Browsing by Author "Beeckman, Dimitri"
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- Clinical performance characteristics for bordered foam dressings in the treatment of complex wounds: an international wound dressing technology expert panel reviewPublication . Santamaria, Nick; Woo, Kevin; Beeckman, Dimitri; Alves, Paulo; Cullen, Breda; Gefen, Amit; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Najafi, Bijan; Sharpe, Andrew; Swanson, TerryThe aim of this article is to identify and describe clinical practice performance characteristics for bordered foam dressings in the treatment of complex wounds. Our recently published systematic review of outcomes and applied measurement instruments for the use of bordered foam dressings in complex wounds has led to us identifying a range of important clinical and patient-centred issues related to this dressing class. Specifically, here, we focus on an overview of performance criteria in the areas of application, adhesion, exudate management and debridement functions of bordered foam dressings. Our hope is that by highlighting the clinical performance criteria, future testing standards for wound dressings will more closely match our clinical expectations and, thereby, assist clinicians to make better wound treatment choices based on meaningful and clinically relevant dressing product performance standards. complex wounds, complex wound care, treatment, bordered foam dressings, dressing performance.
- Development and psychometric property testing of a skin tear knowledge assessment instrument (OASES) in 37 countriesPublication . Van Tiggelen, Hanne; Alves, Paulo; Ayello, Elizabeth; Bååth, Carina; Baranoski, Sharon; Campbell, Karen; Dunk, Ann Marie; Gloeckner, Mary; Hevia, Heidi; Holloway, Samantha; Idensohn, Patricia; Karadağ, Ayişe; Langemo, Diane; LeBlanc, Kimberly; Ousey, Karen; Pokorná, Andrea; Romanelli, Marco; Santos, Vera Lucia Conceição de Gouveia; Smet, Steven; Williams, Ann; Woo, Kevin; Van Hecke, Ann; Verhaeghe, Sofie; Beeckman, DimitriAim: To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES). Design: Prospective psychometric instrument validation study. Method: The skin tear knowledge assessment instrument was developed based on a literature review and expert input (N = 19). Face and content validity were assessed in a two-round Delphi procedure by 10 international experts affiliated with the International Skin Tear Advisory Panel (ISTAP). The instrument was psychometrically tested in a convenience sample of 387 nurses in 37 countries (April–May 2020). Validity of the multiple-choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, and test–retest reliability (stability) were analysed and evaluated in light of international reference standards. Results: A 20-item instrument, covering six knowledge domains most relevant to skin tears, was designed. Content validity was established (CVI = 0.90–1.00). Item difficulty varied between 0.24 and 0.94 and the quality of the response alternatives between 0.01–0.52. The discriminating index was acceptable (0.19–0.77). Participants with a theoretically expected higher knowledge level had a significantly higher total score than participants with theoretically expected lower knowledge (p < .001). The 1-week test-retest intraclass correlation coefficient (ICC) was 0.83 (95% CI = 0.78– 0.86) for the full instrument and varied between 0.72 (95% CI = 0.64–0.79) and 0.85 (95% CI = 0.81–0.89) for the domains. Cohen's Kappa coefficients of the individual items ranged between 0.21 and 0.74. Conclusion: The skin tear knowledge assessment instrument is supported by acceptable psychometric properties and can be applied in nursing education, research, and practice to assess knowledge of healthcare professionals about skin tears. Impact: Prevention and treatment of skin tears are a challenge for healthcare professionals. The provision of adequate care is based on profound and up-to-date knowledge. None of the existing instruments to assess skin tear knowledge is psychometrically tested, nor up-to-date. OASES can be used worldwide to identify education, practice, and research needs and priorities related to skin tears in clinical practice.
- Fluid handling by foam wound dressings: from engineering theory to advanced laboratory performance evaluationsPublication . Gefen, Amit; Alves, Paulo; Beeckman, Dimitri; Cullen, Breda; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Santamaria, Nick; Swanson, Terry; Woo, Kevin; Söderström, Bengt; Svensby, Anna; Malone, Matthew; Nygren, ErikThis article describes the contemporary bioengineering theory and practice of evaluating the fluid handling performance of foam-based dressings, with focus on the important and clinically relevant engineering structure– function relationships and on advanced laboratory testing methods for preclinical quantitative assessments of this common type of wound dressings. The effects of key wound dressing material-related and treatment-related physical factors on the absorbency and overall fluid handling of foam-based dressings are thoroughly and quantitively analysed. Discussions include exudate viscosity and temperature, action of mechanical forces and the dressing microstructure and associated interactions. Based on this comprehensive review, we propose a newly developed testing method, experimental metrics and clinical benchmarks that are clinically relevant and can set the standard for robust fluid handling performance evaluations. The purpose of this evaluative framework is to translate the physical characteristics and performance determinants of a foam dressing into achievable best clinical outcomes. These guiding principles are key to distinguishing desirable properties of a dressing that contribute to optimal performance in clinical settings.
- How should clinical wound care and management translate to effective engineering standard testing requirements from foam dressings? Mapping the existing gaps and needsPublication . Gefen, Amit; Alves, Paulo; Beeckman, Dimitri; Cullen, Breda; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Najafi, Bijan; Santamaria, Nick; Sharpe, Andrew; Swanson, Terry; Woo, KevinSignificance: Wounds of all types remain one of the most important, expensive, and common medical problems, for example, up to approximately two-thirds of the work time of community nurses is spent on wound management. Many wounds are treated by means of dressings. The materials used in a dressing, their microarchitecture, and how they are composed and constructed form the basis for the laboratory and clinical performances of any advanced dressing. Recent Advances: The established structure/function principle in material science is reviewed and analyzed in this article in the context of wound dressings. This principle states that the microstructure determines the physical, mechanical, and fluid transport and handling properties, all of which are critically important for, and relevant to the, adequate performances of wound dressings. Critical Issues: According to the above principle, once the clinical requirements for wound care and management are defined for a given wound type and etiology, it should be theoretically possible to translate clinically relevant characteristics of dressings into physical test designs resulting specific metrics of materials, mechanical, and fluid transport and handling properties, all of which should be determined to meet the clinical objectives and be measurable through standardized bench testing. Future Directions: This multidisciplinary review article, written by an International Wound Dressing Technology Expert Panel, discusses the translation of clinical wound care and management into effective, basic engineering standard testing requirements from wound dressings with respect to material types, microarchitecture, and properties, to achieve the desirable performance in supporting healing and improving the quality of life of patients.
- Mechanical and contact characteristics of foam materials within wound dressings: theoretical and practical considerations in treatmentPublication . Gefen, Amit; Alves, Paulo; Beeckman, Dimitri; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Najafi, Bijan; Swanson, Terry; Woo, KevinIn the treatment of acute and chronic wounds, the clinical performance of a given foam-based dressing, and, ultimately, the wound healing and cost of care outcomes are strongly influenced by the mechanical performance of the foam material/s within that dressing. Most aspects of the mechanical performance of foam materials, for example, their stiffness, frictional properties, conformability, swelling characteristics and durability, and the overall mechanical protection provided by a foam-based dressing to a wound strongly depend on the microstructure of the foam components, particularly on their microtopography, density and porosity. This article, therefore, provides, for the first time, a comprehensive, self-inclusive compilation of clinically relevant theoretical and practical considerations, based on published analytical and experimental research as well as clinical experience related to the mechanical performance of foams in foam-based wound dressings. The current bioengineering information is useful for establishing understanding of the importance of mechanical properties of foams in foam-based dressings among clinicians and researchers in industry and academia, and other potential stakeholders in the wound care field, for example, regulators and buyers. This information is also particularly important for the development of standardised test methods for the evaluation of foam-based wound dressings and resulting standard mechanical performance metrics for these dressings.
- Study protocol for the development of a core outcome set (COS) for clinical effectiveness trials of bordered foam dressings in the treatment of complex woundsPublication . Raepsaet, Charlotte; Alves, Paulo; Cullen, Breda; Gefen, Amit; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Najafi, Bijan; Santamaria, Nick; Sharpe, Andrew; Swanson, Terry; Woo, Kevin; Beeckman, Dimitri
- The development of a core outcome set for clinical effectiveness studies of bordered foam dressings in the treatment of complex woundsPublication . Raepsaet, Charlotte; Alves, Paulo; Cullen, Breda; Gefen, Amit; Lázaro-Martínez, José Luis; Lev-Tov, Hadar; Najafi, Bijan; Santamaria, Nick; Sharpe, Andrew; Swanson, Terry; Woo, Kevin; Beeckman, DimitriAim: The aim of this project was to develop a core outcome set (COS) for clinical effectiveness studies of bordered foam dressings in the treatment of complex wounds. Methods: The research project followed the Core Outcome Measures in Effectiveness Trials (COMET) initiative and consisted of two phases. The first phase prepared the background and process, while the second phase had three steps: outcome list generation via systematic review and qualitative study, Delphi consensus study, and consensus meeting. The study has been registered in the Core Outcome Measures in Effectiveness Trials database. Results: The systematic review resulted in 82 outcomes and 20 additional outcomes were obtained during the interviews. After refinement, 111 panellists from 23 countries rated a list of 51 outcomes. In the following consensus meeting, six outcomes were prioritized to be included in the core outcome set. After the consensus meeting, a patient-reported outcome was added to the core outcome set. Conclusion: The COS for evaluating the effectiveness of bordered foam dressings in treating complex wounds includes 7 outcomes: “ability to stay in place”, “leakage”, “pain”, “dressing related periwound skin changes”, “change in wound size over time”, and “overall satisfaction”. These identified outcomes are correlated with contemporary bioengineering testing and evaluation methods for dressing performance, which underpins the need for a close multidisciplinary collaboration to advance the field of wound dressings. The outcome ‘overall satisfaction’ reflects the impact of complex wounds and their treatment on a patient's daily life. The use of these outcomes is recommended to improve data synthesis and promote evidence-based practice. Future developments in COS development involve creating measurement instruments and relevant endpoints for these outcomes.