Pulse Lavage for Full Thickness Wounds

February 10, 2012 — Matthew Livingston R.N. C.W.S.

Matt, a question for you: Have you had any experiences with pulse lavage therapy as a treatment for wounds? In particular, stage III and IV wounds. If so, what are your thoughts on the therapy?

K, I have a lot of experience with pulse lavage in deep full thickness wounds (mostly in the early 2000s). I believe that pulse lavage has lost favor related to the high risk for spreading microorganisms via water droplets that inevitably spray back out of the wound. Two other developments have lead to the reduction in pulse lavage use including VAC instill (NPWT) and Celleration Mist therapies.  That being said pulse lavage does have a place in the care of patient’s if the wound is grossly contaminated (say status post traumatic injury to flush debris).

I would review the goals that you expect to achieve when treating the patient with pulse lavage. Typically, pulse lavage helps to reduce slough and clean a contaminated wound bed.  Depending on your goals I think there are better solutions. To reduce or loosen slough in high draining wounds I recommend DrawTex (SteadMed). If you fear contamination (and in a hospital setting) I would recommend VAC instill with Microcyn as the irrigant. If the patient is at an ECF, Home Care, or being seen at a wound clinic I would consider going with our classic antimicrobial silver (We use a ton of Silvadene) , but opt for an silver alginate if the patient can’t get the dressing changed daily.

Thanks again for the question,

Matthew

Posted in NPWT - VAC Education, Products, Wound Infection. Tags: , , , . Leave a Comment »

Wound Blog 2011 Year in Review

January 20, 2012 — Matthew Livingston R.N. C.W.S.

Wound Blog did very well in the 2011 year with over 17,000 visits.  Many of the visits came from outside of the United States which is the goal of any author sharing clinical information. Countries that represented the bulk of visitors included Canada, UK, India, Philippines, Australia, and New Zealand. The top searches from visitors included topics such as Panafil and Santyl.  Clearly, we as clinicians are still looking for a better way to debride our patient’s wounds (Take a look at Wound Blogs article on DrawTex which research suggests actively debrides draining wounds).  Other common searches that brought visitors to wound blog include diabetic foot ulcers.  I cover a lot of very specific clinical suggestions for diabetic patients, so I’m pleased that search engines recognized the value of these articles. I look forward to sharing more clinical wound information with you in 2012.

Best Wishes, Matthew Livingston RN

Posted in Wound Blog News. Tags: , , , , , , , , , , . Leave a Comment »

Wound Care Tool Kit – Drawtex

April 19, 2011 — Matthew Livingston R.N. C.W.S.

Drawtex (SteadMed) is a new find as a hydroconductive debridement agent. I was able to see an average reduction in slough of up to 75% in the eight patients I have tried it on so far. The assumed mode of action is through the dressings ability to forcefully remove drainage (up to 150cc/hr) and content from the wound into the dressing. The force of the fluid transferred into the hydroconductive dressing is able to cleave the denuded collagen that bonds the necrotic tissue from the healthy tissue. The advantage of hydroconductive debridement is that it is a top down debridement tool that can debride over a large surface area (versus the peripherial wound area such as side down debridement agents i.e. Santyl Collagenase).

Indications:

Drawtex works well with wounds with moderate to large drainage, Reoccurring slough, Adherent slough, Consolidated slough with is difficult to remove with curettage and as an alternative for patients who have pain with sharps debridement.

Author notes:

Drawtex is also useful for controlling Biofilm as noted in the  (Randy Wilcott Poster which won first place at the SAWC Spring, 2011 Conference).

The dressing will not degrade in the wound and will continue to pull fluid from high draining cavities, so it is very useful with deep narrow or wide tunnels (Were alginates fail).

Posted in Wound Care Tool Kit. Tags: , , , , , , , , , . Leave a Comment »

Hydroconductive Debridement a new Perspective in Wound Debridement

March 8, 2011 — Matthew Livingston R.N. C.W.S.

I have long been looking for what to do once we lost Panafil and Accuzyme.  Currently, many clinicians have been using Santyl as the default wound debridement agent.  We know that Santyl  has a place in the scope of debridement, but it in itself has limitations. Needless to say, I have found what we may have been looking for as a wound debridement agent. I recently had the opportunity to finish a case study with a product that provides what I have been looking for as a debridement agent.  I will be submitted a poster on a Hydroconductive Debridement dressing called Drawtex  (SteadMed)  at the Spring 2011 SAWC . The numbers (in terms of reduction of avascular tissue) were very promising. This case study series included a average (with 8 cases) percentage reduction in the total slough and necrosis of  36% at week one, 52% at week two, and 72% at week three. Please note that no other types of debridement were utilized during this study. The study also noted an average percentage reduction in wound area of 15% at week one, 35% at week two, and 47% at week three.

Disclosure: the author receives no financial incentives from SteadMed.

Posted in Wound Care Tool Kit. Tags: , , , , , , , , . Leave a Comment »
Follow

Get every new post delivered to your Inbox.