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This book describes how chronic wounds follow a completely different healing trajectory to acute wounds and discusses the factors associated with these poor healing trajectories. These factors include age, chronic inflammation, phenotypic changes in such cells as macrophages, fibroblasts, and keratinocytes, colder, alkaline wound milieu, wound related hypoxemia, and diabetes. Other factors implicated include reperfusion injury, poor patient compliance, presence of undiagnosed and therefore unmanaged biofilms and wound pain. The past decades have yielded reliable evidence-based guidelines and standardized care, but the healing of diabetic foot wounds continues to be unpredictable notwithstanding these advances, while the recurrence rates are also high. The benefits of technology in wound diagnosis are evidence-based and the use of this technology also features in guidelines. However, the same argument cannot be extended to adjuvant devices to facilitate wound closure even though many devices potentially benefit wound healing. Chronic Wound Management describes how innovation is based on technology that itself informs evidence, the gap between the evidence available, the performance of technology and how do we bridge this gap. It reviews the lessons learnt from the COVID-19 pandemic and whether traditional medicine systems offer us real or imaginary benefits. Consequently, this book is an important addition to the literature in the area and an essential read for all healthcare professionals working with these patients.

Dermatology. --- Medicine --- Skin --- Diseases --- Wounds and injuries --- Treatment --- Equipment and supplies. --- Human beings --- Injuries --- Trauma, Physical --- Wounds --- Surgical emergencies --- Traumatology

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Currently, no comprehensive practical surgical textbook or other reference exists for the management of injured and other surgical patients at sea. This text focuses on the increasingly important field of medical and surgical management of patients in the modern expeditionary maritime environment. The editors and contributors to this new handbook are a group of physicians, nurses, and corpsmen with extensive experience in caring for patients in the expeditionary maritime environment, designing and implementing current doctrine and policy, and publishing peer-reviewed articles focused on these topics. This handbook takes the approach of a "how to" manual for the management of combat or disaster victims, beginning at the point of injury and proceeding through each stage of care until they leave the maritime environment. This includes sections on prehospital care, triage, en-route care, and maritime mass casualty management, as well as additional chapters covering unique aspects of maritime platforms, capabilities, and missions. The bulk of the book focuses on the initial patient evaluation and resuscitation as well as the operative and perioperative phases of care including prolonged casualty care. The primary focus throughout the book is on simple, practical, and proven practices that can be easily understood and implemented by physicians and independent providers of any experience level who may find themselves in similar situations. For the clinical chapters, each begins with a clinical vignette relevant to the chapter based on actual patients or maritime scenarios experienced by the authors demonstrating the various challenges that can occur caring for injured and surgical patients at sea while deployed on maritime and amphibious platforms. When appropriate, each clinical chapter will conclude by describing the recommended management and outcome of the patient(s) presented in the vignette that opened the chapter. The style is plain and direct language, avoiding scientific jargon and unnecessary complexity whenever possible. Each chapter begins with 5 to 10 bullet points that summarize the key information or “BLUF” (bottom line up front) from that chapter and conclude with common tips and pitfalls, as well as recommended high-yield resources for the entire maritime surgical team.

Surgery. --- Surgery, Primitive --- Medicine --- Critical care medicine. --- Medicine, Naval. --- Surgical emergencies. --- Critical care surgery --- Emergency surgery --- Medical emergencies --- Surgery --- Marine medicine --- Medicine, Marine --- Medicine, Nautical --- Nautical medicine --- Naval medicine --- Navies --- Shipboard medicine --- Medicine, Military --- Naval hygiene --- War --- Intensive care --- Intensive medicine --- Emergency medicine --- Intensive care units --- Medical service --- Relief of sick and wounded