l Objective: To evaluate the acceptability, tolerance and efficacy of Urgotul wound dressing in the
management of epidermolysis bullosa (EB) skin lesions.
l Method: This was an open-label uncontrolled clinical trial involving 20 patients (11 adults and nine
children) with EB simplex or dystrophic EB. Patients were selected from the register of EB patients at
the investigating centre and included if they presented with at least one skin lesion requiring
management with a non-adherent wound dressing. Lesions were treated with the study dressing for a
maximum of four weeks. All dressing changes, wound parameters, pain and effect on quality of life were
recorded.
l Results: All patients completed the trial. Nineteen out of 20 wounds healed within 8.7 ± 8.5 days.
Overall, 11 patients (55%) considered that their quality of life had improved following use of the dressing,
which was also reported to be pain free and ‘very easy’ or ‘easy’ to remove at most dressing changes.
Nineteen out of 20 patients stated that they would use the study dressing to manage their lesions
in future.
l Conclusion: This study confirmed the very good acceptability and efficacy of Urgotul in the
treatment of skin lesions in patients with EB.
Archives
Evaluation of Technology Lipido Colloid with Silver (TLC-Ag) Dressing Qinzhou (China) A Case Series
Safe management and prevention of wound infection has been
discussed and advocated by expert group consensus documents. Infection
is a significant problem in wound management and early identification
and intervention are considered as key to the patient’s wellbeing and
healing outcomes. Various agents have been applied topically to treat
infected wounds. A well-recognised option is the use of silver as a viable
antimicrobial, and in recent decades, safer modes of application have been
introduced. Here we discuss three cases from Qinzhou (China), where the
author evaluated a Technology Lipido-Colloid with silver (TLC-Ag) dressing.
Positive outcomes were reported in all cases, concordant with the clinical
outcomes documented in publications the results of other publications both
from Europe and Asia.
Management of Burn patients with Technology Lipido-Colloid with Silver Sulphate to Fight Local Infection and Restore the Healing Process
Burn wounds are predisposed to infection and topical antimicrobial
preparations are used both to prevent and treat infection. The choice
of topical antimicrobial should be based on the ability of the agent to
inhibit microorganisms that may be harmful within the wound bed and
on the host. Silver is indicated when a local negative impact of bacterial
colonisation is suspected and/or confirmed, because it has a broad
antimicrobial effect. Technology Lipido-Colloid (TLC) is a matrix containing
hydrocolloid and lipophilic substances that has been shown to promote
the proliferation of fibroblasts and to be atraumatic for patients. TLC-Ag
incorporates silver sulphate (3.5%) into the TLC matrix. When it is in contact
with the wound, the dressing releases a constant supply of antibacterial
silver. This article will discuss the use of antimicrobials in burn wound
management, show the evidence for the TLC-Ag antimicrobial healing
matrix and portray outcomes of cases of burns patients in India who have
been managed with TLC-Ag.
The Use of a Non-adherent Lipido-Colloid Dressings with Silver in the Management of Wounds
Silver has been used in wound care throughout the millennia for its
antimicrobial properties. It was used by many cultures, predominantly in
times of war, as an antimicrobial reservoir for food and water, from the
ancient Phoenicians, Greeks, Romans and Egyptians, up to the Second
World War (Alexander, 2009). The first mention of silver as a medicine
comes from Hippocrates, who used silver particles in wounds for its
beneficial therapeutic effects and anti-disease properties (Fong, 2005).
Meanwhile, John Woodall recommended the use of silver nitrate in
chronic wound management as early as 1617 (Klasen, 2000)
URGOTUL® AG/Silver Dressing as an Intermediate Layer in Negative Pressure Wound Therapy in a Patient with a Chronic Wound and History of Multiple Laparotomies
Treating of postoperative complications in patients after numerous laparotomies is
difficult. In the case of dehiscence the surgical wound, infection and the coexisting formation of
intestinal fistulas requires a multidisciplinary approach. In these cases, vacuum assisted thera py is very useful. However, it is necessary to protect the intestines, fistula and surrounding tissu es from the action of polyurethane foam – protect the intestines and skin against ingrowing into
the black foam. A 54-years-old male patient, with a history of numerous laparotomies was admit ted to Clinic to treat complications after left-sided nephrectomy. The patient developed intestinal
and enterocutaneous fistulas. Wound dehiscence and necrosis of surrounding tissues was pre sent. Negative pressure wound therapy was applied. Dressing was changed three times. Correc tion of the stomy was performed. UrgoTul® Ag/Silver was applied each time between the wound
and the polyurethane foam as a protective intermediate layer. The use of UrgoTul® Ag/Silver (in
patients with infection, dehiscence of wounds, and with enterocutaneous fistulas) showed a si gnificant decrease in the secretion from the intestinal fistula. Healing and closure of the surgical
wound, its epithelialization and elimination of inflammation of the abdominal wall was observed.
Wound management with Technology Lipido-Colloid Silver Non-Adherent dressing a case series from Chinese clinicians
Prevention and appropriate management of wound infection is central
to promote the healing process. While not all wounds will necessitate
use of systemic antibiotics, some may benefit from the use of topical
antimicrobials as part of a holistic standard of care. This article describes
five different cases, from China, where the clinicians used Technology
Lipido-Colloid Silver Non-Adherent (TLC-Ag) dressings as part of their
holistic multidisciplinary wound management strategy. The wounds
discussed were mainly chronic, including two venous leg ulcers and
lymphoedema ulcer, a post-amputation wound as well as a case of
pyoderma gangrenosum. Managing these wounds with TLC-Ag as a part
of the standard holistic multidisciplinary care provided resulted in positive
outcomes for the patients.
When the Tissue Viability Nurse becomes a patient reflections on a personal journey
This paper presents a reflection of my journey as a patient following a breast
abscess. As an experienced community nurse with a specialist interest in tissue
viability, we daily assess a range of different wound types and are adept at early
identification and management of an infected wound. We instinctively know which
dressing type to use to manage localised wound infection and slough and reduce
pain for patients; however, when the nurse becomes the patient with a wound and
has welcomed a new born child into the world, we can suddenly lose the specialist
knowledge. This paper reflects on a journey I recently experienced.
Evaluation of the Nanooligosaccharide Factor Lipido-Colloid Matrix in the Local Management of Venous Leg Ulcers Results of a Randomised, Controlled Trial
The nano-oligosaccharide factor (NOSF) is a new compound aiming to promote wound closure mainly through inhibition of matrix metalloproteinase (MMP) activity. This factor is incorporated within a lipido-colloid matrix (Techonology Lipido-Colloid-NOSF matrix) and locally released in the wound. The objective of this study was to document the performance (non inferiority or superiority) of the NOSF relative to the Promogran® matrix (oxidised regenerated cellulose, ORC) effect in the local management of venous leg ulcers (VLUs). This was a 12-week, open, two-arm, multicentre, randomised study. Patients were selected if the area of their VLU [ankle brachial pressure index ≥ 0.80] ranged from 5 to 25 cm2 with a duration≥3 months.
Ulcers had to be free from necrotic tissue. In addition to receiving compression bandage therapy, patients were randomly allocated to either NOSF matrix or ORC treatment for 12 weeks. The VLUs were assessed on a weekly basis and wound tracings were recorded. Percentage wound relative reduction (%RR) was the primary efficacy criterion. Secondary objectives were wound absolute reduction (AR), healing rate (HR) and % of wounds with≥ 40% reduction compared with baseline. A total of 117 patients were included (57 NOSF matrix and 60 ORC). Mean population age was 71.3 ± 13.5 years, body mass index was ≥ 30 kg/m2 in 39.3% and 15.4% were diabetics. Fifty-six per cent of the VLUs were present for >6 months, 61% were recurrent and 68%were stagnating despite appropriate care. Mean wound area at baseline was 11.2 ± 7.4 cm2. At the last evaluation, mean difference between the groups for %RR was 33.6 ± 15.0% in favour of NOSF matrix with a unilateral 95% confidence interval (CI) lower limit of 8.6% not including the null value. Therefore, a superiority of NOSF matrix effect compared with ORC was concluded (P= 0.0059 for superiority test). The median of the wound area reduction was 61.1% and 7.7% in the NOSF matrix and control groups, respectively (per-protocol analysis), or 54.4% versus 12.9% in intent-to-treat analysis (p =0.0286). Median AR was 4.2 cm2 in the NOSF group and 1.0 cm2 with ORC (P = 0.01). Median HR was -0.056 and -0.015 cm2/day in NOSF and ORC groups, respectively (P = 0.029). By logistic regression, the NOSF versus control odds ratio to reach 40% area reduction was 2.4 (95% CI: 1.1 – 5.3; P = 0.026). In the oldest and largest VLUs, a strong promotion of healing effect was particularly observed in the NOSF matrix group compared with the control group. NOSF matrix is a very promising option for the local management of chronic wounds, especially for VLUs with poor healing prognosis.
World Union of Wound Healing Societies Evidence in Wound Care
Wound management research improves patient care and clinical
outcomes by standardising assessment, planning and implementation
of treatment. In the field of wound care, high-level evidence is
possible, but it can be difficult to conduct due to the wide-ranging
nature of wounds and patients.
Additionally, there is an ever-growing variety of products and devices available to practitioners to improve healing rates and patient outcomes. In many cases, these products have enabled practitioners to heal more complex wounds and manage more
challenging and difficult cases. However, practitioners must be able to critically appraise evidence to make appropriate and effective evidence-based changes to practice.
UrgoStart Plus in Real Life
The prevalence of patients with chronic wounds continues to grow year-on-year and this places a substantial burden on health care resources. It is estimated that the NHS treats more than 2.2 million wounds annually, equating to 4.5% of the adult population, and the total cost of managing these wounds and associated co-morbidities is calculated to be £5.3 billon per year (Guest et al, 2015). However, it has been recognised that there are considerable unwarranted
variations in wound care services across the UK and that standardising practices offers opportunities to improve healing rates, reduce patient suffering and provide cost efficiencies
(NWCSP, 2020). In 2019 the National Institute for Health and Care Excellence published medical technologies guidance in relation to the UrgoStart treatment range. The committee reviewed five empirical
research papers, three of which were randomised controlled clinical trials. The committee critically appraised the publications and concluded that there was evidence to support the case
for adopting the UrgoStart treatment range to treat patients with diabetic foot ulcers and venous leg ulcers in the NHS, as the use of the UrgoStart treatment range was found to be associated
with increased rates of wound healing when compared with non-interactive dressings. Furthermore, they suggested that using the UrgoStart treatment range as part of the overall
management of diabetic foot ulcers and venous leg ulcers could reduce costs for the NHS.