Wound bed preparation and oxygen balance – a new component?

Abstract

Chronic wounds have traditionally been treated by conservative means. It was Winter's moist wound healing research, in 1962, that stimulated a proliferation of a moist interactive dressing technologies. Even considering this advancement in thinking, chronic wounds continue to be a problem for many clinicians. An increasing delineation of the science of healing in the past 20 years has redefined the way in which we both evaluate and treat wounds. This scientific understanding has raised wound care from the clinical problem arena to that of clinical specialty, where many now cross refer patients to specialists in this field. Wound bed preparation (WBP) has played a significant role in this change in practice. The concept has changed an 'art' of switching at random from one dressing to another, into a clinical science. WBP has come to the forefront as a major educational aid to help others develop appropriate treatment of the underlying disease causing the wound and patient requirements. The concept of WBP evolved over the recent years, becoming more and more sophisticated with time. Recent adaptations have brought together many of the current components. This article proposes yet another element of WBP, that of 'oxygen balance'.

Polymers in Wound Repair

“…The advanced wound products thus aim to accelerate repair by promoting/augmenting the activities of these mediators in non-healing conditions (Scheme 14.1). Although in many cases the role of polymers in such products is merely to provide a structural support, they are also crucial to maintain moisture environment, critical in the wound bed to promote growth factors, cytokines and migration of cells [52].…”

Citric Acid Treatment of Large Non-Healing Ulcer in a Patient with Chronic Liver Disease

“…Chronic wounds are significant medical and economical challenges (1) and continue to be a problem for clinicians because the orderly sequence of events is disturbed at one or more of the different stages of wound healing (2,3). The underlying problems in patients with large chronic wounds further complicate the healing.…”

Continuous Topical Oxygen for the Treatment of Chronic Wounds

“…Through the respiratory burst activity, oxygen is converted by leukocytic nicotinamide adenine dinucleotide phosphate oxidase to superoxide ion and other reactive oxygen species that are all lethal to bacteria. 3,4 Oxygen may be relatively deficient in the wound environment because of disrupted vasculature or high energy demand during metabolic activities to support tissue regeneration. In addition, increased sympathetic outflow and circulating vasoactive stress hormones due to wound-related pain may further compromise tissue oxygenation levels at the wound surface.…”