Wound healing dressings and drug delivery systems: a review

The variety of wound types has resulted in a wide range of wound dressings with new products frequently introduced to target different aspects of the wound healing process. The ideal dressing should achieve rapid healing at reasonable cost with minimal inconvenience to the patient. This article offers a review of the common wound management dressings and emerging technologies for achieving improved wound healing. It also reviews many of the dressings and novel polymers used for the delivery of drugs to acute, chronic and other types of wound. These include hydrocolloids, alginates, hydrogels, polyurethane, collagen, chitosan, pectin and hyaluronic acid. There is also a brief section on the use of biological polymers as tissue engineered scaffolds and skin grafts. Pharmacological agents such as antibiotics, vitamins, minerals, growth factors and other wound healing accelerators that take active part in the healing process are discussed. Direct delivery of these agents to the wound site is desirable, particularly when systemic delivery could cause organ damage due to toxicological concerns associated with the preferred agents. This review concerns the requirement for formulations with improved properties for effective and accurate delivery of the required therapeutic agents. General formulation approaches towards achieving optimum physical properties and controlled delivery characteristics for an active wound healing dosage form are also considered briefly.

The healing power of grandparents who parent

This paper explores the changing role of contemporary grandparents with many demonstrating a willingness and ability to take on parental responsibilities for their grandchildren, where they may face challenges and opportunities in difficult times. Three main forms of grand parenting are identified in the literature, those who hâve primary responsibility and are raising their grand children as their main carers perhaps in response to crisis situations, those who live in extended families and participate in care, and those who provide day care while the child's parents work. The rôle of Grandparents encompasses ail three areas in the United Kingdom. This has occurred as a resuit of the increased récognition of children living in abusive families, of the increasing frequency of divorce, single parenting, children and families living in poverty, socio-economic deprivation and the lack of available or subsidised child care in the United Kingdom when parents hâve to work to support the family. Ail of this against the backdrop the Every Child Matters change for children Agenda. When grandparents step into a troubled situation and attempt to offer stability and security for their grandchildren they may hâve to manage the combined responsibilities of family caregivers and parental figures. Grandparenthood is atenuous rôle, lacking clear agreement on behaviour norms. In the current culture of advice and parenting support, while care must be taken not to undermine parenting skills or make judgements about the ability to cope with the demands of childcare, an exploration of the impact on grandparents, and children in the context of families must be undertaken. Due to the complex web of interrelated factors the process and outcomes of care giving by grandparents is not well known in the literature. It is proposed therefore that it is timely to explore the impact of this on the health of children and their families in the current climate of change when there has been dissolution of the nuclear family and grandparents are playing increasingly significant rôles in healing and supporting their families.