UNIQUE NURSING METHODS FOR THE CARE OF PERMANENT WOUNDS IN AUTOINFLAMMATORY OR AUTOIMMUNE PATHOLOGIES
Main Article Content
Keywords
rheumatological ulcer, chronic Wound, inflammation, tissue regeneration
Abstract
Background: Chronic wounds are a major worldwide health concern that are negatively affecting people's quality of life and placing a financial and personal burden on healthcare systems. The intricacy of persistent wounds demands an efficient management strategy that incorporates patients and/or their surroundings and guarantees that medical personnel get the most recent training in care methods. Chronic wounds exhibit diverse forms depending on contributing factors, with auto-inflammatory and autoimmune disorders playing a prominent role. Immune-mediated disorders, characterized by modifications in innate and adaptive immune responses due to genetic flaws, fall into this category. Conditions fostering chronic wounds include chronic inflammation, prothrombotic phases, immune complex-associated vasculitis, and treatment resistance consequences.
Patient-Centric Approach: To prioritize patients during chronic wound healing, this work focuses on nursing management, specifically addressing individuals with auto-inflammatory/autoimmune disorders. It aims to highlight cutting-edge strategies and therapies for effective patient care.
Advanced Wound Healing Strategies: The study explores the potential of nano hydrogels, particularly those with a three-dimensional porous structure, for enhanced wound healing applications. Specifically, a gellan-cholesterol nano hydrogel containing the antioxidant polyphenol baicalin is investigated for its ability to accelerate the wound healing process. This hydrogel, with its non-sticky nature, respects the wound bed, facilitates oxygen permeation, and simplifies topical treatment.
Encapsulation of Medications: The hydrogel's capacity to encapsulate medications, such as baicalin, demonstrates noteworthy outcomes in terms of skin healing and the suppression of inflammatory indicators. The study emphasizes the flexibility of delivery techniques, aligning with the increasing interest in injectable applications.
Innovative Nano Hydrogel Compositions: In addition to baicalin-containing hydrogels, an alternative nano hydrogel incorporating VEGF, natural polysaccharides, nano silicates, and k-carrageenan shows promise by enhancing cell adhesion and proliferation. This diversification in nano hydrogel compositions opens avenues for advanced wound healing strategies.
Conclusion: The comprehensive approach to chronic wound management, involving nursing care and innovative nano hydrogel therapies, represents a significant step toward addressing the global burden of chronic wounds. These advancements offer potential breakthroughs in patient-centered care and contribute to the ongoing evolution of wound healing practices.
A significant global health issue, chronic wounds are becoming more common. They have a crippling impact on many people's quality of life, and managing them has a significant financial and personal impact on the healthcare system. For this reason, it's essential to implement an effective management system involving the patient and/or his environment and training staff in the most recent care techniques. Depending on the factors that make a wound chronic, several forms of chronic wounds exist. Being classified as autoinflammatory/autoimmune, most immune-mediated disorders typically entail modifications of innate and adaptive immune responses brought on by flaws in several genes.
Conditions that encourage the development of chronic wounds, such as chronic inflammation, prothrombotic phases, immune complex-associated vasculitis, or consequences of treatment resistance, are examples of autoinflammatory and autoimmune disorders. To put the patient at the center of attention during the healing of chronic wounds, this work focuses on the management of nurses in caring for patients with autoinflammatory/autoimmune disorders and chronic injuries. It also presents some of the most cutting-edge management strategies and therapies.
Nano hydrogels' distinctive three-dimensional porous structure, which allows for ideal liquid absorption while preserving a pleasant, humid environment, has made them attractive candidates for enhanced wound healing applications. This work investigates the possibility of using a gellan-cholesterol nano hydrogel containing the antioxidant polyphenol baicalin (found in Scutellaria baicalensis) to speed up the healing process after wounds. Because the hydrogel is not sticky, it respects the wound bed, permits oxygen to pass through, and makes topical treatment easier for patients.
The hydrogel's ability to encapsulate medications—in this case, baicalin—has shown noteworthy results in terms of skin healing and the suppression of inflammatory indicators. The study emphasizes how flexible the delivery techniques are, which is in line with the growing interest in injectable usage. An additional nano hydrogel including VEGF, natural polysaccharides, nano silicates, and k-carrageenan has demonstrated improved cell adhesion, and proliferation
References
2. Abd El‐Aleem, S. A., Abd‐Elghany, M. I., Ali Saber, E., Jude, E. B., & Djouhri, L. (2020). A possible role for inducible arginase isoform (AI) in the pathogenesis of chronic venous leg ulcer. Journal of Cellular Physiology, 235(12), 9974-9991.
3. Adler, A. I., Boyko, E. J., Ahroni, J. H., & Smith, D. G. (1999). Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetes care, 22(7), 1029-1035.
4. Ahmadi, A. R., Chicco, M., Huang, J., Qi, L., Burdick, J., Williams, G. M., . . . Sun, Z. (2019). Stem cells in burn wound healing: A systematic review of the literature. Burns, 45(5), 1014-1023.
5. Altiok, D., Altiok, E., & Tihminlioglu, F. (2010). Physical, antibacterial and antioxidant properties of chitosan films incorporated with thyme oil for potential wound healing applications. Journal of Materials Science: Materials in Medicine, 21, 2227-2236.
6. Awad-Igbaria, Y., Dadon, S., Shamir, A., Livoff, A., Shlapobersky, M., Bornstein, J., & Palzur, E. (2022). Characterization of early inflammatory events leading to provoked vulvodynia development in rats. Journal of Inflammation Research, 3901-3923.
7. Bazaliński, D., Kózka, M., Karnas, M., & Więch, P. (2019). Effectiveness of chronic wound debridement with the use of larvae of Lucilia sericata. Journal of clinical medicine, 8(11), 1845.
8. Borojeny, L. A., Albatineh, A. N., Dehkordi, A. H., & Gheshlagh, R. G. (2020). The incidence of pressure ulcers and its associations in different wards of the hospital: a systematic review and meta-analysis. International Journal of Preventive Medicine, 11.
9. Burgess, J. L., Wyant, W. A., Abdo Abujamra, B., Kirsner, R. S., & Jozic, I. (2021). Diabetic wound-healing science. Medicina, 57(10), 1072.
10. Carstens, M. H., Quintana, F. J., Calderwood, S. T., Sevilla, J. P., Ríos, A. B., Rivera, C. M., . . . Bertram, K. A. (2021). Treatment of chronic diabetic foot ulcers with adipose-derived stromal vascular fraction cell injections: Safety and evidence of efficacy at 1 year. Stem cells translational medicine, 10(8), 1138-1147.
11. Cheng, J. Z., Farrokhi, A., Ghahary, A., & Jalili, R. B. (2018). Therapeutic use of stem cells in treatment of burn injuries. Journal of Burn Care & Research, 39(2), 175-182.
12. Comino-Sanz, I. M., López-Franco, M. D., Castro, B., & Pancorbo-Hidalgo, P. L. (2021). The role of antioxidants on wound healing: A review of the current evidence. Journal of clinical medicine, 10(16), 3558.
13. Deldar, N., Monsefi, M., Salmanpour, M., Ostovar, M., & Heydari, M. (2021). Wound healing potential of crocin and safranal, main saffron (Crocus sativus L.), the active constituents in excision wound model in rats. Galen Medical Journal, 10, e1900-e1900.
14. Donnelly, R., Emslie-Smith, A. M., Gardner, I. D., & Morris, A. D. (2000). Vascular complications of diabetes. Bmj, 320(7241), 1062-1066.
15. Farahani, M., & Shafiee, A. (2021). Wound healing: From passive to smart dressings. Advanced Healthcare Materials, 10(16), 2100477.
16. Gerardi, C., Pinto, L., Baruzzi, F., & Giovinazzo, G. (2021). Comparison of antibacterial and antioxidant properties of red (cv. Negramaro) and white (cv. Fiano) skin pomace extracts. Molecules, 26(19), 5918.
17. Huang, K., Jinzhong, Z., Zhu, T., Morsi, Y., Aldalbahi, A., El-Newehy, M., . . . Mo, X. (2021). Exploration of the antibacterial and wound healing potential of a PLGA/silk fibroin based electrospun membrane loaded with zinc oxide nanoparticles. Journal of materials chemistry B, 9(5), 1452-1465.
18. Kharaziha, M., Baidya, A., & Annabi, N. (2021). Rational design of immunomodulatory hydrogels for chronic wound healing. Advanced Materials, 33(39), 2100176.
19. Kolluri, R., Lugli, M., Villalba, L., Varcoe, R., Maleti, O., Gallardo, F., . . . Hinahara, J. (2022). An estimate of the economic burden of venous leg ulcers associated with deep venous disease. Vascular Medicine, 27(1), 63-72.
20. Las Heras, K., Igartua, M., Santos-Vizcaino, E., & Hernandez, R. M. (2020). Chronic wounds: Current status, available strategies and emerging therapeutic solutions. Journal of controlled release, 328, 532-550.
21. Ma, W., Zhang, X., Liu, Y., Fan, L., Gan, J., Liu, W., . . . Sun, L. (2022). Polydopamine decorated microneedles with Fe‐MSC‐derived nanovesicles encapsulation for wound healing. Advanced Science, 9(13), 2103317.
22. Mathew-Steiner, S. S., Roy, S., & Sen, C. K. (2021). Collagen in wound healing. Bioengineering, 8(5), 63.
23. Mohebali, A., & Abdouss, M. (2020). Layered biocompatible pH-responsive antibacterial composite film based on HNT/PLGA/chitosan for controlled release of minocycline as burn wound dressing. International journal of biological macromolecules, 164, 4193-4204.
24. Nazempour, M., Mehrabani, D., Mehdinavaz‐Aghdam, R., Hashemi, S. S., Derakhshanfar, A., Zare, S., . . . Vahedi, M. (2020). The effect of allogenic human Wharton's jelly stem cells seeded onto acellular dermal matrix in healing of rat burn wounds. Journal of cosmetic dermatology, 19(4), 995-1001.
25. Nieman, D. C., Luo, B., Dréau, D., Henson, D. A., Shanely, R. A., Dew, D., & Meaney, M. P. (2014). Immune and inflammation responses to a 3-day period of intensified running versus cycling. Brain, behavior, and immunity, 39, 180-185.
26. Olsson, M., Järbrink, K., Divakar, U., Bajpai, R., Upton, Z., Schmidtchen, A., & Car, J. (2019). The humanistic and economic burden of chronic wounds: A systematic review. Wound Repair and Regeneration, 27(1), 114-125.
27. Pakdeesuwan, A., Araki, T., Daduang, S., Payoungkiattikun, W., Jangpromma, N., & Klaynongsruang, S. (2017). In vivo wound healing activity of crocodile (Crocodylus siamensis) hemoglobin and evaluation of antibacterial and antioxidant properties of hemoglobin and hemoglobin hydrolysate. Journal of Microbiology and Biotechnology, 27(1), 26-35.
28. Palumbo, P., & Melton, L. J. (1985). Peripheral vascular disease and diabetes. Diabetes in America, 2, 401-408.
29. Paul, W., & Sharma, C. P. (2004). Chitosan and alginate wound dressings: a short review. Trends Biomater Artif Organs, 18(1), 18-23.
30. Przekora, A. (2020). A concise review on tissue engineered artificial skin grafts for chronic wound treatment: can we reconstruct functional skin tissue in vitro? Cells, 9(7), 1622.
31. Raziyeva, K., Kim, Y., Zharkinbekov, Z., Kassymbek, K., Jimi, S., & Saparov, A. (2021). Immunology of acute and chronic wound healing. Biomolecules, 11(5), 700.
32. Şakul, A. A., Ayla, Ş., Okur, M. E., Karadağ, A. E., Daylan, B., Güzel, E., . . . Günal, M. Y. (2023). In vivo wound-healing and in vitro antibacterial and antioxidant properties of Carduus adpressus extract. Journal of Research in Pharmacy.
33. Schneider, C., Stratman, S., & Kirsner, R. S. (2021). Lower extremity ulcers. Medical Clinics, 105(4), 663-679.
34. Wilkinson, H. N., & Hardman, M. J. (2020). Wound healing: Cellular mechanisms and pathological outcomes. Open biology, 10(9), 200223.
35. Xiong, S., Li, R., Ye, S., Ni, P., Shan, J., Yuan, T., . . . Zhang, X. (2022). Vanillin enhances the antibacterial and antioxidant properties of polyvinyl alcohol-chitosan hydrogel dressings. International journal of biological macromolecules, 220, 109-116.
36. Zhou, X., Ning, K., Ling, B., Chen, X., Cheng, H., Lu, B., . . . Xu, J. (2019). Multiple injections of autologous adipose-derived stem cells accelerate the burn wound healing process and promote blood vessel regeneration in a rat model. Stem Cells and Development, 28(21), 1463-1472.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Shabana Benjamin
Nursing Instructor, Quetta Mission Hospital, Pakistan
Dr. Roma Bhatii
Department of Nursing, Ittefaq College of Nursing, Pakistan
Dr. Nosheen Akhtar Rana
College of Nursing, Niazi Medical and Dental College Sargodha, Pakistan
Saira Aslam
Registered Nurse, MS Scholar, The Lahore School of Nursing, The University of Lahore, Pakistan
Thomas Nyaroo
MSC, Department of Clinical and Medicine Studies, Kenya Medical and Training College, Pakistan