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Biomedical subjects

JoAnne D Whitney

Publications and source records attributed to JoAnne D Whitney.

9 recordsLinked to original sources
PubMed2005

Overview: acute and chronic wounds.

Knowledge of normal wound healing and the changes associated with chronic wounds have advanced significantly. Distinct characteristics identified through basic and clinical studies are found in nonhealing wounds, including bacterial and growth factor imbalances, increased inflammatory responses, and proteolytic forces that tip the balance toward tissue degradation rather than repair. This article describes the alterations that reduce healing and that also have important implications for the management of chronic wounds and presents a focus for future developments in wound therapy.

Acute Disease↗
PubMed2004

The effect of early postoperative physical activity on tissue oxygen and wound healing.

BACKGROUND: Supplemented postoperative activity was compared to standard activity for effects on wound healing, subcutaneous tissue perfusion, and oxygen (PscO2) following hip replacement (THR). METHODS: 58 patients were randomized to standard post-THR activity (N = 27) or supplemental activity (N = 31) (arm and leg exercises, walking protocol). PscO2was measured with a microelectrode/tonometer system and perfusion determined by oxygen response. Healing was evaluated by (1) tissue cellularity, (2) mRNA for pro collagen, (3) hydroxyproline, and (4) DNA content obtained from a subcutaneous implant removed on the 7th postoperative day. RESULTS: Activity significantly increased DNA levels, but did not increase PscO2, perfusion, cellularity, or collagen measures. CONCLUSIONS: Healing measures were not improved with increased activity levels. However, activity did not reduce PscO2or wound healing. The majority of patients adhered to additional activity and tolerated the protocol well. Increased activity was associated with earlier discharge, suggesting other recovery-related benefits.

Aged↗
PubMed2003

Treating chronic and acute wounds with warming: Review of the science and practice implications.

Systemic and local warming of tissue produces physiologic and cellular responses in the local wound environment conducive to wound healing. The use of warming to treat wounds is not a new idea, but the ability to deliver warming with controlled temperatures and conditions is a recent development. This article reviews basic science and clinical studies of active systemic and local warming and the reported effects on wound physiology, healing, and rate of infection in chronic and acute wounds. Twelve clinical studies evaluating active warming were identified. Existing data demonstrate improved healing outcomes and infection reduction associated with active warming therapy. Practical implications of using active warming therapy, including appropriate wound types and settings, obtaining product, guidelines for administering therapy, patient teaching, and cost-benefit information, are discussed.

Acute Disease↗
PubMed2002

Effects of an augmented postoperative fluid protocol on wound healing in cardiac surgery patients.

BACKGROUND: Cardiac surgery patients are vulnerable to hypoperfusion postoperatively and often have subcutaneous tissue oxygen tension less than 50 mm Hg. Hypovolemia most likely contributes to this hypoperfusion and may lead to impaired wound healing. OBJECTIVES: To determine if a modified postoperative fluid replacement protocol would result in improved tissue oxygen tension, blood flow, and healing in cardiothoracic surgery patients. METHODS: A total of 166 cardiac surgery patients, 18 to 90 years old, participated in a randomized, 2-group, repeated-measures study. The experimental group received fluid augmentation during the first 36 hours after surgery; the control group received standard postoperative replacement fluids. Subcutaneous tissue oxygen tension and temperature were measured 8, 18, and 36 hours after surgery. Tissue cellularity and accumulation of hydroxyproline were evaluated in tissue obtained from subcutaneous expanded polytetrafluoroethylene tubes. Wound complications were evaluated by using the ASEPSIS Wound Scoring System. RESULTS: Tissue oxygen levels, tissue cellularity, and accumulation of hydroxyproline were similar in the 2 groups. A negative correlation (P = .01) existed between higher tissue oxygen values and lower (better) ASEPSIS leg wound scores. More than 80% of the patients had tissue oxygen levels of 50 mm Hg or less at each time of measure. Many values were 30 to 40 mm Hg less than the ideal for control of bacteria and healing. CONCLUSIONS: The frequency of low oxygen levels is consistent with data from earlier studies. Determination of other interventions to improve subcutaneous tissue perfusion in cardiac surgery patients is needed.

Adolescent↗
PubMedDate not supplied

Lifestyle physical activity for individuals with spinal cord injury: a pilot study.

PURPOSE: To evaluate the acceptability and feasibility of a lifestyle physical activity program for people with spinal cord injury (SCI). METHODS: Sixteen nonexercising adult volunteers with SCI participated in a single group pre-post-test of the "Be Active in Life Program" comprising stage-matched educational materials, home visit by a nurse, construction of a personal plan to increase activity, and four follow-up phone calls. Program acceptability, stage of change, barriers to health-promoting activities, abilities for health practices, health, depression, and muscle strength were rated. Physical activity was monitored using actigraphy and a self-report record. RESULTS: Participants rated the program positively, although some preferred a structured exercise approach. Eighty-one percent of participants progressed in stage of change and 60% increased physical activity. There were significant changes in motivational barriers, exercise self-efficacy, self-rated health, and muscle strength. DISCUSSION: Lifestyle physical activity is feasible and acceptable and could be effective in promoting greater physical activity among people with SCI.

Adolescent↗