Unveiling the role of artificial intelligence for wound assessment and wound healing prediction

Wound healing is a very dynamic and complex process as it involves the patient, wound-level parameters, as well as biological, environmental, and socioeconomic factors. Its process includes hemostasis, inflammation, proliferation, and remodeling. Evaluation of wound components such as angiogenesis, inflammation, restoration of connective tissue matrix, wound contraction, remodeling, and re-epithelization would detail the healing process. Understanding key mechanisms in the healing process is critical to wound research. Elucidating its healing complexity would enable control and optimize the processes for achieving faster healing, preventing wound complications, and undesired outcomes such as infection, periwound dermatitis and edema, hematomas, dehiscence, maceration, or scarring. Wound assessment is an essential step for selecting an appropriate treatment and evaluating the wound healing process. The use of artificial intelligence (AI) as advanced computer-assisted methods is promising for gaining insights into wound assessment and healing. As AI-based approaches have been explored for various applications in wound care and research, this paper provides an overview of recent studies exploring the application of AI and its technical developments and suitability for accurate wound assessment and prediction of wound healing. Several studies have been done across the globe, especially in North America, Europe, Oceania, and Asia. The results of these studies have shown that AI-based approaches are promising for wound assessment and prediction of wound healing. However, there are still some limitations and challenges that need to be addressed. This paper also discusses the challenges and limitations of AI-based approaches for wound assessment and prediction of wound healing. The paper concludes with a discussion of future research directions and recommendations for the use of AI-based approaches for wound assessment and prediction of wound healing

Prognostic factors for delayed healing of complex wounds in adults: a scoping review protocol

(1) Background: The high prevalence of persons with wounds and its consequences for a person’s quality of life makes the issue a relevant focus of attention for healthcare professionals. Through prognostic factors for healing, the individual risk of complications can be predicted, is possible to predict imminent delays and guide decision-making, thus helping healthcare professionals. (2) Methods: A scoping review performed according to JBI methodology and guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR) checklist will aim to identify the studies that meet predefined eligibility criteria. Five databases and gray literature will be the sources used to research adults with pressure ulcers, venous leg ulcers, arterial ulcers, or diabetic foot ulcers and report the prognostic factors for delayed healing in any care setting. (3) Results: This review will consider all quantitative and mixed studies in the last five years. The selection of articles will be carried out by two reviewers independently, using EndNoteWeb and Rayyan. Prognostic factors will be presented by design study, sampling, setting, outcome, wound type, and statistical methods. (4) Conclusions: Mapping prognostic factors for delayed healing could also be a starting point for a systematic review and meta-analyses to quantify the value of each factor.info:eu-repo/semantics/publishedVersio

Impacto da formação profissional contínua nos custos do tratamento de feridas crónicas

Nos contextos da prestação de cuidados de saúde, os avanços da ciência e da tecnologia rapidamente desactualizam as competências específicas adquiridas nas escolas. Os erros clínicos, más práticas e performances deficientes, frequentemente associadas ao défice de formação, para além dos prejuízos clínicos, imputam enorme carga económica aos custos da saúde. No investimento em formação, mais do que saber quanto se gasta, importa saber quanto se pode poupar tornando mais competentes os profissionais de saúde. Com o objectivo geral de desenvolver um modelo de estimação dos custos da não formação, construímos e validamos (1) casos clínicos virtuais de pessoas com feridas crónicas, (2) modelo matemático para estimação dos Custos Óptimos (baseados nas decisões clínicas óptimas) e (3) simulador de tomada de decisão para construir as matrizes de Custos da Acção (baseados nas decisões terapêuticas registadas no simulador). Desenvolvemos um estudo analítico transversal numa amostra não aleatória de 78 enfermeiros com diferentes níveis de formação e experiência no tratamento de feridas crónicas. Nos resultados reunimos evidência empírica de que os custos do tratamento são mais elevados entre os profissionais que não frequentaram formação acreditada específica, e de que os custos tendem a baixar à medida que o número de horas de formação sobe

Pressure ulcers assissment through the pressure ulcer scale for healing application (PUSH)

Objective: To assess pressure ulcers(PU) with focus on the PUSH scale application. Methods:It is a prospective longitudinal study, performed between September and October 2010, in the three Intensive Care Units (ICUs) of a hospital in Teresina city, with sample of 19 patients and 134 PUSH applications, non-probabilist by convenience. Results: it was featured by the predominance of PU in females(52,6%), aged ≥ 80years old(36,8%) and mixed color (52,6%); the main caregivers were their grown-up children (73,7%). All patients had bladder probe, bowel incontinence and bed restriction with an average of 1,18 years(±5,18). Such limitations in 73,68% were caused by the underlying disease, being that 84,2% of them were unaware. PUs prevalence was of 61,29%, from which 63,33% were in the sacral region, stage II, being that 29,6% of them were treated with AGE oil. The EFA was the predominant coverage(29,6%).There was a decline or maintenance of the scale scores. Conclusions: The PUSH scale is useful in the wound scarring, by allowing monitoring global results and being presented as valid to integrate protocols, in order to implement the nursing care

PRESSURE ULCERS ASSESSMENT THROUGH THE PRESSURE ULCER SCALE FOR HEALING APPLICATION (PUSH)

OBJETIVO: avaliar úlceras por pressão(UPP) com enfoque na aplicação da escala PUSH. METODOLOGIA: Realizou-se entre setembro-outubro de 2010, estudo longitudinal prospectivo em três Unidades de Terapia Intensiva de um Hospital, Teresina, Piauí com amostra de 19 pacientes e 134 aplicações da PUSH, não probabilística por conveniência. RESULTADOS: caracterizada pelo predomínio de UPP no sexo feminino(52,6%), ≥ 80 anos(36,8%) e cor parda(52,6%);. Prevaleceu cuidadores diretos-filhos(73,7%). Todos os pacientes apresentaram sonda vesical, incontinência intestinal, restrição ao leito com média de 1,18 anos (±5,18), limitações em 73,68% causada pela doença de base e 84,2% inconscientes. A prevalência de UPP foi 61,29%, das quais 63,33% localizadas na região sacral, grau II, 29,6% tratadas com óleo AGE. Houve queda ou manutenção dos escores da escala. CONCLUSÃO: a PUSH é útil na avaliação da cicatrização de feridas permitindo monitorar resultados globais e apresentando-se válida para integrar protocolos, a fim de implementar a assistência de enfermagem

PRESSURE ULCERS ASSESSMENT THROUGH THE PRESSURE ULCER SCALE FOR HEALING APPLICATION (PUSH)

OBJETIVO: avaliar úlceras por pressão(UPP) com enfoque na aplicação da escala PUSH. METODOLOGIA: Realizou-se entre setembro-outubro de 2010, estudo longitudinal prospectivo em três Unidades de Terapia Intensiva de um Hospital, Teresina, Piauí com amostra de 19 pacientes e 134 aplicações da PUSH, não probabilística por conveniência. RESULTADOS: caracterizada pelo predomínio de UPP no sexo feminino(52,6%), ≥ 80 anos(36,8%) e cor parda(52,6%);. Prevaleceu cuidadores diretos-filhos(73,7%). Todos os pacientes apresentaram sonda vesical, incontinência intestinal, restrição ao leito com média de 1,18 anos (±5,18), limitações em 73,68% causada pela doença de base e 84,2% inconscientes. A prevalência de UPP foi 61,29%, das quais 63,33% localizadas na região sacral, grau II, 29,6% tratadas com óleo AGE. Houve queda ou manutenção dos escores da escala. CONCLUSÃO: a PUSH é útil na avaliação da cicatrização de feridas permitindo monitorar resultados globais e apresentando-se válida para integrar protocolos, a fim de implementar a assistência de enfermagem

Abdominal Wall Reconstruction: Improving Research Quality and Identifying the Predictors of Ventral Hernia Recurrence

Abdominal wall reconstruction (AWR) is an emerging subspecialty within general surgery. To date, research has focused mostly on surgical reconstruction techniques without sufficient regard to research quality. As a result, much published work has produced spurious data with unstandardised variable definitions. Published data is therefore challenging to interpret, giving little robust evidence to guide AWR surgeons. Consequently, the first part of this thesis focuses on improving research quality. Initially, I performed two systematic reviews analysing variable reporting amongst interventional trials, demonstrating the current heterogeneous reporting of perioperative variables, post-operative outcomes, and patient reported outcomes as well as poor trial methodology. Next, I targeted “loss of domain” (LOD) and published a systematic review and a clinician survey which revealed current inconsistent definitions, both in the literature and amongst practicing surgeons. Whilst performing these systematic reviews, I also identified that terms used to defined and name abdominal wall planes were used inconsistently. To rectify this, I performed a series of consensus studies. First, I performed a Nominal Group Technique study and established minimum datasets for primary and incisional ventral hernia interventional trials. These datasets reached consensus on standardised peri-operative variable definitions and detection methods, outcomes reporting, follow-up duration, and criteria to improve trial methodology. Next, I performed two Delphi studies with 20 international hernia experts. The first established new written and volumetric definitions for LOD. The second study created ‘ICAP’, an International Classification of Abdominal wall Planes, which defines and names the tissue planes into which mesh can be placed for ventral hernia repair. The second part of this thesis uses systematic review and meta-analysis across 20 years of AWR literature to identify peri-operative factors that significantly predispose to hernia recurrence after apparently curative repair. This systematic review forms the evidence-base from which to develop a prognostic model of ventral hernia recurrence

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

ACKNOWLEDGEMENTS Review and editing: S.R. Brown, Professor of Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Email [email protected]. Patient summary: R.G. Arnott, Retired Professor, Patient Liaison Group, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK. Email [email protected]. Delphi review: C.P. Macklin. BMedSci BM BS FRCS DM, Consultant Colorectal Surgeon, Mid Yorkshire Hospitals, UK. Email [email protected] reviewedPublisher PD

Point-of-Care Detection Devices for Healthcare

With recent technological advances in multiple research fields such as materials science, micro-/nano-technology, cellular and molecular biology, bioengineering and the environment, much attention is shifting toward the development of new detection tools that not only address needs for high sensitivity and specificity but fulfil economic, environmental, and rapid point-of-care needs for groups and individuals with constrained resources and, possibly, limited training. Miniaturized fluidics-based platforms that precisely manipulate tiny body fluid volumes can be used for medical, healthcare or even environmental (e.g., heavy metal detection) diagnosis in a rapid and accurate manner. These new detection technologies are potentially applicable to different healthcare or environmental issues, since they are disposable, inexpensive, portable, and easy to use for the detection of human diseases or environmental issues—especially when they are manufactured based on low-cost materials, such as paper. The topics in this book (original and review articles) would cover point-of-care detection devices, microfluidic or paper-based detection devices, new materials for making detection devices, and others