The clinical impact of hydroresponsive dressings in dynamic wound healing: Part I

An observational study of wounds treated with hydro-responsive wound dressings

OBJECTIVE

Acute and hard-to-heal wounds are a significant burden to both a patient's quality of life and resources in healthcare systems. Here, we evaluate the outcomes of a non-comparative case series study in which Ringer's solution-preactivated polyacrylate dressings were used to treat acute and hard-to-heal wounds (the presence of Ringer's solution provides a wound dressing that allows, upon application, the immediate hydration of the underlying wound tissue).

METHOD

Patients with acute and hard-to-heal wounds were enrolled into an open-labelled, non-comparative observational study. Patients were treated with Ringer's solution-preactivated polyacrylate dressings to enable wound debridement and wound cleansing for up to 12 weeks.

RESULTS

A total of 303 patients were enrolled in the study and 278 were included in the analysis. Wound size decreased, from a median of 3.6cm² (interquartile range (IQR): 1.2-9.3] at baseline to a median of 2.6cm² (IQR: 1.1-7.8] at 84 days. Relative wound area reduction (WAR) was 43.1% at 84 days and estimated probability of achievement of a WAR of ≥40% and ≥60% was 68.7% and 53.4%, respectively. Median time to achieve a WAR of ≥40% and ≥60% was 54 days and 75 days, respectively. The median percentage of wound area covered by fibrin had decreased from 50.0% to 10% and granulation tissue had increased from 25% to 50% after 84 days. In addition, periwound skin condition, local signs of infection and pain all showed improvement. The majority of the wounds were assessed as 'healed' or 'better' at the conclusion of the evaluation period.

CONCLUSION

Based on the findings of this study, the use of Ringer's solution-preactivated polyacrylate dressings in daily practice has the potential to improve clinical outcomes, including healing, in patients with acute and hard-to-heal wounds.

Physicochemical Characterization of Star Anise Silver Nanoparticles Incorporated Chitosan Biomaterial for Absorb Water and Cure Wounds

Chronic wounds threaten the geriatric society worldwide irrespective of their social status. The current treatment approach to cure chronic ailments is associated with its demerits. A novel treatment approach that is coordinated is required to adsorb water from wounds and cure chronic wounds. Star anise condiment used in the Indian kitchen is shown to have the potency to cure various ailments. In this study, silver nanoparticles were prepared using the star anise extract. The biological potency of star anise extract was confirmed through Gas Chromatography Mass Spectroscopy, antioxidant assay, and anti-inflammatory study. From the DPPH assay result, it was inferred that star anise extract was able to scavenge the free radicals at the concentration of 10 μg/ml using the aqueous extract silver nanoparticles were prepared. The prepared particles were characterized by UV-visible, scanning electron microscopy, and their biological efficacy was determined for their potency against bacteria and prevention of protein aggregation. The anti-inflammatory assay suggests that nanoparticles prevent the aggregation of proteins in a dose-dependent manner. IC50 was found to be 20 μg/ml. The synthesized nanoparticle was incorporated into the chitosan biomaterial and characterized by various physicochemical parameters such as differential scanning calorimetry, scanning electron microscopy, FTIR, and thermogravimetric analysis. According to the findings, silver nanoparticles incorporated in chitosan biomaterials can be used to adsorb water from wounds and wound healing materials.

The clinical impact of hydro-responsive dressings in dynamic wound healing: Part II

OBJECTIVE

Over the course of a wound's healing trajectory, whether the wound is acute or hard-to-heal, management is likely to involve the use of several different dressing types. Minimising the complexity of treatment (in terms of dressing usage) would aid clinicians in providing effective wound care but excellent clinical outcomes must remain the primary goal.

METHOD

This study was an open-labelled, non-comparative study assessing the clinical effectiveness of a coordinated wound dressing treatment regimen. After an initial phase of using a hydro-responsive wound dressing (HydroClean, HRWD-1, PAUL HARTMANN AG, Germany) to cleanse and debride hard-to-heal wounds, the wounds were subsequently treated with either HydroTac (HRWD-2, PAUL HARTMANN AG, Germany) (to maintain healing progression and re-epithelialisation) or RespoSorb (a superabsorbent dressing, PAUL HARTMANN AG, Germany) (to manage moderate-to-high levels of exudate). The Pressure Ulcer Scale for Healing (PUSH) assessment tool was used to measure the wound status over the course of the treatment period and to assess several wound status parameters (for example, wound area, exudate levels and wound characteristics such as level of re-epithelialisation).

RESULTS

The results from this study demonstrated that wounds treated with HRWD-2 showed a positive healing response when using the PUSH score assessment tool with a significant mean reduction (p<0.0001) in the PUSH score of wounds treated with HRWD-2, with >75% of wounds being closed by the end of the study. This result underlines the effectiveness of HRWD-2 in supporting healing progression.

CONCLUSION

The results from this study support the coordinated use of HRWDs for the effective management and treatment of a variety of hard-to-heal wounds.

Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence

A break in skin integrity must be repaired as quickly as possible to avoid excess blood and fluid loss, and to minimise the onset of infection. Hard-to-heal wounds, in which the progression of the wound healing response is compromised, present several challenges to healing (for example, the presence of devitalised tissue acting as a physical barrier to healing and as a focus for bacterial contamination with the potential for subsequent infection). The objective of this article is to present, as a narrative review, the clinical evidence supporting the use of a unique hydro-responsive wound dressing (HydroClean, HRWD1, PAUL HARTMANN AG, Germany). The dressing provides a simple treatment option to address a number of clinical challenges clinicians must overcome in order to facilitate wound healing progression. These studies demonstrated that this product supported successful debridement/cleansing of a wide variety of wounds, including hard-to-heal wounds, enabled wound bed preparation, and lead to positive healing outcomes, including in wounds that previously had failed to heal. The simplicity of using HRWD1 as a single dressing can help clinicians overcome a variety of challenges when treating both acute and hard-to-heal wounds, which, with the benefit of proven patient outcomes, could make it an ideal choice for a first-line treatment.