Scuola Internazionale di Riparazione Tessutale

La Scuola

La Scuola Internazionale di Riparazione Tessutale (SIRTES) ha come suo obiettivo costitutivo quello di implementare ed arricchire le conoscenze nel Wound Care.

Tali finalità vengono perseguite attraverso:

-          La realizzazione di percorsi didattici di approfondimento monotematici
-          La partecipazione a progetti di ricerca
-          La stesura di testi eo capitoli di testi
-          La produzione di articoli scientifici

Impegno della Scuola è e sarà quello di sostenere la crescita culturale dei propri Soci e di qualsiasi Professionista che si occupi di Wound Management.
Al fine di raggiungere quanto prefissato SIRTES apre al dialogo attivo con gli associati (area riservata) al fine di sviluppare quanto sino ad oggi rimasto dietro alle quinte ma di rilevante impatto nell’attività quotidiana.

Percorsi didattici 

La riparazione tessutale
Il wound assessment e la diagnostica non invasiva
Il debridement
La chirurgia rigenerativa
Le ulcere atipiche

Laboratori pratici

Diagnostica non invasiva
Elastocompressione
Laboratorio di microscopia
Tecniche di debridement
Tecniche di medicazione

Testi

Atlante di ulcere atipiche: diagnosi e cura (in press, ottobre 2012)

Articoli scientifici

1. Adv Skin Wound Care.2013 Aug;26(8):352-359.

Improvement of Periulcer Skin Condition in Venous Leg Ulcer Patients: Prospective, Randomized, Controlled, Single-blinded Clinical Trial Comparing a Biosynthetic Cellulose Dressing with a Foam Dressing.

Dini VRomanelli MAndriessen ABarbanera SBertone MSBrilli CAbel M.

Source

Valentina Dini, MD, is a Consultant Dermatologist, Wound Healing Research Unit, and Marco Romanelli, MD, PhD, is Assistant Professor, both in the Department of Dermatology, University of Pisa, Pisa, Italy. Anneke Andriessen, PhD, PA, is Director, Andriessen Consultants Malden and UMC St Radboud, Nijmegen, the Netherlands. Sabrina Barbanera, MD, is a Consultant Dermatologist; Maria Stefania Bertone, NT, is a Nutritionist; and Cinzia Brilli, RN, is a Consultant Dermatology Nurse, all in the Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy. Martin Abel, PhD, is Head of Medical & Regulatory Affairs, Lohmann & Rauscher GmbH & Co KG, Rengsdorf, Germany. Drs Dini, Romanello, Andriessen, and Barbanera and Mss Bertone and Brilli have disclosed they have no financial relationships related to this article. Dr Abel has disclosed that he is an employee of Lohmann & Rauscher GmbH & Co KG.

Abstract

OBJECTIVES::

The aim of this study was to investigate the influence of a biosynthetic cellulose wound dressing (BWD) to stimulate wound healing in patients with a venous leg ulcer on periulcer skin condition when compared with standard care using a foam dressing.

METHODS::

Each patient with a venous ulcer received compression therapy with a short stretch bandage system and either a BWD + foam (study group [SG]) or foam (control group [CG]). Periulcer skin condition was compared with the untreated lower leg skin and the forearm skin, using noninvasive parameters, comparing day 0 versus day 28 results. Ulcers were further evaluated for healing rate. The study period was 28 days, and the follow-up period was 12 weeks. Fifty patients were recruited to the study, of which N = 46 (SG, n = 26; CG, n = 20) completed the 28-day study period and were included in the analysis.

RESULTS::

The BWD showed a more improved periulcer skin condition versus the CG. Transepidermal water loss was significantly less in the SG (P = .003), as well as the results shown with the chromatometer (P =. 05). Ulcer healing rate was also statistically significant in favor of the SG (P = .0001).

CONCLUSION::

Treatment for the BWD + foam group was shown to be safe and significantly improved periwound skin condition, leading to more expeditious wound healing than treatment with foam alone

 

2. Curr Opin Support Palliat Care.2013 Mar;7(1):106-10. doi: 10.1097/SPC.0b013e32835dc0fc.

Use of diagnostics in wound management.

Romanelli MMiteva MRomanelli PBarbanera SDini V.

Source

Wound Healing Research Unit, Department of Dermatology, University of Pisa, Pisa, Italy. marco.romanelli@med.unipi.it

Abstract

PURPOSE OF REVIEW:

Wound healing research has progressed impressively over the past years. New insights into the pathogenesis of different chronic wounds and the study of novel treatment have made wound healing a model disorder and have revealed basic cellular and molecular mechanisms underlying chronic wounds. Although the observation is so obvious and simple, the interpretations by different observers can be quite variable. The interpretations of severity and change in severity by treatment may differ considerably between patient and practitioners.

RECENT FINDINGS:

In this review we provide comprehensive view on different aspects of wound diagnostic, including clinical measurement, new biomarkers in wound pathology, proteases evaluation, and future noninvasive sensor-based devices.

SUMMARY:

Wound caregivers are in the unique position of being able to observe the wound changes and describe these with knowledge and strict methodology, but also with the wide range of available wound diagnostic devices. The complexity of severity assessment in wound healing is reflected by the multiple clinical scores available. The best objective methods used to evaluate cutaneous tissue repair should have a high specificity and sensitivity and a low inter and intraobserver variation

 

3.  J Wound Care.2011 May;20(5):242-8.

Clinical efficacy of a new monofilament fibre-containing wound debridement product.

Bahr SMustafi NHättig PPiatkowski AMosti GReimann KAbel MDini VRestelli JBabadagi-Hardt ZAbbritti FEberlein TWild TBandl K.

Source

Therapy Centre for Chronic Wounds, Lahr, Germany. Michael.Schmitz@de.LRMed.com

Abstract

OBJECTIVE:

To evaluate the wound debridement efficacy (that is, achievement of 100% granulation tissue on the wound bed) of a new monofilament fibre product (Debrisoft).

METHOD:

This multicentre, prospective, observational evaluation assessed the debridement efficacy, safety, patient comfort and user satisfaction of this new product. Time taken to perform the debridement procedure was also recorded. The new product was wetted with either saline or polihexanide and applied for 2-4 minutes, following which the usual dressing regimen was applied. Clinical outcome was scored by a trained clinician. Additionally, before and after photographs were assessed by one and the same clinician, who was blinded to the treatment given. The debridement outcomes achieved with the test product were compared with results obtained using other methods of debridement, both non-surgical and surgical, taken from an electronic database but using the same scoring systems as here.

RESULTS:

Sixty patients with chronic wounds requiring debridement were recruited, of whom 57 were included in the analysis. Debridement was effective in 93.4% (142/152) of the sessions, and the product remained intact in 95.4% (145/152). The average time for each debridement session was 2.51 minutes, markedly less than for the current debridement methods at the evaluation centres. Visible debris and slough were successfully removed with the test product. Patients reported no pain during the procedure in 45% of cases and slight discomfort for a short duration (2.0 minutes on average) in 55% of cases.

CONCLUSION:

The results indicate the potential for this monofilament fibre product to replace several modes of debridement, based on its efficacy, short procedure, ease of use and patient comfort. Conflict of interest: The evaluation protocol was proposed and supported by Lohmann & Rauscher GmbH, who provided the evaluation products. MS and MA are employees of Lohmann & Rauscher. The other authors declare to have no relevant financial interest in the evaluation. Apart from input to the protocol, the sponsors had no role in the conduct of the study, such as data collection, analysis, or preparation, review, or approval of the manuscript.

 

4.  Arch Dermatol.2007 Oct;143(10):1333-4.

Wound assessment by 3-dimensional laser scanning.

Romanelli MDini VBianchi TRomanelli P.

Recent advances in our understanding of the biology of cutaneous tissue repair have influenced current therapeutic strategies for chronic wound management and will continue to influence chronic wound management strategies into the future.

An effective and accurate monitoring of skin lesions should be performed by measuring in an objective, precise, and reproducible way the complete status and evolution of the wound.The main goal of current research projects is to design an easy-to-use technological system that can monitor the qualitative and quantitative evolution of a skin lesion.

This level of monitoring can be achieved by using 3-dimensional scanners: in particular, systems based on active optical approaches.There are 2 different areas of potential applications of such types of devices: in medical treatment (to improve the efficacy of therapeutic regimens)and pharmacologic scientific research (to assess the quality and effectiveness of new chemicals or clinical procedures).

Source

Wound Healing Research Unit, Department of Dermatology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy. m.romanelli@med.unipi.it

 

5.  Arch Dermatol.2007 Oct;143(10):1310-3.

Hydroxyurea-induced leg ulcers treated with a protease-modulating matrix.

Romanelli MDini VRomanelli P.

Source

Department of Dermatology, University of Pisa, Pisa, Italy. m.romanelli@med.unipi.it

Abstract

BACKGROUND:

The development of painful leg ulcers in the ankle area is a rare and only partially described complication in patients receiving high-dose, long-term hydroxyurea treatment for myeloproliferative diseases. Several reports have described treatments for chronic wound management with this type of lesion.

OBSERVATIONS:

We describe 2 patients who were diagnosed as having hydroxyurea-induced leg ulcers that were successfully treated with a freeze-dried sponge containing oxidized regenerated cellulose and bovine purified collagen. This dressing is able to modulate the activity of proteases such as plasmin, neutrophil-derived elastase, and matrix metalloproteinase by physically entrapping them and thus inhibiting their activity.

CONCLUSION:

This case demonstrates that topical application of a matrix metalloproteinase modulator can be a successful and safe treatment option for patients with hydroxyurea-induced recalcitrant leg ulcers.