Efficacy of topical cadexomer iodine treatment in chronic wounds: Systematic review and meta-analysis of comparative clinical trials

The Chronic Wound-Related Pain Model: Holistic Assessment and Person-Centered Treatment

Chronic wound-related pain is a complex biopsychosocial experience that is experienced spontaneously at rest and exacerbated during activities. Tissue debridement, trauma at dressing change, increased bioburden or infection, exposure of periwound skin to moisture, and related treatment can modulate chronic wound-related pain. Clinicians should consider multimodal and multidisciplinary management approach that take into account the biology, emotions, cognitive thinking, social environment, and other personal determinants of pain. Unresolved pain can have a significant impact on wound healing, patients' adherence to treatment, and individual's quality of life.

Improving wound infection management: education and evaluation of an infection management pathway

OBJECTIVE

To assess the clinical impact and acceptance of an infection management (IM) pathway, designed to improve the consistency of care of wound infection when introduced, and supported by an educational programme.

METHOD

An education and evaluation programme (T3 programme) was-conducted in Portugal, Spain and Italy. This consisted of a two-hour educational, virtual seminar, followed by a four-week evaluation of an IM pathway during which survey data were collected on the impact of this pathway on clinician-selected patients. Finally, all participants reconvened for a virtual meeting during which the combined results were disseminated. The pathway provided guidance to clinicians regarding the targeted use of antimicrobial wound dressings according to the presence and absence of signs and symptoms of wound infection.

RESULTS

Responses relating to 259 patients treated according to the IM pathway, 139 (53.7%) of whom had received previous antimicrobial treatment, were captured. Signs and symptoms of infection resolved within four weeks of treatment in >90% of patients. All 25 patients who had received prior antimicrobial treatment for ≥3 months experienced a resolution in the signs and symptoms of infection within four weeks. The majority of participating clinicians agreed that the IM pathway improved decision-making (94.9%) and confidence (97.3%), and helped to determine the correct antimicrobial treatment (91.4%) in the context of wound infection.

CONCLUSION

The T3 programme was an efficient way to deliver a structured educational programme. The use of the IM pathway resulted in >90% of patients achieving resolution of their signs and symptoms of wound infection.

Wound cleansing and care in treating leg ulcers: a commentary on a Cochrane systematic review

Leg ulcers pose a significant challenge to healthcare services, requiring effective wound cleansing strategies to promote healing and prevent complications. Large amounts of nursing time is spent managing patients with venous leg ulcers (VLUs), with an average appointment time of approximately 30 minutes. Yet, there is a lack of clear guidance for the treatment of VLUs, with nurses adopting a wide range of cleansing practices. This commentary provides an overview of existing evidence on wound cleansing and care in treating leg ulcers, for the benefit of healthcare professionals working within clinical practice.

Comparison of the Outcomes of Cadexomer Iodine and Povidone-Iodine Ointments in Wound Management

Background In this era of upcoming newer formulations of topical ointments in the market, selecting an appropriate topical ointment for managing ulcers is challenging with regards to granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from the ulcer. This study compares the outcomes of two topical iodine formulations, namely, cadexomer iodine ointment (0.9%) and povidone-iodine ointment (5%), for the management of various types of ulcers. Methodology This prospective, interventional study was conducted in a tertiary care hospital. After screening, 40 patients with ulcers (venous, arterial, diabetic, traumatic, infective) were subjected to simple randomization based on computer-generated random numbers at a ratio of 1:1 for the application of cadexomer (n = 20) (Group A) and povidone-iodine ointment (n = 20) (Group B). Selected patients were subjected to broad-spectrum antibiotics on admission and then shifted to special antibiotics based on the culture and sensitivity report of the wound. The application of these two formulations was done in three settings, each lasting 48 hours. The efficacy of these two formulations was assessed based on the following three parameters: (a) the percentage of granulation tissue promotion, (b) wound size reduction, and (c) decline in wound discharge. The study groups were compared using an unpaired t-test, while the association among the study groups was performed using Fishers' test, Student's t-test, and chi-square test. P-values less than 0.05 were considered significant. Results Significant improvement (p < 0.05) in granulation tissue was observed with cadexomer ointment application compared to povidone-iodine ointment. Statistically significant reductions in ulcer size and discharge from ulcers were seen in both groups; however, clinically, cadexomer ointment was found to be more effective compared to povidone-iodine ointment in reducing ulcer size as well as in reducing the amount of discharge from ulcers. Conclusions Cadexomer iodine ointment proved to be better than povidone-iodine ointment in the management of ulcers regarding the percentage of granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from ulcers.

An Overview on the Recent Advances in the Treatment of Infected Wounds: Antibacterial Wound Dressings

A wound can be surgical, cuts from an operation or due to accident and trauma. The infected wound, as a result of bacteria growth within the damaged skin, interrupts the natural wound healing process and significantly impacts the quality of life. Wound dressing is an important segment of the skincare industry with its economic burden estimated at $ 20.4 billion (in 2021) in the global market. The results of recent clinical trials suggest that the use of modern dressings can be the easiest, most accessible, and most cost-effective way to treat chronic wounds and, hence, holds significant promise. With the sheer number of dressings in the market, the selection of correct dressing is confusing for clinicians and healthcare workers. The aim of this research was to review widely used types of antibacterial wound dressings, as well as emerging products, for their efficiency and mode of action. In this review, we focus on introducing antibiotics and antibacterial nanoparticles as two important and clinically widely used categories of antibacterial agents. The perspectives and challenges for paving the way for future research in this field are also discussed. This article is protected by copyright. All rights reserved.