New Treatment Option for Acute Traumatic Wounds Resulted in Reduced Pain, Length of Stay, and Frequency of Dressing Changes: A Case Study from a Ukrainian Combat Hospital

Introduction: Combat injuries inflict substantial pain and debilitation, often prolonging return to duty.  Ukrainian health facilities are overwhelmed with a staggering influx of seriously wounded soldiers on a daily basis.  With over 30,000 new injuries per month and over 500,000 casualties to date, the demand for effective wound management is urgent.  This study evaluates the efficacy of a commercially available, shelf-stable, extended-wear transforming powder dressing (TPD), recently initiated at a Ukrainian combat hospital for treatment of acute, traumatic wounds. We present the first case treated with TPD, involving a Ukrainian soldier injured by shrapnel.Methods:A 34-year-old male with no significant medical history, except daily chewing tobacco, sustained a combat injury from a shrapnel embedded deep into the upper anterior thigh near the groin. He was transferred to a Role 2 field hospital for stabilization. Hospital course was complicated by hematoma and necrotic tissue, which was excised on day 2 post injury resulting in a 5 x 2 x 2 cm contaminated wound that was treated with TPD.   TPD aggregates upon hydration with fluids to form an extended wear (up to 30 days) moist, oxygen-permeable barrier that helps to cover and protect the wound from contamination while facilitating the flow of excess exudate through vapor transpiration. TPD can be topped off as required and secured with simple secondary dressings in areas of high exudation or friction. As the wound heals, TPD dries and flakes off.   The patient was prescribed oral antibiotics and TPD treatment was initiated instead of the standard of care (SOC) packing with topical antimicrobials and gauze.      Results:The soldier experienced no pain post TPD application [visual analogue scale (VAS) 0/10 versus 3/10 prior to TPD] and required no oral pain medications. He returned to duty within one week, 50% sooner than the anticipated 15-days. The wound healed in 24 days with no primary dressing changes and only 2 additional top-offs of TPD, an average of once every 8 days instead of twice daily with SOC.Discussion: Implementation of TPD resulted in a significant decrease in wound pain, expected LOS and dressing change frequency for this traumatic injury.  References:1. https://abcnews.go.com/International/hospital-sees-30-rise-wounded-ukrainian-soldiers-doctor/story?id=106197525