Katarzyna Skórkowska-Telichowska

The local treatment and available dressings designed for chronic wounds

The great diversity of wounds and the broad range of available dressings complicate the selection of proper chronic wound treatment. Choosing the right treatment is the essential step in the healing process. In this review, we focus on chronic nonhealing ulcers, which are a critical problem in clinical practice, and current knowledge about persistent wound care. Here, we present the objectives of local treatment with description of several types of dressings and their ingredients, features, indications, and contraindications. These include hydrocolloid, alginate, hydrogel, and dextranomer dressings; polyurethane foam and membrane dressings; semipermeable polyurethane membrane dressings; and TenderWet (Hartmann, Rock Hill, SC) and flax dressings. There is also a brief section on the use of other alternative wound-healing accelerators, such as platelet-rich plasma and light-emitting diode therapy.

New dressing materials derived from transgenic flax products to treat long-standing venous ulcers - a pilot study.

A new flax dressing product was developed based on three components (fibers, oil emulsion, and seedcake extract) from genetically engineered flax plants that were obtained by plant transformation using three genes controlling the synthesis of antioxidative compounds from the phenylpropanoid pathway. Simultaneous flax explant transformation with three genes coding for chalcone synthase, chalcone isomerase, and dihydroflavonol reductase resulted in an accumulation of phenolic acids in the fibers, polyunsaturated fatty acids in the oil, and lignans in the seedcake. The fibers, oil, and seedcake from transgenic flax contained a broad spectrum of antioxidative compounds. They were tested for cytotoxicity, and none were found to have a negative effect on the growth and morphology of Balb/3T3 cells. In this preliminary report, we present pilot data on the effects of using linen dressing treatment on its own or in combination with oil emulsion and/or seedcake extract on chronic wound healing. After a 12‐week study, we concluded that an application of a modified flax‐dressing (linen) bandage might yield a more rapid rate of healing and reduce the wound exudes and wound size. In several cases, wound healing was completed during the period of investigation. Interestingly and importantly, the patients reported that the new bandage made from modified flax diminished the pain accompanying chronic venous ulceration. Further study is required to determine any definitive effects of flax bandage on wound healing. This is the first pilot study report suggesting the benefits of a flax‐based dressing on wound healing.

Nordic pole walking improves walking capacity in patients with intermittent claudication: a randomized controlled trial

Abstract Purpose: The aim of the study was to compare the efficacy of Nordic pole walking (NPW) training with traditional treadmill training (TT) on a claudication (CD) and maximum walking distance (MWD) in patients with peripheral arterial disease (PAD). Method: Patients with intermittent claudication (IC) (n = 70; age=68.27) in the Fontaine class II were randomized into a two three-month rehabilitation programs performed three times per week. TT were finished by 31 patients, NPW by 21. Walking capacity was measured by an exercise treadmill test (ETT) with the Gardner–Skinner protocol (before and after the program) and six minute walk test (6MWT) (before, during and after the program). Results: In an ETT both groups reached significant increase in CD and MWD (p ≤ 0.005). In 6MWT NPW group reached significant increase in both CD (p = 0.001) and MWD (p = 0.001), whereas the TT group only in MWD (p = 0.001). Conclusions: NPW has been shown to be as effective as the standard TT and is much less expensive. It should be the preferred method of exercise for PAD patients with IC. Implications for Rehabilitation Nordic walking training is a valuable form of rehabilitation for peripheral arterial disease (PAD) patients with intermittent claudication (IC). Nordic walking has been shown to be as efficient as traditional treadmill training. It is however more cost-effective method of rehabilitation in PAD patients.

The Effects of Newly Developed Linen Dressings on Decubitus Ulcers

Several studies based on hospital billing codes showed an increase in the number of hospital stays involving pressure ulcers by nearly 80% between 1993 and 2006.1–4 The newly developed flax dressings (FlaxAid) were used to treat decubitus ulcers in this clinical study. It has been discovered that genetic engineering methods can be used to enrich bandages in particular antioxidant substances that promote healing in the wound bed.5 The highly hygroscopic linen fibers keep the ulcer at its optimal moisture level by absorbing the excess of exudates, and reduce inflammation in the wound thanks to the high quantities of fenolic acids and flavonoids, which have antiallergenic, antiviral, antiinflammatory, and vasodilator activities6,7 and strengthen the wound tissue against stresses.8,9 This therapy consist of three elements: the linen layer, the oil emulsion, and the seedcake extract and was performed as part of a complex ulcer therapy regime that included necrotic tissue debridement, infection control, nutritional support, physiotherapy, education about proper care, and analgesic and antiplatelet therapy.

Positive effects of egg-derived phospholipids in patients with metabolic syndrome

PURPOSE Patients with metabolic syndrome (MBS) have an increased risk of all-cause mortality, especially from cardiovascular disease. Egg phospholipids (PL) have been shown to exert a positive impact on cholesterol metabolism and inflammation; eggs are an important source of PL. Our study examined potential effects of egg-yolk-derived PL in non-diabetic patients with MBS. METHODS The study group consisted of 40 patients with MBS diagnosed according to IDF criteria and divided into an experimental group receiving the PL preparation (n-6: n-3 fatty acids ratio: 1.79) and the comparison group receiving an olive oil preparation, for one month (2012/2013year). The studied dosage was 45ml (15ml 3 times per day). It was a randomized, double blinded study. RESULTS The waist to hip ratio, GGTP levels, plasma platelet concentrations and flow mediated vasodilation of brachial artery (FMD) significantly improved in the experimental group. A significant decrease in daytime ABPM blood pressure was noticed in both groups. CONCLUSIONS A phospholipid-enriched diet caused a significant improvement of endothelial vasodilatory function and a significant decrease in waist to hip ratio. A significant decrease in daytime systolic blood pressure were observed in both the phospholipid-enriched and oil-olive group.

The response of diabetic foot to a new type of dressing

Background FlaxAid is a newly developed type of dressing enriched in particular flavonoids through genetic engineering of flax plants that exhibit health-promoting activities due to their strong antioxidant properties. The purpose of the current study was to assess the clinical efficacy of the FlaxAid bandage therapy for a patient affected with a diabetic foot ulcer which was unresponsive to previous treatments. The patient was treated with FlaxAid bandages for 12 weeks and the size and properties of the wound were routinely observed and recorded. Due to the the clinical picture of the wound study design was adopted whereby the comparative treatment was cotton gauze wetted with isotonic salt solution. Findings Following therapy, the foot ulcer decreased in size, despite the decompensation of advanced diabetes. It is believed that the beneficial nature of FlaxAid is derived from its high level and broad spectrum of antioxidants. Conclusions The FlaxAid dressing provides a novel and effective method for the treatment of diabetic foot ulcers. This study presents a preliminary pilot investigation and a larger number of subjects need to be included within the study in order to draw firm clinical conclusions. Efforts to this effect are currently under way.

Emulsions Made of Oils from Seeds of GM Flax Protect V79 Cells against Oxidative Stress

Polyunsaturated fatty acids, sterols, and hydrophilic phenolic compounds are components of flax oil that act as antioxidants. We investigated the impact of flax oil from transgenic flax in the form of emulsions on stressed Chinese hamster pulmonary fibroblasts. We found that the emulsions protect V79 cells against the H2O2 and the effect is dose dependent. They reduced the level of intracellular reactive oxygen species and protected genomic DNA against damage. The rate of cell proliferation increased upon treatment with the emulsions at a low concentration, while at a high concentration it decreased significantly, accompanied by increased frequency of apoptotic cell death. Expression analysis of selected genes revealed the upregulatory impact of the emulsions on the histones, acetylases, and deacetylases. Expression of apoptotic, proinflammatory, and anti-inflammatory genes was also altered. It is thus suggested that flax oil emulsions might be useful as a basis for biomedical products that actively protect cells against inflammation and degeneration. The beneficial effect on fibroblast resistance to oxidative damage was superior in the emulsion made of oil from transgenic plants which was correlated with the quantity of antioxidants and squalene. The emulsions from transgenic flax are promising candidates for skin protection against oxidative damage.

Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly

Introduction A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

V79 Fibroblasts Are Protected Against Reactive Oxygen Species by Flax Fabric

Chinese hamster pulmonary fibroblasts (V79 cells) pre-treated with flax fabrics derived from non-modified or genetically engineered flax fibres and treated with H2O2 revealed a markedly lower level of intracellular reactive oxygen species (ROS) than control, non-pre-treated cells. The fabrics were prepared from fibres derived from two kinds of transgenic plants: W92 plants, which overproduce flavonoids, and M type plants, which produce hydroxybutyrate polymer in their vascular bundles and thus in fibres. Incubating the V79 cells with the flax fabrics prior to H2O2 treatment also reduced the amount of DNA damage, as established using the comet assay (also known as alkaline single-cell gel electrophoresis) and pulsed-field electrophoresis of intact cellular DNA. Selected gene expression analysis revealed the activator impact of fabrics on the apoptotic (BCL2 family, caspases) gene expression. This promoting activity was also detected for histone acetyltransferase (HAT; MYST2) gene expression. The flax fabric derived from both GM flax plants exhibited a protective effect against oxidative stress and ROS-mediated genotoxic damage, but the W92 fabric was the strongest. It is thus suggested that these fabrics might be useful as a basis for new biomedical products (e.g. wound dressings) that actively protect cells against inflammation and degeneration.

The effect of a new type of dressing for chronic venous wounds.

Aims: The aim of the current study was to assess the clinical efficacy of the FlaxAid dressing for the treatment of chronic venous wounds in a patient unresponsive to previous treatment protocols. Presentation of Case: A 50-year old male patient presented with recurrent venous ulcers of the lower extremities. All of the ulcers had lasted for 5 years and their size was increasing despite clinically relevant local therapy. FlaxAid dressing were applied to the wound area in three stages consisting of FlaxAid dressings wetted with: isotonic salt solution; oil emulsion; and seedcake extract. Discussion and Conclusion: After 12 weeks of therapy with the newly developed FlaxAid bandages, all of the patient’s ulcers had been cured. After 6 months of follow-up, the sites of the patient’s ulcers were found to still be in a healthy state. Case Study British Journal of Medicine & Medical Research, 4(12): 2463-2469, 2014 2464