Clinical trial report stirs debate.
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Biomedical subjects
Publications and source records attributed to Liza G Ovington.
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Interest in silver as a topical agent in wound healing is undergoing a renaissance. Having basic information regarding silver's chemical properties and potential actions in the wound bed is important to its appropriate clinical use. Such information is also relevant to the interpretation of silver's in vitro antimicrobial (antiseptic) effects, which in turn relate to issues involved in the evaluation of the clinical effects of silver in vivo. Gaining an understanding of the basic science of silver products and the different challenges inherent to in vitro versus in vivo antimicrobial evaluations will allow clinicians to address several key questions inherent when considering the use of silver as a topical antimicrobial: 1) Are there different forms of silver? 2) How does the amount of silver released into the wound environment correlate with clinical benefit? 3) How does the rate of silver release correlate with clinical benefit?
Managing exudate is a critical factor in reaching successful outcomes. Accurately assessing the quantity and quality of exudate is essential to a comprehensive assessment and the development of an initial plan of care. Likewise, skilled care is required to accurately determine healing progression and modifications to the care plan. This article provides the scientific rationale and tips for practice to update clinicians on this important competency.
Harkening back to the beginning of wound management, this article presents a fascinating look into how wounds have been viewed and cared for over the last 2,000 years. To celebrate 's 20th anniversary, changes in wound management over the past 2 decades are also described.
Increasingly, basic research is revealing that the biochemical environment of the non-healing wound is different from that of the healing wound in ways that negatively affect multiple aspects of the healing process. These areas of biochemical difference may provide avenues of research for new therapeutic interventions. A particular biochemical finding in nonhealing wounds of diverse etiologies is the persistent elevated levels of a specific class of proteolytic enzymes known as the matrix metalloproteases or MMPs. The effects of these high levels of MMPs in the wound environment are thought to include local destruction of growth factors and their receptors as well as degradation of granulation tissue components. MMPs are fast gaining attention as potential causative factors in impaired healing, and recently, strategies have been focused on preventing or reducing their levels, once elevated, in the wound environment. A proprietary combination of bovine collagen and oxidized regenerated cellulose has demonstrated an ability to not only reduce elevated wound proteases but also sequester and protect wound growth factors and promote cellular chemotaxis and proliferation.