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Wound Bed Preparation

A Clinical Concept led by Smith & Nephew

Background

What is wound bed preparation?

Wound bed preparation is a new way of thinking which develops proven concepts to build a platform for the treatment of chronic wounds. In essence, wound bed preparation organizes currently approved medical practices and procedures by using a holistic approach to evaluate and remove displayed barriers to the healing process. Removal of these barriers allows the wound repair process to progress normally. Wound bed preparation is an essential underpinning element for obtaining maximum benefits from the advanced wound care products available today. Even technologically sophisticated dressings may be less effective if the wound has not been sufficiently prepared. The overall goal is to achieve a stable wound, characterized by a well-vascularized wound bed with minimal exudate. Wound bed preparation is the first stage towards this end point, facilitating wound management solutions, characterized by on-going debridement, reduction of bacterial burden and exudate management. Click on one of the below objectives to find out more information.


The Origins of Wound Bed Preparation

Dr Vincent Falanga and Dr Gary Sibbald initially developed wound bed preparation in the United States and Canada from their extensive experience in the treatment of chronic wounds. It has subsequently gained momentum with key opinion leaders who have discussed and expanded the concept at international conferences and symposia around the world. Wound bed preparation is still evolving, but initial definitions proposed by Dr Vincent Falanga, Dr Gary Sibbald and Professor Keith Harding are cited on the next page.


Why is wound bed preparation important?

The concept of wound bed preparation is having a positive impact on the way in which chronic wounds are managed. While it is based on current practice, this approach to wound care is altering the way chronic wounds are managed for the benefit of patients. Wound bed preparation identifies the major components for chronic wound care and organizes these components to create a purposeful approach to wound care interventions, utilizing current medical standards and practices. It also has the potential to ensure that maximum benefits are derived from advanced wound care products to overcome the barriers to wound improvement. The major barriers that must be overcome to achieve optimal wound closure in chronic wounds are necrotic burden, bacterial imbalance and excessive levels of exudate(2). 

KOL Activity

Key Opinion Leaders play a key role in the development of Wound Bed Preparation, it is thanks to their continued efforts and commitment to raising awareness that WBP is increasingly being recognised by healthcare professionals as the next great paradigm after moist wound healing. The concept of WBP identifies a number of barriers that obstruct wound healing and recognises that these need to be removed before wound healing can take place. Research and publishing in Wound Bed Preparation has been taking place over recent years. Below are ten of the leading international clinicians in this field, who collectively make up an International Advisory Board.

Video on Wound Bed Preparation (WBP)

View the International Wound Bed Preparation Advisory Board talking about the concept of TIME. The video is approximately 4 minutes long.



Vincent Falanga

Professor of Dermatology and Biochemistry, Boston University
Chairman of Dermatology and Training Program,
Roger Williams Medical Centre, Rhode Island, USA

Wound Bed Preparation KOL activity Vincent FalangaVincent Falanga, MD, FACP is a Professor at Boston University School of Medicine and Chairman of the Department of Dermatology and Training Program at the Roger Williams Medical Centre, Providence, Rhode Island. Dr Falanga graduated from Harvard Medical School in 1977 and is board certified in Internal Medicine and Dermatology. An internationally recognised expert in chronic wounds, he has over 200 publications and has co-authored four textbooks on wound healing. Dr Falanga oversees clinical investigation for the development of new approaches to wound healing and the treatment of diabetic, venous and pressure ulcers. He is a consultant for the National Institute of Health and other granting agencies, and oversees a basic science program dedicated to wound healing and fibrosis. He is a member of the American Dermatological Association, Society of Investigative Dermatology, American Federation of Clinical Research, American Academy of Dermatology, American College of Physicians and the American College of Rheumatology.


R. Gary Sibbald
Professor of Medicine and Public Health Science
Director of Continuing Education,
Department of Medicine, University of Toronto
Director, Dermatology Day Care and Wound Healing Clinic,
Sunnybrook and Women's College Health Sciences, Toronto, Canada

Wound Bed Preparation KOL activity R. Gary SibbaldProfessor R. Gary Sibbald is a specialist in internal medicine and dermatology with a special interest in chronic wound care and a master's degree in education. He was a founding board member of the Association for Advancement of Wound Care in the United States and a co-founder and past chairman of the Canadian Association of Wound Care. His dermatology expertise led to his roles as advisory council executive member for Canada of the American Academy of Dermatology and a previous president of the Toronto Dermatological Association. Professor Sibbald is the director of continuing education for the Department of Medicine at the University of Toronto and chair of the Faculty Continuing Education Committee and a board member of the Canadian Association of Continuing Health Education. Presently, Professor Sibbald is the director of the Dermatology Daycare and Wound Healing Clinic at the Women's College Campus of Sunnybrook and Women's College Health Sciences Centre. He is the director of the International Interdisciplinary Wound Care Course at the University of Toronto and co-editor of the Third Edition of Chronic Wound Care: A Clinical Source Book for Healthcare Professionals. On the international scene, he is the chair of the Education Committee of the World Union of Wound Healing Societies. Dr. Sibbald has lectured and presented at over 500 scientific meetings on five continents. He has published over 100 articles and book chapters.


Keith Harding
Professor of Rehabilitation Medicine (Wound Healing)
University of Wales College of Medicine, UK

Wound Bed Preparation KOL activity Keith HardingKeith Harding, MB ChB, MRCGP, FRCS is a professor of Rehabilitation Medicine at the University of Wales College of Medicine with an expertise in basic science and prevention and treatment of all chronic wounds. For the past ten years he has been director of the Wound Healing Research Unit, a self funded unit within the College of Medicine, designed to provide academic and clinical focus in wound healing. Professor Harding is a founding member of the European Wound Management Association, President of the European Tissue Repair Society. He has authored over 200 publications in peer review journals. From 1980-1990 he was principal in General Practice in Cardiff, UK.


Gregory S. Schultz
Professor of Obstetrics and Gynaecology, University of Florida USA

Wound Bed Preparation KOL activity Gregory S. SchultzDr Schultz is the Director of the Institute for Wound Research at the University of Florida. Dr Schultz's research focuses on the role of growth factors, cytokines and proteases in normal and chronic wound healing in the skin and in the eye. He has published over 170 research papers, chapters and review articles, which have been cited more than 4,400 times. He has been continuously funded by grants form the National Institutes of Health, has multiple patents in the areas of wound healing, and is a consultant for pharmaceutical and biotechnical companies. He served as President of the Wound Healing Society from 1999-2001.


Michael Stacey
Associate Professor of Surgery, Fremantle Hospital, Australia

Wound Bed Preparation KOL activity Michael StaceyMichael Stacey is a general and vascular surgeon and has a research interest in wound healing and chronic venous disease. His specific research interests are in the biochemistry and molecular biology of impaired healing in chronic venous ulcers. He also has research interests in venous physiology, pressure ulcers and diabetic foot ulcers. He was Inaugural President of the Australian Wound Management Association. He is currently Chairman of the World Union of Wound Healing Societies, and is on the Editorial Board of a number of journals associated with wound healing, in particular Wound Repair and Regeneration, The Journal of Wound Care, and Primary Intention.


Luc Teot
Professor of Surgery, Montpellier University, France

Wound Bed Preparation KOL activity Luc TeotLuc Teot is qualified in general, orthopaedic and plastic surgery. He is Founding President of the French Society for Wound Care, Board member of the European Tissue Repair Society and President and organiser of The 2nd World Wound Healing Congress, to take place in Paris in 2004. He has authored over 20 international publications and 47 French publications on several aspects of surgery. He is on a number of journal editorial boards, has authoured eight books and written 17 chapters in French and international publications.


Caroline Dowsett
Nurse Consultant Tissue Viability , Newham Primary Care Trust, London

Wound Bed Preparation KOL activity Caroline DowsettCaroline Dowsett is a Nurse Consultant and has been working in the field of Tissue Viability for the past seven years. She won Wound Care Nurse of the Year in 1999. She also lectures on wound care courses at both City and South Bank Universities, London and is currently undertaking a PhD at City University, London. She is an Executive Committee member of the National Leg Ulcer Forum. She had authored numerous publications in peer-reviewed journals and is currently a member of the Tissue Viability Society.


Elizabeth Ayello
Clinical Associate Professor, Faculty of Nursing, University of New York, USA.

Wound Bed Preparation KOL activity Elizabeth AyelloElizabeth is a clinical nurse specialist, her area of speciality is adult Medical-Surgical nursing. She is particularly focused on the care of patients with all types of wounds and ostomies. Elizabeth's research interests include Nursing Education, distance learning, Wound Care, Pressure Ulcer risk assessment. Internationally known for her expertise in wound care Elizabeth has served as the President for the National Pressure Ulcer Advisory Panel (NPUAP), and as a past co-chair and now current member of the Wound, Ostomy, and Continence Nurses Society (WOCN) Accreditation Committee, Elizabeth has developed criteria for evaluating all the WOCN programs in the US. For the past two years, Elizabeth has been a consultant to the Centres for Medicare and Medicaid Services (CMS) for their 3 year project to develop a scope and severity scale for Pressure Ulcers. She has authored several books and papers including: Pressure ulcers in America. Prevalence, Incidence, and implications for the future and "Skip the knife. Debriding wounds without surgery"


Professor Wolfgang Vanscheidt
Professor of Dermatology
Rheintalklinik Astoria-Privatkliniken, Bad Krozingen, Germany

Wound Bed Preparation KOL activity Professor Wolfgang VanscheidtProfessor Wolfgang Vanscheidt is a Professor of Dermatology and President of the German Wound Healing Society (DGfW). In 2002 he was made a co-opted Member of the Board of the European Wound Management Association (EWMA). His main research topics are pathogenesis and therapy of venous leg ulcers, phlebology and laser therapy both experimentally and clinically. Since 1987 Professor Vanscheidt has participated in numerous international clinical multicentre studies in phebology and wound treatment, and has in some cases been the leader of the clinical study. He has published numerous papers and sits on the editorial board for a number of national and international publications.



Dr. Marco Romanelli
Consultant Dermatologist at the Department of Dermatology and Head of Wound Healing Service at Azienda Ospedaliera Pisana and University of Pisa.

Wound Bed Preparation KOL activity Professor Dr. Marco RomanelliCurrently President and founding member of the European Pressure Ulcer Advisory Panel (EPUAP), he is also board member of the European Tissue Repair Society (ETRS), council member of the European wound Management Association (EWMA). He is member of the editorial board of the journal WOUNDS and referees several peer-reviewed journals in the field of chronic wounds. He is also member and fellow of several scientific societies. He is the author and co-author of numerous scientific papers and book chapters in the field of tissue repair. Research interests include tissue engineering for acute and chronic wounds, measurements in wound healing, management of pressure ulcers. Dr. Romanelli is the clinical project leader of a research program named DERMA which received a two years (2001-2003) research grant from the European Commission inside the Fifth Framework program. Partners in this project include Oxford Wound Healing Institute, Copenhagen Wound Healing Centre and Wound Healing Unit in Budapest. The study is devoted to the creation of an engineering prototype for the advanced measurements of wound physical and biochemical parameters. The Wound Healing Unit in Pisa is organised as a multi disciplinary team to serve as a centre of excellence for the central part of Italy. The team is working on acute and chronic wounds and has a special interest in research and continuing medical education in this field. An annual National Tissue Repair School in Pisa two years ago with the objective to create professional expertises in wound healing.

Product Range

The healing of chronic wounds is a step-by-step process which involves a team of products designed to provide an effective environment to promote healing. Wound bed preparation is an essential step within the process. Smith & Nephew is able to offer a full range of products for wound bed preparation.

ACTICOAT

Wound Bed Preperation Product Range Acticoat

ACTICOAT and ACTICOAT 7 are highly versatile barrier dressings offering quicker kill rates, longer wear times and much greater convenience than other wound care therapies.  


ALLEVYN

Wound Bed Preperation Product Range Allevyn

ALLEVYN dressings have a trilaminate structure comprised of a non-adherent wound contact layer, a highly-absorbent central layer and an outer layer which is waterproof and aids in the prevention of bacterial contamination. The result is a dressing for those wounds which have traditionally proved difficult to treat because the exudate is difficult to manage.

References

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  2. Sibbald RG, Williamson D, Orsted HL et al. Preparing the wound bed - debridement, bacterial balance and moisture balance. Ostomy Wound Manage 2000;46(11):14-35 Click here for abstract.
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