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    Unsere Forschungs- und Entwicklungsteams sind weltweit im Einsatz und generieren Synergien aus unserem Expertenwissen und verwandten Fachdisziplinen. Wir stehen im internationalen Austausch mit unabhängigen Fachinstitutionen, Key Opinion Leadern und Multiplikatoren, um so Kooperations- und Wissensmanagement auf höchstem Niveau gewährleisten zu können. Im Rahmen dessen führen wir umfangreiche Forschungen durch, die kontinuierlich auf Kongressen in Form von Postern oder freien Vorträgen unserer Kooperationspartner sowie in Symposien und Workshops präsentiert und in namhaften wissenschaftlichen Fachzeitschriften veröffentlicht werden. Die größtenteils von unabhängigen Gutachtern bewerteten, evidenzbasierten Fachpublikationen, stellen wir Ihnen in dieser Datenbank zur Verfügung:

    1. Journal article

      Het verhaal van Amber: Complicaties na een Gastric bypass

      Nederlands Tijdschrift Voor Huidzorg 2022 12(2)

      Amber is 42 jaar en moeder van 3 prachtige kinderen. Van kleins af aan was ze al redelijk gezet en dat bleef zo ondanks veel pogingen om af te vallen. Haar vader is overleden vlak na haar geboorte, ook hij was veel te zwaar en had te hoge cholesterol waarden. Amber dacht: dit gaat mij niet gebeuren en ik ga hulp zoeken om af te vallen. Ze kwam in 2016 in het ziekenhuis in Almelo bij de internist terecht en kreeg daar allerlei onderzoeken inclusief een erfelijkheidsonderzoek in verband met haar vader. Tijdens de tweede afspraak bij de internist werd ze goed met haar neus op de feiten gedrukt. Amber: ‘Hij zei, er moet gauw iets gebeuren want anders wordt u geen 38 jaar oud. Hier schrok ik dus behoorlijk van. Mijn bloeddruk was te hoog, ik rookte, had diabetes en een super hoog cholesterol gehalte.’ Al snel kreeg Amber groen licht voor een gastric bypass. ‘Maar daarvoor moest ik wel een jaar lang een voorbereidend traject volgen’. De operatie vond uiteindelijk plaats in april 2017.

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    2. Journal article

      Clinical experience using a monofilament fiber cleansing and debriding technology for various skin conditions.

      Journal of Drugs in Dermatology 2022 21(11) 11731180

      Background: Gentle skin cleansing and exfoliation and the use of moisturizers as an adjunct to medical treatment should be part of the prevention, treatment, and maintenance of cutaneous conditions such as acne vulgaris (acne) psoriasis, and xerosis. A monofilament fiber debriding technology (MFDT) is used for effective, safe, and rapid skin cleansing and exfoliation and debris, slough, and biofilm removal. The current review addresses the clinical experience using MFDT for various cutaneous conditions that require cleansing or exfoliation or both and how to combine it with medical treatment.

       

      Methods: A literature review explored clinical insights into the role of skin cleansing and exfoliation for patients with various dermatological conditions.

      The searches yielded 29 publications, 7 guidelines/algorithms, 13 reviews, 8 clinical studies, and one in vitro study.

       

      Results: Mechanical cleansing using a device can be helpful; however, avoid injury of the skin as it may result in thickening of the epidermis leading to hyperkeratosis and disruption of the skin barrier. Clinical experience with MFDT for acne, psoriasis, atopic dermatitis, and xerosis is discussed. Additionally, MFDT was used to exfoliate hyperkeratosis, actinic keratosis, and traumatic skin tattoos.

       

      Conclusions: Mechanical cleansing using MFDT was shown to be safe and beneficial for skin cleansing and exfoliation of various cutaneous conditions; however, only anecdotal evidence or small studies are available to support its use for these conditions.

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    3. Journal article

      Case study: night compression use in a patient with Milroy's disease

      British journal of nursing (Mark Allen Publishing) 2022 31(12) 3441

      AIM

      Lymphoedema is associated with dysfunctional lymphatics, tissue fibrosis and inflammatory changes in the skin and local tissue. Ensuring compression supports tissue health is crucial to managing lymphoedema. Providing patients with safe compression which enhances their tissue health is paramount when supporting their 24-hour self-management regimens. This case study explores the use of a new compression garment in two sitting positions in an adult with primary lymphoedema.

      METHOD

      An 18-year-old female (body mass index 25.2 kg/m2) with Milroy's disease was recruited. She attended two separate 1-hour sessions to evaluate tissue oxygenation (StO2) in chair-sitting and long-sitting (sitting up with a supported back and legs horizontal) positions. Following removal of her usual class 2 (20-30 mmHg) flat-knit compression hosiery, StO2 was recorded for 20 minutes: pre-, during and post the application of an adjustable compression garment (Lohmann & Rauscher) to the right leg.

      RESULTS

      In the long-sitting position, StO2 levels started high at baseline (94.5%), and were relatively maintained both during and post-a short 20-minute intervention (94.1%). In the chair-sitting position, StO2 levels were significantly lower at baseline (52%), showing a 77% increase during the intervention (92%), followed by a small 9% decrease post-intervention (83.7%).

      CONCLUSION

      This compression garment significantly increased StO2 levels in the chair-sitting position, while maintaining the effects of the patient's compression stockings, in the long-sitting position. Similar to non-lymphoedematous limbs, the patient's normal prescription hosiery maintains StO2. Through implementation of the short intervention sessions, night compression garments may have the potential to improve tissue health in individuals with primary lymphoedema, encouraging self-management and offering a potential night compression solution where the need arises in a 24-hour management plan.

      PMID 35736853
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    4. Journal article

      Combined endoscopic-percutaneous treatment of upper gastrointestinal enterocutaneous fistula using vacuum therapy and resorbable plug insertion (Vac-Plug)

      Scientific reports 2022 12(1) 12221

      After gastrointestinal resections, leakages can occur, persist despite conventional therapy and result in enterocutaneous fistulae. We developed a combination method using flexible endoscopic techniques to seal the enteric orifice with an absorbable plug in addition to a percutaneously and fistuloscopically guided open-pore film drainage (Vac-Plug method). We retrospectively searched our endoscopy database to identify patients treated with the outlined technique. The clinical and pathological data were assessed, the method analyzed and characterized and the technical and clinical success determined. We identified 14 patients that were treated with the Vac-Plug method (4 females, 10 males with a mean age of 56 years, range 50-74). The patients were treated over a time period of 23 days (range 4-119) in between one to thirteen interventions (mean n = 5). One patient had to be excluded due to short follow-up after successful closure. Seventy-seven percent (10/13) were successfully treated with a median follow-up of 453 days (range 35-1246) thereafter. No treatment related complications occurred during the therapy. The data of the analysis showed that the Vac-Plug therapy is safe and successful in a relevant proportion of the patients. It is easy to learn and to apply and is well tolerated. In our opinion, it is a promising addition to the armamentarium of interventional methods of these difficult to treat patients. Of course, its usefulness must be further validated in larger prospective studies.

      PMID 35851392
    5. Journal article

      A biofilm based wound care pathway in the community setting:: a review

      Wounds UK 2022 18(4) 1420

      In recent years, the impact of biofilms on non-healing wounds has gained increasing interest and it has been reported that between 80% to 100% of non-healing wounds have a biofilm associated with them that impedes wound healing (Bjarnsholt et al, 2017; Malone et al, 2017). Biofilms consist of a complex community of microorganisms, which tend to attach to surfaces, and are encased within a matrix consisting of extracellular polymeric substances (EPS) (Malone et al, 2017). This matrix provides

      the microorganisms with protection against antimicrobial treatment and an individual’s immune system. There is an increasing focus and awareness around the use of biofilm based wound care (BBWC) pathways, and they are recommended in several consensus documents (Bianchi et al, 2016; Shultz et al, 2017; Murphy et al, 2020; International Wound Infection Institute (IWII), 2022), This article will discuss the evidence behind BBWC and the potential for introduction of a BBWC pathway into the community setting.

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    6. Journal article

      Transabdominal esophago-cutaneous fistula closure with endoscopic negative pressure therapy using a thin open-pore film drain in a pull-through technique

    7. Journal article

      Cutting costs and caseloads with a monofilament debridement pad

      Journal of Community Nursing 2022 36(6) 4248

      Debridement is the removal of non-viable tissue from the wound bed and surrounding skin and is an important part of wound healing and wound bed preparation. Devitalised tissue, such as necrosis, slough and hyperkeratosis, interfere with the process of wound healing. When a wound fails to progress, there is a need to assess the wound bed and surrounding tissue and promote an optimum environment that encourages the formation of healthy granulation tissue (Young, 2014). Recent advances in debridement techniques using monofilament fibre technology can be practised by nonspecialist nurses and used safely and effectively in a patient’s home. In a recent audit, a dataset of 486 patients who had been newly prescribed a monofilament fibre debridement pad was obtained to validate clinical effectiveness and cost efficiency. The total cost of wound care prescribing fell by 14% or £101,723 in the six months after the intervention compared with the six months before. The average monthly expenditure per patient fell from £244 before the intervention to £209 after (Burnett et al, 2021). This evidence reinforces the National Institute for Health and Care Excellence (NICE) recommendations for use of monofilament fibre debridement in the community, based on evidence of its effectiveness and estimated cost savings (NICE, 2019).

      Products Debrisoft Lolly
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    8. Journal article

      Silver nanoparticles: an overview of scientific toxicity and safety data and introduction of a new dressing, Venus Ag

      Wounds UK 2022 18(4) 2229

      Nanotechnology has opened a new area of scientific research. This field deals with materials within the dimensions of 1–100nm and a plethora of new technologies have emerged. In wound care, silver nanoparticles are used to aid wound healing as an antimicrobial agent, but also as an anti-inflammatory agent. The properties of silver nanoparticles differ from that of the material on a larger scale and their production can be controlled to give varied properties and characteristics that have different uses. These resultant properties are very important and differences in characterisation can alter their biological and physical attributes. All wound dressings have to undergo rigorous scrutiny around toxicity and safety when regulatory review is undertaken, yet some users still have concerns over long-term effects of silver nanoparticles in vivo. This review will address some of these concerns and reviews the current health and safety data associated with introduction of new products containing silver nanoparticles using Venus Ag dressings (SFM LTD, UK) as an example.

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    9. Journal article

      3D Biofilm Models Containing Multiple Species for Antimicrobial Testing of Wound Dressings

      Microorganisms 2022 10(10)

      The treatment of chronic wounds presents a major challenge in medical care. In particular, the effective treatment of bacterial infections that occur in the form of biofilms is of crucial importance. To develop successful antibiofilm strategies for chronic wound treatment, biofilm models are needed that resemble the in vivo situation, are easy to handle, standardizable, and where results are readily transferable to the clinical situation. We established two 3D biofilm models to distinguish the effectiveness of wound dressings on important microorganisms present in chronic wounds. The first 3D biofilm model contains Staphylococcus aureus, Escherichia coli, and Acinetobacter baumannii, while the second is based on Pseudomonas aeruginosa. Bacteria are cultivated in a nutrient-rich agar/gelatin mix, into which air bubbles are incorporated. This results in a mature biofilm growing in clusters similar to its organization in chronic wounds. The models are convenient to use, have low variability and are easy to establish in the laboratory. Treatment with polihexanide and silver-containing wound dressings showed that the models are very well suited for antimicrobial testing and that they can detect differences in the efficacy of antimicrobial substances. Therefore, these models present valuable tools in the development of effective antibiofilm strategies in chronic wounds.

      PMID 36296303
    10. Journal article

      Pre-emptive active drainage of reflux (PARD) in Ivor-Lewis oesophagectomy with negative pressure and simultaneous enteral nutrition using a double-lumen open-pore film drain (dOFD)

      Surgical endoscopy 2022

      BACKGROUND

      Postoperative reflux can compromise anastomotic healing after Ivor-Lewis oesophagectomy (ILE). We report on Pre-emptive Active Reflux Drainage (PARD) using a new double-lumen open-pore film drain (dOFD) with negative pressure to protect the anastomosis.

      METHODS

      To prepare a dOFD, the gastric channel of a triluminal tube (Freka®Trelumina, Fresenius) is coated with a double-layered open-pore film (Suprasorb®CNP drainage film, Lohmann & Rauscher) over 25 cm. The ventilation channel is blocked. The filmcoated segment is placed in the stomach and the intestinal feeding tube in the duodenum. Negative pressure is applied with an electronic vacuum pump (- 125 mmHg, continuous suction) to the gastric channel. Depending on the findings in the endoscopic control, PARD will either be continued or terminated.

      RESULTS

      PARD was used in 24 patients with ILE and started intraoperatively. Healing was observed in all the anastomoses. The median duration of PARD was 8 days (range 4-21). In 10 of 24 patients (40%) there were issues with anastomotic healing which we defined as "at-risk anastomosis". No additional endoscopic procedures or surgical revisions to the anastomoses were required.

      CONCLUSIONS

      PARD with dOFD contributes to the protection of anastomosis after ILE. Negative pressure applied to the dOFD (a nasogastric tube) enables enteral nutrition to be delivered simultaneously with permanent evacuation and decompression.

      PMID 34973079