Woundcare
Healing chronic wounds
stalled in proliferaton phase
3M has recently released Tegaderm Matrix, a new woundcare product in
their Tegaderm range. Middle East Health spoke to Caroline Bilen, a
technical specialist at 3M about the product.
Wound care has made tremendous
strides over the past two
decades and continues to do so
as our understanding of the
wound healing process
improves. Combine this with
advances in medical technology
and biomedicine and the result
is that researchers are able to
develop specialised wound care
products designed nto facilitate
each phase of the healing
process. These products accelerate
the healing process, break
down barriers that can retard
healing and, in the case of some
chronic wounds, prevent the
worst outcome – amputation.
The wound healing process
is a complex one. Although it
is now quite well understood,
researchers are still finding out
new information about wound
healing at the cellular and
biochemical level.
Briefly, the healing process
can be divided into four phases
– haemostasis; inflammation;
proliferation; remodelling –
which are continuous, overlap
and do not always occur in a
routine way. The process can be
interrupted, delayed or even
stopped entirely by a variety of
factors such as old age, infection,
diabetes, smoking, medication,
immunosuppression, poor
nutrition, cell hypoxia and
dehydration among others.
The four phases of
wound healing
Haemostasis
In the haemostasis phase, the blood stops flowing and a clot
forms through vasoconstriction
and platelet aggregation.
Inflammation
In the inflammatory phase
bacteria and debris are
removed – phagocytised.
Factors are released that cause
the migration and division of
cells involved in the proliferative
phase.
Proliferation
In the proliferative phase there
is angiogenesis – the regrowth
of blood vessels; collagen deposition;
granulation tissue
growth – this tissue usually
grows from the bottom of the
wound and fills the wound bed;
contraction – myofibroblasts
pull the wound edges together
by contracting themselves in a
similar way to smooth muscle
cells; and epithelialisation –
epithelial cells spread across
the wound bed.
Remodelling
In the final stage collagen is
remodelled to increase the
tensile strength of the wound.
Carline Bilen, a technical
specialist for Infection
Prevention at 3M’s Health
Care Business in the Middle
East and Africa says it is important
to assess each wound individually
before treating, as
each person has unique factors
at play which can impede the
healing process.
“This is particularly the case
with chronic wounds,” she emphasised. “As there
are many possible
causes.”
She explained that
recent studies have
shown that an excess
of protease – in particular
an imbalance
between matrix metalloproteinases
(MMP)
and their inhibitors,
tissue inhibitors of
metalloproteinases
(TIMP) – are strongly
associated with retarded
healing in chronic wounds.
This micro-environment
in wounds is now
increasingly well understood
and has led 3M to develop a
unique product called Tegaderm Matrix – launched
across the GCC and Levant in
the past couple of months.
Tegaderm Matrix has been
specifically designed for
chronic wounds which are
stalled in the proliferation
phase of healing.
“3M has a wide range of
wound care products,” Bilen
said. “They are designed
around our concept of ‘protect,
fill and cover’. There are
several products designed for
each phase of the wound
healing process.
“For example, we have Tegaderm Ag Mesh (with
silver) for facilitating the
healing of chronic infected
wounds – in the inflammation
phase.
“Some wounds won’t
progress past the proliferation phases and for this we have
developed Tegaderm Matrix.”
Tegaderm Matrix is used as a
primary wound dressing. It is
composed of an acetate mesh
impregnated with an ointment
containing polyethylene
glycol, citric acid and metal
ions, which help regulate the
production of MMPs in the
wound and normalise the
acidity of the wound. When
this balance is restored to the
wound environment, epithelialisation
is accelerated and
healing is facilitated.
“Tegaderm Matrix is indicated
for chronic non-infected
wounds with delayed healing,
such as pressure ulcers, diabetic
foot ulcers and leg ulcers,”
explained Bilen. “It should be
changed at every dressing
change – that is every one to
three days.” 
Date
of upload: 16th May 2009
