Measurements in Wound Healing: Science and Practice PDF
Preview Measurements in Wound Healing: Science and Practice
Measurements in Wound Healing Raj Mani (cid:129) Marco Romanelli (cid:129) Vijay Shukla Editors Measurements in Wound Healing Science and Practice Editors Dr. Raj Mani, D.Sc., FACA Dr. Marco Romanelli, M.D., Ph.D. Department of Clinical Measurements Wound Healing Research Unit Wound Healing and Vascular Laboratory Department of Dermatology Southampton University Hospital University of Pisa NHS Foundation Trust Pisa Southampton Italy UK Dr. Vijay Shukla, M.B.B.S., M. Ch. (Wales) Shanghai Jiao Tong University Department of General Surgery School of Medicine Institute of Medical Sciences Shanghai Banaras Hindu University China Varanasi Benares India ISBN 978-1-4471-2986-8 ISBN 978-1-4471-2987-5 (eBook) DOI 10.1007/978-1-4471-2987-5 Springer London Heidelberg New York Dordrecht Library of Congress Control Number: 2012942730 © Springer-Verlag London 2012 This work is subject to copyright. 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Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publica- tion does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publica- tion, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) This book is dedicated to care. We dedicate it to our own families and those of our corresponding authors for their collective patience that permit us (authors) to devote time to such scholarly pursuits as writing chapters after long days in hospitals and laboratories. It is also dedicated to the patients with chronic wounds as well as our colleagues every- where who support the care such patients. Raj Mani, D.Sc., FACA Marco Romanelli, M.D., Ph.D. Vijay Shukla, M.B.B.S., M. Ch. (Wales) Foreword For an obstinate ulcer, sweet wine and a lot of patience should be enough Hippocrates (460–370 BC) The complex clinical management of chronic wounds has struggled to move from being an art to being true science. The lack of evidence-based medicine to guide us in the treatment of complex chronic wounds is apparent to most working in this challenging area. If we search, for example, for evidence to guide us as to which dressing to choose for a neuropathic foot ulcer, it is soon clear that we have not progressed far from the statement of Hippocrates thousands of years ago: there are no randomised controlled trials to con fi rm the ef fi cacy or superiority of any particu- lar dressing. One of the results of advances in medical technology is increased longevity that is apparent in most western countries: associated with this is an increased preva- lence of chronic diseases and consequently chronic wounds, especially the common venous and diabetic foot ulcer. In my area of diabetes, there is almost an epidemic of type 2 diabetes across the world, including likely >250 million people with dia- betes in Asia, and the prevalence in the USA predicted to increase from 10% today to over 30% in 2050. Thus we can expect signi fi cant increases in chronic wounds in the next few decades. There is therefore an urgent need to provide an evidence-based approach to the management of chronic wounds: an essential prerequisite is to have accurate mea- surements in the science of wound healing. The information provided in the second edition of this important volume is therefore most welcome and timely. The editors, each of whom is a leader in the fi eld, have amassed a team of true experts to provide the basis of the science of measurement in wound healing. The fi rst section covers the common chronic wounds from venous leg ulcers and diabetic foot disease to pressure ulcers and also includes a welcome contribution on the epidemiology of wounds. The next sections include papers on the histopathology, biomarkers, pres- sure and vascular measurement and papers on burns and scarring. Finally, the all important topics of research in this area, randomised controlled trials and modeling, are discussed. vii viii Foreword By far the most important aspect of this area of medicine is the need for team working. The editors have clearly succeeded in meeting this need as they have brought together authors from numerous disciplines from basic science to clinical medicine. Thus this volume is an important step in progressing the science of wound healing, but, as Charcot said [1] “sera continué” or, “to be continued”. Andrew J.M. Boulton, M.D., D.Sc. (Hon), FRCP Prof of Medicine, University of Manchester Consultant Physician, Manchester Royal In fi rmary, Manchester, UK Visiting Professor, University of Miami, Miami, FL, USA Vice-President and Director of Postgraduate Education for the European Association for the Study of Diabetes Reference 1. Charcot JM. Sur quelques arthropathies qui paraissent dépendre d’une lésion du cerveau ou de la moelle épinière. Arch Physio Norm Pathol. 1868;1:161–78. Preface When is an idea formed? At the moment it is actively discussed or somewhere in the back of beyond? When did the planning for this book begin? In 1998, I was honoured to be invited to the fi rst meeting on Wound Management in Benares, India that was hosted by Vijay Shukla. I was hugely excited at the prospect of returning to northern India to meet Vijay whose papers I had read and who was setting up a multidisciplinary clinic in a city that was on my ‘to visit list’. The day arrived. When the fl ight landed at this small provincial airport with pretty pink and red bougainvillaea and marigolds growing in a tidy lawn in front of a small, ancient ter- minal building, I was met by a young resident from the hospital who escorted me to the hotel and politely enquired when ‘we’ would be ready to meet the Dean. I was puzzled and asked who else might be involved to be told ‘Oh sorry, I thought you were aware that Professor Hunt (he meant Tom Hunt or ‘TK’ from San Francisco) arrived yesterday’. ‘Dr. Shukla would like both of you to meet the Dean.’ The news that I was going to get to meet TK instantaneously cured me of all travel fatigue I was experienc- ing; instead I became nervous and apprehensive. Tom Hunt was (and continues to be) a most knowledgeable person in matters relating to hypoxia and wound healing. I had been measuring extremely low transcutaneous oxygen pressures on peri- wound skin some of which healed – this was surprising and, at that time, inexplica- ble. The prospect of discussing this (with TK) was daunting. But often in life apparently unrelated events occur and effect changes. First of all, in one of his papers, TK had observed ‘to measure a difference, there must be a difference’. Second of all, I was working on a book focused on measurements in wound healing.1 Third of all, a colleague editor/author and now friend, Vincent Falanga, had introduced me to a young, bright and enthusiastic dermatologist and scientist called Marco Romanelli who was contributing a chapter to this book. Once I had overcome anxiety nervosa and survived the fi rst day in TK’s company, I plucked up the courage to invite him to write a foreword to our book. To my surprise and delight, he agreed. Since those 3 days in Benares I have enjoyed many meetings with TK and have come to admire 1C hronic Wound Healing – Basic Science and Clinical Measurements by Mani R, Falanga V, Shearman CP and Sandeman DD. Harcourt Brace, London 1999. ix
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