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.
Archives
A Prospective Randomized Study The Usefulness and Efficacy of Negative Pressure Wound Therapy with Lipido-Colloid Polyester Mesh Compared to Traditional Negative Pressure Wound Therapy for Treatment of Pressure Ulcers
To improve healing of pressure ulcer wounds, it is important to optimize the conditions
of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound
healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or
causing infection. In this study, we reviewed the e cacy of the lipidocolloid non-adherent dressing
(Urgotul®) as a wound contact layer. A total of 38 patients from the same facility who applied
NPWT from April 2016 to October 2019 were included and divided into two groups; NPWT with
the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only
(group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT
application, at one week, and again at three weeks after application. No significant di erences were
found between groups for general characteristics, bacterial culture or photo analysis. However,
when comparing groups based on the time of examination, there was a significant reduction of the
wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds
that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates
healing by shrinking the size of the pressure ulcer wound.
Moving the chronic wound along the healing trajectory
Chronic wounds are an ever-growing challenge for clinicians and represent a
huge burden on healthcare resources (Harding, 2002). They have been referred
to as a silent epidemic that is affecting a large number of people in the world
population (Gottrup, 2004). However, due to a better understanding of what
makes a wound chronic, several new treatments that offer better outcomes
for the patient and a broader choice for the clinician have been developed
(Harding, 2002). A sterile, non-adherent, slough-trapping, poly-absorbent fibre
dressing with the technologie lipido-colloïde (TLC) healing matrix to promote
wound healing and enable pain-free dressing changes, which can be used for
gentle desloughing, has been developed by Urgo. The slough-trapping fibres
(poly-absorbent) have been shown to bind and trap the slough within the
dressing, providing safe and effective desloughing (Kelly et al, 2013), while the
silver lipido-colloid matrix in the antimicrobial version, has been established
in its efficacy in the management of chronic wounds presenting with a risk
of infection as demonstrated through previous randomised controlled trials
(Harding et al, 2012; Lazareth et al, 2012).
Clinical Evaluation of Technology Lipido-Colloid in the Management of Acute Wounds in China
Wound management has evolved from considering wound
dressings as a means to provide protection to a medium that enhances
wound healing and also takes into consideration patient aspects such as
atraumatic removal. Technology-lipido colloid (TLC) is described as a healing
matrix as it stimulates fibroblasts, which is achieved through maintaining a
moist wound environment. It also provides atraumatic removal, thus it not
only protects the wound but avoids unnecessary pain for the patients. This
article discusses five cases from China where the TLC was used on a variety
of wounds with positive outcomes both for the wound and the patients.
Clinical Evaluation of UrgoClean AG (Poly-Absorbent Dressing based on Technology Lipido-Colloid with Silver Ions) in the Management of Infected Wounds in Asia
Wound infections, including biofilms play a significant role in delaying
wound healing and are considered to be one of the major challenges in
wound management. The presence of non-viable tissue, such as slough, is a
prominent feature of chronic wounds and is considered as a barrier against
successful wound healing. A key component in wound care is to integrate
in our care evidence-based dressings that provides continuous cleaning,
antimicrobial activity and which are also effective against biofilms.
UrgoClean Ag is a dressing composed of cohesive poly-absorbent fibres
impregnated with a silver lipido-colloid matrix (Technology Lipido-Coloid Ag healing matrix [TLC-Ag]) that has shown very good results in clinical trials,
including a prospective, multicentre, non-comparative clinical trial, but also
large scale observational studies. In this article, we attempt to replicate the
results obtained in Europe in patients from different countries in the Asian
Continent by means of a case series.
The Importance of Pain Reduction through Dressing Selection in Routine Wound Management The MAPP Study
Objective: To discover the incidence of pain in patients with acute or chronic wounds of various
causes during dressing removal, and the effect of switching to a non-adherent dressing.
l Method: A total of 656 primary care physicians reported the relevant details of all acute or chronic
wounds observed during routine visits throughout the study period. The pain experienced during
dressing changes was systematically evaluated. In patients with moderate to severe pain, a more
extensive evaluation was performed and they were invited to complete a self-evaluation questionnaire.
If the patients were seen at a subsequent visit, a new evaluation was performed.
l Results: In total 5850 patients were seen: 2914 with acute wounds and 2936 with chronic wounds.
During dressing changes, a similar number of patients with acute and chronic wounds reported
‘moderate to severe’ pain during the medical screening visit (79.9% and 79.7%) and ‘very severe’ pain in
their self-evaluation questionnaire completed at home (47% and 59% respectively). Dressing removal
was most painful when there was adherence to the wound bed. Switching to a new, non-adherent
dressing reduced pain during dressing changes in 88% of patients with chronic wounds and 95% of
patients with acute wounds.
l Conclusion: This study demonstrates that similar problems with patient acceptability arise
irrespective of wound aetiology. Pain is a major problem and is most often related to dressing selection.
Selecting a suitable, non-adherent dressing improves patient acceptability.
Management of Burn Wounds by a Technology Lipido-Colloid Polyacrylate Dressing Impregnated with Silver A Case Series from Vietnam
Burn injuries are a mostly avoidable trauma that affect millions of people
worldwide every year. Wound healing in burn patients is complex, and
infection is one of the main clinical complications associated with wound
care in burn patients. Biofilms are mostly associated with chronic wounds,
but have also been identified in acute, traumatic wounds. This article
shows an evaluation of a TLC-polyacrylate fibre dressing impregnated with
silver to manage burn wounds of different severities, in nine patients of
different ages from Vietnam. The outcomes show encouraging results in
the management of burns when considering healing properties, and also
management of infection, desloughing and wound healing outcomes.
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
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.