Bromelain‐based enzymatic debridement of chronic wounds: Results of a multicentre randomized controlled trial

Author(s):  
Yaron Shoham ◽  
Eyal Shapira ◽  
Josef Haik ◽  
Moti Harats ◽  
Dana Egozi ◽  
...  
2021 ◽  
Vol 10 (6) ◽  
pp. 481-493
Author(s):  
Oscar M Alvarez ◽  
Mark S Granick ◽  
Alexander Reyzelman ◽  
Thomas Serena

Aim: Compare foam dressings – Mepilex Border Flex (MxBF), Allevyn Life (AL) and Optifoam Gentle EX (OGEX) – in treatment of chronic wounds. Materials & methods: Prospective, randomized, controlled trial (crossover design). Subjects received one dressing for 2 weeks, then comparator dressing for following 2 weeks. Wound/periwound characteristics evaluated weekly at dressing change. Primary end point: dressing durability (incidence of exudate strikethrough). Results: Higher incidence of intact dressings (no strikethrough) at Day 7 (Week 1) with MxBF (6/17; 35.3%) compared with AL (1/18; 5.6%), and with MxBF (7/16; 43.8%) compared with OGEX (2/16; 12.5%; p < 0.05). No significant differences between groups regarding wound size reduction. Conclusion: MxBF had statistically greater durability than AL/OGEX during first critical week of treatment.


2020 ◽  
Author(s):  
Inés María Comino-Sanz ◽  
María Dolores López-Franco ◽  
Begoña Castro ◽  
Pedro Luis Pancorbo-Hidalgo

Abstract Background: A wound that does not heal in the orderly stages of the healing process or does not heal within three months is considered a chronic wound. Wound healing is impaired when the wound remains in the inflammatory stage for too long. A range of factors can delay the healing process: imbalance between proteases and protease inhibitors in the wound bed; bacterial colonization and the presence of biofilm; and oxidative stress.Recently, wound management has improved significantly. A new antioxidant dressing has been developed, which combines an absorbent matrix obtained from Locust Bean Gum (LBG) galactomannan and a hydration solution with curcumin and N-acetylcysteine (NAC). This dressing combines the advantages of moist healing in exudate management and free radical neutralization, achieving wound reactivation.The primary aim of this study is to compare the effect of antioxidant dressing on chronic wound healing with the use of standard wound dressing in patients with hard-to-heal wounds.Methods: We will conduct a multicentre, single blinded, randomized, controlled trial with parallel groups. Participants will be selected from three primary public health-care centres, located in Andalucía (southern Spain). Patients will be randomized into an intervention group (antioxidant dressing) or control group (standard wound dressing). Assessment will be carried out in weeks 2, 4, 6 and 8. Follow-up will be of 8 weeks or complete healing, if it happens earlier.Discussion: The findings from this study should provide scientific evidence on the efficacy of the antioxidant dressing as an alternative for the treatment of chronic wounds. This study fills some of the gaps in the existing knowledge about patients with hard-to-heal wounds.Trial registration: ClinicalTrials.gov, NCT03934671. Registered on 2 May 2019.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Inés María Comino-Sanz ◽  
María Dolores López-Franco ◽  
Begoña Castro ◽  
Pedro Luis Pancorbo-Hidalgo

2017 ◽  
Vol 4 (12) ◽  
pp. 3858
Author(s):  
Caren Dsouza ◽  
. Rouchelle ◽  
. Chirag ◽  
Erel Diaz ◽  
Shubha Rao

Background: Diabetic foot ulcers are chronic wounds which are difficult to heal, due to ischemia and intrinsic defects in angiogenesis and impaired immunity against infection. VAC therapy influences positive mechanical forces on the growth of tissues, especially in stimulating cell migration and mitosis, optimizes blood flow, decreases local tissue edema from the wound bed and provides an occlusive environment for wound healing under moist, clean and sterile conditions. Aims and objective was to compare the effectiveness of low cost hospital made VAC dressing with conventional dressings in healing of diabetic foot ulcers.Methods: This study was a prospective, randomized controlled trial and included 60 patients with diabetic foot ulcers admitted over 3 months. Patients were randomly allocated to two groups: odd numbered patients to VAC therapy and the even numbered patients to conventional dressings. Wound swab was taken before the start of the study. The data was analyzed and presented in percentages or proportions using Chi-square test and Student-t-test wherever applicable. Results: In this study it was found that in the VAC dressing group 76.7% of the ulcers had red granulation tissue at the end of therapy compared to 46.7% in conventional group. The mean wound bed preparation time was found to be 15.60 days in the conventional dressing group and 8.50 days in the VAC therapy group. In the VAC group 72.73% ulcers had no bacteria at the end of therapy.Conclusion: In this study, it was found that Vacuum Assisted Closure therapy was more effective than conventional dressings in the wound bed preparation of diabetic foot ulcers.


2020 ◽  
Author(s):  
Inés María Comino-Sanz ◽  
María Dolores López-Franco ◽  
Begoña Castro ◽  
Pedro Luis Pancorbo-Hidalgo

Abstract Background: A wound that does not heal in the orderly stages of the healing process or does not heal within three months is considered a chronic wound. Wound healing is impaired when the wound remains in the inflammatory stage for too long. A range of factors can delay the healing process: imbalance between proteases and protease inhibitors in the wound bed; bacterial colonization and the presence of biofilm; and oxidative stress.Recently, wound management has improved significantly. A new antioxidant dressing has been developed, which combines an absorbent matrix obtained from Locust Bean Gum (LBG) galactomannan and a hydration solution with curcumin and N-acetylcysteine (NAC). This dressing combines the advantages of moist healing in exudate management and free radical neutralization, achieving wound reactivation.The primary aim of this study is to compare the effect of antioxidant dressing on chronic wound healing with the use of standard wound dressing in patients with hard-to-heal wounds.Methods: We will conduct a multicentre, open, randomized, controlled trial with parallel groups. Participants will be selected from three primary public health-care centres, located in Andalucía (southern Spain). Patients will be randomized into an intervention group (antioxidant dressing) or control group (standard wound dressing). Assessment will be carried out in weeks 2, 4, 6 and 8. The follow-up of patients will be prolonged until week 8 or complete healing.Discussion: The findings from this study should provide scientific evidence on the efficacy of 20 the antioxidant dressing as an alternative for the treatment of chronic wounds. This study fills 21 some of the gaps in the existing knowledge about patients with hard-to-heal wounds.


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