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Die konsequente und adäquate Durchführung einer Reinigung oder eines Debridements von Wunden ist neben der Behandlung der Grunderkrankung eine grundlegende Voraussetzung für die Überwindung der Exsudationsphase, die Reduzierung des Infektionsrisikos und den Anstoß von reparativen Prozessen.

BACKGROUND

It is widely believed that the loss of compression pressure of inelastic bandages is associated with a loss of efficacy in contrast to elastic material, which maintains its pressure and performance. This study compared the effect exerted by inelastic bandages vs elastic compression stockings on the venous pumping function in patients with severe superficial venous insufficiency immediately after application and 1 week later.

METHODS

Ejection fraction (EF) of the calf pump was measured in 18 patients presenting with bilateral reflux in the great saphenous vein (CEAP C(3)-C(5)) without any compression and immediately after application of an inelastic bandage on one leg and an elastic compression stocking on the other leg. Measurements were repeated 1 week later, before compression removal. EF was measured using a plethysmographic technique. The changes of interface pressure of the applied compression products were recorded simultaneously with EF measurements.

RESULTS

After application, bandages and stockings achieved a significant improvement of EF (P < .001) that was much more pronounced in the bandaged legs. The median resting pressure was 45 mm Hg (interquartile range, 41-48.5 mm Hg) under the stockings and 64.5 mm Hg (interquartile range, 51-80 mm Hg) under the bandages. After 1 week, EF was still significantly improved in the bandaged leg (P < .001), but not under the stockings. At this time, the pressure under the stockings was only slightly reduced (5.9% supine, 3.6% standing), but the mean pressure loss under the bandages was much higher (54.3% supine, 35.4% standing).

CONCLUSION

The findings supporting inelastic compression are important in explaining the benefits of its use in chronic venous insufficiency. Inelastic bandages maintain their superior efficacy on the venous pumping function after a wearing time of 1 week, despite a significant loss of pressure.

Introduction:

The exudates of chronic wounds contain elevated levels of reactive oxygen and nitrogen species (ROS/RNS). This overproduction of free radicals perpetuates the inflammatory phase and results in severe tissue damage. Therefore, the reduction of these active speates while keeping the wound environment moist; an additional binding of matrix degrading proteases by the super absorbers has been shown. A further anti-oxidative effect would be another beneficial attribute of polyacrylate superabsorbers.

Materials & Methods:

Antioxidant potential of a polyacrylate-superabsorber containing wound dressing (Vliwasorb, Lohmann & Rauscher) was measured using the chemiluminescent ABEL Antioxidant test kits containing Pholasin specific for superoxide and peroxynitrite (Knight Scientific Limited, UK).

Results:

The polyacrylate-superabsorber exhibited a significant concentration dependent antioxidant potential. The wound dressing samples were equally effective in inhibiting the formation of ROS and RNS.

Conclusions:

It is believed, that the overproduction of reactive nitrogen and oxygen species in chronic wounds results in an elongated inflammatory phase and severe tissue damage. Hence, the reduction of these active species seems to be a suitable way to promote normal wound-healing. Polyacrylate-superabsorber inhibits the formation of free radicals in vitro. Therefore, wound dressings containing Polyacrylate-superabsorbers should have an auxiliary influence on the healing of chronic wounds besides the binding of exudates.