The new 2024 Guideline for the Management of Lower Extremity Peripheral Artery Disease, released May 14 by the ACC and the American Heart Association (AHA), offers the latest, evidence-based recommendations to guide clinicians in the diagnosis and treatment of lower extremity PAD

The Tunisian Wound Care Association in collaboration with Lohmann & Rauscher International opened the center in February 2023. This is brilliant and inspiring news!  Click on the image left to read more about this. 

We have updated the chapter on the challenges with Pseudomonas in wound care. 

In this chapter, you will learn all you need to know about negative-pressure wound therapies. We present you with an oversight over then necessary equipment and have many tips and tricks for you. 

As you might be aware, there has been an ongoing discussion about the safety and effectiveness of povidone-iodine (PI) in wound healing. This is a very relevant discussion for Africa because PI is used extensively in wound care on the continent. We use it ourselves with good results in infected wounds but always felt unsure if this was an outdated method. After a thorough literature search, we found several relatively recent articles that conclude that PI dressings are safe and effective. The article on the left link is from 2017, so it is hardly fresh news. However, it is a very well-written article, and it gives a comprehensive overview of what we know about PI in wound care today. 

There are legal issues with sharing medical images with colleagues. You cannot, for example, send a medical photo by email or as a text message on the phone, as this is not considered safe. International Medical Solutions offers a cloud-based solution in collaboration with Google. You can securely store and share medical images here. You can comment on other colleagues' images and even create quizzes or examinations on the platform. In the future, we are going to see a number of other platforms that provide similar services.

Bruin Biometrics is a pioneer in developing sensors to enable us to detect pressure injuries before they are apparent. The scanners register surface capacitance, an electrophysical marker indicative of increased fluid content and inflammation of the tissues. This works particularly well at the heels and the sacrum. The early detection capability can lead to targeted interventions, reduced ulceration severity, earlier recovery, and decreased hospital days. In some studies, the scanner detected pressure injuries up to ten days before they were apparent to the eye. This may be particularly useful for dark-skinned people, where it is particularly challenging to detect early pressure injuries. 

The centre will be established at the Institute of Training and Research in Ayurveda in Gujarat, India. According to WHO, around 80% of the world’s population is estimated to use traditional medicine. In many parts of the world it is very common to use traditional approaches in wound healing also. 

For many millions of people around the world, traditional medicine is the first port of call to treat many diseases,” said Tedros Adhanom Ghebreyesus, WHO Director-General. “Ensuring all people have access to safe and effective treatment is an essential part of WHO’s mission, and this new centre will help to harness the power of science to strengthen the evidence base for traditional medicine. 

Are you by any chance passing through Copenhagen in November? Then you may have the opportunity to visit the biggest health and rehabilitation fair in Scandinavia. Catch up on the latest technological developments in this field. And the best? It costs nothing to attend. Click on the link for more information.

Spinal Cord Stimulation (SCS) involves placing an electrode into the epidural space.  A battery similar to a pacemaker sends electrical pulses to replace pain with a tingling sensation similar to paresthesia.  SCS is used mostly in the treatment of failed back surgery, complex regional pain syndrome and refractory pain due to ischemia. The Proclaim Elite SCS system is unique in that it allows the pulse generator to be controlled from an app on an iPhone or iPad.  

This is obviously an expensive treatment and will not be available to the majority of patients in Africa. We would like our readers to be up-to-date on all topics however, and mention the product here for that reason. 

As a result of the Covid-19 epidemic, the number of products for disinfection available on the market has grown exponentially. This is good news for us who work in wound care. There are more models to choose from, and the prices for these types of foggers have also become cheaper. Using foggers for disinfecting rooms and surfaces is nothing new, but many people are still unaware that they can use hypochlorous acid. This is an inexpensive disinfectant, environmentally safe, and effective against most organisms within short periods. ( images left: copyright anolyte services)

Mediven angio is a new type of compression stocking available as Class 1 or Class 2 compression.

This medical-grade compression device is unique because it makes it safer to use compression in patients with mild to moderate peripheral arterial disease ( PAD) and in those with poor circulation due to diabetes. The unique design also offers added protection to the toe areas in patients with sensory neuropathy. There has already come some scientific evidence that Mediven Angio stockings are safe in daily use.

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The Butterfly IQ is a handheld ultrasound scanner that can be connected to an iPhone and thus makes this technology accessible to patients in off-the grid areas.  Click on the image to read an article about this from the New York Times where this technology was tested in Uganda.  Ultrasound imaging is also very useful in woundcare to detect for example abscesses beneath chronic wounds and to determine the extent of these. 

Now, this is a real game-changer in our experience! Hyiodine is a combination of hyaluronic acid and iodine. The hyaluronic acid promotes the formation of new tissue, while the iodine has well-known antibacterial properties. We have tested this unique product for over a year now and have had particularly good results in undermined wounds and fistulas. A vial of Hyiodine will last quite long, making it a cost-effective wound care product.  

A wound care nurse describes her experiences of working in a wound care clinic in Pretoria during the COVID-19 pandemic. She describes the impact of lockdown in South Africa and how it has affected her practice, colleagues, patients, and working conditions. She shares her hopes and fears as the number of cases rises and threatens to overwhelm the healthcare system. Read the full article in Wounds International by clicking on the image to the left. 

You may have used a super oxidized solution called Veriforte before? This product has been taken over by Mölnlycke and has been replaced by Granudacyn. It is available as a solution in bottles of different volumes, as sprays, and in gel form. Superoxidized antibacterial solutions are our preference when using NPWT with irrigation.  

Mölnlycke has recently re-introduced its Avance Solo NPWT system in a new and improved version.  The pump is single-use, and the kit contains an absorbable dressing and a 50ml canister. 

Incontinence-associated dermatitis (IAD) is, unfortunately, a widespread challenge. Professor Dimitri Beeckman and his team at Ghent University in Belgium have published a simple tool for IAD classification. Click on the image to get to the link of this tool.

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Researchers at the University of Bath and Queen Victoria Hospital, UK, have developed a hydrogel dressing that emits fluorescent light when coming into contact with a biofilm of certain bacterial species. This is only a prototype, and it is uncertain when the product will be commercialized. The future will bring several so-called intelligent dressing that can aid decision-making.

University of Wisconsin (USA) has developed a smartphone app (WoundCheck) that simplifies the follow-up of patients who have undergone surgery. In a small study 40 patients took pictures of their surgical wounds daily and sent these to the investigating team. in the course of two weeks. Seven patients had some wound complications which could be identified by the pictures alone and these patients were called inn for a physical examination. This app is currently not yet available for downloading but the study shows that follow-up can be performed i a safe manner by using telemedicine and at the same time saving valuable resources.