"ADVANCES AND CHALLENGES IN THE MANAGEMENT OF CHRONIC NON-HEALING WOUNDS: A CRITICAL REVIEW"
Main Article Content
Keywords
wound healing, non-healing wound, Dushta Vrana
Abstract
Maintaining the skin's barrier function requires the intricate and tightly controlled process of wound healing. Unfortunately, a number of contamination processes can interfere with the series of events that lead to wound healing, causing chronic wounds that never heal and putting a great deal of stress on both the patient and the healthcare system. Numerous variables need to be considered in order for a superficial wound to heal, and therapies and dressings for wounds have been created to address the challenges that can arise, such as pressure and infection. Wound tissue never fully recovers to its pre-injury strength, even during optimal healing, and certain aberrant healing states can result in chronic wounds that never fully heal. A chronic wound is one that does not heal in the expected stages and timeframe, or one that does not heal within three months. These wounds often remain in the inflammatory stage for too long and may never heal or take years. Chronic wound patients often experience persistent pain, which is the main problem for those with chronic ulcers. Some wounds may not heal easily due to their severity or the poor health of the individual. Any wound that does not heal within a few weeks should be examined by a healthcare professional, as it may be infected or indicative of an underlying disease. This article will discuss the structure of non-healing wounds and current strategies for treating chronic non-healing wounds.
References
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9. W. A. Zamboni, H. P. Wong, L. L. Stephenson, and M. A. Pfeifer, "Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study,"Undersea and Hyperbaric Medicine, vol.24, no. 3, pp. 175-179, 1997[63] P. Kranke, M. Bennett, I. Roeckl-Wiedmann, and S. Debus.
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11. Groppa, E.; Colliva, A.; Vuerich, R.; Kocijan, T.; Zacchigna, S.Immune Cell Therapies to Improve Regeneration and Revascularization of Non-Healing Wounds. Int. J. Mol. Sci. 2020, 21, 5235. https://doi.org/10.3390/ijms21155235. Clinical study on orthopaedic treatment of chronic osteomyelitis with soft tissue defect in adults, International Wound Journal, 10.1111/iwj.13729.
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27. Serra R, Rizzuto A, Rossi A, Perri P, Barbetta A, Abdalla K, Caroleo S, Longo C, Amantea B, Sammarco G, de Franciscis S. Skin grafting for the treatment of chronic leg ulcers - a systematic review in evidence-based medicine. Int Wound J. 2017 Feb;14(1):149-157. doi: 10.1111/iwj.12575. Epub 2016 Mar 4. PMID: 26940940; PMCID: PMC7949524.
28. Paneysar JS, Barton S, Ambre P, Coutinho E. Novel Temperature Responsive Films Impregnated with Silver Nano Particles (Ag-NPs) as Potential Dressings for Wounds. J Pharm Sci. 2022 Mar;111(3):810-817. doi: 10.1016/j.xphs.2021.11.009. Epub 2021 Nov 20. PMID: 34808215.
29. Xu DH, Zhu Z, Fang Y. The Effect of a Common Antibiotics Doxycycline on Non-Healing Chronic Wound. Curr Pharm Biotechnol. 2017;18(5):360-364. doi: 10.2174/1389201018666170519095339. PMID: 28524000.
30. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27://dx.doi.org/10.7897/2277-4343.096166d
31. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27 http://dx.doi.org/10.7897/2277-4343.096166
32. Asutkar, S. G., &Bhatbhage, B. (2018). A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana) In Patients of DushtaVrana w. s. r. Chronic Non-Healing Wound. Airline: International Journal of Research in Indian Medicine, 2(06). https://doi.org/10.52482/ayurline.v2i06.158
33. Singh A, Singh AK, Narayan G, Singh TB, Shukla VK. Effect of Neem oil and Haridra on non-healing wounds. AYU [serial online] 2014 [cited 2022 Jul 3];35:398-403. Available from: https://www.ayujournal.org/text.asp?2014/35/4/398/158998
34. Tukaram S. Dudhamal, S. K. Gupta, and C. Bhuyan Role of honey (Madhu) in the management of wounds (Dushta Vrana)Int J Ayurveda Res. 2010 Oct-Dec; 1(4): 271–273.DOI: 10.4103/0974-7788.76793 PMCID: PMC3059452 PMID: 21455457
35. Teguh DN, Bol Raap R, Koole A, Knippenberg B, Smit C, Oomen J, van Hulst RA. Hyperbaric oxygen therapy for nonhealing wounds: Treatment results of a single center. Wound Repair Regen. 2021 Mar;29(2):254-260. doi: 10.1111/wrr.12884. Epub 2020 Dec 30. PMID: 33377598; PMCID: PMC7986203
36. Groppa E, Colliva A, Vuerich R, Kocijan T, Zacchigna S. Immune Cell Therapies to Improve Regeneration and Revascularization of Non-Healing Wounds. Int J Mol Sci. 2020 Jul 23;21(15):5235. doi: 10.3390/ijms21155235. PMID: 32718071; PMCID: PMC7432547.
37. Zhang X, Wang G, Sun Y, Ding P, Yang X, Zhao Z. The Z‐plasty contributes to the coalescence of a chronic non‐healing wound. Int Wound J. 2021;18:796–804. 10.1111/iwj.13583 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
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40. Ansari TA, Barik S, Meena P, Arora S. Comparison of Topical Oxygen with Vacuum Assisted Closure in Wound Healing in a Low Resource Setting. Ethiop J Health Sci. 2022 Sep;32(5):955-962. doi: 10.4314/ejhs.v32i5.11. PMID: 36262707; PMCID: PMC9554766.
41. Jones V, Grey JE, Harding KG. Wound dressings. BMJ. 2006;332(7544):777–780. doi: 10.1136/bmj.332.7544.777. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
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43. Beckmann KH, Meyer-Hamme G, Schröder S. Low level laser therapy for the treatment of diabetic foot ulcers: a critical survey. Evid Based Complement Alternat Med. 2014;2014:626127. doi: 10.1155/2014/626127. Epub 2014 Mar 16. PMID: 24744814; PMCID: PMC3976827.
44. Sebastian KMS, Lobato I, Hernandez I, et al. Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: phase III study. BMC Fam Pract. 2014;15:211. doi: 10.1186/s12875-014-0211-8. [PMC free article] [PubMed] [CrossRef] [Google Scholar] Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27://dx.doi.org/10.7897/2277-4343.096166d
45. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27 http://dx.doi.org/10.7897/2277-4343.096166
46. Asutkar, S. G., &Bhatbhage, B. (2018). A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana) In Patients of DushtaVrana w. s. r. Chronic Non-Healing Wound. Ayrline: International Journal of Research in Indian Medicine, 2(06). https://doi.org/10.52482/ayurline.v2i06.158
47. Singh A, Singh AK, Narayan G, Singh TB, Shukla VK. Effect of Neem oil and Haridra on non-healing wounds. AYU [serial online] 2014 [cited 2022 Jul 3];35:398-403. Available from: https://www.ayujournal.org/text.asp?2014/35/4/398/158998
48. Tukaram S. Dudhamal, S. K. Gupta, and C. Bhuyan Role of honey (Madhu) in the management of wounds (Dushta Vrana)Int J Ayurveda Res. 2010 Oct-Dec; 1(4): 271–273.DOI: 10.4103/0974-7788.76793 PMCID: PMC3059452 PMID: 21455457
2. Gurtner GC, Werner S, Barrandon Y, Longaker MT (2008) Wound repair and regeneration. Nature 453(7193):314-321.doi:10.1038/nature07039 3. Harding KG, Morris HL, Patel GK (2002) Science, medicine and the future: healing chronic wounds. BMJ 324(7330):160163
3. Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TK et al (2009) Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen Off Publ Wound Heal Soc Eur Tissue Repair Soc 17(6):76
4. Bailey and Love's Short Practice of Surgery: Edited by Norman S. Williams, Christopher J.K.Bulstrode and P.Ronan O' Connell Published by London, Hodder Education, 25th. Edition-2008, Chapter 3, Pg. No.24-256.
5. Sushruta; Sushruta Samhita, Ayurvedtatvasandipika, edited by kaviraj Dr Ambikadattashastri: Published by Varanasi, Choukambha Surbharati Prakashan -2007. Chikitsa Sthana 1/57-58, Pg. No.10.
6. Pankaj B. Patil Dissertation of Rajiv Gandhi University of Health Science Bangalore, Karnataka 2011 Page No.81(VB GroupApplication)
7. S. Hunter, D. K. Langemo, J. Anderson, D. Hanson, and P. Thompson, "Hyperbaric oxygen therapy for chronic wounds,"Advances in Skin &Wound Care, vol. 23, no. 3, pp. 116 119,2010.
8. J. V. Boykin, "Hyperbaric oxygen therapy: a physiological approach to selected problem wound healing,"Wounds, vol.8, no. 6, pp. 183-198, 1996.
9. W. A. Zamboni, H. P. Wong, L. L. Stephenson, and M. A. Pfeifer, "Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study,"Undersea and Hyperbaric Medicine, vol.24, no. 3, pp. 175-179, 1997[63] P. Kranke, M. Bennett, I. Roeckl-Wiedmann, and S. Debus.
10. Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device: a review. Am J Clin Dermatol. 2005;6(3):185-94.
11. Groppa, E.; Colliva, A.; Vuerich, R.; Kocijan, T.; Zacchigna, S.Immune Cell Therapies to Improve Regeneration and Revascularization of Non-Healing Wounds. Int. J. Mol. Sci. 2020, 21, 5235. https://doi.org/10.3390/ijms21155235. Clinical study on orthopaedic treatment of chronic osteomyelitis with soft tissue defect in adults, International Wound Journal, 10.1111/iwj.13729.
12. homas J Koob, Robert Rennert, Nicole Zabek, Michelle Massee, Jeremy J Lim, Johnna S Temenoff, William W Li, Geoffrey Gurtner, Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing, International Wound Journal, 10.1111/iwj.12140, 10, 5, (493-500), (2013).
13. Mulder G, Jones R, Cederholm-Williams S, Cherry G, Ryan T. Fibrin cuff lysis in chronic venous ulcers treated with a hydrocolloid dressing. Int J Dermatol. 1993;32(4):304–306. doi: 10.1111/j.1365-4362.1993.tb04275.x. [PubMed] [CrossRef] [Google Scholar]
14. Brem H, Stojadinovic O, Diegelmann R, Entero H, Lee B, Pastar I, et al. Molecular markers in patients with chronic wounds to guide surgical debridement. Mol Med. 2007;13(1–2):30–9. [PMC free article] [PubMed] [Google Scholar]
15. 19.Pereira FLC, Ferreira MVL, da Silva Mendes P, Rossi FM, Alves MP, Alves BLP. Use of a high-power laser for wound healing: a case report. J Lasers Med Sci. 2020;11(1):112-114. doi:10.15171/jlms.2020.19.
16. Suthar, M., Gupta, S., Bukhari, S. et al. Treatment of chronic non-healing ulcers using autologous platelet rich plasma: a case series. J Biomed Sci 24, 16 (2017).
17. Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med 1999;341:738-46.
18. Cited Here | View Full Text | PubMed | CrossRef 22.
19. Fathke C, Wilson L, Hutter J, et al. Contribution of bone marrow-derived cells to skin: collagen deposition and wound repair. Stem Cells 2004;22:812-22. Cited Here | PubMed | CrossRef
20. Lau K, Paus R, Tiede S, Day P, Bayat A. Exploring the role of stem cells in cutaneous wound healing. Exp Dermatol 2009;18:921-33. Cited Here | View Full Text | PubMed | CrossRef .
21. Li WW, Talcott KE, Zhai AW, Kruger EA, Li VW. The role of therapeutic angiogenesis in tissue repair and regeneration. Adv Skin Wound Care 2005;18:491-500. Cited Here | View Full Text | PubMed | CrossRef
22. Wu Y, Chen L, Scott PG, Tredget EE. Mesenchymal stem cells enhance wound healing through differentiation and angiogenesis. Stem Cells 2007;25:2648-59.Cited Here | PubMed | CrossRef
23. Sasaki M, Abe R, Fujita Y, Ando S, Inokuma D, Shimizu H. Mesenchymal stem cells are recruited into wounded skin and contribute to wound repair by transdifferentiation into multiple skin cell type. J Immunol 2008;180:2581-7. Cited Here | PubMed | CrossRef
24. Li H, Fu X, Ouyang Y, Cai C, Wang J, Sun T. Adult bone-marrow-derived mesenchymal stem cells contribute to wound healing of skin appendages. Cell Tissue Res 2006;326:725-36.
25. .Zheng-Ying Jiang, Xiao-Ting Yu, Xin-Cheng Liao, Ming-Zhuo Liu, Zhong-Hua Fu, Ding-Hong Min, Guang-Hua Guo Negative-pressure wound therapy in skin grafts: A systematic review and meta-analysis of randomized controlled trials
26. Junwei Xu a, Yunxue Jia a, Weizhen Huang a, Qiusheng Shi a, Xuemei Sun a, Lisha Zheng a, Ming Wang b, Ping Li a Non-contact electrical stimulation as an effective means to promote wound healing.
27. Serra R, Rizzuto A, Rossi A, Perri P, Barbetta A, Abdalla K, Caroleo S, Longo C, Amantea B, Sammarco G, de Franciscis S. Skin grafting for the treatment of chronic leg ulcers - a systematic review in evidence-based medicine. Int Wound J. 2017 Feb;14(1):149-157. doi: 10.1111/iwj.12575. Epub 2016 Mar 4. PMID: 26940940; PMCID: PMC7949524.
28. Paneysar JS, Barton S, Ambre P, Coutinho E. Novel Temperature Responsive Films Impregnated with Silver Nano Particles (Ag-NPs) as Potential Dressings for Wounds. J Pharm Sci. 2022 Mar;111(3):810-817. doi: 10.1016/j.xphs.2021.11.009. Epub 2021 Nov 20. PMID: 34808215.
29. Xu DH, Zhu Z, Fang Y. The Effect of a Common Antibiotics Doxycycline on Non-Healing Chronic Wound. Curr Pharm Biotechnol. 2017;18(5):360-364. doi: 10.2174/1389201018666170519095339. PMID: 28524000.
30. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27://dx.doi.org/10.7897/2277-4343.096166d
31. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27 http://dx.doi.org/10.7897/2277-4343.096166
32. Asutkar, S. G., &Bhatbhage, B. (2018). A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana) In Patients of DushtaVrana w. s. r. Chronic Non-Healing Wound. Airline: International Journal of Research in Indian Medicine, 2(06). https://doi.org/10.52482/ayurline.v2i06.158
33. Singh A, Singh AK, Narayan G, Singh TB, Shukla VK. Effect of Neem oil and Haridra on non-healing wounds. AYU [serial online] 2014 [cited 2022 Jul 3];35:398-403. Available from: https://www.ayujournal.org/text.asp?2014/35/4/398/158998
34. Tukaram S. Dudhamal, S. K. Gupta, and C. Bhuyan Role of honey (Madhu) in the management of wounds (Dushta Vrana)Int J Ayurveda Res. 2010 Oct-Dec; 1(4): 271–273.DOI: 10.4103/0974-7788.76793 PMCID: PMC3059452 PMID: 21455457
35. Teguh DN, Bol Raap R, Koole A, Knippenberg B, Smit C, Oomen J, van Hulst RA. Hyperbaric oxygen therapy for nonhealing wounds: Treatment results of a single center. Wound Repair Regen. 2021 Mar;29(2):254-260. doi: 10.1111/wrr.12884. Epub 2020 Dec 30. PMID: 33377598; PMCID: PMC7986203
36. Groppa E, Colliva A, Vuerich R, Kocijan T, Zacchigna S. Immune Cell Therapies to Improve Regeneration and Revascularization of Non-Healing Wounds. Int J Mol Sci. 2020 Jul 23;21(15):5235. doi: 10.3390/ijms21155235. PMID: 32718071; PMCID: PMC7432547.
37. Zhang X, Wang G, Sun Y, Ding P, Yang X, Zhao Z. The Z‐plasty contributes to the coalescence of a chronic non‐healing wound. Int Wound J. 2021;18:796–804. 10.1111/iwj.13583 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
38. Faulk WP, Matthews R, Stevens PJ, Bennett JP, Burgos H, Hsi BL. Human amnion as an adjunct in wound healing. Lancet 1980;1:1156–8. [PubMed] [Google Scholar]
39. Ramakrishnan KM, Jayaraman V. Management of partial‐thickness burn wounds by amniotic membrane: a cost‐effective treatment in developing countries. Burns 1997;23(Suppl 1):S33–6. [PubMed] [Google Scholar]
40. Ansari TA, Barik S, Meena P, Arora S. Comparison of Topical Oxygen with Vacuum Assisted Closure in Wound Healing in a Low Resource Setting. Ethiop J Health Sci. 2022 Sep;32(5):955-962. doi: 10.4314/ejhs.v32i5.11. PMID: 36262707; PMCID: PMC9554766.
41. Jones V, Grey JE, Harding KG. Wound dressings. BMJ. 2006;332(7544):777–780. doi: 10.1136/bmj.332.7544.777. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
42. Ramundo J, Gray M. Enzymatic wound debridement. J Wound Ostomy Continence Nurs. 2008 May-Jun;35(3):273-80. doi: 10.1097/01.WON.0000319125.21854.78. PMID: 18496083.
43. Beckmann KH, Meyer-Hamme G, Schröder S. Low level laser therapy for the treatment of diabetic foot ulcers: a critical survey. Evid Based Complement Alternat Med. 2014;2014:626127. doi: 10.1155/2014/626127. Epub 2014 Mar 16. PMID: 24744814; PMCID: PMC3976827.
44. Sebastian KMS, Lobato I, Hernandez I, et al. Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: phase III study. BMC Fam Pract. 2014;15:211. doi: 10.1186/s12875-014-0211-8. [PMC free article] [PubMed] [CrossRef] [Google Scholar] Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27://dx.doi.org/10.7897/2277-4343.096166d
45. Jetesh Ray et al. Clinical study on doorvadi taila in management of dushta Vrana. Int. J. Res. Ayurveda Pharm. 2018;9(6):22-27 http://dx.doi.org/10.7897/2277-4343.096166
46. Asutkar, S. G., &Bhatbhage, B. (2018). A Conceptual Study of Wound Bed Preparation by Leech Therapy (Jallaukavacharana) In Patients of DushtaVrana w. s. r. Chronic Non-Healing Wound. Ayrline: International Journal of Research in Indian Medicine, 2(06). https://doi.org/10.52482/ayurline.v2i06.158
47. Singh A, Singh AK, Narayan G, Singh TB, Shukla VK. Effect of Neem oil and Haridra on non-healing wounds. AYU [serial online] 2014 [cited 2022 Jul 3];35:398-403. Available from: https://www.ayujournal.org/text.asp?2014/35/4/398/158998
48. Tukaram S. Dudhamal, S. K. Gupta, and C. Bhuyan Role of honey (Madhu) in the management of wounds (Dushta Vrana)Int J Ayurveda Res. 2010 Oct-Dec; 1(4): 271–273.DOI: 10.4103/0974-7788.76793 PMCID: PMC3059452 PMID: 21455457
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Dr. Pradeep Kumar Pradhan, Prof. Dr. Sheetal Asutkar, Dr. Yogesh Yadav, & Pratiksha Mandaokar. (2022). "ADVANCES AND CHALLENGES IN THE MANAGEMENT OF CHRONIC NON-HEALING WOUNDS: A CRITICAL REVIEW". Journal of Population Therapeutics and Clinical Pharmacology, 29(02), 581-590. https://doi.org/10.53555/jg7zfj85
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Author Biographies
Dr. Pradeep Kumar Pradhan
PhD Scholar, Department of Shalya Tantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod Wardha, Maharashtra
Prof. Dr. Sheetal Asutkar
S., PhD, Fellow Ayu Oncology, Prof and Head of Department, Department of Shalya Tantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod Wardha, Maharashtra
Dr. Yogesh Yadav
B.A.M.S., PG Scholar, Department of Shalya Tantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod Wardha, Maharashtra
Pratiksha Mandaokar
Intern, Mahatma Gandhi Ayurveda College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Salod Wardha, Maharashtra
How to Cite
Dr. Pradeep Kumar Pradhan, Prof. Dr. Sheetal Asutkar, Dr. Yogesh Yadav, & Pratiksha Mandaokar. (2022). "ADVANCES AND CHALLENGES IN THE MANAGEMENT OF CHRONIC NON-HEALING WOUNDS: A CRITICAL REVIEW". Journal of Population Therapeutics and Clinical Pharmacology, 29(02), 581-590. https://doi.org/10.53555/jg7zfj85