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Significance
Chronic wounds are associated with significant morbidity, marked loss of quality of life, and considerable economic burden. Evidence-based risk prediction to guide improved wound prevention and treatment is limited by the complexity in their etiology, clinical underreporting, and a lack of studies using large high-quality datasets.
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... of making intelligent machines, especially intelligent computer programs that exhibit characteristics associated with intelligence in human behavior including among other faculties of reasoning, learning, goal seeking, problem solving, and adaptability.'' 28 ML and deep learning are the subsets of AI, and deep learning is a subset of ML ( Fig. 1). To paraphrase Arthur Samuel, who coined the term, ML is a method for developing the models by using mathematical methods to make classifications and predictions, and discover patterns without being explicitly programmed. 29 Deep learning is the subcategory of ML that uses mul- layers of artificial neural networks to discover ...
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Background
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Introduction
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Citations
... The question that arises is: Is it necessary to apply manual approaches? We know that there is a plethora of manual and instrumental, invasive, and non-invasive treatments available, but none have proven to be the standard preferred choice [58][59][60]. The clinician's goal is to facilitate the recovery of the psychophysical autonomy of the person who suffers from pathological scars, in concert with the patient's awareness [61]. ...
The skin is a complex organ, a system that influences and is influenced by the body system, with different skin layers always mechano-biologically active. In the presence of a lesion that damages the dermis, the skin undergoes sensory, morphological, and functional alterations. The subsequent adaptation is the formation of scar tissue, following distinct and overlapping biological phases. For reasons not yet fully elucidated, some healing processes lead to pathological scars, from which symptoms such as pain, itching, and functional limitations are derived. Currently, there is no gold standard treatment that fully meets the needs of different scars and can eliminate any symptoms that the patient suffers. One such treatment is manual medicine, which involves direct manual approaches to the site of injury. Reviewing the phases that allow the skin to be remodeled following an injury, this article reflects on the usefulness of resorting to these procedures, highlighting erroneous concepts on which the manual approach is based, compared to what the current literature highlights the cicatricial processes. Considering pathological scar adaptations, it would be better to follow a gentle manual approach.
... Chronic wounds include a wide variety of aetiologies and intricate relationships between risk factors. Therefore, there is a critical need for trustworthy, proven risk prediction methods that can more effectively target each patient's particular set of predisposing factors, which affect each patient's likelihood of disease development and treatment response once chronic wounds have formed [7]. One of them is burns, an injury that can cause wounds, infection, ulcers, and trauma; however, those caused by chronic illnesses such as diabetes, vascular diseases, and cancers can lead to delay and low wound-healing progress [8]. ...
Wound care management is incredibly challenging for chronic injuries, despite the availability of various types of wound care products in the market. However, most current wound-healing products do not attempt to mimic the extracellular matrix (ECM) and simply provide a barrier function or wound covering. Collagen is a natural polymer that involves a major constituent of the ECM protein, thus making it attractive to be used in skin tissue regeneration during wound healing. This study aimed to validate the biological safety assessments of ovine tendon collagen type-I (OTC-I) in the accredited laboratory under ISO and GLP settings. It is important to ensure that the biomatrix will not stimulate the immune system to produce any adverse reaction. Therefore, we successfully extracted collagen type-I from the ovine tendon (OTC- I) using a method of low-concentration acetic acid. The three-dimensional (3D) skin patch of spongy OTC-I was a soft and white colour, being tested for safety and biocompatibility evaluations based on ISO 10993-5, ISO 10993-10, ISO 10993-11, ISO 10993-23, USP 40 <151>, and OECD 471. For the dermal sensitisation and acute irritation test, none of the tested animals displayed any erythema or oedema effects (p > 0.005). In addition, there were no abnormalities detected in the organ of the mice after being exposed to OTC-I; additionally, no morbidity and mortality were observed in the acute systemic test under the guideline of ISO 10993-11:2017. The grade 0 (non-reactive) based on ISO 10993-5:2009 was graded for the OTC-I at 100% concentration and the mean number of the revertant colonies did not exceed 2-fold of the 0.9% w/v sodium chloride compared to the tester strains of S. typhimurium (TA100, TA1535, TA98, TA1537), and E. coli (WP2 trp uvrA). Our study revealed that OTC-I biomatrix does not present any adverse effects or abnormalities in the present study’s condition of induced skin sensitization effect, mutagenic and cytotoxic towards cells and animals. This biocompatibility assessment demonstrated a good agreement between in vitro and in vivo results regarding the absence of skin irritation and sensitization potential. Therefore, OTC-I biomatrix is a potential medical device candidate for future clinical trials focusing on wound care management.
The future of wound care is on the cusp of a transformative technological revolution poised to redefine wound prevention, management and treatment. Advanced technologies are set to usher in a paradigm shift, optimising wound assessment, intervention, monitoring and patient engagement, resulting in improved outcomes, cost-efficiency and a patient-centred approach.
This impending technological revolution is driven by the pressing issue of healthcare staff shortages, which cast a significant shadow over the healthcare system. The shortage of qualified healthcare professionals, particularly nurses and wound care specialists, substantially challenges wound care quality, patient outcomes and the overall healthcare landscape. This chapter delves into the intricacies of this predicament and explores how evolving technologies are positioned to support wound care nurses in the coming years.
To mitigate the impact of nursing shortages on wound care, healthcare institutions must employ strategies such as hiring more wound care specialists, offering training and education programmes for existing staff, optimising wound care protocols and addressing nurse burnout and retention issues. Technologies such as advanced diagnostic modalities through artificial intelligence, smart wound dressings, 3D printing, regenerative therapies and telemedicine offer crucial tools to bridge care gaps during nursing shortages.
This guide aims to help healthcare professionals of all backgrounds make sense of economic evaluations to determine whether interventions represent value for money
