Wednesday, 10 February 2010 07:11
 Achieving the correct moisture balance is critical to wound healing.1,2 Dry, desiccated wounds quickly become necrotic, while wounds that are too moist may show localized maceration. Fortunately, evidence suggests that this concern may be addressed through use of the innovative and technologically advanced dressing, TheraGauzeTM. TheraGauze is designed to facilitate healing by precisely and differentially regulating moisture over the entire surface of a wound; in other words, the dressing dynamically releases or absorbs moisture according to the underlying condition of the wound. Unlike traditional gauze dressings that are notorious for sticking to wound exudate, TheraGauze can also readily be separated from the wound site with no picking, peeling, or scraping.3
TheraGauze uses a proprietary inert breathable polymer, known as “Skin Moisture Rebalancing Technology”, which is integrated into a nonwoven polyester/rayon substrate. This polymer allows fluids to move to and from the wound interface as required by the differing conditions in the wound. Importantly, the fluid balance provided by TheraGauze occurs at the wound surface, rather than within the dressing.
As well as resolving maceration and wound adherence, the use of TheraGauze reduces the pain associated with dressing changes, decreases the number of dressing changes required, and leaves no residue at the wound site.
Several case studies are available to support the benefit of using TheraGauze in a number of clinical applications.4 In addition, a clinical study was undertaken in which the benefit of TheraGauze was compared with TheraGauze plus Bercaplermin (Regranex 0.01%) and with historic controls (saline-moistened gauze, and Bercaplermin covered with saline-moistened gauze) in 32 diabetic foot ulcers. This study found that the rate of wound closure was faster with TheraGauze (0.37 cm2/week) and TheraGauze plus Bercaplermin (0.41 cm2/week), than with either saline-moistened gauze alone (0.16 cm2/week) or Bercaplermin covered with saline-moistened gauze (0.24 cm2/week). It was also found that a larger percentage of wounds closed after 12 and 20 weeks with TheraGauze and with TheraGauze plus Bercaplermin compared to both saline-moistened gauze alone and Bercaplermin covered with saline-moistened gauze. Based on these data, the authors conclude that the percentage of wounds which went on to full closure was doubled and the rate was twice as fast, when comparing regular saline moistened gauze to wounds where moisture was precisely regulated with TheraGauze. This finding illustrates the value of precision moisture control and the role it plays in achieving wound healing.
TheraGauze dressings are just one type of product covered in the highly respected online Woundeducators.com certification courses. WoundEducators.com offers the most comprehensive online wound care information available, and can help you take the next step in your career. Contact us today for more information.
References
1. Okan D, Woo K, Ayello E, Sibbald G. The Role of Moisture Balance in Wound Healing. Adv Skin Wound Care 2007;20(1):39-53.
2. Schultz GS, Sibbald RG, Falanga V, et al. Wound Bed Preparation: A Systematic Approach to Wound Management. Wound Repair Regen 2003;11(2):1-28.
3. Ovington L. Hanging Wet-to-Dry Dressings Out to Dry. Adv Skin Wound Care 2002;15(2):79–86.
5. Landsman A. A Randomized, Multi-Center, Prospective Analysis of Diabetic Foot Ulcers treated with TheraGauze™ alone or TheraGauze+Becaplermin. Poster presented at APMA National Scientific Meeting, July 2008.
Wednesday, 10 February 2010 07:03
 A common problem in wound management is that different features of a wound often require a different treatment strategy, or that the requirements of the wound continue to change over time. It can be very difficult to meet all the requirements of the wound with one dressing; and the need to continually address the different features of a wound is time consuming and potentially costly if a large number of dressings are required.
 PolyMem, a single dressing which can be used throughout the wound-healing continuum, comes close to solving this problem.1-5 This dressing combines the four key requirements of wound care (cleansing, filling, absorbing, and moistening) in a single formulation known as QuadraFoam®. PolyMem QuadraFoam is indicated for all wound types, and has been shown to create an optimal healing environment,1-6 and to enhance patient comfort.1-5
PolyMem QuadraFoam dressing provides continuous wound-bed cleansing through the release of a mild, non-toxic, tissue-friendly cleansing agent that is activated by moisture, drainage, and/or exudate. The glycerine present in the dressing prevents adhesion to the wound bed, while also reducing odor, conserving living fat cells, reducing hypergranulation, soothing traumatized tissues, and supporting autolytic debridement. PolyMem's QuadraFoam also offers impressive wound wicking power through its integrated polyurethane membrane matrix and the dressing provides a liquid barrier while also allowing vital gas exchange.
Several case studies demonstrating the effectiveness of PolyMem QuadraFoam dressings have been collected.7 In one unsponsored example, the dressings were found to improve quality of life in a 97-year-old lady with advanced Alzheimer’s Disease who had developed a painful, malodorous Stage III trochanter pressure ulcer due to immobility.8 Daily iodine and gauze dressing changes had appeared to cause the patient considerable procedural pain and distress. She was eventually hospitalized with the aim of minimizing wound pain and reducing wound odour. Wound closure was not considered an option for this elderly and debilitated patient.
A standard PolyMem QuadraFoam dressing was applied to this patient’s wound as a combined primary and secondary dressing. Because the dressings contain a built-in wound cleansing system, no additional wound bed cleansing or even rinsing was required at dressing changes, making the process very quick and easy. Dressings were replaced daily at first, decreasing gradually to twice a week as the wound became cleaner and exudate diminished.
After two weeks of treatment with PolyMem QuadraFoam, the patient no longer moaned or stiffened with pain when she was handled, and wound odour disappeared completely. After two months, the patient was dismissed with increased home-health support. The PolyMem QuadraFoam dressings were changed every other day at first, then twice weekly. Unexpectedly, the wound gradually filled in, and closed in less than four months. Aided by improved nutrition, the dressings brought wound closure to this extremely debilitated patient.
PolyMem QuadraFoam dressings are just one type of product covered in the highly respected online Woundeducators.com certification courses. WoundEducators.com offers the most comprehensive online wound care information available, and can help you take the next step in your career. Contact us today for more information.
References
1. Blackman JD, Senseng D, Quinn L, Mazzone T. Diabetes Care 1994;17(4): 322-5.
2. Carr RD, Lalagos DE, Upman PJ. Wounds: A Compendium of Clinical Research and Practice 1989;1(1):53-61.
3. Carr RD, Lalagos DE. Decubitus 1990; 3(3):38-42.
4. Fowler E, Papen J C. Ostomy Wound Management 1991;35:35-8, 40-4.
5. Kim YJ, Lee SW, Hong SH. J Korean Soc Plast Reconstr Surg 1999;109:1165-72.
6. Rodeheaver GT. In Krasner DL, Rodeheaver GT, Sibbald GR (Eds.). A Clinical Source Book for Healthcare Professionals, 2001 (3rd ed.). (pp. 369-383). Wayne, PA: HMP Communications.
8. Agathangelou C. Increased Quality of Life with the Help of Unique PolyMem QuadraFoam Dressings. Poster presented at 18th Conference of the European Wound Mgmt Association. Poster #P16. May 14 - 16, 2008. Lisbon, Portugal; 3rd Congress of the World Union of Wound Healing Societies. Poster #PF431. June 4 - 8, 2008. Toronto, Ontario Canada; NPUAP 11th Biennial Conference. Poster #34. February 27 - February 29, 2009. Arlington, VA USA.
Thursday, 28 January 2010 15:27
Continuing our series on innovative products in wound management, we turn our attention this week to active Leptospermum honey dressings.
A sweet solution for wounds and burns
Honey has been used for centuries for the treatment of wounds, including leg ulcers in particular. Many types of honey possess low levels of antiseptic agents, such as gluconic acid and hydrogen peroxide, which may be released to inhibit the growth of skin bacteria. However, certain types of honey, especially those native to Australia and New Zealand, have been found to contain additional substances that have a more powerful antimicrobial action. 
Honey-based dressings that contain a high percentage of Leptospermum honey from New Zealand are increasingly being used in all phases of healing in chronic and acute wounds and burns. These dressings are effective in the presence of wound fluid, blood, and tissue, and promote an optimal healing environment. MEDIHONEYTM was the first such honey-based product to be approved for use by the FDA and is indicated for the management of moderate-to-heavily exuding wounds including:
- diabetic foot ulcers
- venous stasis leg ulcers
- arterial leg ulcers
- leg ulcers of mixed etiology
- pressure ulcers (I-IV)
- 1st and 2nd degree burns
- donor sites
- traumatic and surgical wounds
MEDIHONEY tube and MEDIHONEY honeycolloid dressings are indicated for light to moderate exudate. MEDIHONEY Calcium Alginate is indicated for moderate to heavy exudate.
The benefits of leptospermum honey dressings have been demonstrated in numerous case studies.1-3 In one striking case, a 44 year-old female with locally advanced ductal carcinoma sought treatment for bilateral breast wounds after previous treatment with silver sulfadiazine and Dakin’s 0.25% solution had proven ineffective for exudate and odor management. After the wounds were cleansed with a surgical scrub cleanser, rinsed with water, and excess moisture had been absorbed with gauze, treatment with leptospermum honey was initiated. The dressing was changed daily. As the patient continued to receive cancer treatment, the necrotic slough tissue was debrided and malodor was rapidly eradicated. The patient reported a decrease in pain from the wound itself and also due to dressing changes. The combined antimicrobial, deodorizing, and debriding properties of the Leptospermum honey helped to prevent malodor associated with microbial growth and necrotic tissue. The right breast wound completely healed and the left breast wound continued to progress toward healing. In this case study, both patient and staff found the treatment to be easy to use, and to eradicate odor, improve exudate management and allow pain-free dressing changes.
 Images courtesy of MEDIHONEYTM (D. Segovia.)
Leptospermum honey dressings are just one type of innovative product covered in the highly respected online Woundeducators.com certification courses. WoundEducators.com offers the most comprehensive online wound care information available, and can help you take the next step in your career. Contact us today for more information.
References
1. Robson V, Cooper R. Using leptospermum honey to manage wounds impaired by radiotherapy: a case series. Ostomy Wound Manage 2009;55(1):38-47.
2. Gethin G, Cowman S. Case series of use of Manuka honey in leg ulceration. Int Wound . 2005;2(1):10-5.
3. Lusby PE, Coombes A, Wilkinson JM. Honey: a potent agent for wound healing? J Wound Ostomy Continence Nurs 2002;29(6):295-300.
4. Segovia, D., (2009). The clinical benefits of active Leptospermum honey: oncologic wounds. CSAWC. Poster: San Antonio, TX.
Wednesday, 27 January 2010 17:21
Over the next few weeks, we will use this blog to discuss some interesting and innovative products that are currently being used to treat wounds. This week, we will consider AmeriGel® Hydrogel Saturated Gauze Dressing.
A unique hydrogel with antimicrobial properties
 AmeriGel Hydrogel Saturated Gauze Dressing (AmeriGel) is the only impregnated gauze dressing available that contains Oakin®, a proprietary oak extract historically used to treat a variety of skin problems and conditions. Oakin contains antimicrobial properties proven in vitro to be bactericidal against 51 gram+ / gram− microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). Other constituents of AmeriGel include zinc acetate, known for its skin-protective properties, and polyethylene glycol which helps to maintain a moist-wound environment.
AmeriGel pads are indicated for stage I-IV pressure ulcers, venous stasis ulcers, diabetic skin ulcers, first and second degree burns, post-surgical incisions, cuts and abrasions. The dressing stays moist for up to seven days and eradicates 99.2% of MRSA bacteria within 24 hours.1 At a time when bacterial infections are becoming more difficult to manage, the effectiveness of AmeriGel against increasingly antibiotic-resistant bacterial strains is invaluable. AmeriGel also increases incorporation rates of Bioengineered Alternative Tissue (BAT) and accelerates healing.2
AmeriGel is believed to derive its effectiveness through a combination of mechanisms, including:
- Balancing the mix of MMPs and TIMPs in the wound
- Proliferating proteins to the wound site
- Decreasing cell-membrane permeability
- Promoting development of new granulation tissue
- Prompting wound contracture
A 50-patient peer-reviewed, published case series revealed the benefits of using AmeriGel following BAT application2. Results included substantially improved incorporation rates, increased frequency of wound closure, decreased time to achieve wound closure and a reduction in overall treatment costs. In one particularly striking case, a 63 year-old male with type II diabetes and severe venous insufficiency in the left leg presented with a full thickness ulceration on this leg. The patient was advised to use AmeriGel with compression, and the wound showed remarkable healing within one week.
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| {case study (1). Image courtesy of AmeriGel} |
{case study (2). Image courtesy of AmeriGel } |
Impregnated hydrogel dressings are just one type of product covered in the widely recognized online Woundeducators.com certification courses. WoundEducators.com offers the most comprehensive online wound care information available, and can help you take the next step in your career. Contact us today for more information. Learn more about wound care certification.
References
1. AmeriGel Hydrogel Saturated Gauze Dressing. BioScience Lab's (study available upon request).
2. Moore J. Creating the Ideal Microcosm for Rapid Incorporation of Bioengineered Alternative Tissues Using An Advanced Hydrogel Impregnated Gauze Dressing: A Case Series. The Foot & Ankle Journal 2008; 1(9): 2
3. Company Information, Case Study #403
Thursday, 14 January 2010 16:03
Wound care certification can appear to be a daunting prospect; even the number of organizations and authorities involved in the process can seem overwhelming. Each body also has its own impenetrable set of acronyms and abbreviations to navigate, with all acronyms appearing to be no more than anagrams of each other. Its enough to put you off wound certification altogether.
This article attempts to shed some light onto two of the key organizations that deal with wound certification; the American Academy of Wound Management (AAWM) (www.aawm.org) and The American College of Certified Wound Specialists (ACCWS) (www.theccws.org).
The AAWM was established in 1995 as a national, not-for-profit, multidisciplinary certifying board for healthcare professionals involved in wound care. It operates independently of any membership or education organization. The AAWM offers two different, highly respected credentials:
- Certified Wound Specialist (CWS)
- Certified Wound Care Associate (CWCA).
The CWS board certification is the most prestigious and rigorous certification in wound care and demonstrates a distinct and specialized expertise in the practice. The CWS credential displays to patients, employers and peers a dedication to the highest standards and achievement in wound care. To be eligible to sit for the CWS exam, an applicant must 1) possess a Bachelor’s degree, 2) hold a license or designation as one of the following: MD, DO, DPM, PA, DMD, or equivalent; VDM or equivalent; RN, PT or OT, and 3) be able to document three years of clinical wound care-related experience, including direct patient care.
To be eligible to sit for the CWCA exam, an applicant must have three years of clinical wound care-related experience, including direct patient care. Applicants do not have to have a Bachelor’s degree.
Since their inception, the CWS and CWCA programs have been hugely successful, and have helped thousands of wound care specialists advance their careers. However, it gradually became apparent that the AAWM, which operates purely as a certifying organization, was no longer fulfilling the needs of all its diplomates. Therefore in 2005, and in response to repeated requests for the formation of an advocacy and educational arm, the ACCWS was formed.
The ACCWS serves as the educational resource and advocate for CWS and CWCA status, providing informational resources for wound care professionals, and promoting an awareness of the potential benefit of CWSand CWCA credentials on the general healthcare environment.
The following credentials are available through the ACCWS:
- Fellow of the American College of Certified Wound Specialists (FACCWS)
- available to any CWS currently credentialed by the AAWM
- Associate of the American College of Certified Wound Specialists (AACCWS)
- available to any CWCA currently credentialed by the AAWM
- Honorary Fellow of the American College of Certified Wound Specialists (FACCWS)
- available to individuals of national or international stature, selected by the Board of Directors, who have made an outstanding contribution to the interdisciplinary practice of wound management.
The designation FACCWS or AACCWS after a name is highly prestigious and demonstrates that the professional in question has reached a level of excellence in wound management.
The e-learning courses offered by Woundeducators.com provide a convenient and affordable way to prepare you for wound certification. Contact us at today for more information about how to take the next step in your career in wound management.
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The WoundEducators.com course is endorsed by the American College of Certified Wound Specialists (ACCWS).
To learn more about ACCWS, please visit www.theccws.org.
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Reference
Rappl LM, Fleck C, Hecker D et al. Wound care organizations, programs, and certifications: an overview. Ostomy Wound Manage. 2007 53(11):28-39.
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