SURGICAL/CRITICAL CARE wound healing and comes in many sizes


that give clinicians more options.” Dressed to live


Choosing the appropriate wound dress- ing is vital to proper healing. In fact, one of the major problems in wound care today is that wounds are not dressed to live, aka, promote healing.


Fortunately, companies such as Medline, a distributor of medical sup- plies, continue to develop transformative new products and technologies in wound healing. When HPN asked Sebastian Barba,


DVM, Senior Director, Strategic Marketing, Advanced Wound Care, Medline, about some of his company’s most recent developments in wound management, he detailed one of the com- pany’s most recognized products, PluroGel Burn and Wound Dressing, as well as IoPlex foam dressing. According to Barba, “a common chal- lenge is managing pain from uncomfort- able dressing changes in burn patients. This not only stresses the patient and the family, but it can also delay their dis- charge. PluroGel can lead to less painful dressing changes, allowing patients to achieve a better outcome while healing at home.” Barba described how Medline’s IoPlex foam dressing has used a completely new approach, in this case, iodine, to effectively treat significantly recalcitrant wounds.


Sebastian Barba “It (Ioplex) is the only foam dressing


with controlled release iodine. A recently published in-vitro study showed iodine is more effective than other topical agents for managing chronic biofilm infec- tions. This allows healthcare workers to treat significantly recalcitrant wounds effectively, that before could have been stalled.”


Another company that is making their


mark in the development of advanced wound care products is Dynarex. Igal Hodorov, Vice President, Sourcing & New Product Develop- ment at Dynarex, affirms his company’s dedication.


“At Dynarex we pro- vide advanced wound


Igal Hodorov


care solutions with a wide range of specialized dressings. Some dressings are highly absorbent, multi-layered, and medicated based on the specific wound


needs. Our dressings are specialized in keeping wounds moist, as well as absorb- ing and managing exudates. They also help facilitate the healing process.”


Losing our footing


With the skyrocketing rates of diabetes (both nationally and internationally), the attention on diabetic foot ulcers has, and will continue to, heighten immeasur- ably. Close to 25% of diabetes patients will develop wounds in their lower extremities1


; more than 10% of these


wounds result in amputations.2 When one thinks of amputations, they may think of limbs being lopped off in the midst of The Civil War, because, at that time, we simply did not have the means or methods to save them. It’s estimated that in that horrific 4-year span, approximately 60,000 soldiers underwent amputations.3 According to Regulski, diabetic foot wounds result in 80,000 amputations in the United Stats every single year. And, during the COVID-19 pandemic, the rate of amputations are 11 times greater than they were previously.


He continued, “The cost of treating a diabetic foot ulcer can range anywhere from $9,000 to $27,000. If you end up with a leg amputation, your chances of surviving for 5 years are less than 30%. The existential threat is that here in the U.S., we have about 95 million pre- diabetics; 5 to 10% of them are going to convert to diabetes. There are 37 million diabetics currently in this country, and about 2 million foot ulcers a year. Every 30 seconds, a limb is amputated due to diabetes (in this country).”


It seems we don’t understand the the degree to which we are responsible for our own wound management, and heal- ing progression. Such is the case where wounds arise in our extremities as the result of diabetes. According to Regulski, “wounds get


stuck in the inflammatory phase. They can’t progress on and there’s multiple factors, such as poor nutrition, and low levels of Vitamin C, D, and pro- tein; these all need to be checked and supplemented.


Also, when patients have a diabetic foot ulcer, they need proper off-loading to rest the wound and protect it from shearing and pressure forces; if not, it will be very hard to heal. In addition to the pressure, other factors prevent- ing proper healing include smoking, poor sugar control, peripheral vascular disease, acute infection, pathologic poor edema and exudate management.”


18 June 2022 • HEALTHCARE PURCHASING NEWS • hpnonline.com


Perhaps just (if not more) startling is that the negative circumstances of wounds can often be attributed to the doctors that are trying to treat them. As Regulski stated, “I’ve seen people that have come in and they’ve had four or five different things just applied to the wound, or they’d had eight or nine different antibiotics pre- scribed. I treat 10,000 chronic wounds a year and I’ve probably given out antibiotic prescriptions for 4 of them.”


Numbers don’t lie According to the CDC, 1.6 million people in the United States had diabetes in 1999; in 2015, that number increased to 23.4 million.4


According to Regulski, “by the year


2030, one in every seven to eight people are going to be diabetic. When we look at people that have a diabetic foot ulcer- ation, that alone carries a 50% mortality rate, which is higher than all cancers, with the exception of pancreatic.5


In 2019, 4.2


million people died from diabetes and its related complications, and we spent $760 billion on its treatment.6 The numbers are inarguable. For those of us working in healthcare, it is our duty to be constantly immers- ing ourselves in information. Regulski asserted, “I study and read about wound healing everyday. If I don’t know some- thing, I research it, I ask questions. I am not afraid to say that I don’t know. I have been in practice for 18 years and can tell you that there are so many physicians who don’t do that.” The innumerable factors and strategies vary between every patient and every wound. Thus, it could not be more vital to take a holistic appoach to wound heal- ing. As Regulski said, its’s a team effort. “Wounds are a multisystemic issue that require a multifactorial approach.” HPN


References


1. Bharara M, Mills JL, Suresh K, Rilo HL, Armstrong DG. Diabetes and landmine-related amputations: a call to arms to save limbs. Int Wound J. 2009;6(1):2-3.


2. Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, Sanders RW, Jones AL, McAndrew MP, Pat- terson BM, McCarthy ML, Travison TG, Castillo RC. An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. N Engl J Med. 2002 Dec 12;347(24):1924-31.


3. American Battlefield Trust. Amputations and the Civil War. https://www.battlefields.org/learn/articles/amputations-and- civil-war. Accessed May 16, 2022.


4. https://www.cdc.gov/. Accessed May 16, 2022.


5. Rowley WR, Bezold C, Arikan Y, Byrne E, Krohe S. Diabetes 2030: Insights from Yesterday, Today, and Future Trends. Popul Health Manag. 2017;20(1):6-12. doi:10.1089/pop.2015.0181.


6. Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besançon S, Bommer C, Esteghamati A, Ogurtsova K, Zhang P, Colagiuri S. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020 Apr;162:108072. doi: 10.1016/j. diabres.2020.108072. Epub 2020 Feb 13. PMID: 32061820.


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