Chronic Wounds or Hard to Heal Ulcers: Updating Epidemiology, Physiopathology, and Therapies-Part II

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (25 November 2023) | Viewed by 5613

Special Issue Editor


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Guest Editor
Community Nursing, Preventive Medicine, Public Health and History of Science Department, Faculty of Health Sciences, University of Alicante, Alicante, Spain
Interests: wound care; pressure ulcers; lower leg ulcers; diabetic foot ulcers; wound infection; wound biofilm; hard-to-heal wounds; prevention and treatment; quantitative research
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Special Issue Information

Dear Colleagues,

In December 2020, the first volume of the Special Issue “Chronic Wounds or Hard-to-Heal Ulcers: Updating Epidemiology, Physiopathology, and Therapies” was launched (https://www.mdpi.com/journal/jcm/special_issues/hard_to_heal_ulcers), and we received many excellent papers on the prevention and management of chronic wounds. Now, we would like to launch a second volume on this topic.

Currently, there is intense debate about the terminology, etiology, and epidemiology of so-called chronic wounds, and about current strategies for their prevention and management. Researchers usually use terms such as “chronic wound”, “skin ulcer”, and “hard-to-heal wound or ulcer” indistinctly. However, for certain types of wound, the terminology is changing due to new insights into their physiopathology and etiology; this has led to new theoretical models of wound development, for instance, the progression from decubitus or bed sores to pressure ulcers, and then, to pressure injuries. The case is similar for leg or lower-extremity wounds, where different etiologies could be present.

Nevertheless, many people suffer from such lesions, experiencing a direct cost burden, as well as indirect impacts such as decreased quality of life for themselves and their families. On the other hand, the current prevention and treatment strategies are still limited and are often less effective, or there is little evidence to support them.

This highlights the urgent need for new approaches and new, higher-quality research, requiring further understanding of the whole process, from etiology to wound healing.

In this Special Issue of the Journal of Clinical Medicine on chronic or hard-to-heal wounds, we intend to present cutting-edge original research and systematic, integrative, or scoping reviews on the epidemiology, risk factors, and physiopathology of those wounds; additionally, we welcome research on existing strategies and emerging advanced clinical approaches to prevention and treatment management.

Prof. Dr. José Verdú-Soriano
Guest Editor

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Keywords

  • epidemiology
  • physiopathology
  • advanced therapies
  • hard-to-heal wounds
  • chronic wounds
  • skin ulcers
  • new theoretical models
  • etiology research
  • risk factors
  • prevention strategies

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Published Papers (2 papers)

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Review

19 pages, 2717 KiB  
Review
Larval Wound Therapy: Possibilities and Potential Limitations—A Literature Review
by Dariusz Bazaliński, Joanna Przybek-Mita, Kamila Pytlak, Daria Kardyś, Adrian Bazaliński, Marek Kucharzewski and Paweł Więch
J. Clin. Med. 2023, 12(21), 6862; https://doi.org/10.3390/jcm12216862 - 30 Oct 2023
Cited by 2 | Viewed by 2129
Abstract
Patient-centered care (PCC) is recognized as a standard in healthcare for determining high quality. Honoring patients’ values, experiences, needs, and preferences in devising, coordinating, and delivering care underscores the enhancement of the therapeutic rapport between patients and healthcare providers. Wound treatment involves a [...] Read more.
Patient-centered care (PCC) is recognized as a standard in healthcare for determining high quality. Honoring patients’ values, experiences, needs, and preferences in devising, coordinating, and delivering care underscores the enhancement of the therapeutic rapport between patients and healthcare providers. Wound treatment involves a multi-stage process encompassing diagnostics and local wound dressing, which reduces the risk of infection through a coordinated interdisciplinary team. Within this team, nurses undertake specific professional functions and roles. The implementation of local therapy using innovative and scientifically substantiated methods may be hindered by a deficit of knowledge or inappropriate knowledge among staff and patients themselves. This study presents the challenges concerning the care of patients with chronic wounds treated using Lucilia sericata larvae, based on a review of the current scientific literature. A critical analysis of the literature spanning from 2002 to 2022 was conducted using the Medline, PubMed, Cochrane, and Termedia databases, employing keywords such as “maggot debridement therapy” in relation to acceptance and perception. As a result of the preliminary selection, 472 papers were identified, of which 12 publications were included in the development of this concept. The acquired data were organized and presented in the concluding section in the form of tables, accompanied by descriptions and references to individual studies. Negative psychological and somatic sensations were among the most prominent challenges among patients treated with Maggot Debridement Therapy (MDT). Pain related to peripheral ischemia or infection in this group of patients requires pain prophylaxis, including hyperalgesia and allodynia, in order to improve method tolerance. On the other hand, augmenting patients’ understanding of MDT diminishes negative emotions, reinforces positive behaviors, and mitigates anxiety levels. MDT constitutes an effective and safe method. Its widespread use for chronic wounds requires substantial knowledge among healthcare professionals and patient education, along with that of their caregivers, to develop a positive attitude. Full article
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25 pages, 1874 KiB  
Review
Evolution of the Chronic Venous Leg Ulcer Microenvironment and Its Impact on Medical Devices and Wound Care Therapies
by Gisele Abreu Coelho, Philippe-Henri Secretan, Lionel Tortolano, Loïc Charvet and Najet Yagoubi
J. Clin. Med. 2023, 12(17), 5605; https://doi.org/10.3390/jcm12175605 - 28 Aug 2023
Cited by 5 | Viewed by 3012
Abstract
Studies have reported that the constituents of the wound microenvironment are likely to have critical roles in the degradation and fate of the polymeric matrix and the compounds dissolved in the wound dressing matrix. Thus, chronic wound assessment and the design of effective [...] Read more.
Studies have reported that the constituents of the wound microenvironment are likely to have critical roles in the degradation and fate of the polymeric matrix and the compounds dissolved in the wound dressing matrix. Thus, chronic wound assessment and the design of effective medical devices and drug products for wound care partly rely on an in-depth understanding of the wound microenvironment. The main aim of this review is to identify and discuss the different stages of chronic wound progression, focusing on the changes in the biochemical composition of the wound microenvironment, with particular attention given to venous leg ulcers (VLUs), as they are one of the most prevalent chronic wound aetiologies. The pathophysiology of venous ulcers is detailed, followed by a thorough review of what is known about the VLU microenvironment and its changes as a function of the evolution of the VLU. Simulating conditions for VLU are then discussed with the view of highlighting potentially relevant simulating media as a function of VLU evolution for a better assessment of biological safety, in particular medical devices intended to be in contact with these wounds. Full article
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