Local wound treatment
To ensure the treatment choice is safe and effective, dressing selection must be based on the highest level of evidence.
Primary dressing selection for patients with chronic wounds should aim to achieve three key objectives:
- The treatment should have robust clinical evidence to support faster healing times.
- The treatment should be efficient in its absorption qualities, based on the exudate levels presented. Its abilities to be interactive with a secondary dressing that can absorb excess exudate (which is not retained by the primary treatment) is key. This reduces the risk of peri-wound skin damage.
- The treatment should be able to conform to the wounds anatomical shape whilst remaining simple to apply (including how easy it is to cut and shape)
The primary objective of chronic wounds treatment is to close the wound as quickly as possible, so that the patient can resume their normal life. All chronic wounds have local factors that may impair healing and thus delay wound closure:
- Excess levels of matrix metalloproteinases (MMPs), which damage the healthy tissues and result in the wound becoming stuck in the inflammatory stage of healing⁽¹⁾.
- Impaired neo-vascularisation, which impedes the supply of nutrients and oxygen to the wound⁽²⁾.
Innovative interactive dressings that are supported by robust clinical evidence, that are recommended by international guidelines and national health authorities are available. They can be applied to the wound at presentation, and will act on these local factors until complete healing occurs, with the aim being to reduce healing times⁽³⁾.
1. Lázaro JL, Izzo V, Meaume S et al. Elevated levels or matrix metalloproteinases and chronic wound healing: an updated review of clinical evidence. J Wound Care. 2016: 25(5):277–87. https://doi.org/10.12968/jowc.2016.25.5.277
2. Honnegowda TM, Kumar P, Udupa EG et al. Role of angiogenesis and angiogenic factors in acute and chronic wound healing. Plast Aesthet Res. 2015; 2:243-9
3. Dissemond J, Augustin M, Dietlein M et al. Efficacy of MMP-inhibiting wound dressings in the treatment of hard-to-heal wounds: a systematic review. J Wound Care. 2002; 29(2):102-118. https://doi.org/10.12968/jowc.2020.29.2.102