Impact of Wound Hygiene incorporating an advanced antimicrobial gelling fiber dressing on hard-to-heal diabetic foot ulcers: real-world evidence.

Introduction: Hard-to-heal wounds are a major challenge to healthcare systems globally1.       The aim of this real-world study was to evaluate the impact of the Wound Hygiene Protocol (WHP), a 4-step (cleanse, debride, refashion, and dress) wound management protocol on hard-to-heal diabetic foot ulcers (DFUs).Methods:A subgroup analysis of patients with DFUs in a prospective, real-world study of hard-to-heal wounds managed with WHP incorporating at step 4, a carboxymethylcellulose dressing containing ionic silver, ethylenediaminetetraacetic acid and benzethonium chloride* for approximately 4 weeks or as deemed clinically appropriate. The primary endpoint in this analysis was change in DFU wound volume from baseline to final assessment, while secondary endpoints were changes in exudate levels, suspected biofilm, and local infection.Results:66 patients had DFUs and were included in this analysis (median treatment duration 35 days). Of 58 patients with baseline and final wound volume assessments, 20 (34%) had complete wound closure and 86% had at least one-third volume reduction. Mean wound volume reduced from 37.9 cm3 at baseline to 3.3 cm3 (91% reduction) at final assessment (p