Advancing the science of wound bed preparation and healing in chronic wounds

Chronic wounds continue to be a source of significant morbidity and tragically, mortality worldwide. It is imperative that the clinician treating wounds understand the impact and importance of wound bed preparation as it relates to healing. There are many factors that one needs to consider to effectively manage the patient through this process of resetting the wound chronicity to an acute state. T

wo novel medical devices are presented to improve the wound bed environment and ensure optimal wound bed preparation. Both medical devices are advanced, adjunctive therapies that are synergistic in wound bed preparation.

Regenerative Debridement Technology* is a topical liquid agent for use by healthcare practitioners in the cleansing of lesions of the skin and damaged dermal tissue during standard mechanical debridement procedures. It removes necrotic tissue and destroys biofilm upon contact. Additionally, post inflammatory markers are reduced in the wound bed and mitigates their negative effects that keeps a wound in a chronic state. This chemical process works on a unique non biologic platform; mechanical, cellular, and molecular. There is also a normalizing of wound pH to approximate the dermal tissue acid mantle of 5.5, altering the chronic alkaline status.

Electrospun Synthetic Polymer Technology** is a fully synthetic product and contains no human or animal tissue/cells, eliminating the risks inherent to allogenic and xenogeneic products.Wound pH management has been demonstrated to be transformative for accelerating biofilm resolution and promote angiogenesis. A relatively new, scientifically engineered 3D electrospun synthetic polymer technology has been recently developed to maintain a wound pH of 5.5-6.0. The dressing mimics native extracellular matrix (ECM) morphology providing a multi-dimensional, microporous scaffold which stimulates and facilitates natural cellular adhesion, infiltration and proliferation.

The acidic degradants are comprised of polymers which naturally biodegrade via hydrolysis to Glycolic acid, Lactic acid, and Caproic acid monomers. By maintaining a low pH wound environment, persistently chronic inflammation is decreased, and pro-regenerative cellular activity and angiogenesis is promoted. Several cases demonstrating these novel technologies are discussed.