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Clinical Solutions in Practice

New Wound Dressing Offers Promise Of Improved Healing

By Brian McCurdy, Associate Editor
June 2003

It can be challenging to maintain an optimum environment for wound healing in certain patients. It can also be challenging to sift through the vast array of wound care dressings on the market and find the right one that will help your patient. However, you may welcome the arrival of a new dressing that is reportedly cost-effective, easy to use and has a wide range of potential indications. You can use the phytacare Alginate Hydrogel wound dressing to treat a wide variety of lower extremity wounds, ranging from diabetic ulcers and pressure ulcers to abrasions and second-degree burns, according to the manufacturer PhytaTek Laboratories. It says the dressing is ideal for managing moderately exuding, partial to full-thickness wounds. As PhytaTek notes, the dressing promotes a moist physiologic environment, which can facilitate debridement, natural granulation and natural autolysis. The ingredients are humectants and moisturizers, which include vegetable glycerin, sodium PCA and aloe vera gel. Also in the mix are formulation stabilizers, sodium alginate, xanthan gum and guar gum, which absorbs excess exudate. The dressing also contains the antioxidants ascorbyl palmitate (vitamin C) and d,I-alpha tocopherol (vitamin E), which help provide a nutrient rich environment. The hydrogel is impregnated on a 12-ply cotton gauze pad and is packaged in a 6- by 6-inch foil-laminated pouch made for one use, according to PhytaTek. After debriding and cleaning the wound, you peel and remove the saturated gauze dressing in an aseptic manner and apply it to the ulcer by packing the wound. PhytaTek says to cover and secure it with a secondary dressing of your choice. The company recommends applying the dressing once a day or as often as necessary, and cleansing the wound between dressing changes. What The Physicians Say Charles Miller, DPM, has used the alginate hydrogel dressing in clinical trials and reports that it “worked very well” in facilitating shorter healing times. Dr. Miller cites the dressing’s promotion of a moist wound environment and notes the gel’s micronutrients increase healing as compared to becaplermin and a hydrogel vehicle. He notes that he has had particularly good success in treating stage III (as per the National Pressure Ulcer Advisory Panel guidelines) diabetic foot ulcers. The dressing “showed definite accelerated wound healing potential for diabetic stage III ulcers,” says Dr. Miller. “This may be related to synthesis of granulation tissue, new blood vessel growth, an increase in DNA content of the resulting granulation tissue, stimulation of collagen secretion and/or elastin and acceleration of epithelialization.” Melchior Vallone, DPM, has used the dressing on several patients who had diabetic ulcers. He recalls one particular case in which the ulcer was a 16 cm2, full-thickness plantar ulcer. Dr. Vallone used the phytacare dressings for two months. In using the dressings adjunctively with debridement and infection control, Dr. Vallone found the response of the wound was quickly apparent. “Ultimately, the wound completely epithelialized with no permanent defects,” notes Dr. Vallone. PhytaTek cites a case study of a 62-year-old female who presented with a stage III pressure ulcer (as per the National Pressure Ulcer Advisory Panel guidelines) on the heel of her left foot. She had the ulcer for two months and it had not responded to Bactroban. The patient proceeded to use the alginate hydrogel dressings and was able to achieve nearly 100 percent closure of the ulcer within seven weeks, according to PhytaTek. It notes the patient was “completely satisfied” with the product and its ease of use. As for other benefits of the product, Dr. Vallone cites the ability to encourage granulation tissue, the convenience of the alginate hydrogel dressing and the fact that it appears to be well tolerated by patients. Dr. Miller also touts its cost-effectiveness. As for potential side effects, Dr. Vallone notes occasional complaints of stinging and says the gauze may dry if you don’t use a semi-permeable cover.

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