Wound Management
Laurence R. Sands, Dana R. Sands in Ambulatory Colorectal Surgery, 2008
The Vacuum Assisted Wound Closure system (VAC)—or VAC dressings—is an important development in this field. This system includes several items: foam, drape, pad, canisters, and pump. After the black granular foam dressing is cut to fit the wound, the thin and adhesive film drape is used to cover the foam and keep the entire wound completely sealed. A round 1.5 cm diameter hole is then cut out of the drape. A pad is attached to the hole and connected to the pump. The foam dressing has reticulated pores to help evenly distribute negative pressure to the entire wound. The VAC system has multiple roles: it removes the exudates and infectious material, reduces edema, promotes granulation, and provides an airtight wound. This may be an effective device for difficult and complicated wounds.
Natural Products in the Treatment of Unremitting Wounds Secondary to Diabetes or Peripheral Vascular Disease
Namrita Lall in Medicinal Plants for Cosmetics, Health and Diseases, 2022
Hundreds of commercially available wound products exist for topical use. Maintaining a moist wound bed environment to prevent tissue desiccation became a core concept of wound healing with research in the 1960s (Winter, 1962). The primary role of a topical wound dressing is to manage wound exudate by maintaining the balance of a moist wound bed. Dressings range from absorptive dressings such as hydrofibers, calcium alginates or foams to dressings that add moisture to a wound bed such as hydrogels. Other dressings go beyond maintaining a moist wound balance and enhance the proliferation of new tissue growth. Collagen dressings form a scaffold for new fibroblast activity, as well as inactivate matrix metalloproteinases (MMPs) that can contribute to a non-healing chronic wound (Chattopadhyay and Raines, 2014).
Selective Antimicrobial Agents from Terrestrial Plants A Hope in the Battle of Infection
Mahendra Rai, Chistiane M. Feitosa in Eco-Friendly Biobased Products Used in Microbial Diseases, 2022
In addition, the antimicrobial effect of C. phlomidis was tested using the agar diffusion method against a panel of infectious microorganisms represented by S. aureus, B. subtilis, E. coli and P. aeruginosa. The ethanol extract of the shade-dried leaves showed the highest activity exerting the mean diameter of zone inhibition ranging between 13–14 mm that could be attributed to its richness with different secondary metabolites (Latha et al. 2018). In addition, the ethyl acetate extract of C. phlomidis formulated in the form of Electrospun Poly Caprolactone (PCL) nanofibrous may revealed potent antibacterial activity against S. aureus, S. typhi, E. coli and P. aeruginosa with good releasing properties that was evidenced using a period of 60 hours for examining the related studies. Results of the releasing studies showed the initial release started in the first 8 hours and continued for a long time. It is noteworthy to highlight that the extract is rich in secondary metabolites, as revealed by GC-MS analysis that showed the presence of 40 compounds in the non-polar solvent extract mainly belonging to terpenoids, flavonoids with phytol, hexadecanoic acid and palmitic acid representing the predominant compounds. Thus it can be used as an antibacterial wound dressing (Ravichandran et al. 2019).
Novel linezolid loaded bio-composite films as dressings for effective wound healing: experimental design, development, optimization, and antimicrobial activity
Published in Drug Delivery, 2022
Dina Saeed Ghataty, Reham Ibrahim Amer, Reham Wasfi, Rehab Nabil Shamma
Nowadays, a wide range of dressing materials including films, hydrogels, hydrocolloids, or foams are applied for diverse types of wounds and target various phases of the wound healing process. Dressing materials such as films are used to treat wounds and deliver therapeutic agents including, antibiotics and anti-inflammatory agents to the wound interface, to manage infection and pain (Colobatiu et al., 2019). Generally, films are biocompatible, biodegradable, and can be easily removed without trauma. They can be applied around different body parts exhibiting different shapes and contours, specifically around joints including knees, elbows, and hips owing to their mechanical properties. When applied over the wound, films promote wound healing by preventing the collection of exudates in the wound bed and maintaining a moist environment at the wound site to enhance tissue regeneration with minimum scar formation (Hafezi et al., 2019).
Topical negative-pressure wound therapy: emerging devices and techniques
Published in Expert Review of Medical Devices, 2020
Raymund E. Horch, Ingo Ludolph, Wibke Müller-Seubert, Katharina Zetzmann, Theresa Hauck, Andreas Arkudas, Alexander Geierlehner
Since the first commercially available negative-pressure wound therapy device, various foam types with different properties have been developed and used in numerous areas of application. First, the traditional black polyurethane ether (V.A.C. GranuFoamTM, KCI) a highly hydrophobic material and preferably used for wounds requiring large fluid drainage and granulation tissue formation. A more hydrophilic foam consisting of black polyurethane ester (V.A.C. VeraFloTM, KCI) was designed for the use of instillation therapy. Polyvinyl alcohol sponges (V.A.C. WhiteFoamTM, KCI) usually have smaller and denser pores developed for the coverage of more delicate structures such as tendons and blood vessels. This foam type additionally restricts granulation formation and is thought to reduce the pain during dressing changes. It is mostly used on wounds where hypergranulation might be a concern [56]. Recently open reticulated foams with very large holes (V.A.C. VeraFlo Cleanse ChoiceTM, KCI) have been introduced to alleviate the removal of viscous and fibrinous exudate and infectious material in cases where surgical debridement is not feasible for any reason [57]. This specific foam type can be applied to burns, contaminated, diabetic, acute or chronic infected wounds [58,59]. This overview of foam types is by no means subject to completeness. Many other foam types are commercially available or under development.
Preparation and characterization of a hydroxypropyl methylcellulose based wafer for simultaneous delivery of phenytoin and insulin as wound dressing material
Published in Pharmaceutical Development and Technology, 2022
Somayeh Taymouri, Negin Amiri, Mohammad Rabbani, Mohsen Minaiyan, Azar Baradaran
Wafers are dressings prepared by freeze-drying the aqueous gels of polymers to yield a porous polymeric inter-connecting structure. They have become a promising dressing due to several advantages for wound healing; these include easy application on the skin, capability of gas transmission, maintenance of a moist environment, and absorption of the accumulated exudates at the wound site due to their high porosity (Atia et al. 2019). When wafers are applied at the wound surface, they can absorb exudate, turning it into a highly viscous fluid or a resilient gel. Compared with semisolid gels, they can keep their swollen structure for a longer time, thus leading to a longer residence time and the direct delivery of the drug to the wound in a sustained manner. In addition, wafers have a higher absorption rate and drug loading, as compared to films, owing to their porous nature and wide surface area (Ayensu et al. 2012). Different hydrophilic polymers, alone or in combination, can be, therefore, employed to fabricate wafers to achieve the desired properties of wafers (Ayensu et al. 2012). Hydroxypropyl methylcellulose (HPMC) has been identified as a good choice for the preparation of wafers due to its good water-solubility, biocompatibility, high availability, and low price (Kondaveeti et al. 2017). To obtain the desired characteristics, in this study, the mixtures of HPMC with Carbopol 940 (CB) or xanthan gum (XG) were used to prepare the wafer.