Subjects -> MEDICAL SCIENCES (Total: 8677 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (219 journals)
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    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (235 journals)
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    - EMERGENCY AND INTENSIVE CRITICAL CARE (124 journals)
    - ENDOCRINOLOGY (151 journals)
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    - INTERNAL MEDICINE (177 journals)
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    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2410 journals)
    - NURSES AND NURSING (367 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (386 journals)
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    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

MEDICAL SCIENCES (2410 journals)            First | 3 4 5 6 7 8 9 10 | Last

Showing 1201 - 1400 of 3562 Journals sorted alphabetically
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Evidence-Based Medicine     Partially Free   (Followers: 4)
Journal of Exercise Science & Fitness     Open Access   (Followers: 29)
Journal of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
Journal of Family and Community Medicine     Open Access   (Followers: 3)
Journal of Family Medicine and Primary Care     Open Access   (Followers: 11)
Journal of Foot and Ankle Research     Open Access   (Followers: 5)
Journal of Forensic Science and Research     Open Access   (Followers: 2)
Journal of Gandaki Medical College-Nepal     Open Access  
Journal of Generic Medicines     Hybrid Journal   (Followers: 2)
Journal of Geographical Sciences     Hybrid Journal   (Followers: 1)
Journal of Global Antimicrobial Resistance     Hybrid Journal   (Followers: 3)
Journal of Hand Therapy     Hybrid Journal   (Followers: 19)
Journal of Head & Neck Physicians and Surgeons     Open Access   (Followers: 2)
Journal of Health & Medical Informatics     Open Access   (Followers: 61)
Journal of Health and Biological Sciences     Open Access   (Followers: 1)
Journal of Health Design     Open Access   (Followers: 1)
Journal of Health Economics and Outcomes Research     Open Access   (Followers: 1)
Journal of Health Promotion and Behavior     Open Access  
Journal of Health Research and Reviews     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science Research     Open Access  
Journal of Health Sciences     Open Access   (Followers: 1)
Journal of health sciences     Open Access  
Journal of Health Sciences / Sağlık Bilimleri Dergisi     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Medicine     Open Access   (Followers: 2)
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Specialties     Open Access  
Journal of Health Studies     Open Access  
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 1)
Journal of Heavy Metal Toxicity and Diseases     Open Access  
Journal of Helminthology     Hybrid Journal   (Followers: 2)
Journal of Herbs Spices & Medicinal Plants     Hybrid Journal  
Journal of HIV for Clinical and Scientific Research     Open Access   (Followers: 2)
Journal of Hospital Medicine     Hybrid Journal   (Followers: 11)
Journal of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal  
Journal of Human Hypertension     Hybrid Journal   (Followers: 3)
Journal of Human Rhythm     Open Access  
Journal of Human Transcriptome     Open Access  
Journal of Ideas in Health     Open Access  
Journal of Inflammation     Open Access   (Followers: 2)
Journal of Inflammation Research     Open Access  
Journal of Injury and Violence Research     Open Access   (Followers: 7)
Journal of Innovation in Health Informatics     Open Access   (Followers: 17)
Journal of Institute of Medicine     Open Access  
Journal of Insulin Resistance     Open Access   (Followers: 1)
Journal of Interactional Research in Communication Disorders     Hybrid Journal   (Followers: 5)
Journal of Interferon & Cytokine Research     Hybrid Journal   (Followers: 3)
Journal of International Medical Research     Open Access   (Followers: 3)
Journal of Interventional Medicine     Open Access   (Followers: 1)
Journal of Investigative Medicine     Hybrid Journal   (Followers: 3)
Journal of Islamabad Medical & Dental College     Open Access   (Followers: 2)
Journal of Istanbul Faculty of Medicine     Open Access  
Journal of Karnali Academy of Health Sciences     Open Access   (Followers: 1)
Journal of Kathmandu Medical College     Open Access   (Followers: 1)
Journal of King Abdulaziz University : Medical Sciences     Open Access   (Followers: 2)
Journal of Laboratory Medicine     Hybrid Journal   (Followers: 27)
Journal of Laryngology and Voice     Open Access   (Followers: 11)
Journal of Lasers in Medical Sciences     Open Access  
Journal of Law, Medicine & Ethics     Hybrid Journal   (Followers: 24)
Journal of Legal Medicine     Hybrid Journal   (Followers: 7)
Journal of Limb Lengthening & Reconstruction     Open Access  
Journal of Lumbini Medical College     Open Access   (Followers: 1)
Journal of Mahatma Gandhi Institute of Medical Sciences     Open Access  
Journal of Manipulative and Physiological Therapeutics     Hybrid Journal   (Followers: 6)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access   (Followers: 1)
Journal of Marine Medical Society     Open Access  
Journal of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
Journal of Maternal and Child Health     Open Access  
Journal of Mechanics in Medicine and Biology     Hybrid Journal  
Journal of Medical and Biological Engineering     Hybrid Journal   (Followers: 4)
Journal of Medical and Biomedical Sciences     Open Access   (Followers: 2)
Journal of Medical Case Reports     Open Access   (Followers: 1)
Journal of Medical Cases     Open Access   (Followers: 6)
Journal of Medical Colleges of PLA     Full-text available via subscription  
Journal of Medical Disorders     Open Access  
Journal of Medical Economics     Hybrid Journal   (Followers: 8)
Journal of Medical Education and Curricular Development     Open Access   (Followers: 6)
Journal of Medical Ethics     Partially Free   (Followers: 25)
Journal of Medical Ethics and History of Medicine     Open Access   (Followers: 17)
Journal of Medical Humanities     Hybrid Journal   (Followers: 21)
Journal of Medical Hypotheses and Ideas     Open Access  
Journal of Medical Imaging and Health Informatics     Full-text available via subscription   (Followers: 1)
Journal of Medical Investigation and Practice     Open Access  
Journal of Medical Laboratory and Diagnosis     Open Access  
Journal of Medical Law and Ethics     Full-text available via subscription   (Followers: 16)
Journal of Medical Microbiology     Full-text available via subscription   (Followers: 6)
Journal of Medical Sciences     Open Access  
Journal of Medical Sciences     Open Access  
Journal of Medical Screening     Hybrid Journal   (Followers: 6)
Journal of Medical Signals and Sensors     Open Access   (Followers: 3)
Journal of Medical Society     Open Access  
Journal of Medical Systems     Hybrid Journal  
Journal of Medical Toxicology     Hybrid Journal   (Followers: 6)
Journal of Medical Ultrasound     Open Access   (Followers: 2)
Journal of Medicinal Botany     Open Access  
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 203)
Journal of Medicine     Open Access   (Followers: 1)
Journal of Medicine and Biomedical Research     Open Access   (Followers: 1)
Journal of Medicine and Philosophy     Hybrid Journal   (Followers: 8)
Journal of Medicine and the Person     Hybrid Journal  
Journal of Medicine in Scientific Research     Open Access  
Journal of Medicine in the Tropics     Open Access  
Journal of Medicine Research and Development     Open Access   (Followers: 3)
Journal of Medicine, Physiology and Biophysics     Open Access   (Followers: 5)
Journal of Medicines Development Sciences     Open Access   (Followers: 1)
Journal of Metabolomics & Systems Biology     Open Access   (Followers: 2)
Journal of Mind and Medical Sciences     Open Access   (Followers: 1)
Journal of Molecular Medicine     Hybrid Journal   (Followers: 11)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1)
Journal of Nanotechnology in Engineering and Medicine     Full-text available via subscription   (Followers: 6)
Journal of Nanotheranostics     Open Access   (Followers: 1)
Journal of Natural Medicines     Hybrid Journal  
Journal of Natural Science, Biology and Medicine     Open Access   (Followers: 3)
Journal of Nature and Science of Medicine     Open Access   (Followers: 4)
Journal of Negative and No Positive Results     Open Access  
Journal of Nepalgunj Medical College     Open Access  
Journal of Neurocritical Care     Open Access  
Journal of Neurodegenerative Diseases     Open Access   (Followers: 2)
Journal of Neurorestoratology     Open Access  
Journal of Neuroscience and Neurological Disorders     Open Access  
Journal of Nobel Medical College     Open Access  
Journal of Obesity and Bariatrics     Open Access   (Followers: 1)
Journal of Occupational Health     Open Access  
Journal of Occupational Therapy Education     Open Access   (Followers: 11)
Journal of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
Journal of Oral Biology and Craniofacial Research     Full-text available via subscription  
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Orofacial Sciences     Open Access  
Journal of Otorhinolaryngology, Hearing and Balance Medicine     Open Access   (Followers: 1)
Journal of Ovarian Research     Open Access  
Journal of Ozone Therapy     Open Access  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 47)
Journal of Paramedical Sciences & Rehabilitation     Open Access  
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Participatory Medicine     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Pathogens     Open Access   (Followers: 1)
Journal of Patient Experience     Open Access  
Journal of Patient Safety and Risk Management     Hybrid Journal   (Followers: 2)
Journal of Patient-Centered Research and Reviews     Open Access  
Journal of Patient-Reported Outcomes     Open Access  
Journal of Periodontal Research     Hybrid Journal  
Journal of Personalized Medicine     Open Access   (Followers: 3)
Journal of Pest Science     Hybrid Journal   (Followers: 1)
Journal of Pharmaceutical Policy and Practice     Open Access   (Followers: 4)
Journal of Physiobiochemical Metabolism     Hybrid Journal   (Followers: 2)
Journal of Physiology-Paris     Hybrid Journal   (Followers: 2)
Journal of Pioneering Medical Sciences     Open Access  
Journal of Postgraduate Medicine     Open Access  
Journal of Pregnancy     Open Access   (Followers: 4)
Journal of Prevention & Intervention Community     Hybrid Journal   (Followers: 6)
Journal of Preventive Medicine and Public Health     Open Access  
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Prosthodontic Research     Full-text available via subscription   (Followers: 1)
Journal of Prosthodontics     Hybrid Journal   (Followers: 2)
Journal of Receptor, Ligand and Channel Research     Open Access   (Followers: 1)
Journal of Regenerative Medicine     Partially Free   (Followers: 4)
Journal of Research in Medical Sciences     Open Access   (Followers: 2)
Journal of Science and Applications : Biomedicine     Open Access   (Followers: 1)
Journal of Science and Technology (Ghana)     Open Access   (Followers: 3)
Journal of Scientific Innovation in Medicine     Open Access  
Journal of Scientific Perspectives     Open Access   (Followers: 1)
Journal of Sensory Studies     Hybrid Journal   (Followers: 4)
Journal of Shaheed Suhrawardy Medical College     Open Access  
Journal of Shoulder and Elbow Arthroplasty     Open Access  
Journal of Sleep Disorders : Treatment & Care     Hybrid Journal   (Followers: 10)
Journal of South American Earth Sciences     Hybrid Journal   (Followers: 5)
Journal of Spinal Cord Medicine     Hybrid Journal   (Followers: 4)
Journal of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Stem Cell Therapy and Transplantation     Open Access   (Followers: 1)
Journal of Stomal Therapy Australia     Full-text available via subscription  
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 77)
Journal of Substance Use     Hybrid Journal   (Followers: 15)
Journal of Surgical Academia     Open Access   (Followers: 1)
Journal of Surgical and Clinical Research     Open Access  
Journal of Surgical Case Reports     Open Access  
Journal of Surgical Education     Full-text available via subscription   (Followers: 3)
Journal of Surgical Technique and Case Report     Open Access  
Journal of Systemic Therapies     Full-text available via subscription   (Followers: 3)
Journal of Taibah University Medical Sciences     Open Access  
Journal of Telemedicine and Telecare     Hybrid Journal   (Followers: 12)
Journal of The Academy of Clinical Microbiologists     Open Access  
Journal of the American Association for Laboratory Animal Science     Full-text available via subscription   (Followers: 9)
Journal of the American College of Certified Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American College of Clinical Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American Medical Directors Association     Hybrid Journal   (Followers: 5)
Journal of the American Medical Informatics Association : JAMIA     Hybrid Journal   (Followers: 36)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of the Anatomical Society of India     Full-text available via subscription  
Journal of the Anus, Rectum and Colon     Open Access  
Journal of The Arab Society for Medical Research     Open Access  
Journal of the Australasian College of Nutritional and Environmental Medicine     Full-text available via subscription  
Journal of the Australasian Society of Aerospace Medicine     Open Access   (Followers: 1)
Journal of the Ceylon College of Physicians     Open Access  

  First | 3 4 5 6 7 8 9 10 | Last

Similar Journals
Journal Cover
Journal of the American College of Certified Wound Specialists
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1876-4983
Published by Elsevier Homepage  [3203 journals]
  • Letter from the Chair
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3



      PubDate: 2012-12-17T22:03:25Z
       
  • ABWMS
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3



      PubDate: 2012-12-17T22:03:25Z
       
  • Split-Thickness Skin Grafts Remain the Gold Standard for the Closure of
           Large Acute and Chronic Wounds
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3

      Healing large chronic and acute wounds is a challenging task for wound care providers. It requires numerous visits and frequent dressing changes and often involves expensive therapeutic modalities. Our primary and ultimate goal is to heal these wounds as quickly as possible. In a prepared wound bed, covered with granulation tissue and free of infection, skin graft is the gold standard procedure to achieve this goal. One should keep in mind that not all patients are good candidates for surgery.

      PubDate: 2012-12-17T22:03:25Z
       
  • A Comprehensive Review on Marjolin's Ulcers: Diagnosis and Treatment
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3

      Despite the misnomer, Marjolin's ulcers really reflect malignant degeneration arising within a pre-existing cicatrix or scar. In most instances, biopsied lesions demonstrate well-differentiated squamous cell tumors, although other epidermoid lesions are occasionally encountered. The lesions are rare and are most commonly found in the lower extremity, especially the heel and plantar foot. In light of the close association of these lesions with scarred tissues associated with various chronic lower-extremity wounds, those involved in health care delivery to these patients must be aware of Marjolin's ulcer, its manifestations and potential ramifications.

      PubDate: 2012-12-17T22:03:25Z
       
  • The History of Wound Care
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3

      The history of wound healing is, in a sense, the history of humankind. This brief history of wound healing has been compiled for the benefit of readers. It is amazing to see that some of the basic principles of wound healing have been known since 2000 bc.

      PubDate: 2012-12-17T22:03:25Z
       
  • Ace Your Certification Exam
    • Abstract: September 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 3

      Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Chair
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2



      PubDate: 2012-12-17T22:03:25Z
       
  • Correction of Hypoxia, a Critical Element for Wound Bed Preparation
           Guidelines: TIMEO2 Principle of Wound Bed Preparation
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2

      Wound bed preparation is an organized approach to create an optimal environment for wound healing by the use of the most cost-effective therapeutic options. It has become an essential part of wound management and seeks to use the latest findings from molecular and cellular research to maximize the benefits of today’s advanced wound care products. The international advisory panel on wound bed preparation met in 2002 to develop a systemic approach to wound management. These principles of this approach are referred to by the mnemonic TIME, which stands for the management of nonviable or deficient tissue (T), infection or inflammation (I), prolonged moisture imbalance (M), and nonadvancing or undermined epidermal edge (E). One critical element of pathophysiology, understanding of the hypoxic nature of the wound and correction of hypoxia as a critical element of wound bed preparation, is not covered. This article proposes to add correction of hypoxia to the TIME principle (TIMEO2 principle) based on the evidence. The evidence that will support the reason and the need for modification of the wound bed preparation protocol is discussed.

      PubDate: 2012-12-17T22:03:25Z
       
  • Novel Wound Healing Powder Formulation for the Treatment of Venous Leg
           Ulcers
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2

      Chronic venous disorders are common in the Western world. The current treatment of venous leg ulcers is unsatisfactory despite the availability of well-documented standards of care. Patients today are interested in alternative approaches to modern medicine. We have developed a wound-healing powder containing natural ingredients with absorptive, aromatic, antiseptic, and anti-inflammatory synergistic properties. This report describes 3 cases that were successfully treated with the powder, demonstrating the potential of herbal remedies in the clinical treatment of venous leg ulcers.

      PubDate: 2012-12-17T22:03:25Z
       
  • Clostridium Tertium Isolated From a Necrotizing Soft Tissue Infection in a
           Diabetic but Otherwise Nonimmunocompromised Patient
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2

      Clostridium tertium has historically been regarded as nonpathogenic, and its implication as the primary microbe in infectious etiologies remains unclear. Although there have been several reports of C tertium isolated from blood, tissue, and other specimens, largely this population has consisted of patients with neutropenia, hematologic malignancies, or gastrointestinal disorders. Here we describe a case of a 39-year-old nonimmunocompromised man with a history of type 1 diabetes mellitus and intravenous drug use who presented to our institution with a necrotizing soft tissue infection involving his right upper extremity. The infection had developed after the patient had injected methamphetamines. At surgery, tissue was obtained for Gram stain and culture, yielding C tertium, after an initial misidentification as Lactobacillus species. After undergoing extensive surgical debridement and treatment with an appropriate antibiotic regimen, the patient was able to be discharged home with retained function of his extremity. Although not common, infections involving C tertium can produce severe, potentially life- and limb-threatening disease processes, which may require aggressive therapy even in the nonimmunocompromised patient.

      PubDate: 2012-12-17T22:03:25Z
       
  • Consider Skin Hygiene and Care Beyond the Wound
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2



      PubDate: 2012-12-17T22:03:25Z
       
  • Ace Your Certification Exam
    • Abstract: June 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 2

      Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam.

      PubDate: 2012-12-17T22:03:25Z
       
  • A Case Report: Efficiency of Microbial Cellulose Dressing in Partial
           Thickness Burn Wounds
    • Abstract: Available online 1 April 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists

      Microbial cellulose is a natural polymer that can hold an amount of water without any disconformities as a result it considered to be a wound dressing material. We report a case of 28 percent total body surface area partial thickness flame burn approximately 4.5 % superficial partial thickness burns on anterior face and 23.5 % mixed between superficial and deep partial thickness burns on both upper arms and anterior trunk. Microbial cellulose dressing “Nanocell” (thai nanocellulose Co.LTD, Bangkok, Thailand) was applied onto the face wound for once time without any other dressing changed after this application. Progress of healing until full epithelialization on face was observed within 2 weeks. During the treatment, the patient did not show any irritation or allergic reaction to this new dressing and there was no evidence of bacteria presence after burn wound swab culture. This innovative material will be an alternative dressing in superficial partial thickness burn wounds.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Chair
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1



      PubDate: 2012-12-17T22:03:25Z
       
  • Phase Angle, an Alternative Physiological Tool to Assess Wound Treatment
           in Chronic Nonhealing Wounds
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1

      Background This exploratory study was conducted in an effort to demonstrate that bioelectrical impedance analysis (BIA) phase angle measurement is a novel tool for monitoring the effectiveness of a wound care regimen at a regional level and is valuable in comparing that status with the overall metabolic health of the patient. Isolating and measuring the extent to which nutritional supplementation contributes to the healing process is difficult and confounded by the many treatment modalities patients undergo. Objective The authors conducted a limited exploratory study to determine whether regional phase angle measurements accurately reflected the status of chronic nonhealing wounds. This information would potentially provide the ability to quantitatively evaluate of the role of nutritional supplementation in wounds of varying etiologies by comparing regional BIA phase angle measurement with overall BIA phase angle measurement. Methods Eleven patients with wounds of varying etiologies were selected to participate. Each patient underwent a treatment regimen specific to his or her condition, and all patients were given JUVEN® nutritional supplement. Results and Conclusion In all patients, the BIA phase angle measurement mirrored the health of the wound and provided an accurate tool for assessing the regional tissue health, a valuable insight in measuring the effectiveness of a systemic treatment.

      PubDate: 2012-12-17T22:03:25Z
       
  • Silver Toxicity With the Use of Silver-Impregnated Dressing and Wound
           Vacuum-Assisted Closure in an Immunocompromised Patient
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1

      Silver-containing topical agents are used to help prevent infectious complications in wound therapy. Toxicity from topical silver agent exposure was initially reported in 1975 and was clinically characterized by granulocytopenia. Currently, the data regarding potential toxicity associated with silver-impregnated devices are limited. A 23-year-old patient receiving chemotherapy for acute lymphoblastic leukemia presented with necrotizing fasciitis of the abdominal wall and scrotum from a Crohn disease–related psoas-enteric fistula. Surgical debridement of the soft-tissue and abdominal musculature was performed to the peritoneum. Silver-containing foam sponges and wound vacuum-assisted closure were applied directly to the peritoneum 2 weeks after initial debridement. Subsequently, the patient developed leukopenia, and workup revealed the serum silver level was 4 times normal level. Silver-impregnated sponges were discontinued and silver-free sponges and wound vacuum-assisted closure therapy resumed, followed by leukopenia resolution. Silver toxicity associated with routine application of silver-impregnated sponges has not been previously reported.

      PubDate: 2012-12-17T22:03:25Z
       
  • The Significance of Introducing Permanent Assignments for Nursing
           Assistants at a Long-Term Care Setting on the Incidence Rate of
           Facility-Acquired Pressure Ulcers Among Elderly Patients
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1

      Pressure ulcer prevalence remains a major health concern in long-term care facilities. The treatment of these pressure ulcers causes a financial drain on health care resources and adds potential costs for the family of the institutionalized elderly, according to the Agency for Healthcare Research and Quality. The prevention of pressure ulcer development continues to be an essential objective of caregivers for elderly people. This study demonstrated a correlation between the permanent assignment of nursing assistants and the prevention of pressure ulcers among the elderly in a nursing home.

      PubDate: 2012-12-17T22:03:25Z
       
  • Efficiency of Microbial Cellulose Dressing in Partial-Thickness Burn
           Wounds
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1

      Microbial cellulose is a natural polymer that can hold a quantity of water without any disconformities. Therefore, it is proposed for use as wound dressing material. We report a case of 28% total body surface area partial-thickness flame burn: approximately 4.5% superficial partial-thickness burns on anterior face and 23.5% combined superficial and deep partial-thickness burns on both upper arms and anterior trunk. A microbial cellulose dressing, Nanocell (Thai Nano Cellulose Co Ltd, Bangkok, Thailand), was applied to the face wound only once, without any further dressing change. Progress of healing, until full epithelialization on the face, was observed for 2 weeks. During the treatment period, the patient did not show any irritation or allergic reaction to this new dressing, and wound swab culture showed no evidence of bacteria presence. This innovative material can be an alternative dressing for superficial partial-thickness burn wounds.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter to the Editor
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1



      PubDate: 2012-12-17T22:03:25Z
       
  • Ace Your Certification Exam
    • Abstract: March 2011
      Publication year: 2011
      Source:The Journal of the American College of Certified Wound Specialists, Volume 3, Issue 1

      Dr Jayesh Shah authors this quarterly column, consisting of 5 questions with explanations, to help you practice for your exam.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter From the Chair
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4



      PubDate: 2012-12-17T22:03:25Z
       
  • Calciphylaxis: A Review
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4

      Human calciphylaxis reflects a form of severe tissue compromise attributable to a unique microangiopathy that combines features of vascular thrombotic occlusion with endoluminal calcification. While most frequently described in patients with renal failure, it is seen in other settings, such as multiple myeloma; polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome; cirrhosis; and rheumatoid arthritis. Although most commonly involving the skin, calciphylaxis can affect other organs including the heart and gastrointestinal tract, in which cases it falls under the appellation of systemic calciphylaxis. There are cases in which the main pathology is one of endovascular thrombosis of the vessels of the fat without discernible calcification or one manifesting a pseudoangiosarcomatous pattern, hence adding to the histomorphologic spectrum of calciphylaxis. A variety of factors contribute to this severe occlusive microangiopathy, including an underlying procoagulant state and ectopic neo-osteogenesis of the microvasculature through varied mechanisms, including increased osteopontin production by vascular smooth muscle or reduced synthesis of fetuin and GLA matrix protein, important inhibitors of ectopic neo-osteogenesis. Certain factors adversely affect outcome, including truncal and genital involvement and systemic forms of calciphylaxis. With a better understanding of its pathophysiology, more-effective therapies, such as sodium thiosulfate and biphosphanates to reduce reactive oxygen species and receptor activator of nuclear factor κβ-mediated nuclear factor κβ activity, respectively, are being developed.

      PubDate: 2012-12-17T22:03:25Z
       
  • Off-Loading Practices for the Wounded Foot: Concepts and Choices
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4

      A wound practitioner’s best-laid plan of care and strategy for healing an ulcerated foot is doomed to fail without a properly conceived approach based on sound off-loading principles. Wound healing that has stalled despite best-practice techniques may require reevaluation of off-loading choices. This is particularly true in the patient with abnormal foot pathologies. Special considerations are certainly required with neuropathic ulcers; however, any wound on a weight-bearing surface of the foot requires proper off-loading. This discussion explores the basic biomechanical and pathomechanical concepts that modify and influence ambulation and gait patterns. Integration of these concepts into the choices for off-loading to deter pathologic influences will alert the reader of precautionary measures and other factors for consideration. The aim of this column is to provide both an adequate working knowledge of the available off-loading devices and the necessary tools and concepts needed to stimulate wise decision protocols for wound management and healing.

      PubDate: 2012-12-17T22:03:25Z
       
  • A Review of Cyanoacrylate Liquid Skin Protectant and Its Efficacy on Pedal
           Fissures
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4

      Introduction Skin fissures are a common dermatologic condition caused by excessive dry skin, numerous systemic diseases, and backless shoe gear. They are defects in skin that fall into the category of damaged, partial-thickness skin wounds, as opposed to full-thickness wounds. Patients with heel fissures are at an increased risk for developing infection, which could cause more severe issues, especially in patients with diabetes and peripheral vascular disease. Methods Five patients from Temple Foot and Ankle Institute, Philadelphia, PA, with a total of 8 heel fissures and 2 hallux fissures, were studied. Patients were dispensed 9 vials of a cyanoacrylate liquid skin protectant (Marathon™, Medline Industries, Inc, Mundelein, IL) to be applied to the fissure every 3 days. Patients returned every 2 weeks for follow-up in clinic. Results The hallux fissures and 4 of the heel fissures went to complete closure after 2 weeks. There was an average decrease of 1.16 cm in length of the heel fissure dimensions after 2 weeks and an average decrease of 1.1 cm in length of the hallux fissures. Conclusion This novel skin protectant proved to be a comfortable, easy, and effective tool in aiding the resolution of pedal skin fissures.

      PubDate: 2012-12-17T22:03:25Z
       
  • The Effect of pH on the Antimicrobial Efficiency of Silver Alginate on
           Chronic Wound Isolates
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4

      Background Nonhealing and stalled chronic wounds are often reported to reside within an alkaline environment. Consequently, a number of researchers have proposed that lowering the pH of a chronic wound environment will enable healing to progress. However, it is not known whether the efficacies of silver-impregnated wound dressings are affected by pH. Objective To investigate whether pH has an effect on the antimicrobial barrier efficacy of a silver alginate wound dressing on wound isolates. Methods Twenty-five bacteria and yeasts that had been routinely isolated from chronic wounds were separately exposed to a silver alginate wound dressing with the use of a standardized corrected zone of inhibition (CZOI) assay. Results The silver alginate dressing demonstrated a broad spectrum of antimicrobial barrier activity within the dressing against all wound isolates. However, at a pH of 5.5, compared with a pH of 7, the antimicrobial barrier activity of the silver alginate dressing significantly increased. For all yeasts the CZOI ranged from 6.25 to 11mm at a pH of 7. At a pH of 5.5, the CZOI range increased from 8.5 to 12.25mm. For the Gram-negative isolates, the CZOI ranged from 0.75 to 6.5mm at a pH 7, compared with a CZOI range of 2.75 to 8mm at pH 5.5. The CZOI for the Gram-positive isolates, including meticillin-resistant Staphylococcus aureus, ranged from 3 to 7.75mm at pH 7 and from 4.5 to 11.75mm at pH 5.5. Conclusion For all isolates tested, excluding one strain of Candida albicans and one vancomycin-resistant Enterococcus strain, lowering pH to 5.5 resulted in an improvement in the antimicrobial barrier activity within the silver alginate dressing. Based on these initial in vitro findings, it is possible to suggest that there may be benefits to maintaining an infected or recalcitrant wound in a slightly acid (pH 5.5) environment. In particular, doing so may lead to an enhanced antimicrobial barrier effect of silver, a quicker reduction in the wound microbial bioburden, and therefore a reduction in the need for prolonged antimicrobial use. However, more in vitro and in vivo studies would be warranted to further substantiate these claims.

      PubDate: 2012-12-17T22:03:25Z
       
  • Ace Your Certification Exam
    • Abstract: December 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 4

      Dr Jayesh Shah authors this quarterly column, consisting of 4 questions with explanations, to help you practice for your exam.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Chair
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3



      PubDate: 2012-12-17T22:03:25Z
       
  • Wound Healing and Nutrition: Going Beyond Dressings With a Balanced Care
           Plan
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3

      As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, and (3) nutrition. Nutrition is the area that is most often overlooked, which commonly causes the care plan to be out of balance. In the United States, few clinicians would consider malnutrition to be an issue in the homecare and long-term care setting, yet nutritional status and risk for pressure ulcer formation are well documented and strongly correlated. Our aging population will continue to survive previously catastrophic events, only to present with pressure ulcers or the potential for developing pressure ulcers. Clinicians caring for residents with pressure ulcers must strike a balance between pressure relief, dressings, and nutrition. Functional gastrointestinal-tract impairments must be diagnosed and addressed. Wounds must be treated aggressively with high-protein calorically-balanced diets because wounds heal from the inside out.

      PubDate: 2012-12-17T22:03:25Z
       
  • Modern Collagen Wound Dressings: Function and Purpose
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3

      Collagen, which is produced by fibroblasts, is the most abundant protein in the human body. A natural structural protein, collagen is involved in all 3 phases of the wound-healing cascade. It stimulates cellular migration and contributes to new tissue development. Because of their chemotactic properties on wound fibroblasts, collagen dressings encourage the deposition and organization of newly formed collagen, creating an environment that fosters healing. Collagen-based biomaterials stimulate and recruit specific cells, such as macrophages and fibroblasts, along the healing cascade to enhance and influence wound healing. These biomaterials can provide moisture or absorption, depending on the delivery system. Collagen dressings are easy to apply and remove and are conformable. Collagen dressings are usually formulated with bovine, avian, or porcine collagen. Oxidized regenerated cellulose, a plant-based material, has been combined with collagen to produce a dressing capable of binding to and protecting growth factors by binding and inactivating matrix metalloproteinases in the wound environment. The increased understanding of the biochemical processes involved in chronic wound healing allows the design of wound care products aimed at correcting imbalances in the wound microenvironment. Traditional advanced wound care products tend to address the wound’s macroenvironment, including moist wound environment control, fluid management, and controlled transpiration of wound fluids. The newer class of biomaterials and wound-healing agents, such as collagen and growth factors, targets specific defects in the chronic wound environment. In vitro laboratory data point to the possibility that these agents benefit the wound healing process at a biochemical level. Considerable evidence has indicated that collagen-based dressings may be capable of stimulating healing by manipulating wound biochemistry.

      PubDate: 2012-12-17T22:03:25Z
       
  • The Clinical Effectiveness in Wound Healing With Extracellular Matrix
           Derived From Porcine Urinary Bladder Matrix: A Case Series on Severe
           Chronic Wounds
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3

      A study involving 3 patients was performed to evaluate the efficacy of Matristem, an extracellular matrix scaffold derived from the porcine urinary bladder matrix (UBM), to promote natural healing in patients with severe, chronic wounds that did not respond well to standard wound management. In all cases, the wounds closed after only a few weeks of repeated treatments with UBM, with all patients showing complete epithelialization of the wound with limited formation of scar tissue by 13 weeks after first treatment. These initial results suggest that UBM warrants further investigation for treatment of chronic nonhealing ulcers that are recalcitrant to standard wound therapies.

      PubDate: 2012-12-17T22:03:25Z
       
  • Reduction of Postoperative Scar Formation With Silicone Sheeting: 2 Case
           Studies
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3

      Elective surgeries account for millions of acquired scars annually. Many of these scars can be problematic, being aesthetically unpleasant and causing discomfort. Silicone gel sheeting has been shown to be efficacious for the prevention and treatment of problematic scars. By wound hydration, along with other factors, silicone dressings are thought to decrease scarring. However, we found the usual treatment was commonly started after epithelialization of the incision site. The current standard of care in wound healing is to promote a moist wound environment to ensure quick epithelialization and decrease excessive scar formation. With that standard in mind, after foot surgery was performed on 2 patients, silicone sheeting was applied immediately in order to compare its effects with those of standard moist wound healing (XEROFORM Petrolatum Gauze).

      PubDate: 2012-12-17T22:03:25Z
       
  • Ace Your Certification Exam
    • Abstract: September 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 3

      Dr. Jayesh Shah will be publishing a quarterly column titled “ACE Your Certification Exam.” Every quarter, he will publish 5 questions with explanations to help you practice for your exam.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Chair
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2



      PubDate: 2012-12-17T22:03:25Z
       
  • Complicated Lower Extremity Wound Caused by Immune Thrombocytopenic
           Purpura Leading to Hypercoagulable State: A Team Approach for Limb Salvage
           
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2

      This article describes a complicated lower extremity wound due to hypercoagulable state caused by immune thrombocytopenic purpura. A team approach was important to limb salvage. A literature review is included.

      PubDate: 2012-12-17T22:03:25Z
       
  • Limb Salvage Surgery and Wound Treatment in the Establishment of Globally
           Standardized Diabetes, Amputation, and Limb Salvage Centers to Address
           Lower Extremity Morbidity and Mortality in Thailand
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2

      Diabetes and its consequences, particularly diabetic foot ulcerations and amputations, are increasing exponentially on a global level. Universal interest exists in the establishment of educational programs, clinics, and patient materials. However, the availability and skills needed to develop, implement, and consistently manage diabetes and related problems are lacking. This article reviews problems related to care of the diabetic foot, with a focus on Thailand as a model. Recommendations are made to assist with the development and implementation of limb salvage centers for the treatment of the at-risk diabetic foot. The guidelines presented may be applied to any countries where diabetic foot care is in the initial stages of development.

      PubDate: 2012-12-17T22:03:25Z
       
  • Commentary on the Conversion to an Advanced Standard of Care for the
           Treatment of Diabetic Foot Ulcers and Other Chronic Wounds
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2

      There have been notable contributions in the literature regarding the consensus for a new standard for the treatment of diabetic foot ulcers. The more recent advances in wound care therapies, modalities, and evidence-based research have demonstrated that an advanced standard of care for wound healing should exist. Failure of treatment protocols, which center on a 50% area of wound reduction within 4 weeks as a response to standard conventional care, should indicate the use of adjuvant therapies. Negative pressure wound therapy (NPWT), hyperbaric oxygen therapy (HBOT), growth factors, human-derived bioengineered tissue, and extracellular matrix products are readily available. This commentary will explore a brief selection of the current wound care literature as it relates to the acceptance of a new advanced standard of care. Furthermore, the intention is to stimulate further discussion and thought on the relevance of this approach in the treatment of diabetic foot ulcers and chronic wounds and how it may correlate with the ultimate outcome of healing in general.

      PubDate: 2012-12-17T22:03:25Z
       
  • Scarless Wound Healing
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2

      Scarring results from injuries and disease in mammalian adults and can cause pain and loss of function in the afflicted tissues. This negative aspect of wound repair is not always true for certain amphibians and during fetal development of mammals. Based on this knowledge, scientists and clinicians are investigating the mechanisms and growth factors that contribute to or deter a suitable environment for wound healing. This review summarizes these aspects and challenges for scarless repair.

      PubDate: 2012-12-17T22:03:25Z
       
  • Letter to the Editor
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2



      PubDate: 2012-12-17T22:03:25Z
       
  • Instructions for Authors
    • Abstract: June 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 2



      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Chair
    • Abstract: 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 1



      PubDate: 2012-12-17T22:03:25Z
       
  • Letter from the Editor
    • Abstract: 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 1



      PubDate: 2012-12-17T22:03:25Z
       
  • The National Lymphedema Network Is Joining Forces With the American
           College of Certified Wound Specialists
    • Abstract: 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 1



      PubDate: 2012-12-17T22:03:25Z
       
  • Use of Alternatives to Air-Fluidized Support Surfaces in the Care of
           Complex Wounds in Postflap and Postgraft Patients
    • Abstract: 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 1

      Air-fluidized support surface therapy has many drawbacks, such as dehydration, in an already difficult recovery for those wound patients who have undergone flap and graft surgery. In addition, patient care and handling are also problematic. Patients complain of discomfort, and the instability of the surface interferes with patient stability in side lying and semi-Fowler's positions. Alternative support surfaces can be considered for postflap or postgraft patients. Such technologies as alternating pressure, low-air-loss, and therapeutic nonpowered, advanced, and lateral rotation surfaces are widely used for pressure management in high-risk patients and those with existing pressure ulcers. These surfaces must be used within a total pressure ulcer management program that includes frequent turning and repositioning, skin and ulcer care according to evidence-based protocols, patient and caregiver instruction, nutrition, and offloading and positioning. The proposed recommendations require more research on the relative effectiveness of less expensive and more user-friendly support surfaces such as low-air-loss and nonpowered advanced support surfaces and is necessary in order to conclusively recommend one type of surface over another. However, at this time the available clinical studies and opinions remain positive.

      PubDate: 2012-12-17T22:03:25Z
       
  • Hyperbaric Oxygen Therapy
    • Abstract: 2010
      Publication year: 2010
      Source:The Journal of the American College of Certified Wound Specialists, Volume 2, Issue 1

      Hyperbaric oxygen is a treatment in which a patient breathes 100% oxygen intermittently while inside a treatment chamber at a pressure higher than at sea level pressure (ie, >1 atm). In certain circumstances, it represents the primary treatment modality, whereas in others it is an adjunct to surgical or pharmacologic interventions. After reviewing all the scientific evidence available to date, the Undersea and Hyperbaric Medical Society, in its latest publication, Hyperbaric Oxygen Therapy Indications (12th ed.), recommends 13 indications for hyperbaric oxygen therapy. Several of these indications are related to our practice of wound care. The article discusses these indications in detail.

      PubDate: 2012-12-17T22:03:25Z
       
 
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