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    Our research and development teams operate at a global level and generate synergies from our collective expertise and by drawing on related disciplines. We are also constantly exchanging information at an international level with independent technical institutions, key opinion leaders and multipliers in order to be able to ensure cooperation and knowledge management of the highest order. As part of this process, we also conduct extensive research, the results of which we continually present in workshops, at conferences and symposiums - either in documentation or talks given by our cooperation partners - and also publish in renowned scientific journals. This database contains a large number of these evidence-based scientific articles, most of which have been evaluated by independent assessors:

    1. Poster

      REDUCED TISSUE FIBROSIS WITH ADDITION OF TEXTURED COMPRESSION GARMENTS TO EDEMA MANAGEMENT PROGRAM

      Poster presented at WUWHS 2020 13.09.2020 Abu Dhabi, UAE

      Background and Aims

      In the management of leg ulcers and hyperkeratosis of the surrounding skin, it is not uncommon for them to affect very large areas of the leg. The large size also leads to an increase in the level of exudate and the amount of devitalised tissue. As a result, a larger amount of material is needed to loosen and remove the devitalised tissue than is the case with smaller wounds. To evaluate the performance of this debridement pad optimised for larger wounds and the surrounding skin, a small case series was performed.

       

      Methods

      For the case series leg ulcers of various origins that needed debridement were treated once or over a longer period of time with the larger pad when indicated. The treatment was documented both photographically and in writing.

       

      Results

      Five patients between the ages of 64 and 83 were treated. All of them suffered from chronic ulcers covering a big area on their legs. At least some of the wounds were colonised with bacteria/biofilm. Two patients were suffering from hyperkeratosis, too. The debridement with the debridement pad was well tolerated by the patients. Biofilm as well as devitalised tissue were removed effectively. All wounds were healed or becoming better.

       

      Conclusions

      Most of the time one pad was sufficient, even for ulcers spreading to cover the entire gaiter area. A much larger area could be treated efficiently and quicker than it would have been possible with a smaller device. In addition, the enlargement of the device is accompanied by an increase in the absorption capacity for exudate, slough and debris.

      Further versions
    2. Poster

      Surgical treatment of extended keloid scar with dermal substitute, negative pressure wound therapy and partial thickness skin graft: A case study

      Poster presented at WUWHS 2020 13.09.2020 Abu Dhabi, UAE

      Aim

      We present the case of a young female patient, with sequela from 2nd and 3rd degree burn wounds on her legs and forearms bilaterally. Within 3 month after injury and conservative treatment, the patient developed extended keloids on the dorsal side of her left hand and forearm with functional impairment at the wrist and elbow.

       

      Method

      After the excision of the scar lesion, the full thickness skin defect was reconstructed in stages. To reconstruct a sufficient dermal layer, we locally applied a dermal substitute, initially covered with a meshed silicone sheet. To adequately steady the matrix and avoid shear stress, we used the technique of NPWT in general and a very easily manageable sleeve-like dressing* in particular.

       

      Results

      After complete healing of the graft, the patient is pain-free and no longer limited in her movements. At 1.5 years of follow-up there is no sign of recurrence for keloid.

       

      Conclusions

      The excision of large surface keloids overpassing joints and the use of a dermal matrix associated with skin grafts is a useful technique for restoring full thickness skin defects, particularly on the extremities. NPWT is known to perfectly mold the grafts to the wound. Yet, its application using gauzes or cut out foams and several pieces of transparent and self-adhering film is often difficult and time-consuming. Accordingly, NPWT that can be sealed by overlaying a sleeve simplifies the process, lowers the number of manipulations and thus speeds up the execution time.

       

      *Suprasorb CNP EasyDress - Lohmann & Rauscher

      Further versions
    3. Poster

      THE USE OF NIGHT TIME GARMENTS FOR CHRONIC EDEMA MANAGEMENT IMPACTS PATIENTS' QUALITY OF LIFE AND EDEMA MANAGEMENT

      Poster presented at WUWHS 2020 13.09.2020 Abu Dhabi, UAE

      Background and Aims

      In the management of leg ulcers and hyperkeratosis of the surrounding skin, it is not uncommon for them to affect very large areas of the leg. The large size also leads to an increase in the level of exudate and the amount of devitalised tissue. As a result, a larger amount of material is needed to loosen and remove the devitalised tissue than is the case with smaller wounds. To evaluate the performance of this debridement pad optimised for larger wounds and the surrounding skin, a small case series was performed.

       

      Methods

      For the case series leg ulcers of various origins that needed debridement were treated once or over a longer period of time with the larger pad when indicated. The treatment was documented both photographically and in writing.

       

      Results

      Five patients between the ages of 64 and 83 were treated. All of them suffered from chronic ulcers covering a big area on their legs. At least some of the wounds were colonised with bacteria/biofilm. Two patients were suffering from hyperkeratosis, too. The debridement with the debridement pad was well tolerated by the patients. Biofilm as well as devitalised tissue were removed effectively. All wounds were healed or becoming better.

       

      Conclusions

      Most of the time one pad was sufficient, even for ulcers spreading to cover the entire gaiter area. A much larger area could be treated efficiently and quicker than it would have been possible with a smaller device. In addition, the enlargement of the device is accompanied by an increase in the absorption capacity for exudate, slough and debris.

      Further versions
    4. Poster

      Mechanical debridement of leg ulcers and the surrounding skin using a monofilament fibre debridement pad designed for larger wounds and surface areas

      Poster presented at WUWHS 2020 13.09.2020 Abu Dhabi, UAE

      Background and Aims

      In the management of leg ulcers and hyperkeratosis of the surrounding skin, it is not uncommon for them to affect very large areas of the leg. The large size also leads to an increase in the level of exudate and the amount of devitalised tissue. As a result, a larger amount of material is needed to loosen and remove the devitalised tissue than is the case with smaller wounds. To evaluate the performance of this debridement pad optimised for larger wounds and the surrounding skin, a small case series was performed.

       

      Methods

      For the case series leg ulcers of various origins that needed debridement were treated once or over a longer period of time with the larger pad when indicated. The treatment was documented both photographically and in writing.

       

      Results

      Five patients between the ages of 64 and 83 were treated. All of them suffered from chronic ulcers covering a big area on their legs. At least some of the wounds were colonised with bacteria/biofilm. Two patients were suffering from hyperkeratosis, too. The debridement with the debridement pad was well tolerated by the patients. Biofilm as well as devitalised tissue were removed effectively. All wounds were healed or becoming better.

       

      Conclusions

      Most of the time one pad was sufficient, even for ulcers spreading to cover the entire gaiter area. A much larger area could be treated efficiently and quicker than it would have been possible with a smaller device. In addition, the enlargement of the device is accompanied by an increase in the absorption capacity for exudate, slough and debris.

      Products Debrisoft Pad
      Further versions
    5. Poster

      Providing Compression Options: The Key to Better Compliance and Concordance

      Poster presented at ALA Virtual Conference 2020 28.05.2020 Hobart, Australia

      Aim:

      Compression remains the gold standard for long-term management of chronic edema. Reviews have shown that the benefits of compression diminish according to levels of non-adherence. Reasons commonly stated for nonadherence to compression include inconvenience, heat, cost, and pain. We hypothesize that offering compression options will have positive impact on patients’ compliance and concordance to compression regimens.

       

      Method:

      Observational study performed at 2 different edema management clinics. Ten patients presenting with lower extremity swelling and history of non-compliance with previous compression regiments were observed. Objective data measured included limb volume, range of motion (ROM), functional activity status using the Timed Up and Go(TUG), and assessment of quality of life (QOL) using the Lymphoedema QOL Tool (LYMQOL-LEG). Measurements were taken at four different intervals over a minimum of 3 months. Compression options were individualized to patient's physical presentation and lifestyle for long term management of their edema.

       

      Results / Discussion:

      Compression therapy had a positive impact on all outcomes measured during the intensive phase of therapy. Follow-up outside the intensive phase of therapy demonstrated further volume loss in 6/10 subjects; Volume remained constant 3/10, increased slightly 1/10. LYMQOL scores and functional performance level maintained stable during the follow-up period.

       

      Conclusion:

      Offering multiple compression options including custom and ready-to-wear flat knit stockings*, an adjustable wrap ** and nighttime compression options*** had a positive impact on patients’ adherence to compression regimens during the study period compared to single compression modalities offered previously. Individualizing the compression regimen to each patient’s lifestyle improved their adherence to chronic edema management.

      Further versions
    6. Journal article

      Adjustable Compression Wraps are Non-Inferior to Custom-Made Flat Knit Compression Stockings in the Maintenance Phase of Complex Decongestive Therapy

      Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2020

      Background

      Evidence supports the use of adjustable compression wraps (ACW) in the intensive phase of complex decongestive therapy (CDT), whereas evidence of its use in the maintenance phase of oedema therapy is sparse.

       

      Methods

      Randomised controlled non-inferiority trial in the maintenance phase of oedema therapy (CDT phase II) of symmetric lymphostatic oedema of the lower leg. Oedema therapy was performed with ACW and custom-made flat knit compression stockings (FCS) as a reference therapy in parallel over 3 days in n = 30 subjects. The primary outcome was lower leg volume as measured with perometer. Safety of ACW self-application and the patient perspective were secondary outcomes.

       

      Results

      ACW is non-inferior to custom-made FCS in CDT phase II of lymphostatic lower leg oedema. The differences of volume effects lie within the apriori defined equivalence interval of ± 50 ml (p = 0.163; 95 %-CI [ − 38.2; + 6.8]). Self-administration of ACW has shown no relevant side effects. ACW are easier to put on and off, while wearing comfort is comparable.

       

      Conclusions

      ACW are an alternative therapy option in the maintenance phase of CDT. Self-application seems to be safe, subject to diligent instruction of patients. Patients with difficulties putting on and off compression stockings could benefit from the use of ACW. Patients with pronounced limb volume may need to wear shoes with bigger sizes when wearing ACW. Further research with a longer observation time is to follow.

      Products ReadyWrap Leg
      Further languages
    7. Journal article

      A small scale quality improvement study trialling the use of a monofilament-fibre (Debrisoft®) debridement lolly on chronic ulcers

      Wounds UK 2020 16(1)

      Objective:

      A small-scale quality improvement study to determine the clinical effectiveness and patient satisfaction of the long-handled monofilament fibre (Debrisoft®) debriding lolly on foot ulcers that were considered to be slow healing in nature.

       

      Methods:

      This was a non-comparative, small-scale quality improvement study conducted on ulcers with slough (non-fibrous) at the ulcer base. The longhandled monofilament fibre (Debrisoft®) debriding lolly was used to treat seven patients during ulcer management, following the Trust's guidance for podiatric ulcer treatment.

       

      Results:

      Improvement was noted to the majority of ulcers within the second to third week and visible changes were evident, particularly in healing times and slough reduction. Both user and patient satisfaction were high.

       

      Conclusion:

      The long-handled monofilament fibre (Debrisoft®) debriding lolly provides an easy-to-use method of debriding foot ulcers. It allows easy access to difficult areas and enables the healing mechanism to commence. Patients verbally reported positive satisfaction when the long-handled monofilament fibre (Debrisoft®) debriding lolly was used.

      Products Debrisoft Lolly
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    8. Journal article

      Spezifischer biphasischer Druckaufbau unter nicht nachgiebigen Kompressionsverbänden beim intensiven Gehen

      Vasomed 2020 32(2) 5460

      Ziel

      110 Jahre nach Heinrich Fischers Veröffentlichung “Eine neue Therapie der Phlebitis” (7) möchten wir Daten aus unseren mobilen Grenzflächen-Druckmessungen unter nicht nachgiebigen Fischer-Verbänden veröffentlichen. Wir zeigen die biologisch physikalischen Gesetzmäßigkeiten auf, die über das Phänomen des biphasischen Druckaufbaus für die deutlich höheren Arbeitsdruckwerte unter nicht nachgiebigen Materialien im Vergleich zu nachgiebigen Kompressionsmedien beim schnellen und ausgedehnten Gehen verantwortlich sind.

       

      Methoden

      Wir verwendeten das von der Universitäts-Hautklinik Tübingen in Zusammenarbeit mit dem MIPM 1996 entwickelte Kompressionsdruck-Messsystem MCDI-1 (20) in der Spezialversion PIVI. Es arbeitet mit einem piezoresistiven Sensor. Darüber modellierten wir einen fixierten nicht nachgiebigen Unterschenkelkompressionsverband nach Heinrich Fischer (18). Die Gehstreckenlänge betrug 2 km, die Gehgeschwindigkeit 5,5 km/h. Die auf dem Handydisplay wiedergegebenen Einzelwerte wurden mit einer Digitalkamera gefilmt und danach zur Auswertung in Super-Slow-Motion ausgelesen. Dasselbe Verfahren durchlief ein Kompressionsstrumpf (KKl-2).

       

      Ergebnisse

      Bis zu einer Gehstreckendistanz von ca. 300 m liegen Fischer-Verband und Kompressionsstrumpf (KKl-2) mit intermittierenden Druckamplitudenspitzen von 80 mmHg gleichauf. Danach entwickelt sich die Phase 2 des biphasischen Druckanstiegs unter dem nicht elastischen Verband: Die Druckamplitudenspitzen steigen kontinuierlich weiter an, bis nach ca. 800 m ein Plateau mit einem durchschnittlichen Spitzendruck von 200 mmHg erreicht wird. Die Druckspitzendauer beträgt < 1/10 Sekunde.

       

      Schlussfolgerung

      3 Kraftquellen sind an der Druckgenese bei der Kompressionstherapie beteiligt: 1. der externe Anpressdruck des Kompressionsmediums, 2. die interne Kraft aus der Filament-Gleit-Schwellung der kontrahierenden Muskulatur, 3. die interne Kraft aus der zeitverzögert einsetzenden belastungsabhängigen vaskulär-metabolischen Pumpeffekt-Schwellung der Muskulatur. Sie ist verantwortlich für das spezifische Phänomen des biphasischen Druckanstiegs unter nicht nachgiebigen Kompressionsmedien. Der Anpressdruck (Anlagedruck) des Kompressionsmediums wirkt bei der nachgiebigen und nicht nachgiebigen Kompressionstherapie gleichermaßen. Die beiden internen Kraftquellen (Filament-Gleit-Schwellung und Pumpeffekt-Schwellung) summieren sich und entfalten nach Gehstrecken größer 800 m biphasisch eine Kraft, die je nach Steifheit des nicht nachgiebigen Materials im Binnenraum unter dem Verband (für < 1/10 sec.) vollständig in Druckkraft übergeht. Unter einer nachgiebigen Kompression verpufft diese Energie zum größten Teil in der Elastizität des textilen Materials. Beim flotten und ausgedehnten Gehen entwickeln sich deshalb (biphasisch) signifikant höhere Druckamplituden als unter elastischer Kompression. Als Resümee behält der alte phlebologische Leitsatz (15) “Therapie mit nicht nachgiebigen Verbänden und einem Laufprogramm, Halten des Ergebnisses mit Kompressionsstrümpfen” weiterhin seine berechtigte Gültigkeit.

       

      Schlüsselwörter

      Arbeitsdruck, Ruhedruck, Grenzflächen-Druckmessung, Biphasische Druckentwicklung, Filament-Gleit-Schwellung, Pumpeffekt-Schwellung, nicht nachgiebiger Kompressionsverband, nachgiebige textilelastische Kompression.

      Products Rosidal K, Varicex
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    9. Journal article

      Die endoskopische Unterdrucktherapie zur Behandlung von ösophagealen Leckagen

      Downloads Citation (RIS)
    10. Journal article

      Compression Therapy Is Not Contraindicated in Diabetic Patients with Venous or Mixed Leg Ulcer

      Journal of clinical medicine 2020 9(11)

      The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5-0.8) occurs as in mixed leg ulcers (MLU).

      MATERIALS AND METHODS

      in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure <40 mm Hg in patients with MLU and >60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU.

      RESULTS

      Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP (p = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP (p = -0.19).

      CONCLUSIONS

      when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.

      PMID 33227909
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