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Addressing Wound Chronicity Factors UrgoClean AG® and UrgoStart® Case Studies

Chronic wounds are a perennial problem in clinical practice and place a burden
on patients, their families and healthcare providers. By addressing factors that
contribute to chronicity (slough, biofilm, elevated levels of metalloproteinases
and impaired angiogenesis), in addition to managing a patient’s comorbidities,
nutritional status and lifestyle, there is a greater chance of healing. This article
discusses the mechanisms by which UrgoClean Ag and UrgoStart support a
healthy wound environment, along with two case studies of their use in practice.

Evaluation of NOSF in Neuropathic Diabetic Foot Ulcers

Both case studies feature neuropathic patients who have good lower limb arterial blood flow and there is an expectancy these wounds will heal. However, it is the speed of healing that is interesting, as well as the fact
that these wounds were progressed from a non/slow-healing state into a healed state. Of particular interest is the fact that Case Study 1 healed without the use of adequate pressure relief (the patient was non-compliant with the use of an Aircast boot). Pressure relief is an integral part of wound healing (NICE, 2004) and this factor alone could have been the cause of non-healing. Since the wound healed despite pressure relief not being adequate, this would indicate that, in this case, Urgostart Contact dressing was effective.UrgoStart Contact can be used effectively in the management of neuropathic diabetic foot wounds, however, the author has not been involved in case studies that demonstrate its effectiveness on diabetic neuroischaemic wounds.

Use of Nano-Oligosaccharide Factor (Sucrose Octasulfate) Dressing Based on Technology Lipido-Colloid (TLC-NOSF) as an Interface Layer with Negative Pressure Wound Therapy

Complex and complicated wounds (CCWs) tend to exhibit slow wound healing and poor prognoses despite good standards of care. Numerous literature demonstrated the efficacy of TLC-NOSF dressing (UrgoStart®) in healing of both acute and chronic wounds. The author thus hypothesised that inclusion of TLC-NOSF dressing in dressing regimes would enhance wound healing and improve outcomes in CCW. This paper successfully verifies the hypothesis on three such
wounds, with good wound healing outcomes achieved.

Diabetic Foot Ulcer Management with TLC-NOSF (Technology Lipido-Colloid Nano-Oligosaccharide Factor) Wound Dressings from China

Diabetes and its associated complications is one of the biggest burdens that healthcare providers face. Diabetic foot ulcers (DFUs) are difficult-toheal wounds resulting from the diabetes-related pathogenic abnormalities.
Statistics from China are high, with the largest global prevalence of people with diabetes, and the local expenditure for this disease is second only to the US (Zhang et al, 2021). Moreover, 20% to 33% of costs related to diabetes mellitus are used for treatments of the diabetic foot (Chun et al, 2019). International and Chinese national guidelines broadly agree on the standard of care for the management of diabetic foot ulcers and it is very well understood that evidence-based holistic management, including local wound dressings, can improve healing outcomes. The clinical cases portrayed are aimed at describing the attainment of the implementation of Technology-Lipido-Colloid Nano-Oligosaccharide Factor dressing (TLC-NOSF). The TLC-NOSF dressing has been included in recent recommendations by the International Working Group on the Diabetic Foot (IWGDF) 2019 Guidelines and the National Institute for Health and Care Excellence (NICE, UK) and was the focus of a recently published systematic review highlighting the robust evidence behind this technology

A Prospective Study on the Efficacy of Sequential Treatment of Technology Lipido‐Colloid Impregnated with Silver and Technology Lipido‐Colloid Nano‐Oligosaccharide Factor in the Management of Venous Leg Ulcers

Background and Aims: Venous leg ulcers (VLUs) are associated with significant morbidity and poor quality of life (QOL). Compression therapy and wound dressing are the mainstay treatment options. Technology Lipido‐Colloid Impregnated with Silver (TLC‐Ag) reduces bacterial load and Technology Lipido‐Colloid Nano‐Oligosaccharide Factor (TLC‐NOSF) reduces elevated matrix metalloproteinases and improve wound healing. However, evidence is scarce on the role of sequential therapy. This study aims to evaluate if sequential treatment with TLC‐Ag and TLC‐ NOSF improves VLU wound healing and QOL.
Methods: This is a prospective cohort study from May 2020 to October 2021 on patients with VLUs who received sequential therapy, consisting of 2 weeks of TLC‐Ag followed by two‐layer compression bandage (2LB) with TLC‐NOSF until complete wound healing. Participants were followed‐up with weekly dressing changes. Our primary outcomes were wound area reduction (WAR) and Pressure Ulcer Scale of Healing (PUSH) score. Our secondary outcomes were QOL measures.
Results: There were 28 patients with 57.1% males (n = 16) with a mean age of 65.3 years. Mean duration of VLU was 13.9 ± 11.7 weeks before the initiation ofsequential therapy. Mean baseline wound area was 8.44 cm2
. Median time to wound healing was 10 weeks. 57.1% of patients achieved complete wound closure at3 months. There was significant WAR after 1 month (mean area 8.44–5.81 cm2 , 31.2% decrease) and after 3 months (mean area 8.44–2.53 cm2 , 70.0% decrease). Mean monthly WAR was 28.9%. PUSH score also decreased at 1 month (16.5% decrease, p < 0.001) and 3 months (63.3% decrease, p < .001) marks following the sequential therapy. EuroQol Visual Analog Scale (EQ‐VAS) improved following sequential therapy
(baseline: 69.0 ± 15.0, week 13: 80.2 ± 13.2, p < 0.001).
Conclusion: Sequential therapy with TLC‐Ag followed by TLC‐NOSF and 2LB is feasible, with good wound healing and improvement in QOL of patients with VLUs.

Application Tips – [Application Tips] UrgoStart Contact Layer

Welcome to this step by step guide on how to use UrgoStart Contact layer dressings.

All UrgoStart dressings are the only dressings clinically proven to reduce the healing time of wounds, thanks to the unique TLC-NOSF healing matrix.

All UrgoStart dressings are indicated for leg ulcers, diabetic foot ulcers, pressure ulcers and wounds that are at the risk of delayed healing.

UrgoStart contact layer dressings are pain-free at removal so you won’t cause unnecessary pain to your patients during dressing changes.

How to apply UrgoStart contact layer dressings:
• Cleanse the wound as per local protocol. Dry the surrounding skin carefully.
• Apply UrgoStart contact layer directly to the wound
• UrgoStart contact layer can be combined with a secondary dressing, suitable for the location and level of exudate, and secure it in place
• Apply the compression bandage system when prescribed (for mixed or venous leg ulcers)
• UrgoStart contact layer may be left in place up to 7 days, however change the dressing as advised by your healthcare professional.

Australian Guideline on Wound Healing Interventions to Enhance Healing of Foot Ulcers Part of the 2021 Australian Evidence-Based Guidelines for Diabetes Related Foot Disease

Abstract
Background: Diabetes-related foot ulceration (DFU) has a substantial burden on both individuals and healthcare systems both globally and in Australia. There is a pressing need for updated guidelines on wound healing interventions to improve outcomes for people living with DFU. A national expert panel was convened to develop new Australian evidence-based guidelines on wound healing interventions for people with DFU by adapting suitable international guidelines to the Australian context.
Methods: The panel followed National Health and Medical Research Council (NHMRC) procedures to adapt suitable international guidelines by the International Working Group of the Diabetic Foot (IWGDF) to the Australian context. The panel systematically screened, assessed and judged all IWGDF wound healing recommendations using ADAPTE and GRADE frameworks for adapting guidelines to decide which recommendations should be adopted, adapted or
excluded in the Australian context. Each recommendation had their wording, quality of evidence, and strength of recommendation re-evaluated, plus rationale, justifications and implementation considerations provided for the Australian context. This guideline underwent public consultation, further revision and approval by ten national peak bodies.