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

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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).

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Wound debridement when Accuzyme and Panafil are gone (Part 2)- Santyl Collagenase

October 29, 2008 — Matthew Livingston R.N. C.W.S.

Santyl Collagenase (Enzymatic Ointment) - Healthpoint

Description: Santyl Collagenase digests collagen in necrotic tissue

Indications: debridement for chronic dermal ulcers including pressure ulcers, venous ulcers, arterial ulcers, diabetic foot ulcers, and severely burned areas. (Healthpoint, 2006)

Authors notes:

1. Slowest debridement ointment verses Accuzyme or Panafil

2. Less risk for pain or inflammation than with Accuzyme or Panafil

3. Can be used in a wound bed that has a combination of non-viable tissue along with granulation tissue and epithelization

4. Because Santyl doesn’t lead to inflammation, evidence suggests that (While slower to debride at first)the closure times of the wound are the same as papian based products (Brett, 2004).

5.Panafil and Accuzyme are not going to be made after January of 2009 (So Santyl may be the only ointment for debriding wounds)

6. For dry wounds that need to be debrided, use a moist primary dressing (hydrogel impregnated) to keep the Santyl from drying out.

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