Biological Wound Matrices

  In this month’s issue of Wounds, we explore some of the biological dressings effective in wound management. We have seen reports that show honey has been used for thousands of years and amniotic tissue for a century. The concepts are not new, but the explanations provided by our modern science bring the benefits into focus.

  In their comprehensive review, Molan and Rhodes cover the important biological features of Manuka honey: its antibacterial, immunostimulatory, anti-inflammatory, and debriding actions. This natural product from New Zealand moves the wound toward healing by a concert of factors guiding the healing process. The antimicrobial effect provided by this product has efficacy against the most resistant of organisms.  Wounds move from a chronic inflammatory phase into healing with new granulation.  There is active natural cleansing of the slough. The authors conclude that existing and continuously mounting evidence supports honey as a crucial tool for wound care.

  Next, Campitiello and coauthors provide evidence of the benefit of a flowable wound matrix for tunneling and cavitary wounds. In their preliminary report of 18 patients, all but 2 patients experienced progressive remodeling of the tissue gap. Their Brief Communication reports this well-tolerated option offers an alternative for irregularly shaped wounds not suited to sheet-shaped biomaterials, and also aids healing without associated side effects.

  In the final offering for our section, original research by Smiell and colleagues demonstrates the beneficial effect of using amniotic tissue for wound healing in real-world settings. The healing rate and number of wounds healed for even chronic wounds improved dramatically with the use of amniotic tissue.

  These natural biological wound coverings are able to orchestrate multiple factors, thus delivering a momentum toward healing that is deficient in single-modality dressings. This greatly adds to our success in wound management when combined with appropriate underlying disease management.

Stephen G. Bergquist, MD, CWSP
Section Editor, Biological Wound Matrices