Technology and product reviews
Creates a moist environ- ment in dry wounds,
absorbs exudate to pro- mote autolytic debride- ment
Forms moist gels in the presence of fluids, such as wound exudate
microbial colonisation and combats infection
Protects against
Hydrogel
+
Alginate
+ Enzyme alginogels
Flaminal Hydro — (3% alginate) for low-to-moderate exuding wounds
Flaminal Forte — (5.5% alginate) for moderate-to- heavily exuding wounds
Enzyme complex
Figure 1: Te components and mechanism of action of Flaminal (White, 2006). For wounds exhibiting moderate-to-high
exudate levels, foams were used; for low- to-medium exuding wounds, dry dressings were used. Wound volume and surface area were measured at the start of the study and routinely afterwards — the mean volume on inclusion was 2.8 ± 5.6cm3 area 2.6 ± 3.8cm2
. Wound pain, surface area and volume, References
4. Durante C. An open label non- comparative case series on the
efficacy of an enzyme alginogel. J Wound Care 2012; 21(1): 22–28.
5 .White RJ. Natural approaches to wound management: a focus on honey and honey-based dressings. Wounds UK 2005; 1(3 Suppl): S1–60.
6.Ingle R, Levin J, Polinder K. Wound healing with honey— a randomised controlled trial. S Afr Med J 2006; 96(9): 831–35.
7 Eming SA, Krieg T, Davidson JM. Inflammation in wound repair:
molecular and cellular mechanisms. J Invest Dermatol 2007; 127(3): 514–25.
exudate levels, and wound tissues were assessed regularly until healing, or until 60 days had elapsed. Results showed that in all wounds there was a significant decrease in dimensions (p≤0.001). This included chronic wounds refractory to treatment with other modalities (treatment of over 12 weeks’ duration). In each group of patients wound pain (as assessed using a visual analogue scale [VAS]) decreased over time.
THE EXPERT PANEL The expert panel used their clinical experience of Flaminal products, in conjunction with the published evidence, to consider where enzyme alginogels might be positioned according the to the ‘T’, ‘I’
44 Wounds International Vol 3 | Issue 2 | ©Wounds International 2012
and ‘M’ elements of the TIME framework (‘E’ components involve biological dressings or surgery and are not appropriate). The panellists brought the following case evidence to the discussion.
and the mean
CASE STUDY EVIDENCE Australian experience A 91-year-old female patient presented with a three-week-old full-thickness burn to the foot [Fig 2]. She received daily Flaminal therapy following her request to continue with her daily commitments prior to a femoro-popliteal bypass and a skin graft. The extent of healing after three weeks of daily dressing changes is shown in [Fig 3]. Further evidence is presented via the
experience of an 88-year-old female patient with dementia who presented with a full- thickness burn to the knee [Figs 4-7]. The use of Flaminal not only avoided the
need for hospitalisation, with the associated risk of pressure ulceration, but also facilitated rapid healing, as demonstrated in [Fig 7]. The efficacy of Flaminal in older patients with burns, a group with high comorbidity rates
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