Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management

Objective: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing. Method: A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts. Results: In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus. Conclusion: This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions

Functionality of Porous Silicon Particles: Surface Modification for Biomedical Applications

Porous silicon-based particles (PSps) with tailored physical and biological properties have recently attracted great attention given their biomedical potential. Within this context, the objective of the present work is to optimize the experimental parameters for the formation of biofunctional mesoporous PSps. Their functionality has been studied on the one hand by analyzing the fluorescence characteristics, such as tunable narrow band emission and fluorescence aging for PSps with different molecular capping. With regard to the biofunctional characteristics, two different molecular end-capping processes have been assayed: antifouling polyethylene glycol (PEG) and polar binding amino silanes (APTS), which were evaluated by X-ray photoelectron spectroscopy (XPS). Both PEG and APTS binding to the particles could be confirmed from the analysis of Si 2p and C 1s XPS core level spectra. The finding that these PSp-molecule conjugates allow the reduction of fluorescence degradation with time in solution is of interest for the development of cellular or tissue markers. From the morphological point of view, PEG termination is of special interest allowing the PSps after an ultrasonic treatment to get spherical shapes in the micron scale. The functionality as solid state dyes is preliminarily evaluated by direct fluorescence imaging.JRC.I.4-Nanobioscience