Senior Jessica J, Jaworska Kayley, Atkin Leanne, Ousey Karen, Smith Alan M
Department of Pharmacy, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH UK.
Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH UK.
In Vitro Model. 2024 Apr 29;3(2-3):81-89. doi: 10.1007/s44164-024-00071-6. eCollection 2024 Jun.
Wound debridement is commonplace in expediting wound healing in the clinic. Despite this, there are limited resources available for simulation training for practitioners prior to facing real-life patients. Typically, citrus peels or porcine skin are employed in a vain attempt to improve debridement proficiency, yet these fail to provide a realistic experience of the textures and consistencies of wounds. Therefore, there is a clear unmet need for a safe and effective tool that can facilitate hands-on learning under the instruction of an experienced debrider. To fill this niche, a life-like wound model was designed and developed, featuring leathery necrotic eschar, an intermediary sloughy layer, and a rough granulation tissue in the bottommost layer, all within a healthy skin base. The healthy tissue portion of the model was designed to exhibit similar mechanical properties to those found in human skin. Likewise, the sloughy layer was viscous enough to remain within the model under static conditions yet could be removed using any appropriate debriding tool synonymous with real slough. Mechanical testing of the necrotic eschar revealed brittle fracture behaviour, akin to what is observed in patients. Each layer of the wound model provided the visual and haptic feedback of how it would look and feel to debride a patient's wound in the clinic, giving invaluable experience for potential trainees in a safe and effectual way. It is envisaged that these models can be developed in a personalised way to suit the individual needs of the user, such as incorporating underlying models of bone or tendon, while retaining the key elements of the wound, which make it successful. This model is proposed as an important step forward in bridging the gap between becoming a newly qualified debriding practitioner and encountering the first wound in the clinic, subsequently improving the confidence of the debrider and enhancing patient outcomes.
The online version contains supplementary material available at 10.1007/s44164-024-00071-6.
伤口清创术在临床中是加速伤口愈合的常见操作。尽管如此,在面对真实患者之前,可供从业者进行模拟训练的资源有限。通常,人们会徒劳地使用柑橘皮或猪皮来提高清创熟练度,但这些材料无法提供伤口质地和稠度的真实体验。因此,显然迫切需要一种安全有效的工具,以便在经验丰富的清创师指导下促进实践学习。为填补这一空白,设计并开发了一种逼真的伤口模型,其在健康的皮肤基底内,具有皮革样坏死焦痂、中间的腐肉层以及最底层粗糙的肉芽组织。该模型的健康组织部分设计为具有与人类皮肤相似的机械性能。同样,腐肉层的粘性足以在静态条件下保留在模型内,但可以使用任何与实际腐肉同义的合适清创工具将其去除。对坏死焦痂的力学测试显示出脆性断裂行为,类似于在患者身上观察到的情况。伤口模型的每一层都提供了在临床中清创患者伤口时的视觉和触觉反馈,以安全有效的方式为潜在学员提供了宝贵的经验。可以设想,这些模型可以以个性化的方式开发,以满足用户的个人需求,例如纳入骨骼或肌腱的基础模型,同时保留伤口的关键要素,这使其获得成功。该模型被认为是在新合格的清创从业者与在临床中遇到第一个伤口之间架起桥梁的重要一步,随后可提高清创师的信心并改善患者预后。
在线版本包含可在10.1007/s44164-024-00071-6获取的补充材料。