Wound care is a field with many treatment methods and products on the market. The healing period varies, some wounds become difficult to heal and chronic, in many cases a connection can be drawn to underlying diseases. Diabetes is a disease that could cause foot ulcers that are difficult to heal. Bioactive materials in wound care have not yet been studied to a greater extent, however it is of interest for development of new products with improved functions. Fibroblasts in the connective tissue have an important role in building and regenerating the tissue. Former studies show that the bio-ceramic calcium silicate (CS) induce tissue regeneration and promote reepithelization. It has also shown improvement of the biological functions of human epidermal stem cells and positive effects on cells in in vitro studies. The purpose of this project is to be a pre-study for further analysis of CS in wound care. The aim is to investigate additive material’s potential role in wound healing, one part will be a literature study to get an overview of the healing process of wounds and wound treatment. The other part of the study is based on three minor experiment to obtain information about how calcium silicate (CS) and CS/ β-tricalcium phosphate (β-TCP) effect human dermal fibroblasts. The method and results of literature study: The litterature study gathers information from literature and studies within the subject using the searchwords: wound, healing, biomaterials, calcium silicate, alamar blue, cell migration, recent trends, skin regeneration and diabetes. The results from the literature study demonstrates that the wound healing process is very complex and many factors must interact for good healing, some factors accelerate and inhibit healing. Furthermore, healing products with additives are already used for treatment of wounds with antibacterial and pain-relieving effects. However, only a little information about bioactive materials can be found which shows that there is lack of studies in this field. The method and results of experiments: Preparation of the two main samples: [1:10] CS in PBS together with pure water and [1:10] CS + β-TCP in PBS and pure water. The first experiment was the Inductively Coupled Plasma Optic Emission Spectroscopy (ICP-OES) made in an Optical Emission Spectrometer which detected the elements Ca 317,933 (mg/L) and Si 251,611 (mg/L) in the main samples. The second experiment was Alamar Blue which produce data about the cell survival in quantitative numbers to determine the toxicity of the diluted samples. One pre-test and two final tests (24 h apart) was made. The pre-test used the dilutions 1:2, 1:10, 1:100, and two Control Media, the pre-test indicated that CS diluted 1:2 is slightly toxic. The first final test used the dilutions 1:2, 1:10, 1:100, 1:1000, 1:10000 and one Control Media. The first final test indicated that CS diluted 1:2 is almost toxic. The second final used the dilutions 1:2, 1:10, 1:100, 1:1000, 1:10000 and one Control Media. The second final test indicated that CS diluted 1:2 is toxic. The third experiment was a Scratch Healing assay. This experiment struggled with learning how to count cells which made the analysis of this experiment difficult. The results of the Scratch healing assay shows cell migration through a before-picture right after the simulated scratch is made and a picture 24 hours after. In conclusion, two important parameters while investigating the direction of further research are toxicity and cell survival. CS as a bioactive material and additive in wound treatment could be possible but should be avoided when diluted 1:2 due to its toxicity shown in the Alamar blue test. The scratch healing assay showed that the fibroblasts migrate to some extent while interacting in solutions of CS.

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Background: Pyoderma gangrenosum after cardiac surgery is a rare, noninfectious ulcerating skin disease mimicking sternal wound infection. Methods: A systematic search of literature for pyoderma gangrenosum complicating cases of cardiac surgerywas conducted between September 1985 and September 2020 on PubMed and Cochrane databases. A systematic review and detailed overview of clinical presentation, diagnostic, treatment, and outcome is provided. Results: A total of 15 studies enclosing 15 patients suffering from pyoderma gangrenosum following cardiac surgery were identified. Onset of symptoms was observed after a median of 5 days. Patients were predominantly male (81.3%) with a median age of 64 years. Typical clinical presentation mimicked sternal site infection, mainly by means of mediastinitis. Specific signs were rapid progression, erythematous to violaceous color of the wound border, accompanied by unspecific symptoms including fever, malaise, and severe pain. Additionally, pathergy (development of ulcers at the sites of minor cutaneous trauma) was reported frequently. Biopsy is mandatory with a cutaneous neutrophilic inflammation confirming the diagnosis. Initial treatment mostly (75.0% of reported cases) was misled, addressing suspicion of surgical site infection. After correct diagnosis, the treatment was switched to an immunosuppressive therapy. Full sternal wound closure took between 5 weeks and 5 months. Reported case mortality was 12.5% in actually low-risk surgeries. Conclusion: Despite pyoderma gangrenosum has typical signs, it remains an exclusion diagnosis. The treatment is completely opposite to the main differential diagnosis —the typical surgical site infection. Knowledge about diagnosis and treatment is essential in the context of avoiding fatal mistreatment.

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Published Article / In 2005 the third-year facilitators of the generic degree in nursing embarked on an action research initiative within a service learning pedagogy to revitalise the nursing process related to wound care.As a result of the action research a unique wound care project unfolded. This project embraced an integrated assessment approach in order to assess the competence related to wound care and to develop health care practitioners with generic- and field-specific competencies. Action research as mode of delivery for this project created an opportunity for producing Mode 2 knowledge where all participants contributed to the production of knowledge relevant to the wound care context.

Bakgrund Tidigare forskning har visat att det finns en osäkerhet bland sjuksköterskestudenter samt utbildade sjuksköterskor gällande sår och sårvård. Sår skapar ett lidande för den som är drabbad och är resurskrävande ur ett samhällsperspektiv. Syfte Att undersöka kunskap om sår och sårvård hos sjuksköterskestudenter i termin sex vid ett universitet i Mellansverige. Ett delsyfte med studien var att undersöka om förväntningarna på sjuksköterskeutbildningen gällande sår och sårvård stämmer överens med den undervisning studenterna fått ta del av i slutet av sin utbildning. Metod En enkätstudie innefattande 73 studenter. Resultat Av studenterna upplevde 90 % att de fått för lite undervisning i sårvård. Drygt 81 % uppgav att de inte kände sig ha tillräcklig med kunskap inom sårvård inför sitt kommande yrke. Detta resultat skiljde sig inte åt för studenter med tidigare vårderfarenhet jämfört med studenter som inte hade tidigare vårderfarenhet. Studenterna hade även högre förväntningar på mängden sårundervisning än vad de upplevt att de fått ta del av. Slutsats Studiens resultat visar att sjuksköterskestudenterna upplever ett behov av få mer undervisning i sårvård under sin utbildningstid. Majoriteten anser att de inte har tillräcklig kunskap inom sår och sårvård för sitt kommande yrke oavsett tidigare vårderfarenhet eller ej. / Background. Previous research has shown that there is an uncertainty among nursing students and nurses regarding wounds and wound care. Wounds create suffering for the patient and take resources from a societal perspective. Aim The aim of the study was to investigate the knowledge of wounds and wound care in nursing students in semester six at a University in the middle of Sweden. One aim of the study was also to investigate whether expectations regarding nursing wounds and wound care is consistent with how much time the students actually got at the end of their programme. Method The method consisted of a survey in which 73 students participated. Results The results show that 90 % of participants feel that they received too little training. This contributes to that 81 % do not feel they have sufficient knowledge for their future profession. The students also had higher expectations of the amount of training than what they experienced that they had access to. Conclusion The study's results indicate that participants feel a need for more teaching of wound care. The majority believe they do not have enough knowledge of wounds and wound care for their future profession regardless of earlier care work experience or not.