Publications by authors named "Lucian Vlad"
Background: The Wound Care Collaborative Community (WCCC) aims to assess current usable real-world data (RWD) sources to determine which real-world databases (DBs) are suitable and usable for studying the natural history of chronic wounds. Randomized controlled trials (RCTs) do not fully reflect the complexity of patients with chronic wounds. Using RWD, establishment of a scientifically grounded "road map" for RCTs is needed to better navigate the real-world complexity of the patients with chronic wounds.
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- The study investigated the relationship between albumin levels and healing outcomes in patients with diabetic foot ulcers (DFU) over a 12-week treatment period, suggesting that hypoalbuminemia could serve as a risk factor for amputation.
- A retrospective review of 793 patients identified 62 who met inclusion criteria; however, initial albumin levels did not significantly differ between those who healed and those who did not after 12 weeks.
- Findings indicated that while albumin trends had weak correlation with wound healing, a negative trend in albumin was linked to an increase in wound size, limiting albumin’s effectiveness as a bioindicator of healing capacity in the short term.
Objective: Venous leg ulcers (VLUs) are considered the most frequent category of hard-to-heal limb ulcers. Although evidence-based care of VLUs suggests that compression therapy plays a pivotal role in the standard of care, patient adherence is considered low, with at least 33% non-compliance, either due to perceived problems from clinicians regarding their own competency in applying the bandages, or from the patient finding the wrapping bothersome. For many years, four-layer bandaging has been considered the 'gold standard', but application can be difficult and may also prove uncomfortable for patients.
View Article and Find Full Text PDFVitamin A is a general term for retinoids. Vitamin A deficiency leads to a variety of cutaneous manifestations. It also functions as a hormone through retinoic acid receptors altering the activity of multiple cell lines.
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- The use of ultra-portable, mechanically powered disposable negative pressure wound therapy (dNPWT) is increasing for managing wounds in outpatient care and transitioning inpatients to home care, showing similar effectiveness to electric versions.
- Very few studies exist on best practices for dNPWT across different wound types, indicating a need for comprehensive clinical guidelines and knowledge on reimbursement processes.
- A panel of experts has developed recommendations for using dNPWT, including optimal patient selection, wound preparation, and reimbursement guidelines, aimed at improving clinical outcomes and economic value.
There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished.
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