WITA - Wound Management Software Update

Great news...WITA Alpha Version is almost ready to release to our Pioneer Clients. The hard work of Antonic d.o.o and the development team have put WITA in a fantastic position to be available to the wound care market within the next couple of month's. For more information please visit www.wita-imagocare.co.uk.

PARAFRICTA - Frictionless Fabric

Technology is rapidly developing in every market from computers to talking baby dolls. And even over the last 10 years fabrics have come such a long way. I have been lucky enough to experience the birth of Parafricta (www.parafricta.com) a frictionless fabric developed into a range of products to protect and prevent the elderly, bed ridden and people with disabilities from forming pressure ulcers by eliminating the friction and shear forces. For more information please visit www.imagocare.com. For wound management please visit www.wita-imagocare.co.uk

Indications

a) The prophylactic avoidance of Pressure Sores in vulnerable patients

These products are the first proven answer to the key nursing goal identified by EPUAP (European Pressure Ulcer Advisory Board), namely to "protect against the adverse effects of external mechanical forces: pressure, friction and shear on skin".

Parafricta™ Fabric products offer unique protection against two of these, friction and shear, and are compatible with all existing methods of mitigating the effects of pressure, e.g. pressure reducing mattresses and beds.

Variation in friction coefficient with sliding distance

More than 15 NHS sites in the UK have already evaluated our products. These include Great Ormond Street, where trials were conducted on children with fragile skin due to Epidermolysis Bullosa, as well as hospices, nursing homes, and individual community based customers. The results have confirmed that the garments and bedclothes prevent skin breakdown and progression to clinically detrimental pressure sores.

b) The prevention of displacement of chronic wound dressings

Many chronic wounds are initiated by frictional shearing of compromised skin in cardiovascular compromised, diabetic or bed-confined patients. Friction often dislodges and "rucks up" wound dressings that are in place to treat an ulcer, as the patient moves about in the bed or chair. With most materials, static friction is greater than moving friction. This causes a jerk or "snatch" when one surface begins to move against another, which results in damage to skin or displacement of a dressing. Parafricta™ fabric can be used to avoid this effect. A significant feature of Parafricta™ fabrics is that the static and moving friction coefficients are equal.

Wound dressings are expensive to replace in terms of cost per dressing and time spent by nurses cleaning the adhesives from around the wound. Aggressive adhesives that would keep these dressings in place also have a downside: They cause shearing of the already weak skin and expansion of the existing wound trauma, thus creating the need for larger dressings and more adhesive to keep them in place.

Light is Light

After reading about Niels Finsen's 1886 research into the cure of lupus and smallpox through the use of light, I was intrigued to find out how this actually works. I have found an interesting article I would like to share with you regarding the use of red light to help heal chronic wounds and pressure ulcers. To find out more products that can help you with chronic hard to heal wounds please visit www.imagocare.com . For information on how to manage your wound please visit www.wita-imagocare.co.uk.

Light is Light Since Endre Mester and his colleagues first documented the therapeutic benefits of monochromatic light,1,2 a plethora of terminologies and acronyms have emerged and continue to evolve in describing light and laser therapy. Intended or not, each term, old or new, seems to advance the notion that therapeutic lasers and related monochromatic light—often with less than 150 mW cm2 irradiance—are innocuous and safe. Consequently, terms such as “cold laser,” “soft laser,” and “low power lasers,” which were used in the 1970s and 1980s to contrast therapeutic lasers from their high power counterparts, have since metamorphosed into low level laser therapy (LLLT),3–5 low energy laser therapy (LELT),6 low-intensity laser activated biostimulation (LILAB),low-power laser irradiation (LPLI), low power laser therapy (LPLT),8 etc. So much confusion has arisen from describing the same treatment in so many ways that some now resort to using the terms low-level laser therapy, low-energy, cold laser, low power and soft laser concurrently to ensure clarity. During the Cold War era of the 1960s and 1970s, lasers were considered destructive and, in military circles, powerful weapons appropriate for gaining technological advantage over potential enemies. The “Star War” mentality of that period only heightened the awe engendered by lasers. Therefore, the idea that the same tool could be therapeutic at low fluences seemed too far-fetched and remote from prevailing thinking that proponents of lasers as a form of therapy coined soothing terms, such as soft laser and cold laser to project a safe image, foster public acceptance, and distinguish therapeutic lasers from their high power counterparts. As terminologies have evolved, so therapeutic light technology has changed with time. Beginning from the mid-1990s bulky laser devices—mainly gas and dye lasers—were rendered obsolete as semiconductor- and diode-based lasers gained popularity. The evolution continues. Today’s therapeutic light source is as likely to be a superluminous diode (SLD), light emitting diode (LED) or polarized light (PL) as a semiconductor or diode laser, given the increasing number of papers reporting the beneficial effects of SLDs, LEDs and polarized light. This development renders the continued use of LLLT, LELP, LILAB, LPLI, and other terms and acronyms obsolete, and in some instances, inappropriate. A common term or terms recognizing lasers and emerging monochromatic or polarized light sources would seem appropriate to streamline things and minimize the on-going confusion. Therefore, it is recommended that the term “light therapy” or “phototherapy” be used to describe noninvasive interventions involving therapeutic light, as for example, situations involving cutaneous and subcutaneous tissue irradiation for tissue repair, light-based acupuncture, and transcutaneous irradiation for pain relief. The term photomedicine may be appropriate to describe these interventions. However, it broadly covers invasive light therapy such as direct irradiation of stomach ulcer, cardiac infarct, or fracture using a catheter. In addition, the wavelength of light used in each situation should be specified, given the implication of wavelength as an important determinant of treatment outcomes. When multiple wavelengths are used, as for example, treatments involving applicators with “multiarray,” “cluster probes,” and other multi-diode devices, details of the average power of each wavelength of light involved should be reported. Similarly, when multicolor or white polarized light is used, the wavelengths of light encompassed by such devices should be specified in the report. There are additional rationales for these recommendations. First, the terms light therapy, phototherapy and photomedicine are simple. Second, they seem appropriate for every form of light-based treatment—lasers, SLDs, LEDs, polarized light, etc. Third, they streamline therapeutic light lingo, stem the proliferation of acronyms, and minimize confusion. Fourth, there has been a 35year history of safe use of therapeutic lasers. The safety record seems excellent given the dearth of untoward effects in the literature. Therefore, it is no longer necessary to sooth public perception that therapeutic light may be unsafe. Indeed, such perception has diminished significantly; lasers have become an integral part of a wide range of consumer products. Fifth, limiting the terminology to “light therapy,” “phototherapy,” or “photomedicine” further emphasis the notion that light is light. The literature seems clear that the therapeutic effects ascribed to monochromatic light relate more to wavelength and doses than the source of light—lasers, LEDs, SLDs, polarized light, etc. In other words, the source does not have to be a laser in order to produce a therapeutic effect,but rather appropriate doses of light in the range of 600–1000 nm as contemporary reports continue to show.5 Sixth, there is nothing really fancy about being “low,” “soft” or “cold.” Indeed, given the volume of research supporting the clinical benefits of photomedicine, it seems demeaning to be considered “low” or “low level.” Chukuka S. Enwemeka, Ph.D., FACSM Co-Editor-in-Chief

Healing Without the Sting by Keith Cutting

Below I found an interesting article written by Keith Cuttings a Principal lecturer of Tissue Viabilityt highly regarded in the industry. It discusses the use of honey in wound management. For more articles regarding the use of honey in wound management visit www.imagocare.com.

Healing Without the Sting
JCN July 2008

Abstract:

Keith Cutting discusses the renaissance of honey as a therapeutic agent in wound management

Keith F Cutting MN, RN, Dip N, Cert Ed. Principal lecturer Tissue Viability. Buckinghamshire New University

The use of honey in wound care has received increasing attention in recent years, mainly as a result of improved formulations, increased availability, supportive research, clinical efficacy reports and numerous positive reports in the national and international press. These have all contributed to the renaissance of honey as a therapeutic agent, in particular, its use as an antimicrobial agent which neatly confronts the increasing number of reports on the problem of antibiotic resistance.

The therapeutic advantages of honey have been recorded by Molan (2001) and tabulated by Cutting (2007) Table 1.

Good practice dictates that before first application of any honey product the patient should always be assessed for risk of reaction/allergy to bee or honey products and asked about known sensitivities. Adverse effects from application of honey are rare and although Molan (2001) records that patients find honey soothing and non-irritating some clinicians report that a small number of patients may experience a stinging sensation (Vandeputte & Van Waeyenberge 2003). It has been stated that not all honeys are the same and for this reason honey should not be considered a generic term (Molan 2002). Consequently, with the introduction of a new honey product it should not be assumed that painful reactions following application may occasionally be expected.

Melladerm® PLUS is intended for use in all types of wounds, including burns and is derived from Bulgarian (BULGARIA H) mountain flower honey. Bulgaria H has been selected on the basis of its excellent wound healing properties. Melladerm® PLUS is a proprietary wound ointment/gel that contains 45% BULGARIA H and a mixture of ingredients including glycerin and polyethylene glycol 4000 (PEG 4000) to make the honey dressing more user friendly. PEG 4000 is a blend of water soluble polymers and its use as an additive to honey has been assessed by Subrahmanyam (1996).

Clinical evaluation reports prepared as part of a submission for CE marking on Melladerm Plus demonstrate healing without the disadvantage of occasionally incurring pain following application (Vandeputte 2007).

In addition to not inducing pain, a number of clinical advantages to Melladerm PLUS can be found. It has a remarkably rapid debridement capability (Vandeputte 2007). Melladerm PLUS also contains phenolic compounds (most frequently reported for antibacterial and antioxidant activities). Melladerm PLUS has a moisture content of 16.8%, possessing a high osmolarity that promotes a moist environment and permits easy change of dressing. Melladerm PLUS has a low pH (3.4) and it is known that harmful protease are more active when the wound pH is alkaline (Schultz et al 2005).

An additional factor related to low wound pH is the faster release of oxygen from oxyhaemoglobin. Ischaemia is a feature of many chronic wounds and the release of oxygen and subsequent availability assists cellular metabolism and healing (Wilson et al 1979).

The Bulgarian Honey used in Melladerm PLUS is not heat processed. It is filtered to remove contaminants such as pollen that may cause allergic reactions. In order to kill possible anaerobic bacteria in the honey a novel patented process using ozone gas to sterilize the honey is used. This process also destroys fungi and yeasts. This processing does not result in loss of activity of glucose oxidase, an enzyme that is naturally present in honey and is very sensitive to heating. Compared to other types of honey, Bulgarian Honey has a high amount of glucose oxidase and is a rich source of phenolic antioxidants. Phenolics are known to possess antibacterial activity (Schramm et al 2003, Taormina et al 2001).

In order to illustrate the positive benefits of Melladerm PLUS a community tissue viability nurse has recorded the following “Medical honey is an effective wound dressing agent being particularly useful for patients with infected wounds. Unfortunately, some patients experience pain when the honey is initially applied and for some the pain can be so severe that treatment has to be discontinued. With this in mind and with patient consent Melladerm PLUS was applied to a patient with a large chronic leg ulcer. The patient reported no pain on application or during the initial post dressing period.” This account perhaps understates the personal experience of the patient, which, with permission is reported here, “I have never been able to tolerate the pain of any honey based dressing and before now it was so bad I looked like I was dancing out of the door. My wound needed cleaning up and Sister suggested this new Melladerm dressing. I didn’t notice it had been applied, there was no sting and no pain afterwards.”

Melladerm PLUS is available in UK on prescription.

References

• Cutting KF. (2007) Honey and contemporary wound care: an overview. OWM 53,11:49-54
• Molan, P. (2001) Honey as a topical antibacterial agent for treatment of infected wounds. World Wide Wounds. Available at: www.worldwidewounds.com/2001/november/Molan/honey-as-topical-agent.html Accessed May 1st 2008.
• Molan P. (2002) Not all honeys are the same for wound healing. European Tissue Repair Society Bulletin 9,1
• Molan PC. (2001) Why honey is effective as a medicine 2. The scientific explanation of its effects. Bee World 82(1):22–40.
• Schramm DD, Karim M, Schrader HR. (2003) Honey with high levels of antioxidants can provide protection to healthy human subjects. J Agric Food Chem 51: 1732-35
• Schultz G, Ladwig G, Wysocki A. (2005) Extracellular matrix: review of its roles in acute and chronic wounds. World Wide Wounds available at www.worldwidewounds.com/2005/august/Schultz/Extrace-Matric-Acute-Chronic-Wounds.html accessed 20 May 2008.
• Subrahmanyam N. (1996) Addition of antioxidants and polyethylene glycol 4000 enhances the healing property of honey in burns. Annals of Burns and Fire Disasters 9(2):93-95.
• Taormina PJ, Niemira BA, Beuchat LR. (2001) Inhibitory activity of honey against foodborne pathogens as influenced by the presence of hydrogen peroxide and level of antioxidant power. Int J Food Microbiol 69: 217-25
• Vandeputte J, Van Waeyenberge PH (2003) Clinical evaluation of L-Mesitran®, a honey-based wound ointment. European Wound Management Association Journal. 3, 2, 8-11.
• Vandeputte JAJ (2007) Clinical evaluation of Melladerm Plus, Technical file for CE marking.
  Wilson I.A.I et al (1979) The pH of varicose ulcer surfaces and its relationship to healing, Vasa (Bern) 8, 339-342.
  

WITA (Wound Image Tissue Analysis) Analysis, Assessment and Managment Software Solution

Welcome to the WITA WOUND MANAGEMENT Blog,

Over the coming months and years, I will be searching the internet and variety of different internet sources to highlight, in my opinion, the most innovative wound care products in the market, wound care best practice and so that you can follow the development, release and my thoughts on our new WITA (Wound Image Tissue Analysis) Software. Judy Waterlow, leads the commentary on WITA.

"When I first saw WITA I thought Eureeka! It is a very impressive solution. It will encourage & motivate patients and staff to improve wound care best practice. WITA will be the most amazing tool for teaching."

We are almost ready for our first WITA release and are currently looking for wound care distributors to advertise on our unique treatment tool and agents to distribute the software in the UK, EU and US . I will keep you all updated with our progress.

What is WITA?

WITA™ is a sophisticated wound analysis, wound assessment and wound management software solution allowing carers, clinicians, business managers and scholars to quickly and intuitively analyse wounds and manage the ongoing care of patients. To add value to this process and enhance patient recovery, WITA™ will also provide SMART treatments aligned to a hospital’s formulary and even scan the market for alternative treatments.

Its unique image analysis tool takes the visual properties of a wound image and applies an advanced statistical pattern recognition algorithm. The result is a quick analysis of a wound providing accurate tissue and dimension data, which is stored in an interactive wound diary.

For more information please visit www.wita-imagocare.co.uk

Who are Imago Care Ltd?

Imago Care Ltd are a UK based distribution company who procure the most effective products in the health care market to help redefine wound care best practice.

For more information please visit www.imagocare.com