Industry Innovations

  Every July, Ostomy Wound Management highlights product and service innovations in the fields of wound, ostomy, skin, and incontinence care. We invite manufacturers to describe products to entice readers to explore new options and add to their armamentarium of management tools. A more complete list of products is always available at www.WOUNDS360bg.com, a dynamic forum that not only features constantly updated product information along with photos, but also provides opportunity for clinician feedback. OWM hopes readers will make frequent use of all product resources and weigh in and share their experiences with the products and services presented. The editors are grateful to our industry partners for participating in this effort.

WOUND CARE

3M™ Coban™ 2 Layer – 3M Health Care Compression System
  The 3M™ Coban™ 2 Layer Compression System enables patients to wear their own shoes and maintain daily living activities, as demonstrated in a randomized, controlled clinical study (RCT). It is clinically proven to provide safe, comfortable, sustained therapeutic compression to reduce edema while staying in place. Results of an additional RCT showed that with this compression system, pain decreased 50% within 1 to 2 weeks of treatment for venous leg ulcers.

  The system is ideal for the majority of patients with venous leg ulcers and an ankle brachial pressure index (ABPI) of ≥0.8, lymphedema, and other conditions where compression therapy is appropriate. 3M Coban 2 Layer Lite Compression System was developed for patients less tolerant of compression therapy, including persons with wounds of mixed etiology with an ABPI ≥0.5, new to compression, of unknown tolerance, or who are frail and less mobile.

AQUACEL® Foam Dressing – ConvaTec
  ConvaTec just introduced AQUACEL® foam dressing, the first dressing to combine a soft absorbent foam pad with the healing benefits of its proprietary AQUACEL® interface. As shown in an in vitro study, the dressing has a waterproof barrier that allows for the evaporation of excess moisture and protection against viral and bacterial penetration.¹ The soft absorbent foam pad enhances patient comfort and absorbs excess fluid.

  The AQUACEL® dressing interface is engineered to gel on contact with wound exudate.² This allows the dressing to micro-contour to the wound bed, minimizing dead space where bacteria can grow.³ The interface also maintains a moist wound environment that supports the body’s healing process² and prevents lateral spread of fluid to reduce the risk of maceration.⁴

  AQUACEL® foam dressing has a gentle silicone adhesive designed to adhere only to the surrounding skin, not to the wound bed. The silicone allows for easy application and non-traumatic dressing removal.5 It is available in adhesive and nonadhesive options in a range of sizes.

References
1. AQUACEL™ foam dressing-waterproofness, bacterial and viral barrier testing. WHR13538 MS069. Data on File. ConvaTec Inc.
2. Walker M, Hobot JA, Newman GR, Bowler PG. Scanning electron microscopic examination of bacterial immobilisation in a carboxymethylcellulose (Aquacel) and alginate dressing. Biomaterials. 2003;24(5):883–890.
3. Jones SA, Bowler PG, Walker M. Antimicrobial activity of silver-containing dressings is influenced by dressing conformability with a wound surface. WOUNDS. 2005;17(9):263–270.
4. Waring MJ, Parsons D. Physico-chemical characterisation of carboxymethylated spun cellulose fibres. Biomaterials. 2001;22:903–912. 5. Healthy Volunteer Study Report, Protocol CW-0207-11-A736. Data on File, ConvaTec Inc.

IntelliTrak™ – Intellicure, Inc
  Intellicure is unmatched in the area of innovation in wound center billing. The company provides the only electronic health record (EHR) that has published articles¹ validating physician and facility billing using internal, automated chart auditing. The method the EHR uses to determine the facility level of service recently was validated for a second time. IntelliTrak internally audits the chart to calculate the facility level of service based on the documentation provided by the staff, ensuring billing compliance. The system’s ability to internally audit the chart to calculate the physician level of service based on his/her documentation also was validated, thus ensuring the billed level of service is supported by the documentation in the chart. Using Intellicure, wound center evaluation and management charges will follow a normal distribution over time, which is what the Centers for Medicare and Medicaid Services (CMS) expects to see, decreasing the risk of audits.

Reference
1. Ostomy Wound Manage. 2012;58(3):20-28.

V.A.C.Ulta™ – KCI
  V.A.C. Ulta™ Negative Pressure Wound Therapy System (KCI, San Antonio, TX) is an integrated wound management system that provides two therapies in one unit: V.A.C.® Therapy (negative pressure wound therapy [NPWT]) or V.A.C. VeraFlo™ Therapy (instillation therapy [NPWTi]). V.A.C. VeraFlo™ Therapy provides automated, volumetric delivery of topical wound treatment solutions with new Fill Assist and Dressing Soak features. V.A.C. VeraFlo™ Therapy also utilizes dressings specifically designed for instillation therapy with NPWT: V.A.C. VeraFlo™ and V.A.C. VeraFlo Cleanse™ Dressings. For example, in a porcine study¹ with saline instillation, 7 days of V.A.C. VeraFlo™ Therapy using V.A.C. VeraFlo™ Dressings showed a 43% increase in wound fill compared to NPWT using V.A.C.® GranuFoam™ Dressings (P <0.05). V.A.C. VeraFlo™ Therapy cycles utilized a 5-minute soak time followed by 2.5 hours of V.A.C.® Therapy. Data have not yet been correlated in humans.

Reference
1. Lessing C, Slack P, Hong KZ, et al. Negative pressure wound therapy with controlled saline instillation (NPWTi): dressing properties and granulation response in vivo. WOUNDS. 2011;23(10):309–319.

EPIFLO – Ogenix
  EPIFLO utilizes cutting-edge oxygen concentration technology to create tissue regenerative processes, driving closure of delayed-healing acute or chronic wounds. EPIFLO is a 3-oz oxygen generator that continuously delivers 3 mL of pure oxygen to the wound site. The product is US Food and Drug Administration (FDA)-approved as a Class II Medical Device; it also has a CE mark and Health Canada approval.   Using an ischemic rabbit ear model, Said et al¹ have shown that wound epithelial coverage was almost doubled in continuous oxygen-treated wounds when compared with controls. Sibbald et al² demonstrated statistically significant wound area reduction as well as bioburden reduction. In a prospective randomized controlled trial of 17 patients, Park et al³ recently showed an 88% volume reduction for transdermal continuous oxygen therapy-treated wounds, compared to only 22% for the control group (P = 0.09). Inflammatory cytokines and matrix metalloproteinases were shown to be suppressed with continuous oxygen treatment.

References
1. Said HK, Hijjawi J, Roy N, Mogford J, Mustoe T. Transdermal sustained delivery oxygen improves epithelial healing in a rabbit ear wound model. Arch Surg. 2005;140(10):998–1004.
2. Sibbald RG, Wu K, Coutts P. Continuous topical oxygen for the treatment of chronic wounds. Adv Skin Wound Care. 2012; In press.
3. Park N, Yao M, Hasturk H, et al. Clinical Efficacy and Molecular Mecha nisms of Transdermal Continuous Oxygen Therapy (TCOT) in Treatment of Diabetic Foot Ulcer (DFU). Poster presented at Symposium on Advanced Wound Care. April 2012.

Dolphin Fluid Immersion – Joerns Simulation® System
  Initially developed for out-of-water transport of dolphins for the US Navy, the Dolphin Fluid Immersion Simulation® System is an advanced therapy system designed to provide state-of-the-art pressure redistribution by simulating the effects of a body immersed in a fluid medium. This results in decreased vertical shear on the patient to minimize soft tissue deformation and maximize blood flow.   In clinical studies, La Jolla Medical Center demonstrated a 70% improvement in tissue perfusion with The Dolphin™, a large Midwestern medical center lowered their incidence rate of pressure ulcers from 11% to 0%, and another leading long-term acute facility documented that healing times improved as much as 50% over traditional therapies. The Dolphin is indicated for preventing and treating wounds up to Stage IV, as well as flaps, graphs, and stabilized spinal cord injuries.   The Dolphin not only provides state-of-the-art therapy, but is very easy to set up and even easier to operate.

PerforMax – Philips Healthcare
  The PerforMax total face mask complements Philips’ existing noninvasive ventilation (NIV) interface portfolio. The PerforMax may improve the efficacy and comfort associated with NIV, while reducing or eliminating the skin irritation and pressure applied to the nasal bridge seen with other NIV interface designs.¹ The PerforMax has a soft silicone cushion that seals around the perimeter of the face, where patients have less pressure sensitivity and smoother facial contours. The device’s design characteristics make it well suited for use in patients with claustrophobia, excessive facial hair, facial trauma, and persons at elevated risk of developing nasal pressure ulcers.   PerforMax is currently available in three sizes for pediatric and adult NIV patients. It may be used for short-term or prolonged NIV therapy, alone, or in combination with another mask type as part of a mask rotation strategy to minimize skin integrity issues.

Reference
1. Respir Care. 2012;57(3):449–453.

Prevalon® Turn & Position System – Sage
  Turning and repositioning patients is critical to prevent sacral pressure ulcers. Current methods have multiple challenges, including lack of nursing time and staff injury risk. The new Prevalon® Turn & Position System is clinically proven to help protect patients from sacral pressure ulcers and reduce risk of staff injury due to turning and repositioning. A recent study¹ evaluating the effectiveness of the system found a 63% reduction in sacral pressure ulcers over a 90-day period. The system was proven to take 71% less effort,² 60% less time, and 35% less staff to turn patients when compared to a standard draw sheet and pillows.³ Another study⁴ showed worker’s compensation incidents decreased by 89% over 8 months in three facilities using the system. Components include a low-friction glide sheet, 30˚ body wedges to keep patients in the proper offloading position, and a M2 Microclimate Body Pad to manage heat and moisture.

References
1. Flockhart L, Fielding C. Use of a Repositioning System in Postoperative Cardiovascular ICU patients results in 63% Reduction in Facility-acquired Sacral Pressure Ulcers. Poster presented at 17th Annual Wound Care Conference. November 2011.
2. Testing by Sage Products Inc., Data on file.
3. Hall K, Clark R. Save the Butts: Preventing Sacral Pressure Ulcers by Utilizing an Assistive Device to Turn and Reposition Critically Ill Patients. Poster presented at 25th Annual Symposium on Advanced Wound Care Spring/Wound Healing Society Meeting. Atlanta, GA. April 2012.
4. Persby M, Combination of Safe Patient Handling and Use of Ergonomic Repositioning Device Reduces Hospital-acquired Pressure Ulcers and Employee Injury Claims. Poster presented at ALTHA 2012 National Clinical Conference. Dallas, TX. May 2012.

Sizewise Pediatric Pulse™ – Sizewise
  Sizewise provides the industry’s first pediatric mattress line that is free of harmful chemicals of concern for patients and care providers. The pediatric mattress line is made in the US to meet and exceed the newest industry guidelines and certifications for environmental sustainability. This sustainable surface line offers options for every stage of pediatric care, including incubator and bassinet pads, crib mattresses, and pediatric air support surfaces. The Sizewise Pediatric Pulse™, a low-air-loss mattress with dual modes of therapy, provides all the benefits of static low-air-loss therapy and pulsation therapy to pediatric patients. The entire Sizewise Pediatric line has a First Point of Contact™ top cover that is free of latex and harmful chemicals and has been produced from nonhazardous fire-retardant materials.

Drawtex® – SteadMed Medical
  A new class of products, hydroconductive dressings (Drawtex®, with LevaFiber™ Technology) was introduced into the North American market. These dressings provide a hydroconductive action that lifts and moves exudate, slough, and debris away from the wound surface. Clinical results have shown it to decrease wound exudate, tissue bacterial levels, nutrients for biofilm production, and deleterious cytokine levels such as matrix metallo-proteinases (MMP-9).^1,2   Based on this action, Drawtex® facilitates effective wound bed preparation and serves as a possible alternative or replacement to passive absorptive products, such as calcium alginates, hydrofibers, foams, and super absorbers.³ In addition, at times, it can replace some enzymatic, antimicrobial, and some negative pressure wound therapy.⁴

References
1. Couch K: Discovering hydroconductive dressings. Ostomy Wound Manage. 2012;58(4):8–10.
2. Wolcott RD. The effect of a hydroconductive dressing on the suppression of wound biofilm. WOUNDS. 2012;24:132–137.
3. Spruce P. Preparing the wound to heal using a new hydroconductive dressing. Ostomy Wound Manage. 2012;58(7).
4. Scott RG. A hydroconductive dressing as a potential alternative to negative pressure wound therapy. Ostomy Wound Manage. 2012;58(5):10.

Promogran Prisma® – Systagenix
  Promogran Prisma® is a proprietary combination of 55% collagen and 44% oxidized regenerated cellulose (ORC) and 1% silver/ORC in a freeze-dried matrix. The product is designed to help kick-start the healing process. It has been clinically proven in a case study¹ to help increase the healing rate of wounds; a comparative clinical study has shown it provides enough antimicrobial resistance to protect from infection.² In a recent randomized control trial, Promogran Prisma was shown to heal a significantly higher percentage of wounds when compared to a control of the standard treatment protocols in diabetic foot ulcers (79% in the study group versus 43% in the control, P = 0.035).² Additionally, a clinical study³ showed that 87% of stalled venous leg ulcers with a duration of <6 months treated with the product healed or improved within 12 weeks. Promogran Prisma® is 100% bioresorbable and therefore does not need to be removed from the wound bed.

References
1. Cullen B, Gottrup F, et al. Case Studies Demonstrating the Beneficial Effects of Collagen/ORC/Silver in the Treatment of Diabetic Foot Ulcers. Poster presented at the Symposium on Advanced Wound Care. Atlanta, GA. April 2012.
2. Gottrup F, et al. Comparative Clinical Study to Show the Combined Mode of Action of Collagen/ORC/Silver in Controlling Bioburden and Modulating the Wound Microenvironment to Promote Healing. Poster presented at Wounds International. 2011.
3. Cullen B, et al. Early Adoption of Collagen/ORC Dressings Improves Clinical Outcome. Poster presented at the Symposium on Advanced Wound Care. Atlanta, GA. April 2012.

WoundRounds® – Wound Rounds
  WoundRounds® is a point-of-care wound documentation and management solution. Users report time savings, reduction in facility-acquired pressure ulcers, lower wound care costs, decreased rehospitalizations, and reduced risk and liability.

  To evaluate the impact of WoundRounds, a skilled nursing facility measured the incidence of pressure ulcers before and 6 months after implementing the system. The incidence of new facility-acquired pressure ulcers decreased substantially from 24 per month to an average of four per month after implementation. A comparison of total number of wound events to nonevents per month was found significant; chi-square for trend was 63.736 (P = .000) The odds of a new facility-acquired pressure ulcer occurring were 34 times more likely before than in the after period. OR = 34.0, 95% CI = 6.7–232.2.

  The skilled nursing facility in this study was able to significantly decrease the incidence of facility-acquired pressure ulcers, which may be attributable to improved documentation and care team communication provided by WoundRounds.

OSTOMY CARE

Anatomical Apron – MedicalCraft
  The GI Jo Anatomical Apron is a visual and tactile three-dimensional educational model of the abdomen. The apron helps teach and demonstrate various physical and physiological processes of the GI tract and the numerous surgical revisions including colostomy, loop ostomy, ileostomy, urostomy, and double-barrel surgical procedures that occur on the inside and outside of the body during and after abdominal surgeries. It enables your clients to visualize and understand what happens during and after surgery and how an ostomy or stoma will affect their bodies and their daily lives. The apron is realistically proportioned to the adult human body, providing a practical point of reference to your client’s own body structure. It is made with both inner abdominal organs and outer abdominal wall flaps with appropriately placed stomal openings, allowing your client can see and understand where stomas or incisions will be placed in relation to their GI tract and what the abdomen will look like following surgery. The aprons further permit you to teach about the hows and whys of various ostomy appliances and how they will be used. This article was not subject to the Ostomy Wound Management peer-review process.