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Aim:

Traumatic implantation of pigmented particles in the skin require removal as quickly as possible to prevent deeper penetration and persisting skin tattoo. We present the case of a patient with accidental contamination during his work as a channel digger. A cushions were inflated under pressure. the cushion burst when the patient was just 1-2 metres away. Water and mud exploded within the channel and covered the face and hands of the patient. Dirt particles penetrated the skin, eyes and cornea.

Method:

The particles in the eyes and cornea were removed surgically and a systemic antibiotic therapy was started. Laboratory examination revealed a C-reactive protein of 49.3 mg/l (normal: <5 mg/l). Cheeks and periocular region showed remarkable oedema. After a rehydration of the skin with aliphatic ointments (0.4 mg/ml Polihexanid in Unguentum leniens) under semi-occlusive dressing over 4 hours, a mechanical debridement with a monofilament fibre debridement pad* was performed.

Results:

Almost all particles could be eliminated leaving superficial skin lesions - pain-free. Antiseptic ointment (Clioquinol 5 mg/g) was recommended for the further skin treatment. The systemic antibiotic therapy was also continued. A follow-up two days after the debridement showed a decrease of oedema and inflammation and a skin totally cleared from dirt particles.

Conclusion:

The immediate comparison with the use of moistened compresses showed a clear predominance of the monofilament pad in the efficiency of particle removal. Usual treatments with scalpel blade or dermabrasion are time-consuming and painful for the patients. By the use of a monofilament fibre debridement pad in an early stage of traumatic tattoo, a very satisfying cosmetic result could be achieved.

Introduction

Wound care becomes challenging when dealing with infected or infection-prone wounds, demanding both effective infection control and proper management of wound exudate. [1] To address these challenges, a novel antimicrobial calcium alginate dressing was developed. The objective of this study was to evaluate the dressing's performance, safety, and ease of use in the treatment of such wounds.

Methods

The clinical study was conducted across 5 centres in Germany. Wound managers treated 91 patients (46% male/54% female) with the investigated product, following instructions for a minimum of 4 dressing changes over a 7 to 28-day period. Data was collected using an electronic questionnaire, and the patients had an average age of 69.46 ± 16.38 years. The study followed the principles of the Declaration of Helsinki and adhered to §3 clause 4 of the German Medical Devices Act (MPDG) and §47 Section 3 of the MPDG.

Results

The study included patients with various medical conditions, such as venous leg ulcers (23.08%), postoperative wounds (23.08%), pressure injuries (20.88%), diabetic ulcers (10.99%), arterial ulcer (10.99%), and skin graft or donor sites (10.99%). Among these wounds, 42% were deep, and 58% were superficial. During the study period, indicators of infection such as redness, overheating, tissue dysfunction, swelling, and pain were significantly reduced by an average of 1.34 on the Visual Analog Scale (VAS). On average, practitioners effectively met their treatment objectives, which encompassed maintaining wound moisture, facilitating autolytic debridement, protection of the wound edge against maceration, supporting wound healing, managing exudate, controlling existing infections, preventing new infections, and stopping bleeding. These objectives were achieved at a 94% success rate with the use of the examined wound dressing. In only 7.7% of cases did the wound dressing fail to gel. In 98.9% of cases, the wound remained fully covered after the dressing had gelled. The gelled wound dressing effectively removed cellular debris from the wound if present in 97.01% of cases. The dressing conformed to the wound in 98.9% of instances. Maceration resulted from the dressing in only 1.1% of cases. Wound exudate was effectively channelled into the secondary dressing in 97.2% of all cases. In 97.8% of cases, the dressing could be removed in one piece. Easily removable fibre residues were observed in 10.99% of cases. Adherence of the dressing to the wound bed occurred only in 4.4% of cases. Dressing changes were atraumatic in 97.8% of cases. The ease of use, as well as cutting the dressing when dry, was rated as very easy or easy in 100% of cases.

Discussion

The study has shown that the tested wound dressing offers valuable assistance to healthcare professionals in the treatment of infected or infection-prone wounds. Existing infections were either reduced significantly or completely eradicated. The dressing also effectively managed wound exudate and safeguarded wound edges from maceration. Furthermore, the dressing's ability to stay intact during gentle dressing changes contributed positively to the wound healing process.

Conclusion

This study revealed the excellent suitability of the new wound dressing for managing infected or infection-prone wounds. It offers practical insights into how the product performs in real-life situations. To obtain a more comprehensive understanding of the product's capabilities, further prospective randomized studies are required.

*Suprasorb® A + Ag Pro - Speciality Fibres and Materials Ltd

Introduction

Infected or infection-prone wounds are a challenge in wound care, requiring effective infection management and wound exudate control. [1] A new antimicrobial hydroactive fibre dressing* containing silver nanoparticles was developed for these needs. This study aimed to assess the product's performance, safety, and usability in managing such wounds.

Methods

The clinical study took place at 6 centres in Germany (n=5) and Austria (n=1). Eight wound managers treated 81 patients (46% male/54% female) with the investigated product, performing at least 4 dressing changes over 7 to 28 days as per instructions. Results were collected via an electronic questionnaire. Patients' average age was 66.88 ± 16.17 years. The study adhered to the declaration of Helsinki and complied with §3 clause 4 of the German Medical Devices Act (MPDG) and §47 Section 3 of the MPDG.

Results

The study included patients with various medical conditions, such as venous leg ulcers (24.69%), postoperative wounds (13.35%), second-degree burns (12.35%), pressure injuries (12.35%), diabetic ulcers (12.35%), traumatic wounds (12.35%), and wounds prone to bleeding (12.35%). Among these wounds, 41% were deep, and 59% were superficial. Regarding exudation, 75% had a moderate level, while 25% had a high level. Over the study period, signs of infection such as redness, overheating, tissue dysfunction, swelling, pain, and wound odour were significantly reduced by an average of 2.64 on the Visual Analog Scale (VAS). Biofilm was no longer visible in 60% of the treated wounds that initially showed visible biofilm at the beginning of the treatment. In 31% of cases, biofilm was still partially visible. On average, practitioners successfully achieved their treatment goals, including maintaining wound moisture, facilitating autolytic debridement, protecting the wound edge from maceration, supporting wound healing, managing exudate, controlling existing infections, and preventing new infections. These goals were achieved at a rate of 95.3% through the use of the investigated wound dressing. In 100% of the wounds, the gelled wound dressing effectively removed cellular debris from the wound. The dressing conformed to the wound in 98.8% of cases. Only 3.7% of the wounds experienced gelation extending beyond the wound's edge, and wound exudate spread beyond the wound edge in only 26% of cases. Maceration was caused by the dressing in only 2.5% of cases. In all cases, wound exudate was successfully directed into the secondary dressing. The dressing could be removed intact in every case. In 12.4% of cases, easily removable fibre residues remained in the wound. The dressing adhered to the wound bed in 5% of cases. Dressing changes were atraumatic in all cases, and the dressing could be cut to fit the wound in every instance.

Discussion

It has been demonstrated that the tested wound dressing is capable of providing excellent support to the user in treating infected or infection-prone wounds. Pre-existing infections could be reduced or entirely eliminated. Effective exudate management was facilitated, and wound edges were protected from maceration. Additionally, atraumatic dressing changes, without the product falling apart, contributed to wound healing.

Conclusion

This study demonstrated that the new wound dressing is highly suitable for the management of infected or infection-prone wounds. The presented study provides insights into the product's performance under real-life conditions. Further prospective randomized studies are necessary to gain a more comprehensive understanding of the product's capabilities.

*Suprasorb® Liquacel Ag - Speciality Fibres and Materials Ltd