Clinical experiences derived from implementation of an easy to use concept for treatment of wound healing by secondary intention and guidance in selection of appropriate dressings

Abstract

The main objective of this case‐cohort‐type observational study conducted at different Surgical Departments of the Charité‐Universitätsmedizin in Berlin was to evaluate the sequential use concept first described by Systagenix Wound Management in 2007. Fifty‐two patients with different wound healing by secondary intention were treated for 7 weeks at the Charité‐Universitätsmedizin in Berlin. A multidisciplinary team worked together to reach consensus in wound assessment; in classification of infection status according to the criteria described by European Wound Management Association (EWMA); in treatment protocol and on dressings to be used to ‘cover’ wounds. Before dressing application, all wounds were cleaned from debris. Following the sequential use concept, wounds classified as stages 2 and 3 were dressed with SILVERCEL® and TIELLE® or TIELLE PLUS® to ‘clean’ the wounds. After 2–3 weeks, treatment was changed to PROMOGRAN PRISMA® and TIELLE® to ‘close and cover’ wounds, thus providing optimal wound healing. Wounds classified as non infected were dressed with PROMOGRAN PRISMA® and TIELLE® during the complete treatment period. Patients were asked to evaluate the treatment using a simplified questionnaire developed at the Charité‐Universitätsmedizin in Berlin. Wounds comprised 37 surgical procedures, 8 chronic mixed ulcer, 4 pressure sores, 1 diabetic foot ulcer, 1 venous leg ulcer, and 1 mixed arterial/venous ulcer. At baseline, 12 wounds were classified as stage 3, 38 wounds as stage 2 and 2 wounds as stage 1. After 7 weeks of treatment, all patients showed a positive clinical response to the sequential use treatment. Results of wound size showed a high significant progression of wound healing expressed with a profound reduction of wound area (P in all measurements <0·001, chi‐square test) and improved granulation. This study summarises the clinical experiences derived from the evaluation of the sequential use concept in the daily clinical practice of wound treatment. On the basis of the wound healing results, patients' evaluation of treatment and the clinicians' and staff experiences, this concept was implemented at different Surgical Departments of the Charité‐Universitätsmedizin in Berlin.

The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

“…Malodour was used in 25 studies with a total of 1298 CLUs and erythema was used in 25 studies with 811 CLUs 12,14,22,34,37,38,41,45,47,50,51,[53][54][55][56][57][58][59][60][61][62][63][64][65][66] (Table 4). Malodour has been used in combination with other clinical signs 41,58,62 and/or microbial indicators.…”

Einsatz der Vakuuminstillationstherapie für die Wundbehandlung – Ergebnis einer Expertenkonsensuskonferenz

“…Faktoren, wie lange die Wunde bereits bestand, wie oft sie wiedereröffnet wurde und welche Versuche bereits unternommen wurden, um die Wunde zu verschließen, spielen eine Rolle für die Wahrscheinlichkeit einer effektiven und endgültigen Heilung [1][2][3]. Zum Repertoire der Behandlung infizierter Wunden gehören u. a. das Débridement, die Antibiotikabehandlung, die lokale Anwendung von Antiseptika und die Anwendung von Drainagen [4]. In Kombination mit dem chirurgischen Débridement stellt die Wundspülung eine zusätzliche Methode der Wundreinigung dar, da sie Zelltrümmer, Wundexsudat und Stoffwechselprodukte entfernt [5][6][7][8][9].…”

Application of hyaluronic acid in the healing of non-experimental open wounds: A pilot study on 12 wounds in 10 client-owned dogs

“…In addition, the weight of the different tool characterizing the wound at the assessment reflect the mutability of the healing process and is unequivocally linked to the selection of appropriate dressing that should be based on the type of wound, healing status, bio-burden present and amount of exudate [ 35 , 41 ]. In this scenario, wound quality assessment is also performed to determine if wound is changing, not only because it actually may be healing, but also because changes provide useful tool to improve the plan of care and direct clinical decision-making [ 31 ].…”