As the availability of various bioelectric impedance analysis (BIA) tools is increasing, the patient’s position during the test may be of significant importance for the comparability of the results. An observational pilot study was undertaken between March and May 2021 at the Center for Innovative Research in Medical and Natural Sciences at the University of Rzeszow, Rzeszów, Poland. All participants (n = 49: M: 21.05 y ± 1.12 vs. F: 21.34 y ± 2.06) were subjected to measurements of selected nutritional status indicators and body components in three positions: lying, sitting and standing. The body composition indicators were obtained using a bioelectrical impedance device, AKERN BIA 101 Anniversary Sport Edition Analyzer (Akern SRL, Pontassieve, Florence, Italy). The results were analyzed using dedicated software (BodygramPlus 1.2.2.12 from AKERN 2016, Florence, Italy). Our observations indicate that there is a significant difference between lying and standing as well as sitting and standing with respect to anthropometric and nutritional indicators (resistance, reactance, phase angle, standardized phase angle, body cell mass index and fat-free mass index) and body composition components, with particular reference to intracellular and extracellular water. The described differences are significant for both sexes. This study showed that this significantly influenced the scores of components directly related to resistance, reactance and hydrated cell mass, while not affecting the percentages or absolute values of fat and fat-free mass.

Background: Wound healing is a complex physiological process that begins immediately upon injury. Nutritional status significantly affects the course of regenerative processes. Malnutrition can prolong the inflammatory phase, limit collagen synthesis, and increase the risk of new wound formation. The issue of malnutrition is becoming increasingly prevalent and remains a significant concern, particularly among older adults dealing with chronic conditions. Methods: The study was conducted at the Wound Treatment Clinic of the Specialist Hospital at the Podkarpackie Oncology Center in Brzozów, Poland, over 12 months (31 December 2022 to 31 December 2023). A prospective assessment was carried out on 106 patients with chronic wounds. The sample selection was purposeful, based on the following criteria: individuals with hard-to-heal vascular wounds related to diabetic foot disease or venous insufficiency, who provided informed consent to participate after reviewing the study concept. The assessment included a questionnaire and biochemical blood analysis. Further evaluations covered wound characteristics and classification based on clinical scales. The morphotic and biochemical blood parameter assessment included albumin concentration, hemoglobin, C-reactive protein (CRP), and the nutritional risk index (NRI). Results: A larger wound area was associated with lower morphotic values in both groups. Exudate levels and severity in chronic venous insufficiency (CVI) patients and diabetic foot disease (DFD) were associated with lower hemoglobin, albumin, and NRI values. At the same time, the depth of tissue structure damage correlated with the measured biochemical parameters. Conclusions: NRI values and morphotic blood parameters, along with albumin, hemoglobin, and CRP levels, are closely associated with wound characteristics, including surface area, exudate level, and the severity of tissue destruction. The greater the destruction of tissue structures, the higher the risk of malnutrition and wound infection, as indicated by biochemical assessment.

The diagnosis of malnutrition should be one of the pillars of comprehensive patient care, especially in the case of patients with large wounds, prolonged healing, or comorbidities. The condition for a reliable and accurate nutritional diagnosis is to link it with the parameters of nutritional status assessment at the basic level (anthropometric measurements and clinical assessment) and in depth (biochemical tests and bioelectrical impedance). A prospective study included a sample of 60 patients with coexisting chronic wounds (venous ulcers, diabetic foot syndrome, pressure injury) treated at the Wound Treatment Clinic of Fr. B. Markiewicz Podkarpackie Oncology Center (Poland). The method of estimation and diagnostic survey was used; the research tool was a scientific research protocol consisting of four parts. Self-care capacity was assessed based on the Barthel scale, nutritional status using blood biochemical parameters, and electrical bioimpedance. Wounds were classified according to the extent, depth of tissue structures, and potential infection. Subjects with pressure ulcers had statistically significantly lower fat-free mass component indices compared to those with diabetic foot syndrome and venous ulceration. The subjects with pressure ulcers had significantly lower values of body composition components compared to those with diabetic foot syndrome and venous ulcers. In the group of patients with pressure ulcers, the lowest values of albumin (3.20 g/dL), hemoglobin (10.81 g/dL), and nutritional risk index (NRI) (88.13 pts.) scores were confirmed. Subjects with pressure ulcers with limited self-care presented a non-physiological nutritional status, indicating a risk of malnutrition. Local actions related to wound treatment should be preceded by a general examination, considering the state of augmented nutrition with the use of electrical bioimpedance.

Bacteria inhabiting chronic wounds form a biofilm that prolongs and slows down the healing process. Increasingly common antibiotic resistance requires clinicians to search for effective and alternative treatment methods. Defensins are the most common antimicrobial peptides capable of eradicating pathogens. Their discovery in maggot secretions allowed for a broader understanding of the healing mechanisms, and approving the use of Lucilia sericata fly larvae in the treatment of infected wounds resulted in an effective and safe procedure. The aim of the study was to present the possibility of biofilm elimination in a chronic wound by means of medical maggots (Lucilia sericata) with the example of three selected clinical cases. The observation included three women who met the inclusion criterion of having venous insufficiency ulcers with inhibited regeneration processes. Medical maggots were applied in a biobag for three days, and observation was conducted for 21 consecutive days. In 2 cases, a significant elimination of necrotic tissue from the wound bed with local granulation tissue was observed 72 h after application of a larvae colony on the wounds. In 1 case, the application of the larvae accelerated the repair process by reducing the wound area by approximately 40% at the time of observation. The formation of biofilm in a chronic wound is one of the main causes of disturbances in its effective healing. Combining procedures (scraping, antiseptic compresses, MDT, NPWT) related to wound debridement increases the effectiveness of biofilm elimination. The use of medical maggots is a safe and effective method of choice, and it enhances the processes of debridement. However, confirmed indisputable data on their effectiveness and frequency of use in the process of stimulating healing processes are still not available in the literature.

Currently, pain is considered the fifth vital sign, and its effective relief is a priority in many surgical departments. The aim of this study was to determine the influence of selected factors on the intensity of postoperative pain after orthopedic and gynecological procedures. The study was conducted in a group of 200 patients undergoing orthopedic and gynecological procedures at the County Hospital in Nisko between August 2017 and January 2018. The method of estimation and document analysis was applied in the course of the study. A standardized tool was used—Polish adaptation of the Melzack Pain Questionnaire (MPQ), an individual documentation of patients and a scientific and research questionnaire developed by the authors. The tests were conducted for three consecutive days from the day of the operation. The strongest pain immediately after surgery was experienced by the patients after general endotracheal anesthesia, and the mildest after full intravenous short-term anesthesia (p < 0.05). Procedures lasting more than 60 min were associated with greater pain intensity on all tested days. The sex of the patient did not significantly affect the level of the perceived intensity of postoperative pain (p > 0.05). The highest intensity of pain occurred on day 0 after surgery, with a declining trend in the following days (p < 0.001). The highest intensity of postoperative pain was caused by gynecological procedures as well as laparotomy and arthroplasty (p < 0.001). The variability of the results indicates the need for an individual approach to each patient, both in pain assessment and treatment. Therefore, continuous improvement of the quality of health services provided in accordance with the guidelines for pain relief is necessary.

Introduction: Bioelectrical impedance (BIA) is one of the most widely used indirect methods for assessing human body composition. The phase angle (PhA) as its derivative is considered an indicator of cellular health and monitoring of nutritional status. Due to its safety and reproducibility, it...