Aneta Zymon is a nurse, wound specialist and the founder and CEO of AZ MED, Pain and Wound Treatment Centre in Krakow, Poland. There, she manages an interdisciplinary team that deals with the treatment of chronic pain and wounds. Aneta promotes natural wound healing using Lucilia Sericata larvae. She is guided by a holistic approach and loads of empathy towards her patients. In 2014, Aneta decided to take a chance and go out on a limb. She quit her job and put all her savings into AZ MED. She hired two scientists from the Jagiellonian University and created a small laboratory in Krakow.
In the 1990s, when the crisis in antibiotic therapy was observed, the medical community began to return to the methods known and popularized by folk medicine - larval therapy. For a long time, it was believed that the main task of maggots is to mechanically clean the wound of a dead tissue. Nevertheless, today we know that larvae dressing, as the only one, affects all stages of wound healing - the popular TIME. In all types of wounds, the use of larvae dressings significantly reduces the time until the wound heals completely. It is the comfort and quality of a patient's life; it is also a pure economy. Considering the advantages of larval therapy, one must also mention the problems with its application. Sadly, difficulties with an access to dressings, specific and demanding care conditions, unpleasant feelings of both patients and staff cause that this therapy is still not very popular. Following the statement that” It is not important what one puts on a wound, but what one removes from it”, presenting the time and effects of wound healing, determining the indications for the use of dressings in a closed or open form, I highly recommend this method as the most and extremely effective.
Sandeep Shrivastva is the Director of Centre of Autologous Platelet Biotechnological interventions , at Datta Meghe Institute of Medical Sciences , Wardha India. He is Professor of Orthopaedics having done his MS, DNB and Ph.D. He is also Chief Executive Officer, Hospitals. and Ex DEAN of JNMC. In the field of Regenerative Medicine, he has pioneered the wound management with PRP, by developing the clinical Protocol of “Sandeep’s Technique for Assisted Regeneration of Skin (STARS Therapy). His work is widely published and presented across the World. He has 2 books, 63 Publications and 76 presentations, including Orations, Key Note addresses, Guest lectures and Conducts workshops on the same.
In day to day practice, the wounds particularly complex ones like - infected and necrotising; with exposed tendons, bones, implants; chronic & non-healing ulcers- pressure sore present a substantial clinical challenge. They need intense management with multiple surgical intervention, antimicrobial /antibiotics, analgesics, and local care; requiring huge resources, skilled manpower and experts. Despite best of care the results are unpredictable and may be associated with severe morbidity, at times. This study is undertaken to develop a comprehensive solution based on regenerative medicine for such enormous health problem. The Intervention - “STARS therapy (Sandeep’s technique for assisted regeneration of skin)” with Autologous Platelet Rich Plasma (PRP), has been developed and clinically piloted on 268 wounds. It is based on the local infiltration of freshly prepared autoogous PRP. It is the mainstay and mono therapy for the wound management. The results reveal a complete healing with control of infection, filling up of defects and assisted regeneration of skin. For the first time, reversal and revival of grossly necrosed and devitalised tissues such as tendons, muscles and bones has been clinically achieved. The history of Wound management over 4000 years have been till now have been consisting of mostly local applications & Dressings, Drugs and Devices such as negative suctions etc. With development of regenerative medicine, we are looking into an exciting option and possibilities. The PRP is one of the simplest Regenerative medicine products having huge possibility of reproducibility amongst all health settings across the globe. A comprehensive effective mono-therapy solution based on the PRP only, will have a huge impact in improving wound care across the globe. This “STARS therapy” is a simple safe and effective, such solution and a complete Game Changer benefiting hugely scores of patients suffering from such conditions and its morbidity.
Gilles Courtemanche completed his PhD from Pierre & Marie Curie University (Paris, France) in 1991. After more than 20 years in the pharma industry as Medicinal Chemist and Drug Discovery Expert, he is now the Director of the Antimicrobials Program at BIOASTER, a French Technology Research Institute dedicated to Microbiology and Infectious Diseases. He has published more than 12 papers in reputed journals and is an inventor on more than 20 patents.
With the growing spread of antibiotic resistance, everyone agrees there is an urgent need to identify new and innovative antibiotics. Innovative means not only novel chemotypes but also new Mechanisms of Action (MoA). Several new and promising targets have been identified, but target-based screening remains a challenge, since the vast majority of compounds active on the isolated target are inactive on the whole bacteria because of a lack membrane penetration. That’s why phenotypic screening is usually preferred, but in this case, the MoA of hits is unknown. Deciphering a MoA is a long and costly process that is mostly dedicated to Development Candidates, after several years of efforts since hit identification, with substantial financial resources spent. Assessing the novelty of MoA at hit identification stage would allow focussing on the most promising series, saving money and time in drug discovery. A medium throughput screening of hit mechanisms of action, using metabolomics will be presented.
Academy of Veterinary Technicians in Regenerative Medicine, USA
Yudith Quispe Landeo has her expertise in evaluation and managing patients with diabetic foot ulcers. She is the President of the Alliance for the Salvatage of Diabetic Foot Perú. She has years of experience in teaching in different universities and actually she is developing a research work with national impact, calling for participation of representatives of the different regions of Perú. She is a member of the American Diabetes Association and the Latinoamerican Diabetes Association (ALAD). She has master studies in teaching and research in health and doctorate in medicine. I don`t have conflicts of interest.
Venkatesh Mayandi is currently working as a Research Associate I at Anti-Infectives Research Group, in “Singapore Eye Research Institute., Long Term Service Award at SERI, Singapore”. Hands on experience as a Research Assistant in Studying cytotoxicity of different natural plant extracts and nanoparticles against various cancer cell lines, also worked as a Research Assistant in Design and synthesis of peptides for immuno-modulation. Pursuing Ph.D. at School of Biological Science, NTU (Jan 2017); on M.Tech (Masters in Bio- Informatics) and B.Pharm (Bachelor of Pharmacy) professional with 10+ years of cross culture experience in Microbiology, Oncology, Cardiovascular and Metabolic Research, Pharmacology, Reproductive Health, Musculoskeletal Biology, Cell and molecular biology, also on Natural plant extracts, Novel Peptide Synthesis for immunomodulation, with hands on in related software and tools. Previous worked as a Senior Scientist/Study Director in “Maccine Pte Ltd., Singapore”. Long Term Service Award at “Maccine Pte Ltd., Singapore”.
We investigated the antimicrobial and wound healing properties of prototype wound dressings prepared by bio-inspired crosslinking in vitro and in vivo. We prepared the prototype dressings by electrospinning of gelatin nanofibers containing epsilon-poly-L-lysine (ïÂ¥PL) and dopamine on a cotton bandage gauze. Subsequent crosslinking produced mats of mat density 460 g/m2 and labelled as ïÂ¥PL_Gel_pDA mats. Antimicrobial properties and antimicrobial durability were studied against panels of bacteria and yeast strains. Mammalian cell biocompatibility and cell proliferative properties were determined for primary human dermal fibroblasts (hDFs) and keratinocytes (HaCaT) cell lines. ïÂ¥PL_Gel_pDA mats displayed potent antimicrobial properties against common wound pathogens. The mats displayed excellent biocompatibility and cell proliferative properties for both the mammalian cells. In vivo biocompatibility of the mats was examined in juvenile pigs after cutaneous partial thickness burn injury. The results suggested comparable wound closure and re-epithelialization of the burns at 32 days post injury with silver based dressings. The antimicrobial efficacy of the mats in vivo was further examined by colonizing the partial thickness wounds with Staphylococcus aureus and Pseudomonas aeruginosa. Digital status of the wounds after treatment and silver dressings were assessed in terms of clinical examination (Bates- Jensen Wound Assessment Tool, BWAT), relative wound closure (SigmaScan Pro5), bacterial enumeration from swab culture and Hem atoxylin and Eosin (H & E) /Masson Trichrome staining. Infected burns treated with ïÂ¥PL_Gel_pDA mats showed lower BWAT score and bacterial bioburden (>4log10 reduction), increased wound closure, higher keratinization and faster re-epithelialization when compared to silver dressings. This study identified the combined utility of bio-inspired crosslinker, biocompatible antiseptic polymer and hydrogel nanofibers as advanced prototype wound dressings and established its superiority over commercial silver based dressings in infected burns. The nanofibre dressings could potentially be useful for treating life-threatening burn injuries and burn-related infections.
Izabela Kuberka is a Ph.D. candidate and an assistant at the Department of Nervous System Diseases at Medical University in Wroclaw, Poland. Furthermore, she owns a company called ‘Wound Care’ that helps to treat wounds. She specialize in surgical and epidemiological nursing. Actively participate in national and international conferences related to, for instance, would care (i.e. EWMA). As a member of the Board, engage in the activities of the Polish Society of Angiological Nursing. Moreover, she have an active membership at the Polish Society of Wounds Treatment (PTLR).
Prolonged healing process and exposure of ulceration to non-sterile conditions causes a considerable risk of infections and their common relapses. Bedsores covered with slough, ulceration covered with hard to remove bacterial biofilm and wounds without causative medical treatment are the ones especially prone to a delay in healing process. Long-time experience has shown that removing slough from wound and, what is crucial, the order of combining together different procedures of wound treatment play an important part in both tissue regeneration and preventing infections. Implemented by European experts TIME concept is a set of rules connected to the right wound treatment systematising treatment regimen, however, a choice of methods will depend on knowledge and skills of a person in charge of therapy. Currently, therapeutic methods possible to be used in lab conditions consist of larval therapy, hydrotherapy, negative-pressure wound therapy (NPWT), compression therapy and extracorporeal shockwave therapy (ESWT). The aim of the thesis is to present good clinical practice boosting healing process of chronic wounds as well as possibilities of combining different therapeutic methods while taking into account a healing phase. The study included patients with chronic wounds receiving outpatient treatment. The thesis shows a possibility of combining different methods of tissue regeneration through measures available in ambulatory settings. It also suggests the possibility of combining special treatment while using dressings with physical methods such as negative-pressure wound therapy (NPWT) and extracorporeal shockwave therapy (ESWT) which result in an innovative treatment method.
Durgaprasad Reddy is cardiothoracic and vascular surgeon in the prestigious Vydehi Institute of Medical Sciences and Research in Bangalore. He is the head of the department and his expertise includes complex congenital heart diseases, adult cardiac surgery, MICS, thoracic surgery, and vascular surgeries. He has completed over 13,000 cases over his span at Vydehi Institute of Medical Sciences and is geared up to do much more. He is also running a successful postgraduation program in which he personally trains his students as well as his staff. Professor Durgaprasad Reddy has built the department over his 15 year tenure at Vydehi hospital.
Jassin Hamed works as oil engineer often standing in one position outside in hot surroundings for long hours. Mr. Ahmed is a patient with longstanding – recently insulin dependent diabetes mellitus – type 2 with diabetic nephron-, neuro, amigo and retinopathy, overweight, arterial hypertension, ischemic heart disease and a diabetic foot ulcer for the past 5 months. He has been seen in multiple medical centers. These commitments were always temporary until short-lasting improvements deteriorated again.
In short holistic medicine is the recognition of a patient as a person with a certain medical, psychological, social and private status, who needs to be assessed, analyzed and investigated. Meanwhile a circle of care should be formed according to the needs identified to provide the best of care, support and ultimately the optimal environment for a patient to manage his health and life while healing his chronic wound. The members making up this team are nurses, wound care specialists, podiatrists, orthotic and prosthetic specialists, as well as internists, neurologists and endocrinologists, surgeons – of the plastic, vascular, orthopedic and general surgical divisions. In addition, the interventional radiologists, psychologists, dieticians and social workers are to be included. All wounds start as an acute incident of tissue break down, whether due to external causes – cuts, sheer and tear, pressure or moisture or direct hits, or they are caused by internal causes as septic emboli to the skin, lack of blood or oxygen supply, venous stasis, lack of central nervous control either due to peripheral nerve injury or due to central stroke, as well as organ failure. When this wound cannot be healed within a definite frame of time, it is defined as chronic. It’s very important to investigate the cause of the wound initially, and as important to analyze why this wound became chronic. A wound may be considered a non-healable maintenance wound when the general condition of a patient including his social and psychological status do not allow favorable circumstances to change the wound status into a healable one. Once these indirect factors have been considered, healing is possible. Because the whole patient requires attention to all his problems, which need to be addressed, changed, improved - if possible, now the basis for healing is made. Contrary to the common believe, it is not the care giver, but the patient. The patient himself must be empowered to be able to give an informed consent, to accept treatment including possible invasive interventions, to ask for specific requirements and to work with the team for hidden obstacles to be identified and cleared out of the way.
Omnia Sami Hafez has completed Bachelor in nursing Alexandria University. And undergraduate general medicine third year at bogolomets Medical University in Ukraine. He has received wound care certified course from Wound care Institut. He regsitrated master at Cardiff University in wound healing and tissue repair.
Muhammad Bilgary Utama is a pharmacy student in Bandung Islamic University, Indonesia. He is accomplishing his Bachelor Program. He had become Team Expert Staff of External Division in ISMAFARSI Organization. He is one of the authors of Implementation of Halal Products on Moslem Traveler’s Awareness paper and participant of World Bank Group Youth Summit 2018 in World Bank Headquarters, Washington, DC- United States of America on December 3rd-4th, 2018.
In this study, the author realized the using of antibiotics in all aspects should be avoided as possible as we could. Using antibiotics in all aspects irregularly will cause more antibiotic primary issue that is Antibiotics Resistance. Scientists, researchers, pharmacists and doctors are trying to find any solutions for antibiotics resistance not only with low dosage of antibiotic but figure out innovation. This study would be applied as alternative of antibiotics with natural compounds. The formula of silk and alginate created a natural bandage that could stimulate regeneration on wound. Silk had been chosen to be base of the formula because silk has very strong and very stable structure. Silk protein that usually called fibroin was used on this formula not because the perfection of its structure, as in Gita Cahya Eka Darma study about Self-Assembled Polyelectrolyte Complex of Silk Fibroin with Alginate as Drug Delivery Model (2015) that fibroin protein has a therapeutic effect in the treatment of wounds which increase the attachment of fibroblasts (factor in collagen synthesis) on the wound. Therefore, it may recover the wound faster and decrease bleeding time. This silk bandage formulated with combination of honey. Honey already known as super compound of nature that has many roles such as natural antibiotic, natural anti-inflammatory, etc. M. Aurongzeb and M. Kamran Azim (2011) said honey has a lot of interesting bioactivities including antinociceptive, immuno-modulatory and nematicidal activities with in vitro studies indicated potentially beneficial effects of honey on human platelets and blood coagulation proteins. Manisha and Shyamapada reported on their journal (2011) that honey is an ancient remedy for the treatment of infected wounds which has recently been ‘rediscovered’ by the medical profession and Aristotle (384-322 BC), when discussing different honeys, referred to pale honey as being “good as a salve for sore eyes and wounds”. Allen KL et al (2000) honey is effective against methicillin-resistant S. aureus (MRSA), β-haemolytic streptococci and vancomycin-resistant Enterococci (VRE) that have been revealed by laboratory studies. Those cases supported this silk bandage formula to be combined with honey to press the number of using antibiotic drugs. Besides decrease the number of Antibiotics-Resistance.