Journal articles on the topic 'Portable wound treatment'
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Wang, Shuai, Dehui Xu, Miao Qi, Bing Li, Sansan Peng, Qiaosong Li, Hao Zhang, and Dingxin Liu. "Plasma-Activated Water Promotes Wound Healing by Regulating Inflammatory Responses." Biophysica 1, no. 3 (July 7, 2021): 297–310. http://dx.doi.org/10.3390/biophysica1030022.
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Infection can hinder the process of wound healing, so it is important to begin antibacterial treatment quickly after a wound forms. Plasma activated water (PAW) can inactivate a variety of common wound infection bacteria. In this study, we compared the effects of PAW prepared with portable surface discharge plasma equipment and medical alcohol on wound healing in a mouse full-thickness skin wound model. The effectiveness of wound healing processes in mice was ranked accordingly: PAW treatment group > medical alcohol treatment group > control group. In order to further understand the mechanism of PAW in promoting wound healing, we tested the expression levels of the pro-inflammatory factors interleukin (IL)-1β and IL-6, the anti-inflammatory factor IL-10, and vascular endothelial growth factor (VEGF). The results showed that PAW promoted the release of pro-inflammatory factors and anti-inflammatory factors from the wounds in mice, which allowed the mice in the treatment group to transition out of the inflammatory period early and enter the next stage of wound healing. The expression level of VEGF in the wounds of mice in the PAW treatment group was higher, which indicates that the microvessels around the wound in the PAW treatment group proliferated faster, and thus the wound healed faster. PAW biosafety experiments showed that PAW did not significantly affect the appearance, morphology, or tissue structure of internal organs, or blood biochemical indicators in mice. In general, PAW prepared via portable devices is expected to become more widely used given its convenience, affordability, and lack of side effects in promoting wound healing.
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Cordova, Leonardo Zandavalli, Jennifer Martins, and Patricia Terrill. "Negative pressure wound therapy in the management of complex lower limb wounds: a case series highlighting outpatient care with small single-use devices." Wound Practice and Research 27, no. 3 (September 2019): 116–21. http://dx.doi.org/10.33235/wpr.27.3.116-121.
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Background: Traditionally, the treatment of exposed tendon has required vascularised tissue coverage, usually with complex surgical intervention. The introduction of negative pressure wound therapy (NPWT) has challenged this traditional reconstructive concept. Unfortunately, standard NPWT units are usually bulky, noisy and curtail the mobility and lifestyle of patients. The introduction of small, modern, lightweight, portable, single-use NPWT units have therefore revitalised the use of NPWT and provided a solution to the many problems encountered with the larger devices. Case series: This study highlights three cases of patients with complex lower limb wounds with tendon exposure who were successfully treated with single-use NPWT in an outpatient setting. The median time for complete wound granulation was 5–10 weeks. Minor sharp debridement of wounds was required to encourage granulation tissue formation and this was well tolerated in the outpatient setting. Conclusion: Portable NPWT units provide an alternative to surgical reconstruction in patients with lower limb wounds with exposed tendon. These devices can be utilised in a purely outpatient setting, thus avoid long-term hospitalisation. Older patients with high anaesthesia risk or who lack alternative reconstructive options due to vascular co-morbidities are the most appropriate candidates for this treatment option.
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Ma, Wenping, Hongshi Ma, Pengfei Qiu, Hongjian Zhang, Zhibo Yang, Bing Ma, Jiang Chang, Xun Shi, and Chengtie Wu. "Sprayable β-FeSi2 composite hydrogel for portable skin tumor treatment and wound healing." Biomaterials 279 (December 2021): 121225. http://dx.doi.org/10.1016/j.biomaterials.2021.121225.
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Choi, Min Hyub, Dong Seok Shin, Ji Seon Cheon, Kyung Min Son, and Woo Young Choi. "Effective Single-Use Portable Negative Pressure Therapy Used in Acute Morel-Lavallee Lesions: A Case Report." Journal of Wound Management and Research 18, no. 1 (February 28, 2022): 58–61. http://dx.doi.org/10.22467/jwmr.2021.01907.
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Morel-Lavallee (ML) lesions are closed degloving injuries characterized by post-traumatic fluid collection and nonspecific clinical features, such as pain and soft, fluctuant appearance. Though often misdiagnosed, they can be identified by analyzing the patient’s clinical trauma history, fluid collection in a typical location, and imaging findings. After diagnosis, various treatments can be attempted, from conservative treatment to surgery, depending on the condition of the wound. Acute ML lesions can be treated conservatively. If traditional compression therapy, such as using gauze and elastic bandage, is difficult to maintain due to the patient’s daily activities, negative pressure wound therapy may be an effective choice of treatment. Herein, we introduce an effective treatment case using a single-use portable negative pressure wound therapy device for an acute ML lesion.
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Ofstead, Cori L., Brandy L. Buro, Krystina M. Hopkins, and John E. Eiland. "The impact of continuous electrical microcurrent on acute and hard-to-heal wounds: a systematic review." Journal of Wound Care 29, Sup7 (July 1, 2020): S6—S15. http://dx.doi.org/10.12968/jowc.2020.29.sup7.s6.
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Background: Wound infections result in considerable morbidity, mortality and healthcare costs. Antibiotic resistance has complicated wound healing, and new, non-antibiotic-based treatment methods are being developed. Aims: To evaluate evidence on the safety, efficacy and real-world effectiveness of electroceutical devices (ECDs) that provide continuous electrical stimulation to wounds. Method: A systematic search was conducted to identify primary studies published between 2009 and 2019 that described therapeutic wound treatment using portable ECDs. Studies were included if the ECD delivered continuous electrical current directly to the wound area for the duration of treatment. Results: Of 171 citations identified in the search, 13 articles met the inclusion criteria and were analysed. Nine studies evaluated dressings embedded with zinc and silver particles that generated electricity electrochemically, and four evaluated electrode-based units with external batteries. ECDs were effective in healing complex, hard-to-heal wounds that had not responded to other treatments. Four studies showed that ECDs led to complete closure of wounds without complications, and in some cases healed wounds faster than standard of care (SOC). One study found that ECDs resulted in higher ratings by both patients and surgeons than SOC for the progression of wound healing and scar appearance. Additionally, three studies found ECD treatment was less expensive than SOC, due to patients requiring fewer dressing changes or nurse visits. Conclusion: ECDs appeared to be a safe, effective and cost-effective method for treating severe, complex and challenging wounds, including hard-to-heal wounds, surgical incisions and skin graft donor sites.
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Xu, Dehui, Shuai Wang, Bing Li, Miao Qi, Rui Feng, Qiaosong Li, Hao Zhang, Hailan Chen, and Michael G. Kong. "Effects of Plasma-Activated Water on Skin Wound Healing in Mice." Microorganisms 8, no. 7 (July 21, 2020): 1091. http://dx.doi.org/10.3390/microorganisms8071091.
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Cold atmospheric plasma (CAP) has been widely used in biomedicine during the last two decades. While direct plasma treatment has been reported to promote wound healing, its application can be uneven and inconvenient. In this study, we first activated water with a portable dielectric barrier discharge plasma device and evaluated the inactivation effect of plasma-activated water (PAW) on several kinds of bacteria that commonly infect wounds. The results show that PAW can effectively inactivate these bacteria. Then, we activated tap water and examined the efficacy of PAW on wound healing in a mouse model of full-thickness skin wounds. We found that wound healing in mice treated with PAW was significantly faster compared with the control group. Histological analysis of the skin tissue of mice wounds showed a significant reduction in the number of inflammatory cells in the PAW treatment group. To identify the possible mechanism by which PAW promotes wound healing, we analyzed changes in the profiles of wound bacteria after PAW treatment. The results show that PAW can significantly reduce the abundance of wound bacteria in the treatment group. The results of biochemical blood tests and histological analysis of major internal organs in the mice show that PAW had no obvious side effects. Taken together, these results indicate that PAW may be a new and effective method for promoting wound healing without side effects.
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Liu, Xinkuan, Haixia Xu, Mingxin Zhang, and Deng-Guang Yu. "Electrospun Medicated Nanofibers for Wound Healing: Review." Membranes 11, no. 10 (October 9, 2021): 770. http://dx.doi.org/10.3390/membranes11100770.
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With the increasing demand for wound care and treatment worldwide, traditional dressings have been unable to meet the needs of the existing market due to their limited antibacterial properties and other defects. Electrospinning technology has attracted more and more researchers’ attention as a simple and versatile manufacturing method. The electrospun nanofiber membrane has a unique structure and biological function similar to the extracellular matrix (ECM), and is considered an advanced wound dressing. They have significant potential in encapsulating and delivering active substances that promote wound healing. This article first discusses the common types of wound dressing, and then summarizes the development of electrospun fiber preparation technology. Finally, the polymers and common biologically active substances used in electrospinning wound dressings are summarized, and portable electrospinning equipment is also discussed. Additionally, future research needs are put forward.
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Sezai, Akira, Satoshi Unosawa, Makoto Taoka, Shunji Osaka, Yoshiki Kitazumi, Keito Suzuki, Toshiko Nakai, and Masashi Tanaka. "New Treatment for Driveline Infection Following Implantation of a Ventricular Assist Device." Heart Surgery Forum 23, no. 2 (March 13, 2020): E132—E134. http://dx.doi.org/10.1532/hsf.2899.
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In patients with an implantable ventricular assist device (VAD), driveline infection (DLI) is a challenging complication. Once DLI occurs, it may lead to pump contamination and/or septicemia, which means that early treatment is essential. We hereby report our initial experiences of a mechanically-powered portable negative pressure wound therapy system (Smart Negative Pressure: SNaPTM) to treat DLI at an outpatient clinic.
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Kasyan, A. R., V. U. Sataev, and V. G. Alyangin. "Portable Diode Laser Scalpel in Treatment of Ingrown Toenails in Children." Creative surgery and oncology 9, no. 1 (April 25, 2019): 31–36. http://dx.doi.org/10.24060/2076-3093-2019-9-1-31-36.
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Introduction.The ingrown nail (onychocryptosis) is a disease that is common both among children and in adult population. Despite the fact that there is a large number of methods available for the treatment of ingrown nails, a large percentage of recurrence of the disease remains unconquered. Traditional methods of treatment today are often complemented by chemical matrixectomy, cryodestruction, electrocoagulation or laser destruction of the growth zone of the nail plate piece being removed. The purpose of all of these methods of treatment is the reduction of the recurrence of the disease. This study aims to examine the possibilities of using a portable diode laser scalpel for the treatment of ingrown nails in children.Materials and methods.In this study the authors compared treatment outcomes in patients with ingrown toenails treated with the original Winograd procedure (30 patients) with those treated with the same procedure complemented by the laser destruction of the growth zone (50 patients).Results and discussion.There was one relapse case in the study group (n=50, 2%), and two — in the control group (n=30, 6.7 %). The healing period of the postoperative wound amounted to 17.3±2.05 days in the study group and to 12.25±1.24 days in control. Pain VAS scores on the first day following the surgery were 6.2±1.24 in the study group, and 5.8±0.816 in control. Staphylococcus aureus was the pathogen responsible for the local infection process in most patients with ingrown nails.Conclusion. This study demonstrates that using the method proposed results in the reduction of the risk of recurrence of the disease from 6.7% down to 2%, increasing, however, the healing time of the postoperative wound from 12.25±1.24 to 17.3±2.05 days. This makes the use of the method proposed advisable in patients with: a stage III ingrown nail; an apparent local infectious process; a recurrent ingrown nail.
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Milne, Jeanette, Amelia Swift, Jennifer Smith, and Robin Martin. "Electrical stimulation for pain reduction in hard-to-heal wound healing." Journal of Wound Care 30, no. 7 (July 2, 2021): 568–80. http://dx.doi.org/10.12968/jowc.2021.30.7.568.
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Objective: Despite treatment advances over the past 30 years, the societal impact of hard-to-heal wounds is increasingly burdensome. An unresolved issue is wound pain, which can make many treatments, such as compression in venous leg ulcers, intolerable. The aim of this review is to present the evidence and stimulate thinking on the use of electrical stimulation devices as a treatment technology with the potential to reduce pain, improve adherence and thus hard-to-heal wound outcomes. Method: A literature search was conducted for clinical studies up to August 2020 reporting the effects of electrical stimulation devices on wound pain. Devices evoking neuromuscular contraction or direct spinal cord stimulation were excluded. Results: A total of seven publications (three non-comparative and four randomised trials) were identified with four studies reporting a rapid (within 14 days) reduction in hard-to-heal wound pain. Electrical stimulation is more widely known for accelerated healing and is one of the most evidence-based technologies in wound management, supported by numerous in vitro molecular studies, five meta-analyses, six systematic reviews and 30 randomised controlled trials (RCTs). Despite this wealth of supportive evidence, electrical stimulation has not yet been adopted into everyday practice. Some features of electrical stimulation devices may have hampered adoption in the past. Conclusion: As new, pocket-sized, portable devices allowing convenient patient treatment and better patient adherence become more widely available and studied in larger RCTs, the evidence to date suggests that electrical stimulation should be considered part of the treatment options to address the challenges of managing and treating painful hard-to-heal wounds.
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Nuutila, Kristo, Victoria Diaz, Kristin Anselmo, Shomita Steiner, Chandan K. Sen, Anders H. Carlsson, Rodney K. Chan, and Sashwati Roy. "51 Wireless Electroceutical Dressing for the Treatment of Biofilm Infected Burn Wounds." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S35. http://dx.doi.org/10.1093/jbcr/irac012.054.
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Abstract Introduction Burn injuries are common to all military conflicts. In combat, eradication and prevention of burn wound infection is complicated by high rates of soft tissue contamination and prolonged delays to definitive stateside care. Furthermore, in the battlefield setting the salvage rate for infected burned extremities is low. Therefore, a simple, easy, non-invasive and rapid method to protect the wound, while also inhibiting infection, would represent a significant advance in the treatment of combat burn wounds. The purpose of this clinical trial was to investigate the efficacy of an FDA approved disposable and easily portable, wireless electroceutical dressing (WED) in the treatment of burn wounds. The hypothesis was that a low electric field generated by the moisture-activated WED will reduce infection load, improve graft survival and take, enhance wound healing and restore skin barrier function of biofilm infected wounds. Methods A phase I, prospective, randomized, controlled clinical trial was performed to evaluate the efficacy of the WED dressing as compared to the standard of care (SoC) dressing to prevent and disrupt biofilms. Subjects were screened from inpatient admissions for traumatic burns >300cm2 in size. In total 38 subjects were enrolled to the study. Subject burn wounds were divided into two parts and randomized to receive either the SoC dressing or the WED dressing. Dressings were changed on day 4, removed on day 7 and the burns were followed for 30 days. Small biopsies were collected on days 4 and 7 for histology, SEM examination of biofilm and for quantitative bacteriological analysis. In addition, non-invasive wound imaging techniques were utilized to study wound healing. Furthermore, Vancouver scar scale and patient observer scar assessment were used to evaluate quality of healing. Results The results showed that at the time of dressing removal, non-grafted burns that were treated with the WED dressing presented statistically significantly less biofilm in comparison to the SoC treated burns (p < 0.05). The results also demonstrated that the WED dressing was more efficient at eradicating biofilm than the SoC dressing. At the time of the dressing removal, biofilm score [0-3] had decreased in 48% of the WED dressing treated burns in comparison to 28% in the SoC treated burns. In terms of wound healing and quality of healing no significant differences were observed between the WED and the SoC dressings. Conclusions This trial demonstrated that the WED dressing was more efficient against biofilm infection than the SoC dressing. In addition, the study concluded that the WED dressing performed equally well as the SoC in terms of burn wound healing.
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Brown, Sara, and Gilly Glendewar. "Portable Negative Pressure Wound Therapy: A Case Study of a Patient Treated in the Community in Jersey." British Journal of Community Nursing 24, Sup6 (June 2019): S6—S10. http://dx.doi.org/10.12968/bjcn.2019.24.sup6.s6.
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The aim of this case study is to describe the authors' experience with the use of portable negative pressure wound therapy (pNPWT) in a non-NHS community health care environment. In this context, wound care products are funded by the individual patient. Nurses struggle to reconcile best practice and current evidence-based care when cost implications limit treatment options. In this case, funding for pNPWT was provided by a local charity. This afforded the patient the opportunity to receive best-practice wound care, and significant wound healing, pain reduction and improved patient satisfaction were achieved. Further investigation is required around the suitability of developing a strategic plan to facilitate delivery of pNPWT within the authors' community nursing service.
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Rodes-Carbonell, Ana María, Juan Torregrosa-Valls, Antonio Guill Ibáñez, Alvaro Tormos Ferrando, María Aránzazu Juan Blanco, and Antonio Cebrián Ferriols. "Flexible Hybrid Electrodes for Continuous Measurement of the Local Temperature in Long-Term Wounds." Sensors 21, no. 8 (April 13, 2021): 2741. http://dx.doi.org/10.3390/s21082741.
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Long-term wounds need a continuous assessment of different biophysical parameters for their treatment, and there is a lack of affordable biocompatible devices capable of obtaining that uninterrupted flow of data. A portable prototype that allows caregivers to know the local temperature behavior of a long-term wound over time and compare it with different reference zones has been developed. Alternative flexible substrates, screen-printing techniques, polymeric inks, and an embedded system have been tested to achieve potential indicators of the status and evolution of chronic wounds. The final system is formed by temperature sensors attached to a flexible and stretchable medical-grade substrate, where silver conductive tracks have been printed as interconnections with the data-acquisition unit. In addition, a specific datalogger has been developed for this system. The whole set will enable health personnel to acquire the temperature of the wound and its surroundings in order to make decisions regarding the state and evolution of the wound.
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Furuichi, Motohiko, and Mamoru Koga. "Treatment of an Empyema Cavity with a Portable Negative-Pressure Wound ActiV.A.C.® Therapy System." Journal of Nihon University Medical Association 75, no. 6 (2016): 299–302. http://dx.doi.org/10.4264/numa.75.6_299.
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Suvandee, Whijitra, Veerawat Teeranachaideekul, Nutjaree Jeenduang, Patcharakamon Nooeaid, Arthit Makarasen, Laemthong Chuenchom, Supanna Techasakul, and Decha Dechtrirat. "One-Pot and Green Preparation of Phyllanthus emblica Extract/Silver Nanoparticles/Polyvinylpyrrolidone Spray-On Dressing." Polymers 14, no. 11 (May 29, 2022): 2205. http://dx.doi.org/10.3390/polym14112205.
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A spray-on wound dressing has many benefits, including easy and quick administration to broad and uneven wounds, better interface with the wound site, adhesion without additional dressing, and multiple applications in a portable package. By limiting direct contact with the wound site, such a design can prevent wound damage during treatment. This study revealed a simple, one-pot synthesis of spray-on wound dressing relying on polyvinylpyrrolidone solution incorporating silver nanoparticles as a broad-spectrum antibacterial agent and wound-healing antioxidant Phyllanthus emblica extract. Silver nanoparticles were synthesized in situ using Phyllanthus emblica extract as a biogenic reducing agent. Polyvinylpyrrolidone was employed as a film-forming agent to create an adhesive hydrogel-based dressing matrix to provide moisture and establish a shielding barrier for the wound bed as well as to regulate the release of fruit extract. In vitro tests revealed that the produced dressing film had a controlled release of the fruit extract, high antioxidant activity, and a good antibacterial action against S. aureus, P. aeruginosa, E. coli, and MRSA. Additionally, a biocompatibility study has shown that both human fibroblasts and keratinocytes are unaffected by the dressing film. Based on established findings, the current spray-on solution might be a potential option for antibacterial wound dressing.
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Daulton, Emma, Alfian Wicaksono, Janak Bechar, James A. Covington, and Joseph Hardwicke. "The Detection of Wound Infection by Ion Mobility Chemical Analysis." Biosensors 10, no. 3 (February 29, 2020): 19. http://dx.doi.org/10.3390/bios10030019.
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Surgical site infection represents a large burden of care in the National Health Service. Current methods for diagnosis include a subjective clinical assessment and wound swab culture that may take several days to return a result. Both techniques are potentially unreliable and result in delays in using targeted antibiotics. Volatile organic compounds (VOCs) are produced by micro-organisms such as those present in an infected wound. This study describes the use of a device to differentiate VOCs produced by an infected wound vs. colonised wound. Malodourous wound dressings were collected from patients, these were a mix of post-operative wounds and vascular leg ulcers. Wound microbiology swabs were taken and antibiotics commenced as clinically appropriate. A control group of soiled, but not malodorous wound dressings were collected from patients who had a split skin graft (SSG) donor site. The analyser used was a G.A.S. GC-IMS. The results from the samples had a sensitivity of 100% and a specificity of 88%, with a positive predictive value of 90%. An area under the curve (AUC) of 91% demonstrates an excellent ability to discriminate those with an infected wound from those without. VOC detection using GC-IMS has the potential to serve as a diagnostic tool for the differentiation of infected and non-infected wounds and facilitate the treatment of wound infections that is cost effective, non-invasive, acceptable to patients, portable, and reliable.
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Facchin, Federico, Andrea Pagani, Paolo Marchica, Laura Pandis, Carlotta Scarpa, Tito Brambullo, Franco Bassetto, and Vincenzo Vindigni. "The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study." Aesthetic Plastic Surgery 45, no. 4 (January 22, 2021): 1653–59. http://dx.doi.org/10.1007/s00266-020-02122-1.
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Abstract Background Due to the great impact of bariatric surgery on the overweight epidemic, the number of post-bariatric body-contouring procedures is constantly increasing worldwide. The portable incisional negative pressure wound therapy (piNPWT) is a promising medical device for accelerating wounds closure and controlling post-operative complication, which have been shown promising results in post-bariatric population. We aimed to evaluate the role of piNPWT in optimizing wound healing and controlling post-operative complications after a post-bariatric brachioplasty. Patients and Methods 26 post-bariatric female patients who underwent a brachioplasty followed by either a piNPWT (14 cases) or a standard wound treatment (12 controls) were analyzed. The number of post-operative dressing changes, the rate of local post-operative complications (re-operation, hematoma and serosa development, dehiscence and necrosis), the time to dry as well as the scar quality and hospitalization length were evaluated. Results None of the patients prematurely stopped treatment with piNPWT due to intolerance. The piNPWT patient group showed a significant lower healing time as well as a significant reduction of the number of post-operative dressing changes and hospital stay. Despite the scarring process was excellent from the functional point of view in the long term, we noticed a higher rate of hyperchromic scarring at 90 days after surgery. Conclusion The piNPWT is a cost-effective and user-friendly medical tool that increase and promote wound healing. We suggest the use of this device in post-bariatric patients who undergo a brachioplasty, especially if there is the need to minimize the number of post-operative dressing changes. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Brako, Francis, Chaojie Luo, Rupy Kaur Matharu, Lena Ciric, Anthony Harker, Mohan Edirisinghe, and Duncan Q. M. Craig. "A Portable Device for the Generation of Drug-Loaded Three-Compartmental Fibers Containing Metronidazole and Iodine for Topical Application." Pharmaceutics 12, no. 4 (April 18, 2020): 373. http://dx.doi.org/10.3390/pharmaceutics12040373.
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The use of combination therapies for the treatment of a range of conditions is now well established, with the component drugs usually being delivered either as distinct medicaments or combination products that contain physical mixes of the two active ingredients. There is, however, a compelling argument for the development of compartmentalised systems whereby the release, stability and incorporation environment of the different drugs may be tailored. Here we outline the development of polymeric fine fiber systems whereby two drugs used for the treatment of wounds may be separately incorporated. Fibers were delivered using a newly developed handheld electrospinning device that allows treatment at the site of need. Crucially, the delivery system is portable and may be used for the administration of drug-loaded fibers directly into the wound in situ, thereby potentially allowing domiciliary or site-of-trauma administration. The three-layered fiber developed in this study has polyethylene glycol as the outermost layer, serving as a structural support for the inner layers. The inner layers comprised iodine complexed with polyvinylpyrrolidone (PVP) and metronidazole dispersed in polycaprolactone (PCL) as a slow release core. The systems were characterized in terms of structure and architecture using scanning electron microscopy, transmission electron microscopy, attenuated total reflection Fourier transform infrared spectroscopy and diffractometry. As antibacterial creams are still used for managing infected wounds, the performance of our trilayered fiber was studied in comparison with creams containing similar active drugs. Drug release was measured by UV analysis, while antimicrobial efficiency was measured using agar diffusion and suspension methods. It was found that the trilayered systems, averaging 3.16 µm in diameter, released more drug over the study period and were confirmed by the microbacterial studies to be more effective against P. aeruginosa, a bacterium commonly implicated in infected wounds. Overall, the portable system has been shown to be capable of not only incorporating the two drugs in distinct layers but also of delivering adequate amounts of drugs for a more effective antibacterial activity. The portability of the device and its ability to generate distinct layers of multiple active ingredients make it promising for further development for wound healing applications in terms of both practical applicability and antimicrobial efficacy.
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Prasetyono, Theddeus O. H., Irena Sakura Rini, and Cindy Wibisono. "EASEPort NPWT System to Enhance Skin Graft Survival – A Simple Assembly." International Surgery 100, no. 3 (March 1, 2015): 518–23. http://dx.doi.org/10.9738/intsurg-d-14-00029.1.
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Skin graft has been known to be prone to failure. This study was aimed to make a simplification of the negative pressure wound therapy (NPWT), which follows EASEPort (effective, affordable, safe, easily handled, and portable) concept to support the take of skin graft. The design of the EASEPort-NPWT was then made and technically verified. Thereafter, an animal experimental study comparing the EASEPort-NPWT to the classic tie-over technique on skin graft over exudative wound was conducted. The EASEPort-NPWT was verified to be able to yield and sustain the subatmospheric pressure needed. In the animal study, the treatment group showed better skin graft survival rate (97.55 ± 11.18% take) than the control group (54.88 ± 19.73%) on day-7. Histopathology examination showed good quality of the skin structures taken from the treatment group, which was better than the structures of the skin in the control group. In summary, this study has been able to fulfill its objective to create a device following EASEPort concept. Subsequently, the EASEPort-NPWT was able to enhance skin graft survival rate in exudative wound.
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Parkey, Jeffrey, Jenifer Cross, Ryan Hayes, Christi Parham, David Staack, and Anjal C. Sharma. "A Battery Powered, Portable, and Self-Contained Non-Thermal Helium Plasma Jet Device for Point-of-Injury Burn Wound Treatment." Plasma Processes and Polymers 12, no. 11 (May 8, 2015): 1244–55. http://dx.doi.org/10.1002/ppap.201400245.
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Khomenko, I. P., E. V. Tsema, V. Yu Shapovalov, S. V. Tertyshny, and P. P. Yermuraki. "Original method of the frontal abdominal wall defect reconstruction using the principle of the reconstructive-restorative surgery." Journal of Education, Health and Sport 11, no. 1 (January 29, 2021): 372–78. http://dx.doi.org/10.12775/jehs.2021.11.01.037.
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The author srepresent the original clinical data devoting to the further progress in reconstructive surgery. The methodology of the staged anterior abdominal wall defect reconstruction using the Keystone method was used firstly.The aim of the work is to demonstrate the peculiarity of preoperative preparation of patients with the anterior abdominal wall wounds complicated by small intestinal fistulas.The article uses the clinical materials of the concrete patient treatment in the Department of surgical infection of the South Region Military Medical Clinical Centre (Odessa, Ukraine) using the principle of the reconstructive-restorative surgery.The clinical case of the successful surgical treatment of anterior abdominal wall eventration, resulting from numerous laparotomies with pronounced lateralization of the wound, has shown that the solution to this problem should be based on the principles of reconstructive surgery.Preoperative modelling of full-layer flaps using a combined technique (infrared camera FLIR and portable Doppler SONO Trax) reduces the risk of necrosis of the movable flap and accelerates the process of closing of the defect of the anterior abdominal wall. Staged (“step-by-step”) surgical treatment of the postoperative wound of the anterior abdominal wall by reconstruction via to the Keystone method showed a positive and rapid result of solving such a difficult problem as eventration complicated by small intestinal fistula.Restoration of the integrity of the anterior abdominal wall should be considered from the standpoint of reconstructive-restorative features
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Mitchell, Stuart, Edward Ray, and Peter Cordeiro. "Miniaturized Negative-Pressure Wound Therapy for Split-Thickness Skin Graft Donor Sites." Journal of Reconstructive Microsurgery Open 03, no. 02 (July 2018): e46-e49. http://dx.doi.org/10.1055/s-0038-1668561.
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Background Multiple therapeutic options exist for the treatment of split-thickness skin graft (STSG) donor sites, but there is no clear consensus among surgeons about the best option. Negative-pressure wound therapy (NPWT) has rapidly gained in popularity since its invention. Recently, several miniaturized, single-patient NPWT (SP-NPWT) devices have become available. Compared with traditional NPWT devices, SP-NPWT devices are associated with equal wound healing capability and reliability, but offer several advantages. We present a series of 10 consecutive patients whose STSG donor sites were treated with a commercially available SP-NPWT device. Methods We performed a retrospective review for 10 consecutive patients who underwent STSG procedures and were treated with SP-NPWT devices. Results From 2015 to 2017, 10 consecutive patients underwent oncologic reconstruction using STSG and had their donor sites treated with SP-NPWT devices. The SP-NPWT dressing had been left in place for 2 weeks after surgery. The average donor site area measured 80 cm2 (range: 76–106 cm2). In all 10 patients, the donor sites healed uneventfully and with no complications. Conclusion Off-the-shelf, miniaturized, SP-NPWT systems appear to be at least as effective as traditional dressings for STSG donor sites and require no maintenance (skilled nursing or dressing changes). Compared with larger and less portable standard NPWT devices, SP-NPWT dressing systems provide a potential cost benefit as well as enhanced convenience and portability.
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Dzimitrowicz, Anna, Aleksandra Bielawska-Pohl, Piotr Jamroz, Jerzy Dora, Agnieszka Krawczenko, Giovanni Busco, Catherine Grillon, et al. "Activation of the Normal Human Skin Cells by a Portable Dielectric Barrier Discharge-Based Reaction-Discharge System of a Defined Gas Temperature." Plasma Chemistry and Plasma Processing 40, no. 1 (October 22, 2019): 79–97. http://dx.doi.org/10.1007/s11090-019-10039-0.
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Abstract Skin injury leading to chronic wounds is of high interest due to the increasing number of patients suffering from this symptom. Proliferation, migration, and angiogenesis are key factors in the wound healing processes. For that reason, controlled promotion of these processes is required. In this work, we present the portable helium-dielectric barrier discharge (He-DBD)-based reaction-discharge system of controlled gas temperature for biological activities. To make this He-DBD-based reaction-discharge system safe for biological purposes, a multivariate optimization of the operating parameters was performed. To evaluate the effect of the He-DBD operating parameters on the rotational gas temperature Trot(OH), a design of experiment followed by a Response Surface Methodology was applied. Based on the suggested statistical model, the optimal operating conditions under which the Trot(OH) is less than 37 °C (310 K) were estimated. Then, the resulted model was validated in order to confirm its accuracy. After estimation the optical operating conditions of He-DBD operation, the spectroscopic characteristic of the He-DBD-based reaction-discharge system in relevance to the several optical temperatures in addition to electron number density has been carried out. Additionally, the qualitative and quantitative analyses of the reactive oxygen species and reactive nitrogen species were performed in order to investigate of reactions and processes running in the He-DBD-gaseous phase and in the He-DBD-treated liquid. Next, the developed portable He-DBD-based reaction-discharge system, working under the optimal operating conditions, was used to stimulate the wound healing process. It was found that a 30 s He-DBD treatment significantly increased the proliferation, migration, and angiogenesis of keratinocytes (HaCaT) and fibroblasts (MSU-1.1) cell lines, as well as human skin microvascular endothelial cells (HSkMEC.2). Hence, the application of the cold atmospheric pressure plasma generated in this He-DBD-based reaction-discharge system might be an alternative therapy for patient suffering from chronic wounds.
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Primo, F. L., L. B. de Paula, M. P. de Siqueira-Moura, and A. C. Tedesco. "Photobiostimulation on Wound Healing Treatment by ClAlPc-nanoemulsion from a Multiple-Wavelength Portable Light Source on a 3D-Human Stem Cell Dermal Equivalent." Current Medicinal Chemistry 19, no. 30 (October 1, 2012): 5157–63. http://dx.doi.org/10.2174/092986712803530502.
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Kostyakov, D. V., E. V. Zinovev, V. V. Soloshenko, O. O. Zavorotnii, A. A. Popov, M. S. Asadulaev, and K. F. Osmanov. "Evaluating the effectiveness of combined use of non-thermal atmospheric pressure plasma and frequently-modulated electric field signal in skin wound healing." Innovative medicine of Kuban, no. 3 (September 3, 2020): 38–44. http://dx.doi.org/10.35401/2500-0268-2020-19-3-38-44.
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Background Scientists around the world are interested in applying physical phenomena to various fields of science. The development of entire areas united by one concept (‘plasma medicine’, etc.) stands as a bright example. Present work focuses on only two concepts of interest, which are plasma jet and electric field, as far as results of their combined use in clinical practice and in surgery remain understudied. Objective Experimental evaluation of the effectiveness of physical methods of treatment in skin wound healing. Material and methods The study was carried out on 45 small laboratory animals (rats). They were divided into 5 groups of 9 individuals in each according to method chosen for experimental wound healing. To generate the plasma jet, a portable generator was used, which is the original development of specialists of the Peter the Great St. Petersburg Polytechnic University. Planimetric and histological measurements were analysed. The antibacterial effectiveness of methods under research was investigated using Staphylococcus aureus 209P, cultivated in vitro on 6- and 12-millimeter discs. Discussion The combined use of non-thermal atmospheric pressure plasma and frequency-modulated electric field signal exhibited the ability to accelerate eschar separation by 52.1% (p < 0.05) and stimulate restorative regeneration by 56% (p < 0.05). Combination of physical methods of treatment demonstrated pronounced antibacterial effect. A histological examination on biopsy sample on the 21st day of observation revealed formed (mature) granulations and large number of newly formed vessels. The cellular composition of epidermal basement membrane showed high level of differentiation. Conclusion The data obtained suggest that the use of the proposed methods in clinical practice will improve the treatment process of the patients with wounds of different etiology.
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Jafri, Anwar Abbas, Sanjay Gupta, Zaki Ibrahim, Paul Baker, Tamsin Oswald, and Mike R. Reed. "Assessing the efficacy of photocatalytic oxidation on bacterial contamination in a clinical setting – a randomised controlled trial." Journal of Infection Prevention 12, no. 6 (October 4, 2011): 251–53. http://dx.doi.org/10.1177/1757177411415447.
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Airborne contamination has been shown to be a significant source of wound contamination in orthopaedic surgery. This is the first reported study looking at the efficacy of ActivTek 300, a portable UV/TiO2-based air purifier unit to reduce airborne contamination in a clinical setting. In this randomised study the investigator was blinded as to whether the unit had been on or off for the previous seven days. Air contamination was measured weekly using a validated technique in ward treatment rooms using a Mini Air Sampler (MAS-100) and agar plates, over a period of 12 weeks. The agar plates were then incubated for 24 hours and the results were expressed as number of colony forming units per plate (cfu). The biomedical scientist who manually counted the number of cfus was blinded as to whether the unit was on or off. Measurements were duplicated to improve the accuracy of the study, and in addition to this an identical experiment was set up in a second treatment room on a separate randomisation schedule. Analysis of the data demonstrated median colony count was significantly lower with the unit on (Median = 43 interquartile range (IQR) 30 to 83) than when it was off (median = 95 IQR 44 to 143) ( p < 0.01). This represents a 55% mean reduction in the colony count. This study suggests that the portable UV/TiO2-based air purifier unit is efficacious in reducing airborne contamination in the clinical environment and may have a promising role in reducing overall infection rates in surgical patients.
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Drabovsky, V. S., S. V. Malik, A. L. Chelishvili, B. I. Gonzhak, and O. S. Osipov. "THERMOMETRIC PORTRAIT OF ANTERIOR ABDOMINAL WALL WHEN PLANNING HERNIOPLASTY IN UNGUINAL HERNIA." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 21, no. 4 (December 30, 2021): 19–22. http://dx.doi.org/10.31718/2077-1096.21.4.19.
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The period of the Covid-19 pandemic has given a new impetus to the wider application of remote infrared thermometry. In addition to remote body temperature measurement, the portable infrared thermal devices can non-invasively and reliably measure the local temperature of various parts of the body. High informative value of these parameters increases the relevance of such technique for monitoring and control of the effectiveness of surgical treatment, prediction of early postoperative complications, providing information about individual thermometric characteristics of different topographic and anatomical areas. This work is based on the analysis of local temperature of the anterior abdominal wall of healthy people and patients who were hospitalized for elective surgery for inguinal hernia, to determine the dependence of local temperature parameters on age, sex, type of constitution, depth of subcutaneous tissue, duration of hernia history, the presence of episodes of pinching, in order to improve the able to predict the development of local wound complications. The analysis of the results obtained enabled us to conclude that the preoperative thermometric profile of the anterior abdominal wall depends on the thickness of the skin and fat folds; remote infrared thermometry is a up-to-date non-contact diagnostic technique, which should be used to predict local wound complications based on the background and local temperature of symmetrical areas of the anterior abdominal wall. The decrease in temperature in the area of the spermatic cord in men with inguinal hernias indicates microcirculatory impairment in these structures.
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Elsadek, Nehal E., Abdalrazeq Nagah, Tarek M. Ibrahim, Hitesh Chopra, Ghada A. Ghonaim, Sherif E. Emam, Simona Cavalu, and Mohamed S. Attia. "Electrospun Nanofibers Revisited: An Update on the Emerging Applications in Nanomedicine." Materials 15, no. 5 (March 4, 2022): 1934. http://dx.doi.org/10.3390/ma15051934.
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Electrospinning (ES) has become a straightforward and customizable drug delivery technique for fabricating drug-loaded nanofibers (NFs) using various biodegradable and non-biodegradable polymers. One of NF’s pros is to provide a controlled drug release through managing the NF structure by changing the spinneret type and nature of the used polymer. Electrospun NFs are employed as implants in several applications including, cancer therapy, microbial infections, and regenerative medicine. These implants facilitate a unique local delivery of chemotherapy because of their high loading capability, wide surface area, and cost-effectiveness. Multi-drug combination, magnetic, thermal, and gene therapies are promising strategies for improving chemotherapeutic efficiency. In addition, implants are recognized as an effective antimicrobial drug delivery system overriding drawbacks of traditional antibiotic administration routes such as their bioavailability and dosage levels. Recently, a sophisticated strategy has emerged for wound healing by producing biomimetic nanofibrous materials with clinically relevant properties and desirable loading capability with regenerative agents. Electrospun NFs have proposed unique solutions, including pelvic organ prolapse treatment, viable alternatives to surgical operations, and dental tissue regeneration. Conventional ES setups include difficult-assembled mega-sized equipment producing bulky matrices with inadequate stability and storage. Lately, there has become an increasing need for portable ES devices using completely available off-shelf materials to yield highly-efficient NFs for dressing wounds and rapid hemostasis. This review covers recent updates on electrospun NFs in nanomedicine applications. ES of biopolymers and drugs is discussed regarding their current scope and future outlook.
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Balasubramanian, Manjula, Anita Sebastian, Marie Peddinghaus, Gregory Fridman, Alexander Fridman, Alexander Gutsol, Gregory Friedman, and Brooks Ari. "Dielectric Barrier Discharge Plasma in Coagulation and Sterilization." Blood 108, no. 11 (November 16, 2006): 4043. http://dx.doi.org/10.1182/blood.v108.11.4043.4043.
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Abstract Rapid loss of blood, in the operating room or trauma, necessitates a need for hastening coagulation Attempts to hasten coagulation include electrocautery based on thermal plasma discharges. Although there have been other effective attempts to prevent further loss of blood via coagulation, tissue damage and dessication can occur as a result of the high temperatures 2. Our group has developed a method to initiate rapid coagulation with dielectric plasma discharge (cold). Initial experiments were performed using fresh blood from volunteers to compare time for coagulation of whole blood exposed to plasma, one minute versus 10 minutes. We tried same experiments on cut cadaver organs such as spleen and placenta which showed evidence of rapid coagulation compared to control without evidence of tissue damage. Our research team has developed a novel method using non-thermal dielectric barrier discharge plasma (DBD plasma) to coagulate blood and sterilize tissues without causing thermal damage. This treatment would be safe to patients because no exposed electrodes are involved and high frequency current (under 10 KHz) is kept below mili-ampere. Our experiments have shown that such plasma treatment hastens blood coagulation and causes simultaneous wound sterilization via a large concentration of chemically active species in plasma that are ions, radicals (O, OH, N) and electronically-excited atoms and molecules. A kinetic model of blood coagulation under influence of DBD plasma was constructed. The model assumes contact flux of positive ions from DBD plasma into the surface of the blood being treated. Once at the surface, these ions recombine, leading to formation of aqueous Hydrogen ions which catalyze the release of Calcium ions into the blood. The addition of Calcium ions to blood speeds up the coagulation process proportionally to the amount of ions added. The model demonstrates thrombin formation in the presence of DBD plasma peaking and occurring within significantly less time compared to thrombin formation without DBD plasma3. Such medically relevant demonstrations and mathematical explanations have allowed us to develop a portable device that may prove useful in situations where control of bleeding is crucial. In addition, because of the potential for simultaneous sterilization, this device may also help to decrease infections. This pioneering technology will find applicability in many clinical situations: sterilization of human tissue surfaces prior to surgery and sterilization of catheters, a well-known cause of morbidity in hospitals.
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Nadhif, Muhammad Hanif, Hanif Assyarify, Muhammad Irsyad, Em Yunir, Tri Juli Edi Tarigan, Angela Sarumpaet, and Eni Iswati. "Development and characterization of an automated portable wound irrigation device for diabetic ulcers." International Journal of Electrical and Computer Engineering (IJECE) 12, no. 5 (October 1, 2022): 4746. http://dx.doi.org/10.11591/ijece.v12i5.pp4746-4755.
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<p>Patients with diabetes mellitus may experience peripheral neuropathy and extremity system impairment, which may lead to ulceration if the treatments are delayed. Diabetic ulcers, unfortunately, are chronic, which require proper treatments, including debridement and bacterial removal using an irrigation device. To date, commercial irrigation devices included pulsed-lavage, bulb syringe, and gravity bags. Unfortunately, the devices have limitations in terms of portability, measurability, controllability, and disposability. To tackle the limitations, this study aims to design, fabricate, and characterize an automated portable wound irrigation device (Apdice), which is controllable non-disposable, and portable. The device was designed and fabricated using a lightweight construction, a rechargeable battery, and non-disposable materials to support the portability and non-disposable means. Meanwhile, the proportional-derivative-integral controller with its peripheral components were featured to enable controllability. Furthermore, the device was also tested regarding the contamination using a particle counter, and appeared to be contamination free. In short, Apdice showed a robust technological performance. However, it is also worth the try to test the contamination test against biological agents to guarantee the biocompatibility of the device.</p>
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Roa, Dante, Jeffrey Kuo, Harry Moyses, Peter Taborek, Toshiki Tajima, Gerard Mourou, and Fuyuhiko Tamanoi. "Fiber-Optic Based Laser Wakefield Accelerated Electron Beams and Potential Applications in Radiotherapy Cancer Treatments." Photonics 9, no. 6 (June 8, 2022): 403. http://dx.doi.org/10.3390/photonics9060403.
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Ultra-compact electron beam technology based on laser wakefield acceleration (LWFA) could have a significant impact on radiotherapy treatments. Recent developments in LWFA high-density regime (HD-LWFA) and low-intensity fiber optically transmitted laser beams could allow for cancer treatments with electron beams from a miniature electronic source. Moreover, an electron beam emitted from a tip of a fiber optic channel could lead to new endoscopy-based radiotherapy, which is not currently available. Low-energy (10 keV–1 MeV) LWFA electron beams can be produced by irradiating high-density nano-materials with a low-intensity laser in the range of ~1014 W/cm2. This energy range could be useful in radiotherapy and, specifically, brachytherapy for treating superficial, interstitial, intravascular, and intracavitary tumors. Furthermore, it could unveil the next generation of high-dose-rate brachytherapy systems that are not dependent on radioactive sources, do not require specially designed radiation-shielded rooms for treatment, could be portable, could provide a selection of treatment energies, and would significantly reduce operating costs to a radiation oncology clinic.
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Kolar, D. "Treatment-Resistant Depression – What is the Effective Maintenance Treatment." European Psychiatry 65, S1 (June 2022): S555—S556. http://dx.doi.org/10.1192/j.eurpsy.2022.1422.
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Introduction Treatment-resistant depression (TRD) presents a significant challenge in clinical practice. Besides antidepressant medications, neurostimulation methods (ECT, rTMS) and ketamine are viable treatment options. Objectives To objectively evaluate the real effectiveness of treatments within interventional psychiatry in the maintenance treatment. Methods The extensive literature review of the efficacy of ECT, rTMS, and ketamine treatment in the maintenance treatment of TRD and the author’s clinical and research experience will be included in this presentation. Results Neurostimulation, particularly ECT and ketamine treatment are usually effective treatments for patients with TRD. However, both of these treatment modalities do not have sustained benefits and after discontinuing treatment the majority of patients relapse. Ketamine has rapid therapeutic effects in depression, but these effects are short-lived. Continuation treatment with ketamine in the form of intranasal ketamine is an option, but concerns over cognitive impairment, interstitial cystitis and significant addictive potential related to longer use of ketamine are significant limiting factors. rTMS is a first-line treatment option for patients with TRD according to the Canadian CANMAT guidelines. However, the majority of patients may relapse following the course of rTMS. The maintenance rTMS over an extended period of time is usually not feasible as it may significantly affect the waiting time for newly referred patients. Portable TMS machine for home use would be an alternative option for a limited number of patients. Conclusions Maintenance treatment has been always a big clinical challenge in mood disorder psychiatry. Only well-established multimodal treatment is a realistic option for getting long-term benefits in treating patients with TRD. Disclosure No significant relationships.
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Conlin, Timothy, Dave Cheyne, and John Dymond. "Soil temperatures and suckering response of trembling aspen (Populus tremuloides Michx.) following disposal of hog on winter-logged cutblocks." Forestry Chronicle 80, no. 6 (December 1, 2004): 687–93. http://dx.doi.org/10.5558/tfc80687-6.
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Bark and wood residue, commonly referred to as "hog fuel" or "hog," from a portable pulp chipper was deposited on aspen cutblocks in replicated 10 x 10 m treatment plots during winter logging operations in northeastern British Columbia. The treatments emulated disposal of hog under conditions that simulated on-site chipping operations. Three different rates of hog disposal were applied; 34, 68 and 102 kg m-2, and three cutblocks were treated, one each during February of 1997, and March of 1998 and 1999. We originally hypothesized that the deposition of hog would lower soil temperatures in the treated plots and reduce aspen sucker density during the following growing season. However, our observations showed an initial lag in soil warming in the treatments followed by temperature levels that rose above that exhibited in the control plots. Higher soil temperatures were correlated with greater rates of hog disposal. Increased suckering was not observed in response to higher soil temperatures and stem densities decreased as hog application rates increased. Key words: in-woods, on-site, chipping, Populus tremuloides, hog fuel, soil temperature
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Duffy, A. P., E. Arihilam, Hugh Sasse, Sarah Parker, R. Armstrong, N. Wainwright, S. Steggles, and T. Thomas. "Measuring the shielding properties of flexible or rigid enclosures for portable electronics." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 376, no. 2134 (October 29, 2018): 20170456. http://dx.doi.org/10.1098/rsta.2017.0456.
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Heaviside, in volume 1 of Electromagnetic theory , considered shielding of conducting materials in the form of attenuation. This treatment is still significant in the understanding of shielding effectiveness. He also considered propagation of electromagnetic waves in free-space. What Heaviside (1850–1925) could never have imagined is that 125 years later, there would be devices we know as mobile phones (or cell phones, handies, etc.) with capabilities beyond the dreams of the great science fiction writers of the day like H. G. Wells (1866–1949) or Jules Verne (1828–1905). More than this, that there would be a need for law enforcement agencies, among others, to use electromagnetically shielded enclosures to protect electronic equipment from communicating with the ‘outside world’. Nevertheless, Heaviside's work is still fundamental to the developments discussed here. This paper provides a review of Heaviside's view of shielding and propagation provided in volume 1 of Electromagnetic theory and develops that to the design of new experiments to test the shielding of these portable enclosures in a mode-stirred reverberation chamber, a test environment that relies entirely on reflections from conducting surfaces for its operation. This article is part of the theme issue ‘Celebrating 125 years of Oliver Heaviside's ‘Electromagnetic Theory’’.
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Stavrou, Peter, Panagiotis D. Symeonidis, Lukas D. Iselin, and George Dracopoulos. "Sutures versus Sterile Strips for Closure of Ankle Arthroscopy Portals: Prospective Crossover Trial." Foot & Ankle International 33, no. 3 (March 2012): 190–95. http://dx.doi.org/10.3113/fai.2012.0190.
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Background: Either a nylon single suture or adhesive tape in the form of Steri strip are commonly used for the closure of portals in ankle arthroscopy. The purpose of this study was to compare the two methods with regards to their safety, complications and cosmetic result. Methods: This was a prospective cross over study of 100 patients who underwent ankle arthroscopy. Materials used for wound closure were either a 3–0 nylon suture or a single Steri strip. Portals were reviewed according to a validated wound scoring system. Parameters such as the age and gender of the patients, the duration of tourniquet use and the use of an intraarticular corticosteroid injection at wound closure were also studied. Results: Ninety-five patients were included in the statistical analysis. No technique was found to be superior in terms of the wound description ( p = 0.164), infection grade ( p = 0.232), infection treatment ( p = 0.557) and the cosmetic appearance ( p = 0.371). Seventy-two percent of patients had a good to excellent cosmetic result. There were two cases of infection requiring administration of antibiotics, one from each method of closure. Of the independent parameters, the use of cortisone was related to a lower infection treatment score ( p = 0.013). Patients with signs of infection had a shorter total tourniquet time compared to the patients with no infection ( p = 0.002). Conclusion: The use of either a single suture or Steri strip in the closure of ankle arthoscopy portals has equivalent results. Both methods were safe with equivalent cosmesis and low infection rates. Level of Evidence: II; Prospective Comparative Study
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Michelson, G., W. Striebel, W. Prihoda, and Volker Schmidt. "Telemedicine in the control of intra-ocular pressure." Journal of Telemedicine and Telecare 6, no. 1_suppl (February 2000): 126–28. http://dx.doi.org/10.1258/1357633001934410.
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Glaucoma is one of the most common causes of blindness in the Western world and a major risk factor is increased intra-ocular pressure. We therefore used telemedicine in its control. Patients measured their intra-ocular pressure several times a day with a portable instrument and the values were then entered into a portable digital assistant. These data were transmitted by a modem to a central server. If the intra-ocular pressure was pathologically high, an email message was automatically sent to the ophthalmologist. The pressure curve, including a statistical analysis, was displayed in an easily readable chart format. Ten patients with glaucoma participated in a trial. Self-tonometry with telemedicine enabled continuous evaluation of the patient by the ophthalmologist. This approach offered the advantage of controlling the treatment remotely. Advantages for the patient were that the measurements were easily done at home under normal conditions, and the patient could control when the measurement and data transmission would be performed. Telemedicine is a cost-effective technique enabling the early diagnosis of pathologically increased intra-ocular pressure.
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Redmond, Sarah, Sandra Y. Silva, Jennifer Cadnum, Matthew Carlisle, and Curtis Donskey. "Evaluation of a Continuously Active Disinfectant for Disinfection of Mobile Equipment." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s225—s226. http://dx.doi.org/10.1017/ice.2020.770.
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Background: One of the limitations of current cleaning and disinfection strategies is that cleaned surfaces rapidly become recontaminated. In laboratory testing, a novel quaternary ammonium disinfectant provided sustained antimicrobial activity against multiple pathogens on surfaces after 24 hours. We hypothesized that this continuously active disinfectant would be effective in reducing contamination of portable medical equipment in a real-world healthcare setting.Methods: In a hospital and affiliated long-term care facility, 114 portable devices were randomized to receive no treatment (N = 38) or a single spray application of a quaternary ammonium-alcohol disinfectant (N = 38) or of the continuously active disinfectant (N = 38). The devices were cultured at baseline and on days 1, 4, and 7 after treatment for total aerobic colony counts, methicillin-resistant Staphylococcus aureus (MRSA), and enterococci.Results: As shown in Fig. 1, both spray disinfectants significantly reduced total aerobic colony counts in comparison to the untreated controls. The continuously active disinfectant resulted in sustained significant reductions in aerobic colony counts in comparison to baseline levels (P < .05), whereas counts returned to baseline levels by day 4 in the quaternary ammonium-alcohol disinfectant group. Recovery of MRSA and enterococci was significantly reduced on days 1–7 in the continuously active disinfectant group versus untreated controls (3 of 93, 3% vs 20 of 97, 21% respectively; P = .002), but not in the quaternary ammonium-alcohol disinfectant (11 of 97, 11%; P = .12). Conclusions: A single spray application of a continuously active disinfectant resulted in sustained reductions in total aerobic colony counts over 7 days and reduced recovery of MRSA and enterococci. The continuously active disinfectant could potentially reduce the risk for transmission of pathogens by portable devices.Funding: NoneDisclosures: None
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Pace, Steven. "Critique of the Washington State POLST." Ethics & Medics 41, no. 9 (2016): 2–4. http://dx.doi.org/10.5840/em201641918.
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The Washington State POLST (physician orders for life- sustaining treatment) program was developed during the early 1990s in an effort to honor patients’ end-of-life treatment plans, specifically, to prevent emergency medicine technicians and emergency room personnel from administering excessive, harmful emergency medical treatment. Consequently, unlike advance directives and living wills, a POLST provides legal authority for emergency medical personnel not to initiate CPR (cardiopulmonary resuscitation). POLST documents are designed to be universal and portable, regardless of the particular health care setting, and their directives must be followed as standing physician orders. Since then, the department, in conjunction with the state medical association, composed the POLST in use today. However, these two bodies extended the legislature’s intent beyond defining patient wishes for resuscitation during emergency medical treatment. Had the document remained limited to the legislature’s original, narrow focus, many of the problems we now encounter with POLST would not occur.
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Benny, Ashna M., and Senthil Murugappan. "Efficiency of Universal Back Resting Device in Public Health Dentistry Outreach Activities: A Cross-sectional Study among Patients and Service Care Providers." Journal of Scientific Dentistry 10, no. 2 (2020): 34–37. http://dx.doi.org/10.5005/jp-journals-10083-0933.
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ABSTRACT Aims and objectives This study was undertaken to analyze the benefits and drawbacks of the universal back resting device (UBRD) and to use the obtained data to rectify defects if any and modify it for the betterment of treatment outcomes at camp sites. Materials and methods This is a cross-sectional questionnaire study undertaken among a group of 100 patients and 100 healthcare providers who have received treatment with the aid of and provided treatment with the UBRD, respectively. The data that were obtained by analyzed and percentages were calculated using SPSS 17 for windows. Results The results of this study conclusively pointed out that the UBRD meets the demands that it was intended for and it can also be used as an alternative to portable dental chairs at camp sites or even in primary health centers when the available funds are insufficient in ratio to the number of people requiring treatment. The possible alteration that can be made to the device to increase its efficiency was also noted. Conclusion The UBRD has proved to be useful in providing oral healthcare at camp sites and could be stated that it is a fair enough alternative to conventional chairs when minimum resources are available. Clinical significance The UBRD is a unique device that can aid in providing better treatment and is cost efficient and if it is implemented in camp/outreach sites, it would drastically increase the number of patients getting treated in a short period of time and to an efficiency level almost as equal as a portable dental chair. How to cite this article Benny AM, Murugappan S. Efficiency of Universal Back Resting Device in Public Health Dentistry Outreach Activities: A Cross-sectional Study among Patients and Service Care Providers. J Sci Dent 2020;10(2):34–37.
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Sardisco, Lorenza, Pyry-Mikko Hannula, Tim J. Pearce, and Luke Morgan. "Multi-Technique Analytical Approach to Quantitative Analysis of Spodumene." Minerals 12, no. 2 (January 29, 2022): 175. http://dx.doi.org/10.3390/min12020175.
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The aim of this study was to establish the capability of X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) methods to determine different spodumene forms (α-, β- and γ-spodumene) occurring during heat treatment of lithium spodumene. It is essential to correctly identify and quantify the presence of different forms of spodumene after heat treatment to ensure optimum lithium extraction. A sample from the Haapaluoma lithium-pegmatite (western Finland) was used for this study. An experimental programme was initiated to model the progression of the mineral transformation at different stages through heat treatment. The specimen was broken down and split into five portions. One of the splits was analysed unheated with XRD, FTIR, XRF and ICP; the other four splits were analysed with XRD and FTIR after heat treatment at different temperatures from 850 to 1100 °C. In this study, we show that both laboratory-based XRD and portable FTIR methods are effective in identifying and quantifying α-, β- and γ-spodumene as well as impurities. The accuracy of the quantification of the minerals with XRD was established by using a mass balance calculation and was compared with the actual chemistry of the sample measured with ICP analysis. Fully quantitative XRD analysis of heat-treated spodumene is considered a challenge due to peak overlaps between the β-, and γ-spodumene forms, particularly when gangue minerals and amorphous content are present. The novelty of this study consists of the use of the XRD technique complemented by the Rietveld method to fully quantify the different forms of spodumene from one another: α-, β- and γ-spodumene, along with the gangue minerals and the amorphous content. It is also shown that reproducible systematic changes occur in the FTIR spectra that track the spodumene transformation during heat treatment. With more samples and cross-validation between the XRD results, the FTIR methodology could be developed further to provide semi-quantitative information on the different spodumene forms in the future. This would permit the use of a fast, cost-effective and portable technique for quality control of the spodumene forms, which would open opportunities across the Li value chain.
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Chen, Yen-Lin, Chuan-Yen Chiang, Chao-Wei Yu, Shyan-Ming Yuan, and Zeng-Wei Hong. "A CUSTOMIZED AND PORTABLE COMPONENT-BASED FRAMEWORK FOR INTELLIGENT HOMECARE SYSTEM DESIGN WITH VIDEO AND PHYSIOLOGICAL MONITORING MACHINERIES." Biomedical Engineering: Applications, Basis and Communications 23, no. 05 (October 2011): 325–48. http://dx.doi.org/10.4015/s1016237211002748.
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This study proposes a customized and reusable component-based design framework based on the UML modeling process for intelligent home healthcare systems. All the proposed functional components are reusable, replaceable, and extensible for the system developers to implement customized home healthcare systems addressing different demands of patients and caregivers from healthcare monitoring aspects. The prototype design of the intelligent healthcare system based on these proposed components can provide the following features: (1) monitoring and recording videos of rehabilitation situations and patient behavior using multiple CCD cameras, which can be stored accordingly in an archive; (2) recording the patient's physiological data and corresponding treatment plan, which can be stored in an XML archiving database for caregivers' review; (3) automatically alerting patients to remind them of medication schedules or treatment plans, while recording the patient's treatment situations; (4) caregivers monitoring videos and physiological records of the patient's rehabilitation using handheld mobile devices via the Internet or wireless communication networks; and (5) caregivers and patients establishing alert mechanisms for the patients' physiological warning states. If the patient's physiological state suddenly deteriorates, the module would immediately alert caregivers by sending notification messages to their remote mobile devices or web browsers.
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Heaney, Katy, Kerry Whiting, Lynda Petley, Ian Fry, and Andy Newton. "Point-of-care testing by paramedics using a portable laboratory: an evaluation." Journal of Paramedic Practice 12, no. 3 (March 2, 2020): 100–108. http://dx.doi.org/10.12968/jpar.2020.12.3.100.
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Use of point-of-care testing (POCT) equipment by paramedics for triage may reduce unnecessary attendance in emergency departments and inconvenience to patients. A hospital pathology service and an ambulance trust wanted a system for safe and effective use of diagnostic devices by paramedics at the patient bedside. A suite of POCT devices to perform an expanded repertoire of pathology tests was provided, along with technology for electronic data capture, temperature control and monitoring, in a specially designed kit bag—the Labkit. Following a proof-of-concept phase, three Labkit bags were deployed as a pilot in rapid response vehicles and used by specialist paramedics in urgent and emergency care who had been trained in their use. The paramedics used the bag in 25% of patient interactions, typically three times every 24 hours. Having POCT results available at the time of paramedic assessment reduced conveyance to the emergency department by 21%. There was also a 10% rise in admission of patients where pathology results indicated problems that required urgent treatment which would otherwise have gone unnoticed. Overall, 31% of conveyance decisions were changed as a direct consequence of the Labkit results. Patients reported high levels of satisfaction, and paramedics said it added value in 97% of cases where it was used to support decision-making. Reliable, quality-assured POCT by paramedics has the potential to improve efficiency in the healthcare system and benefit patients.
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Covelli, Edoardo, Luigi Volpini, Francesca Atturo, Anna Teresa Benincasa, Chiara Filippi, Silvia Tarentini, Vania Marrone, Simonetta Monini, Annarita Vestri, and Maurizio Barbara. "Delayed Effect of Active Pressure Treatment on Endolymphatic Hydrops." Audiology and Neurotology 22, no. 1 (2017): 24–29. http://dx.doi.org/10.1159/000472245.
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Objective: To identify eventual correlations between the effect of low-pressure treatment and endolymphatic hydrops in Ménière patients. Material and Methods: The study group consisted of subjects affected by definite Ménière disease (2015) and a severe degree of disability, who received a ventilation tube with or without a low-pressure treatment before undergoing a surgical procedure (vestibular neurectomy). After the placement of the ventilation tube, the subjects were either left alone with the tube or received 1 month of self-administered low-pressure therapy with a portable device. In all subjects, an electrocochleography (ECochG) was performed and specific questionnaires - Dizziness Handicap Inventory (DHI) and Functional Scale Level (FSL) - were completed before starting either arm of treatment, at the end of treatment, and then 3 and 6 months later. Results: All selected subjects presented with an ECochG pattern that was indicative of endolymphatic hydrops before starting either treatment. At the end of pressure treatment, 80% showed symptomatic improvement while maintaining the hydropic ECochG pattern. At the 3-month control stage, the hydropic pattern resulted normalized (<0.5) in all the improved subjects. Conclusions: Although 1 month of low-pressure treatment provided a positive symptomatological outcome, normalization of the hydropic ECochG parameters occurred only at a later time. Therefore, it is possible to assume that endolymphatic hydrops could be concurrent with a non-symptomatic stage of Ménière disease, and that the anti-hydropic effect of the low-pressure treatment, if any, would present with a certain delay after its completion.
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O’Rourke, Mark Allen, Matthew F. Hudson, Janet B. Craig, John C. Ropp, and Karen Reeves. "Physician order for scope of treatment (POST) in South Carolina (SC)." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 21. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.21.
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21 Background: Physician Order for Life-Sustaining Treatment (POLST, www.POLST.org ) is a process and tool that translates patients’ goals of care into medical orders in a highly visible, portable way. Trained providers meet with seriously ill patients (or the surrogates) and discuss the available treatment options in light of their current condition, and help clarify the patient’s preferences. The physician then documents those preferences on a standardized medical order form, which travels with the patient if he or she changes settings of care. The POLST form is 1. a physician order, 2. signed by the patient, 3. after consultation with the physician, 4. facilitated by a person trained in advance care planning, 5. directed toward people with serious, chronic illness such that death in the next year would not be a surprise, 6. addressing the decision at a moment of medical crisis to a. hospitalize with full therapeutic intervention, or b. hospitalize with limited therapeutic intervention (such as no CPR), or c. provide supportive, palliative care in the present setting (home or nursing facility), 1. addressing further decisions such as feeding tube, parenteral (IV) hydration, or antibiotics, 2. documented in a widely publicized, recognized and understood form with a distinct pink color, and 3. accepted by EMS responders, hospices, nursing facilities, and hospitals across the state. Methods: The SC Coalition for the Care of the Seriously Ill is comprised of clinical and administrative leaders representing key statewide organizational partners, healthcare entities, and individuals. The Coalition proposes a template order for statewide integration to be called POST. The target population is persons with serious illness for whom death in the next year would “not be a surprise.” Results: Presently, the Coalition is working with state government to undertake a three-county pilot study of POST. Challenges include creating a legal framework, IRB approval, and education of providers and the public. Conclusions: POST may facilitate patient-centered advanced cancer care. Implementation of the POST in SC will require collaboration by stakeholders. Collaboration will require responsiveness to constituents’ concerns in order to facilitate patient-centered care.
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Scandurra, Graziella, Emanuele Cardillo, Gino Giusi, Carmine Ciofi, Eduardo Alonso, and Romano Giannetti. "Portable Knee Health Monitoring System by Impedance Spectroscopy Based on Audio-Board." Electronics 10, no. 4 (February 13, 2021): 460. http://dx.doi.org/10.3390/electronics10040460.
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Knee injuries are among the most common health problems in the world. They not only affect people who practice sports, but also those who lead a rather sedentary life. Factors such as age, weight, working and leisure activities can affect the health of the knees, causing disorders such as inflammation, edema, deterioration of cartilage and osteoarthritis. Although for the diagnosis and treatment of the various pathologies it is always advisable to contact orthopedists and specialized structures, it would often be useful to monitor the state of health of the knees in order to evaluate the healing (or worsening) process and the effects of sport/motion activities or rehabilitation. In this perspective, a portable knee health monitoring system was developed to be used at home or in gyms and sports environments in general. Besides requiring a simple custom front end, the system relies on a PC audio board capable of a sampling rate of 192 kHz to perform bioimpedance measurements at frequencies in excess of 50 kHz. A simple numerical calibration procedure allows to obtain high accuracy while maintaining low hardware complexity. The software developed for the operation of the system is freely available to any researcher willing to experiment with the bioimpedance measurement approach we propose, ensuring the conditions of portability and low complexity. Primary (intracellular and extracellular resistances and cell membrane capacitance) and secondary (real and imaginary parts of the total impedance) bioimpedance parameters can be obtained and analyzed through direct measurements with reference to an equivalent circuit model. The functionality of the system has been tested on nine subjects with different well-known health conditions, providing encouraging results in terms of the ability to correlate bioimpedance measurements to the health status of the knees. If proper clinical trials were to confirm our preliminary results, a system such as the one we propose could be used for fast and frequent monitoring of knee joints, thus possibly reducing the frequency at which complex and expensive medical exams, sometimes involving long waiting lists, must be performed.
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Wang, Yu "Winston", Altaz Khan, Madhura Som, Danni Wang, Ye Chen, Steven Y. Leigh, Daphne Meza, Patrick Z. McVeigh, Brian C. Wilson, and Jonathan T. C. Liu. "Rapid ratiometric biomarker detection with topically applied SERS nanoparticles." TECHNOLOGY 02, no. 02 (June 2014): 118–32. http://dx.doi.org/10.1142/s2339547814500125.
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Multiplexed surface-enhanced Raman scattering (SERS) nanoparticles (NPs) offer the potential for rapid molecular phenotyping of tissues, thereby enabling accurate disease detection as well as patient stratification to guide personalized therapies or to monitor treatment outcomes. The clinical success of molecular diagnostics based on SERS NPs would be facilitated by the ability to accurately identify tissue biomarkers under time-constrained staining and detection conditions with a portable device. In vitro, ex vivo and in vivo experiments were performed to optimize the technology and protocols for the rapid detection (0.1-s integration time) of multiple cell-surface biomarkers with a miniature fiber-optic spectral-detection probe following a brief (5 min) topical application of SERS NPs on tissues. Furthermore, we demonstrate that the simultaneous detection and ratiometric quantification of targeted and nontargeted NPs allows for an unambiguous assessment of molecular expression that is insensitive to nonspecific variations in NP concentrations.
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Gajic, Ina, Jovana Kabic, Dusan Kekic, Milos Jovicevic, Marina Milenkovic, Dragana Mitic Culafic, Anika Trudic, Lazar Ranin, and Natasa Opavski. "Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods." Antibiotics 11, no. 4 (March 23, 2022): 427. http://dx.doi.org/10.3390/antibiotics11040427.
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Antimicrobial resistance (AMR) has emerged as a major threat to public health globally. Accurate and rapid detection of resistance to antimicrobial drugs, and subsequent appropriate antimicrobial treatment, combined with antimicrobial stewardship, are essential for controlling the emergence and spread of AMR. This article reviews common antimicrobial susceptibility testing (AST) methods and relevant issues concerning the advantages and disadvantages of each method. Although accurate, classic technologies used in clinical microbiology to profile antimicrobial susceptibility are time-consuming and relatively expensive. As a result, physicians often prescribe empirical antimicrobial therapies and broad-spectrum antibiotics. Although recently developed AST systems have shown advantages over traditional methods in terms of testing speed and the potential for providing a deeper insight into resistance mechanisms, extensive validation is required to translate these methodologies to clinical practice. With a continuous increase in antimicrobial resistance, additional efforts are needed to develop innovative, rapid, accurate, and portable diagnostic tools for AST. The wide implementation of novel devices would enable the identification of the optimal treatment approaches and the surveillance of antibiotic resistance in health, agriculture, and the environment, allowing monitoring and better tackling the emergence of AMR.
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Ma, Xiaoyan, Fangyuan Wang, Chi Zhang, Weidong Shen, and Shiming Yang. "Self-Directed Neurofeedback Treatment for Subjective Tinnitus Patients Evaluated by Multimodal Functional Imaging." Neural Plasticity 2022 (October 18, 2022): 1–11. http://dx.doi.org/10.1155/2022/5114721.
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Neurofeedback (NFB) is a relatively novel approach to the treatment of tinnitus, and prior studies have demonstrated that the increases in alpha activity rather than reduced delta power seem to drive these NFB-related improvements in tinnitus symptoms. The present study was therefore designed to explore whether the implementation of an alpha training protocol with a portable neurofeedback apparatus would achieve improvements in tinnitus patient symptoms. In this study, 38 tinnitus patients underwent NFB training while 18 were enrolled in a control group. The study was single-blinded such that only participants were not aware of their group assignments. Those in the NFB group underwent 15 NFB training sessions over 5 weeks, in addition to pre- and posttraining tests including the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), visual analog scales (VAS), electroencephalography (EEG), and functional magnetic resonance imaging (fMRI). Our result find that when the THI, THQ, and VAS scores of patients in the two groups were assessed after a 5-week training period, these scores were unchanged in control patients whereas they had significantly improved in the NFB group patients. EEG analyses revealed that the alpha band was increased in the occipital lobe following NFB treatment, while fMRI indicated an increase in regional homogeneity (ReHo) in the right frontal lobe of patients in the NFB group after treatment that was negatively correlated with THI and VAS scores. The results of this analysis indicate that alpha NFB training can be effectively used to reduce tinnitus-related distress and sound perception in patients.
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Tripodi, Armando, Arnaldo A. Arbini, Veena Chantarangkul, Donato Bettega, and Pier Mannuccio Mannucci. "Are Capillary Whole Blood Coagulation Monitors Suitable for the Control of Oral Anticoagulant Treatment by the International Normalized Ratio?" Thrombosis and Haemostasis 70, no. 06 (1993): 0921–24. http://dx.doi.org/10.1055/s-0038-1649700.
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SummaryThe 512 Coagulation Monitor is a portable coagulation photometer that uses disposable cartridges containing a lyophilized rabbit brain thromboplastin to measure the PT for capillary whole blood. It has been proposed as a suitable system for patient self monitoring at home, but its performance has never been thoroughly assessed for results expressed as International Normalized Ratio (INR). In particular, there is no available information about the adequacy of the WHO calibration model with the Monitor. The aims of the study were to determine the International Sensitivity Index (ISI) against the secondary International Reference Preparation for rabbit thromboplastin and to assess the precision of the INR. The study demonstrates that the Monitor can be calibrated with the WHO model, because log-transformed PTs for patients stabilized on oral anticoagulants and normal individuals are linearly related and because the same orthogonal regression line describes patient and normal data points adequately. However, the ISI calculated in this study (2.715) is higher than that adopted by the manufacturer (2.036). The between-assay reproducibility of the Monitor is acceptable (CV = 9.7%) with results expressed in seconds, but become unacceptably poor when the results are converted into INR (CV = 18.8%) because of the high ISI value of the thromboplastin used. We think that the Monitor might be suitable for monitoring oral anticoagulant therapy if the manufacturer would provide a more sensitive thromboplastin in the cartridges.
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Saito, Norihiko, Nozomi Hirai, Akinori Yagihashi, Shusaku Takahagi, Naoki Kushida, Sho Sato, Yu Hiramoto, et al. "NIMG-34. DELAYED PSEUDOPROGRESSION IN GLIOBLASTOMA PATIENTS TREATED WITH TTFIELDS: A REPORT OF TWO CASES." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi136. http://dx.doi.org/10.1093/neuonc/noab196.534.
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Abstract INTRODUCTION: Tumor treating fields (TTFields) is an established treatment modality for glioblastoma (GBM) and is administered with the portable Optune system. Although the EF-14 phase 3 trial demonstrated the efficacy of TTFields for newly diagnosed GBM, uncertainty regarding the specific effects of this treatment has prevented its widespread clinical use. Pseudoprogression in response to chemoradiation is a known problem in GBM patients and most commonly occurs within 3 months after radiotherapy. We report 2 cases of TTFields delayed pseudoprogression. CASE REPORT: Two GBM patients being treated with TTFields showed signs of radiographic progression at 5 to 6 months after completing radiotherapy. Patient 1 was a 37-year-old woman with gliosarcoma in the right temporal lobe. Patient 2 was a 70-year-old man with wildtype-IDH GBM in the left temporal lobe. Both patients received TTFields in addition to maintenance temozolomide (TMZ) after radiotherapy (RT). Radiographic progression was noted at 5 and 6 months after RT in Patients 1 and 2, respectively. Second resections were performed, and pathology showed only the treatment effect, which ultimately led to diagnosis of pseudoprogression. DISCUSSION: Both patients had radiographic progression outside the typical pseudoprogression window. Recent studies reported that TTFields increased plasma cell membrane permeability, which could result in additional gadolinium leakage into the extracellular space. CONCLUSIONS: Better characterization of delayed pseudoprogression would improve treatment and could potentially reduce unnecessary surgeries and discontinuation of successful therapies.