Successful Treatment Of Complex Wounds Using a New Alginate Dressing Containing PHMB
BACKGROUND: Difficult-to-heal, full-thickness wounds often present subsequent to diabetes, surgical procedures, or trauma. Chronic wounds are often unable to support re-epithelialization, and can require dermal substitutes or skin grafts to heal. The use of a alginate dressings has been reported to successfully heal complex wounds and burns. The purpose of this case series is to describe the use of alginate dressings containing PHMB (Alg/PHMB) in full thickness wounds to generate vascularized tissue and neoepithelialization all the way to closure.
METHODS: Three patients with full thickness wounds with were treated with alginate dressings impregnated with PHMB*. Alg/PHMB was placed onto wounds that had been prepared with sharp and/or ultrasonic debridement. A cover dressing was applied to secure the Alg/PHMB to maintain appropriate moisture balance. The wounds were offloaded and/or compressed as medically indicated. Alg/PHMB dressings were reapplied every 2-3 days.
RESULTS: In full thickness wounds, Alg/PHMB formed vascularized granulation tissue and resulted in improved epithelialization. These wounds included a diabetic foot ulcers and venous leg ulcers. Patient co-morbidities included diabetes. Average initial wound size ranged from * - * cm2. The number of Alg/PHMB applications ranged from 1-6 and time to complete wound epithelialization ranged from *-* days.
CONCLUSION: This case series demonstrates the successful treatment of complex wounds using adequate wound bed preparation and an alginate dressing containing 0.08% PHMB. The implanted Alg/PHMB was assimilated with surrounding viable tissue, building granulation tissue and neoepithelialization in stalled, chronic wounds. Similar outcomes have been achieved with a porcine collagen matrix containing .1 % PHMB for burns, venous ulcers, surgical wounds and scar tissue. Further study is warranted to determine if Alg/PHMB can be a stand alone dressing or possibly a cover dressing over skin substitutes to improve healing efficacy.
