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Aim:

Chronic wounds are often colonized by different microorganisms, the most prominent being Staphylococcus aureus and Pseudomonas aeruginosa. PHMB-containing dressings have been shown to effectively inhibit bacterial progeny. However, bacteria do not act alone and the concept of biofilm formation and presence is now widely accepted. Therefore, current research targets antibiofilm strategies to restore an optimal wound-healing environment. A combined treatment approach involving debridement and the addition of antibacterial agents may then provide the highest success rates. Here, the efficacy of the new PHMB-containing PU foam* against a Staphylococcus aureus biofilm was evaluated in vitro. Moreover, antibacterial activity was evaluated in a direct contact method against Staphylococcus aureus and Pseusomonas aeruginosa.

Method:

Antibacterial activity against S. aureus and P.aeruginosa was tested according to JISL1902:2002. S.aureus biofilm was cultivated on glass plates, covered with dressings, and incubated for 24h at 37°C. Biomass was evaluated directly after dressing removal and following 48h regrowth period using the alamar blue assay.

Results / Discussion:

The new PHMB-containing PU foam* displayed complete inhibition of S.aureus and P.aeruginosa in the direct contact test, rated as strong antibacterial activity according to JISL1902:2002 (log-reduction>3). Treatment of S.aureus biofilm with the new PHMBcontaining PU foam* efficiently reduced biomass and significantly less viable bacteria were observed.

Conclusion:

It was found that the new PHMB-containing PU foam* exhibits a strong antibacterial activity against prominent microorganisms in chronic wounds. Moreover, it could be shown to reduce biofilm. Hence, it can be expected to exert beneficial effects in stagnating wounds and promote healing.

Aim:

Acne is a long-term, multiform skin disease that is characterized by increased sebum production (seborrhea) and comedo formation (blackheads or whiteheads). However, over time, inflammatory papules, pustules, and nodules may develop. For acne treatment, several options are available with the aim to normalize skin cell shedding and sebum production in the pore to prevent blockage and kill bacteria (such as P. acnes) to reduce inflammation. Hence, frequent cleansing of the skin is necessary without adding to the skin irritation. The recently introduced monofilament debrider may present a beneficial option, removing the protein-rich crusts, effectively, fast, and pain-free.

Method:

The sebum model consists of glass plates coated with an oil-red-stained layer of artificial sebum. The monofilament debrider* and conventional cosmetic pads**,***,**** were used to clean the glass plates under standardized conditions (p=0.067N/cm2, v=1.6cm/s). Images were obtained before and after treatment and processed using ImageJ 1.45m.

Results / Discussion:

The monofilament debrider* exhibited a significantly higher cleansingefficacy compared to the cosmetic pads in vitro. While the monofilament debrider* was able to remove the artificial sebum almost completely (98.9% cleansed area), significantly lower efficiencies were noted for the conventional cosmetic pad**(46.9%), the conventional cosmetic pad***(76.2%), and the conventional cosmetic pad**** (54.7%).

Conclusion:

Treatment of acne vulgaris requires an efficient skin cleansing to remove surplus sebum and prevent pore blockage. However, added irritation of the skin should be avoided. Using a model with artificial sebum, it could be shown that the cleansing capacity of the new monofilament debrider is significantly higher compared to commercially available cosmetic pads.

Aim:

Debridement is key to management of both slough and biofilm, and a number of methods are available to achieve this including surgical and mechanical debridement. Recent developments have led to new products indicated for debridement of wounds, including a unique sterile pad consisting of monofilament fibres. The purpose of this project was to examine wound related pain during mechanical debridement using monofilament debridement pad (WDP).

Method:

This is a case series of 10 patients with acute or chronic wounds that had slough required debridement. All wounds were debridement weekly for four weeks. Pain at baseline and during the debridement procedure (procedural pain) was evaluated using a verbal analogue scale (VAS) on which 0 was no pain and 10 was the worst pain imaginable.

Results / Discussion:

The wounds treated (number) were surgical wounds (3); pressure injury (3); venous leg ulcer (2); diabetic foot ulcer (1); trauma wound (1). The mean surface area covered by slough in the 10 wounds at week 0 was 79%. In every case the surface area of the wound covered by slough at week 0 reduced by week 4 to a mean of 8%. The average pain score at baseline was 6 in comparison to the mean pain of 7 during the debridement procedure using monofilament pads.

Conclusion:

WDP provides an effective solution to the goal of removing loose slough, deeply cleaning wounds and removing exudate. WDP does not induce high levels of procedural pain and any such pain subsided once debridement was complete.

There is a plethora of wound contact layer dressings on the market each with its own properties to promote healing, which makes dressing selection complicated. An effective and efficient choice of dressing depends on holistic patient assessment, along with an understanding of the wound-healing process, moist wound healing and wound bed preparation. This paper, supported by clinical case studies, demonstrates the effectiveness of the Lomatuell® Pro dressing (Lohmann & Rauscher) in the management of graft wounds, although it is known to be effective in the management of dermal and deep dermal wounds as well. Lomatuell Pro offers benefits of conformability, open mesh gel-forming wound contact properties and a low risk of adhering to the wound bed. It enables moist wound healing by allowing exudate to be absorbed by a secondary dressing. Lomatuell® Pro demonstrates excellence in maintaining a moist wound environment, allows atraumatic dressing removal and encourages a healthy periwound area.

Objective:

Effective and comfortable debridement is an important part of managing complex wounds. This user test evaluated a monofilament-fibre pad (with handle) (Debrisoft Lolly, Lohmann & Rauscher GmbH & Co. KG) in the debridement of various hard-to-reach wounds.

Method:

The multicentre, international user test was performed by experienced physicians and nurses in Germany and the UK, who used the monofilament-fibre pad in their clinical practice. After debridement, using the monofilament-fibre pad, the clinicians completed an evaluation questionnaire. The assessment comprised of performance, usability, tolerability, safety and suitability of the device for debridement, comparing it with standard methods used in the clinicians' centres.

Results:

A total of 23 clinicians in 20 centres each treated between six and 10 patients with the monofilament-fibre pad (a total of 155 wounds of different aetiologies). Most participating patients had deep wounds (n=63 (41%)) or cavity (n=31 (20%)) wounds. When compared with the standard debridement method used at the centres, the tested device was scored as ‘easier’ or ‘equally easy’ to use in all cases. When comparing the standard debridement procedure with the monofilament-fibre pad, debridement duration was reported as equal to or shorter than the standard method in 90% of cases when using the monofilament-fibre pad. Debridement efficacy was scored by the clinician as ‘better’ or ‘equal’ for the monofilament-fibre pad in 67% of cases. Overall, patients reported that the study device was comfortable.

Conclusion:

The monofilament-fibre pad effectively, easily and safely removed slough and debris from wounds of various aetiologies and was effective in wounds of different shapes, such as in cavity wounds and those in hard-to-reach locations.

Compression, in the form of either a compression bandage or a compression stocking, has been touted as the gold standard for treatment of swelling and venous leg ulcers (VLUs). Adjustable Velcro wraps have been marketed as compression alternative. Although there is a growing body of evidence to support use of these products, there has not been a critical evaluation of the functionality of the devices to best matching product to patient presentation and ability to use the device effectively. Unlike compression garments, which are classified by compression category (class I/II or flat knit/circular), there is not an algorithm to direct health professionals to best match a specific adjustable Velcro wrap to an individual patient presentation. This small case series demonstrates that although each product performed as marketed in vitro, performance in clinical setting varied greatly dependent on patient presentation and functional skill level.