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Biomedical subjects

J M McCulloch

Publications and source records attributed to J M McCulloch.

7 recordsLinked to original sources
PubMed2000

Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds.

Diabetic foot wounds present a great challenge to wound care practitioners. The objective of this pilot study was to determine whether vacuum-assisted closure (V.A.C.) therapy would afford quicker wound resolution as compared to saline-moistened gauze in the treatment of postoperative diabetic foot wounds. Ten patients were randomized into either the experimental V.A.C. group or control saline gauze group. Included in the study were diabetic patients 18 to 75 years of age who had a nonhealing foot ulceration. Excluded were those patients with venous disease, coagulopathy, or those who had active infections not resolved by initial surgical debridement. All foot ulcers were surgically debrided prior to initiation of V.A.C. or gauze treatment. In the experimental group, V.A.C. dressings were applied in accordance with manufacturer's protocol for chronic wounds and changed every 48 hours. In the control group, saline gauze dressings were applied at the time of surgical debridement and changed twice a day thereafter. Measurements and photos were obtained to document wound progress. Main outcome measures included: 1) time to satisfactory healing (calculated from date of initial debridement to date of definitive closure, and 2) change in wound surface area (calculated from initial wound tracing to final tracing). Satisfactory healing in the V.A.C. group was achieved in 22.8 (+/- 17.4) days, compared to 42.8 (+/- 32.5) days in the control group. Surface area changes of 28.4% (+/- 24.3) average decrease in wound size in the V.A.C. group, compared to a 9.5% (+/- 16.9) average increase in the control group during measurement period.

Adolescent↗
PubMed1998

The role of physiotherapy in managing patients with wounds.

The physiotherapist is a highly respected member of the wound-care team in the USA. While assisting in all aspects of wound care, including debridement and dressing selection and application, the physiotherapist also provides a unique function. The numerous physical agents, such as electrical stimulation, ultrasound, hydrotherapy and heat all have benefits to offer the patient in contributing to healing. The background knowledge of biomechanics possessed by members of this discipline likewise enhances the services of the wound-care team. Physiotherapists recommend strategies to relieve or redistribute pressure for those confined to bed or wheelchair or for the ambulatory individual with an insensate foot. It is perceived that physiotherapists who remain uninvolved in wound care are a major untapped resource with great potential for promoting wound healing.

Bandages↗
PubMed1994

Intermittent pneumatic compression improves venous ulcer healing.

The effects of intermittent pneumatic compression on the healing rates of ulcers in patients with chronic venous insufficiency were examined in a prospective, controlled study of 22 patients. Patients were randomly assigned to the experimental or the control group. Both groups received local wound care followed by application of an Unna boot. In addition, subjects in the experimental group received intermittent pneumatic compression (IPC) twice weekly for one hour each session. Healing rates were reported in square centimeters per day. Data analysis revealed a mean healing rate of 0.08 cm2 per day for control subjects and 0.15 cm2 per day for experimental subjects. Statistical analysis, demonstrated the healing rates of the two groups to be statistically different. The results appear to indicate that intermittent pneumatic compression is beneficial in the management of venous insufficiency ulcers.

Administration, Cutaneous↗
PubMed1993

Vacuum-compression therapy for the treatment of an ischemic ulcer.

This case report describes the use of a new medical device that utilizes vacuum-compression therapy (VCT) in the management of a 30-year-old female patient with severe arteriosclerosis and an associated nonhealing fasciotomy wound. Attempts were made to treat the patient with local care consisting of debridement and saline-moistened gauze dressings. Following a poor response to nonsurgical management, a skin graft was performed in an attempt to encourage more rapid healing. Infection and poor healing followed the graph, and only 40% of the graft remained viable after 12 days. Outpatient physical therapy management consisted of hydrotherapy and hydrocolloid dressings. This treatment resulted in minimal success until combined with VCT. The patient received hydrotherapy, VCT, and hydrocolloid dressings three times per week for 11 weeks. Wound healing occurred at an average rate of 0.64 cm2 per day, and the wound completely reepithelialized by the end of the eighth week of VCT therapy. Increased capillary filling is proposed as a primary factor in the improved healing.

Adult↗
PubMedDate not supplied

Promotion of wound healing with electrical stimulation.

Clinicians involved in the conservative care of chronic wounds have many treatment interventions from which to choose, including debridement/irrigation, dressings, pressure-relieving devices, hyperbaric or topically applied oxygen, whirlpool/pulsed lavage, ultrasound, topical antibiotics, and cytokine growth factors. All except the last two interventions are physical treatments that create a wound-tissue environment conducive to healing. Unfortunately, many chronic wounds heal very slowly, do not heal, or worsen despite the best efforts of caregivers to promote tissue repair. An intervention commonly used to treat chronic wounds, especially by physical therapists, is electrical stimulation (ES). The rationale for use of this method is based on the fact that the human body has an endogenous bioelectric system that enhances healing of bone fractures and soft-tissue wounds. When the body's endogenous bioelectric system fails and cannot contribute to wound repair processes, therapeutic levels of electrical current may be delivered into the wound tissue from an external source. The external current may serve to mimic the failed natural bioelectric currents so that wound healing can proceed. Certain chemotaxic factors found in wound substrates contribute to tissue repair processes by attracting cells into the wound environment. Neutrophil, macrophage, fibroblast, and epidermal cells involved in wound repair carry either a positive or negative charge. When these cells are needed to contribute to autolysis, granulation tissue formation, anti-inflammatory activities, or epidermal resurfacing, ES may facilitate galvanotaxic attraction of these cells into the wound tissue and thereby accelerate healing.

Chronic Disease↗