients had spontaneous wound healing under NPWT. The patients expressed moderate pain at baseline, which subsided after a few hours with or without step one analgesics. Patients, including those in whom the procedure was aborted, were all very satisfied. They referred to the absence of pain and avoidance of discomfort and pain from daily dressing.
Conclusion: NPWT has been successfully used in the treatment of wounds using local materials. The results obtained are comparable to those in the literature using the same devices or VACR Therapy devices.
Source: Wound Healing Southern Africa 9, pp 18 –20 (2016)More LessBacteria possess the ability to cause infection in two very distinct ways. The first way is when an individual bacterium with its unique genome uses one portion of its genes to stay a free-floating, motile cell (plantonic phenotype) that has a strategy in a host environment to breach and kill cells with its virulence factors to create a source of nutrition. The second way is that the very same bacterium can up-regulate a separate group of genes, which lets it attach to a host structure. Once attached to the host, the bacterium secretes a polysaccharide matrix around itself and its progeny. When this small group reaches a sufficient number (quorum), signalling molecules (quorum-sensing molecules) direct the gene expression of each bacterium throughout the colony. This lets a community of bacteria develop within the protection of the matrix, which gives colony defences against host immunity, including antibodies and white blood cells.Given that a biofilm requires attachment, it cannot use the host tissue to which it is adhered for a nutritional source and, therefore, successful biofilm uses local inflammation to produce plasma exudate on which it can nourish itself.
Source: Wound Healing Southern Africa 9, pp 21 –25 (2016)More Less
Background: The present study determines the anti-inflammatory effect of the topical application of ethanolic extract of commercial propolis, used in wound care, in the mast cell population in connective tissue during the initial healing process of surgical skin wounds.
Method: Sixty Wistar rats were divided into three experimental groups: Group 1 (n = 20) – 30% ethanolic extract of propolis; Group 2 (n = 20) – 70% alcohol; and Group 3 (n = 20) dexamethasone. Each substance was applied topically every 12 hours. The specimens were submitted to histological analysis with Toluidine Blue stain. Mast cell counts were performed using the Axio Vision® software program. Statistical analysis involved the Kruskal-Wallis and Mann-Whitney tests.
Results: Significantly smaller numbers of mast cells were found in the groups submitted to the propolis extract and 70% alcohol in comparison to dexamethasone (p < 0.0001). Moreover, the reduction in the number of mast cells was maintained in all healing phases in the propolis extract group.
Conclusion: The present findings demonstrate a possible anti-inflammatory property of propolis extract and 70% alcohol, which was more effective at reducing the mast cell population in surgical skin wounds at different postoperative times in comparison to the standard pharmacological treatment, dexamethasone.