Technology and product reviews 100
10 20 30 40 50 60 70 80 90
0
Week 0 Week 2 Week 4 Week 8
Pressure ulcers (n=9)
Diabetic ulcers (n=7)
Traumatic wounds(n=3)
Arterial ulcer (n=1)
Other (n=3)
Figure 18: The proportion of wound area covered by epithelium, granulation, fibrin and necrosis during the study for each wound type.
9 AUTHOR DETAILS
HILDE BEELE is a Professor at the Wound Clinic and Dept. of
Dermatology, Ghent University Hospital, Gent, Belgium
CORRADO DURANTE is a Senior
Surgeon at the Wound Care Unit, Emergency Department, Army Military Hospital, Rome, Italy JEAN-CHARLES KERIHUEL is Medical Director for Vertical, Paris, France
JAN RICE is a Co-ordinator in
Wound Education for World of Wounds, La Trobe University, Alfred Health Clinical School, Melbourne, Australia
ARMAND RONDAS is an Elderly
Care Physician at De Zorggroep, Venlo, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht
University, The Netherlands JAN STRYJA is a Vascular
Surgeon at Hospital Podlesi, Trinec, Czech Republic
RICHARD WHITE is a Professor of Tissue Viability at the University of Worcester, Worcester, UK.
8 7 6 5 4 3 2 1 0
Pressure ulcers (n=9)
Diabetic ulcers (n=7)
Traumatic wounds(n=3)
Arterial ulcer (n=1)
Other (n=3)
Week 0 Week 2 Week 4 Week 8
Figure 19: Evolution of pain, as measured by VAS pain score, before, during and after application of the enzyme alginogel (adapted from Durante, 2012).
colonisation and the formation of biofilms would be appropriate.
CONCLUSION While the composition of a dressing is important for classification, its mechanism of action should possibly be a greater influence on dressing selection. Flaminal, with its triple mode of action [Fig 1], is unique and so should not be regarded as either hydrogel, alginate or antimicrobial, but rather as a synthesis of the three. Similarly, its unique enzyme component affords an antimicrobial function with negligible risk of selecting for resistance. The general consensus of this meeting of wound care clinicians is that there is a place for this new class of dressing in care frameworks, but that it also presents a need for the following:
50 Wounds International Vol 3 | Issue 2 | ©Wounds International 2012
Larger scale randomised clinical trials to demonstrate efficacy of the main performance characteristics listed above
Performance versus current comparative competitors (some are listed in Table 1 for the ‘T’, ‘I’ and ‘M’ aspects of the TIME framework);
In vivo proof of the unique antimicrobial action of the enzyme component. While the clinical evidence to date is
definitely promising, these further studies are needed to confirm that Flaminal can avoid the unnecessary requirement for multiple products, presenting a real cost saving and supporting applications for reimbursement from healthcare authorities worldwide.
ACKNOWLEDGEMENT Richard White is a consultant to Flen Pharma.
Percentage of wound area before
during after
before
during after
before
during after
before
during after
before
during after
epithelium granulation fibrin
necrosis
epithelium granulation fibrin
necrosis
epithelium granulation fibrin
necrosis
epithelium granulation fibrin
necrosis
epithelium granulation fibrin
necrosis
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