Chronic Nonhealing Combat Injury of the Foot Heals Using Novel Transforming Powder Wound Care Dressing

Introduction: Several veterans deal with lasting effects of their military service long after discharge, and “their wounds from war are daily facts of life.”1 That was the story of the veteran described here, who dealt with a foot wound from a combat injury for 53 years before enrolling in an ongoing randomized clinical trial funded by the Naval Medical Research Command (NMRC)-Naval Advanced Medical Development (NAMD) via the Medical Technology Enterprise Consortium (MTEC).  Methods:A 75-year-old diabetic male sustained a high velocity injury to his heel (Vietnam War in 1968). Since the injury, he has had multiple infections, a plethora of standard of care (SOC) and advanced wound care treatments (including skin substitutes), and multiple surgical procedures (including grafts) in attempt to heal the wound.  Despite high quality SOC treatment, including a thorough investigation evaluating adequacy of vascular status and nutrition, and smoking cessation, the wound did not completely heal. The patient had been doing daily dressing changes himself and resigned himself to living with a wound the rest of his life. On 19SEP2022, his wound was treated with transforming powder dressing (TPD) for the first time. TPD is an extended wear powder dressing comprised primarily of polymers similar to those used in contact lenses, that when hydrated, aggregate to form a moist oxygen-permeable barrier that covers and protects the wound.Results:The patient had weekly TPD applications or “top offs” (additional powder sprinkled over existing TPD matrix) on the wound, covered by a nonadherent contact layer and secondary dressing over 7 weeks with only 2 debridements indicated. The wound healed in 52 days (09NOV2022). The wound has remained healed to date (1.5 years later).  Discussion: Despite quality SOC for years, the wound didn’t heal.  Once converted to TPD, the wound healed in less than 2 months, requiring only 2 debridements (less than typical), and has remained healed.  Use of novel technology innovations should always be considered, especially when SOC fails. The views and conclusions contained herein are those of the authors and should not be interpreted as necessarily representing the official policies or endorsements, either expressed or implied, of the U.S. Government.  References:1. Library of Congress. Digital Collections. Veterans History Project Collection. Serving: Our Voices. Impact of Service.CONGRESS.GOV. Accessed 28May2024