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Acticoat* Case Study Lorenzini

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Evaluating a new dressing in wounds of different etiologies


Authors: S. Rowan, C.N.S*. A. Morelli M. D**. M. Lorenzini, M.D**
*Smith & Nephew, Florence, Italy
**Plastic surgery, Umberto I Hospital , Mestre, Italy


Introduction

Product evaluations are complex because of the many factors involved. More than one product is often necessary to treat a wound until healing. New products that have multiple functions such as absorbent capacities, moist wound healing and antimicrobial properties all in one product have been launched in the market recently.

Aim
This is an open evaluation of a dressing Acticoat Moisture Control Absorbent Antimicrobial Dressing containing a foam that absorbs, creating a moist wound healing environment and Nanocrystalline† Silver, indicated as an antimicrobial barrier, which protects the wound from bacterial contamination, in a series of wounds of different aetiologies.

Methods

The following points were assessed:

a) ease of application and removal;
b) patient comfort (pain and comfort) at dressing change;
c) healing time;
d) Reduction in clinical signs and symptoms of infection

Dressing changes were carried out initially twice a week and when wound condition allowed once a week. The observation period extended until healing. Most patients were treated on an outpatient basis although initially some were hospitalised. The data were recorded on questionnaire forms and weekly photos of the wound were taken.

Wounds were cleansed with hypochlorite solution and the Acticoat Moisture Control dressing was placed on the wound either fixed in place with retention bandage or with tape.

Results
N = 5 patients. Average age: 62.6. Wound etiologies comprised: 1 trauma due to a car accident, 1 excision of multiple epithelial carcinomas, 1 dehisced surgical wound, 1 fungating wound and 1 severe leg ulcer of mixed etiology.

The fungating wound improved in terms of associated pain and level of inflammation but the patient died after one week of treatment due to her general condition.

For the other 4 patients, average wound size at start of treatment was 100cm²; by the end it was 12.75cm². Two of the wounds healed completely.


Conclusion
Acticoat Moisture Control was an effective dressing for the wounds under evaluation. Improvement was noticed in all 5 cases. Reduction in average wound size was 87.25%.

The dressing improved the quality of patients' lives by reducing pain and allowing less frequent dressing changes.

Case 1
A 76-year-old male who underwent radical excision for multiple epithelial carcinomas on the dorsum of the right hand. Wound closure was achieved using a split thickness skin graft. Due to infection, the graft took only partially. Wound measured 54cm² with 25% slough with moderate manifestation of infection. Before using the present treatment regime with Acticoat Moisture Control, the patient was treated with topical antibiotics and paraffin gauze. Wound was managed with Acticoat Moisture Control for 23 days, in order to achieve complete healing with good quality skin.

Acticoat MC Case 1 Lorenzini
Fig 1: Status of wound at start of treatment: slough and moderate manifestation of infection Fig 2: Major improvement observed already at day 6 Fig 3: Day 17. Almost completely healed. The small lateral wound covered with Acticoat Moisture Control Fig 4: Day 23. Wound healed

Case 2
A 38-year-old male incurred a wound on the lateral aspect of left knee due to dehiscence of the sutures, after removal of a lipoma. The wound, which was present for 7 days, measured 32cm². Wound closure was achieved using Acticoat Moisture Control for 43 days.

Acticoat MC Case 2 Lorenzini
Fig 1: Status at start of treatment Fig 2: Wound with Acticoat Moisture Control in situ. High levels of exudate observed Fig 3: Wound smaller and granulating Fig 4: Day 43. Wound healed

Nanocrystalline Silver is a patented technology of NUCRYST Pharmaceuticals Corp.
TM SILCRYST is a trademark of NUCRYST Pharmaceuticals Corp, used under licence