Preventing Leg Ulcers

The heart of a giraffe is located much higher than its hooves (relative to man's) yet I have never heard of giraffes getting leg ulcers. Would sitting on our haunches help us from getting leg ulcers?

Food for thought.

Could the London attacks have been prevented?

The Times today (Saturday May 25, 2013) in a leader argues the values of brain scans to identify the likelihood of individuals (with a history of criminal activity) to offend again.  This comes in the wake of the recent horrific events in Woolwich, London.   The subtle message is technology is here - why not use it to prevent possible harmful events? Why not indeed! 

Why not use existing knowledge and skills to prevent non communicable diseases and therefore lower extremity wounds?  

Does Washing Help Chronic Wounds?

During my professional youth, our patients would have their lower extremity wounds washed during clinical visits.  This was done in lukewarm water with a drop of potassium permanganate.  Once washed, the patient's leg would be dried, massaged and bandaged before being sent home with a smiling face.

When we look at the evidence though, we cannot say definitively whether or not washing helps, but we do know that it makes the patients feel more at ease. Clearly if they are more relaxed, it must be doing something positive. Clearly if a leg massage makes someone more relaxed, it must be reducing tissue swelling. Right?

Today, we are bombarded with news about chronic wound infection, biofilms, and so on, but the question still remains, should we wash our wounds or not?

Measurements in Wound Healing - Science and Practice

Recently my new book "Measurements in Wound Healing - Science and Practice" was published by Springer. The aim was to present measurements in wound healing that are being used in current practice (and should therefore be part of standard care). The work also addresses the issue where measurements exist, but are not being translated into clinical practice. Finally, it highlights innovations that are currently being developed which may be ready in the coming years.


I happened by a good review of the work: “Chronic wound management - once a Cinderella topic - needs the all the measurements possible to improve standard care.” This is the mission of IJLEW.

I must be off as there is a management meeting this morning. At least it is Spring out there!

The Importance of IJLEW

IJLEW was conceived in the era of "Evidence based Medicine" and the Cochrane Wounds Group. It was meant to be the main vehicle for tapping into the knowledge base of wound healing. This journal will keep the entire community up-to-date on all of the new research within the field of wound healing. It is my hope that this will generate feedback on new innovations and even on practice.

There is now evidence that recurrence of chronic wounds is commonplace among patients. Do they typically comply with the maintenance therapy 'advice'?

INDO-UK Diabetes: January 18th - 19th, 2013

Last week, I went to the INDO-UK Diabetes Summit (www.ibhi/event/diabetes_summit/) organized by the Indo-British Health Initiative and the British Deputy High Commission Chennai. India and the UK have vastly different approaches to confronting the issue of widespread diabetes in their respective populations; examining the difference, learning the significance, could make the difference!

Comparing Healthiness of White and Brown Rice

Last week I visited Chennai (formerly Madras). While there, I came across compelling evidence that brown rice is 'healthier' than white rice. Given that diabetes is becoming a larger international issue, it is important that rice eaters be aware of this. The question is: What is the best way to provide this information to remote populations?  or "best way to influence change in eating habits?"

Wounds International

Wounds International conference is being held in February 2011 in Cape Town, South Africa. This conference is focused on promoting wound care on an international level, focusing on improving, informing, and educating. For more information visit http://www.woundsinternational.com/

September 2010 Issue--Diabetes & Foot Care

Check out the latest issue of the International Journal of Lower Extremity Wounds this month's topic is Diabetes and Foot Care paying close attention to emerging trends and epidemiology in India. Statistics surrounding both diabetes and amputations is staggering, as Vijay Shukla and Raj Mani state in their article, "Emerging Trends in Diabetic Foot Ulcer Management in India," there are nearly 50 million diabetics in India alone and "worldwide, more than a million amputations are performed each year as a consequence to diabetes, which means that a lower limb is lost to diabetes somewhere in the world every 30 seconds." Read more of this article and the rest of the issue at http://ijl.sagepub.com/.

Shukla V., Mani R. Emerging Trends in Diabetic Foot Ulcer Management in India. Int J Lower Extrem Wounds. 2010; 9(3):111-112.

Management of the Diabetic Foot

Brief announcement about courses being held on the Management of the Diabetic Foot in Pisa, Italy. For further information please see their website, http://www.diabeticfootcourses.org/.

Longlasting Oil Spill Effects?

We are giving much due consideration to the likely effects of the world running out of oil. What would be the effects on the ways in which we develop essential health care products? Compression garments that are vital to manage venous disease may need totally different manufacturing processes. These thoughts began rolling around in my mind as I sat in a coffee shop in downtown Manhattan yesterday. There is a great deal more to learn from the terrible oil sill along the Gulf of Mexico.

Raj Mani
Editor-in-Chief
IJLEW

Herbs and Wound Care

Why are herbal cures rare in wound healing? There are some reports of products well tried and rested--don't get me wrong. The main complications in most wounds are lack of blood flow, infection, and edema. Edema makes wounds more painful, it comes in the way of blood flow and oxygen supply to the wounds. And of course it makes walking and standing more tedious.

Simple techniques help to maintain edema. Doctors prescribe water tablets too. Much is understood in the physiology, so why don't we have simple herbal solutions? Of course they need to be safe and effective. Uncomplicated experiments can help to establish these goals. We need Herbal Pharmacologists in the wound healing lab. And given the knowledge of local herbs in most countries, interested Pharmacologists could give us cheap and effective solutions to a common, but difficult problem to resolve.

Plants have evolved over many millenia withstanding varied and even harsh environments. In doing so, their genetic programming is likely to have altered its code and ability to survive. We should look to nature while gazing through the window of the lab.

Raj Mani
Editor-in-Chief
IJLEW

First IJLEW Post

The weather for the greater part of this last weekend was simply perfect: sunny throughout, a gentle breeze that sprang up when the afternoon sun was turned a touch hot. Lots of spring blossoms amidst a few fading winter blooms. Who now remembers the last winter I wandered, pounding steadily along the hardened mud tracks in the nearby woods? Why think of the winter on such a beautiful day? Well simply because I had been pondering how the global finanical crisis may affect wound management.

Will reimbursement of dressing and devices be affected? Will industry be bolder about supporting good research? And how will wound care be helped by new legislation concerning healthcare in the US? I find more variables in all this than I can count and run at the same time. But it's at such times that runners (and wound healers) have to find fresh wind and with it motivation. The next issue of IJLEW will focus on the Diabetic Foot, related complications, and problems in India where the predicted increase in diabetes is logarithmic!

Raj Mani
Editor