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.”


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ate of upload: 16th May 2009

                                  
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