Effective use of Iodophor Foam Dressing in Combination of a Surfactant Topical Gel

In a community wound care clinic, the implementation of an iodophor foam dressing in combination of a surfactant topical gel in patients who experienced painful wounds including atypical soft tissue arm injury and those patients with venous, arterial, and lymphatic comorbidities with lower extremity wounds all demonstrated improvements as defined by each case presentation. It has been documented (Bigliardi et al., 2017) that povidone iodine is an effective treatment for wounds given his broad antimicrobial properties, lack of resistance, and effect on inflammation in both acute and chronic wound care. Research by Yang, Larose, Della Porta, Schultz, and Gibson (2016) noted traditional removal of biofilms typically requires mechanical energy to disrupt, however the use of a surfactant on a regular basis was a ‘simple and adequate approach’ to remove bacterial biofilm in ex vivo models. In addition, Woo et al. (2018) found that the quality of life for patients with chronic wounds was positively impacted with the use of a surfactant gel as patients experienced reduction symptoms such as pain and drainage management. In the four case presentations here, patients experienced painful, colonized wounds and deferred traditional sharp debridement for management of bioburden of their wounds due to pain, or in one setting absence of sufficient arterial flow. Three of the four patients had chronic bioburden and colonization of Methicillin-resistant Staphylococcus aureus (MRSA) and during their treatment plan, no further systemic therapies were needed, and two of the three patients achieved wound closure without recurrence of MRSA infection. The third patient had severe peripheral arterial disease and declined any intervention. The final case presented is a patient with history of intravenous drug abuse with recurring ulcerations and multiple rounds of oral antibiotics for recurrent cellulitis in these areas. Investigators should continue to look at use of combined dressing therapies to achieve optimal patient outcomes.