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A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
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Debridement - how efficient can a wound dressing be? The answer from a large prospective observational study
Finja Reinboldt-Jockenhöfer1, Michael Dietlein2, Arthur Grünerbel3
1MD, Department of Dermatology, Venereology, and Allergology, University Hospital Essen, Essen, Germany.
Objective:
To evaluate the performance and tolerance of two polyabsorbent fibre dressings (a pad impregnated with a technology lipido-colloid healing matrix and a rope) in an unselected cohort of patients with wounds of various aetiologies in daily practice.
Method:
A prospective, observational, multicentre study was conducted in 152 centres across Germany. Wounds were treated with the evaluated dressings (UrgoClean pad and UrgoClean rope, Laboratoires Urgo, France) for six weeks. Main outcomes included changes in: overall wound healing progression; wound bed tissues; exudate; infection status; malodour; and pain, as well as acceptability and tolerance of the dressings.
Results:
A total of 1558 patients (aged 3-100 years) were included: 944 patients with chronic (mostly venous leg ulcers, diabetic foot ulcers and pressure ulcers) wounds; and 614 with other wounds (mostly surgical wounds, skin abrasions and burns). By the final visit, 42.0% of wounds had healed within 33±15 days, and a wound healing improvement was reported in 52.5%. Continuous reduction in sloughy tissue was observed (from 60% initially to 10% at final visit), regardless of dressing or wound type. This improvement was associated with a reduction in: infection rates, by 87.3%; malodour, by 86.7%; maceration by 65.6%; and spontaneous pain by 60.4%. Both dressings were rated as 'very well' tolerated and 'accepted' by most patients (85.3 and 76.1%, respectively), and judged as 'extremely useful' by the majority of physicians (72.0%), notably in cases of infected wounds without antibiotic therapy.
Conclusion:
The two dressings assessed in this study were shown to be efficient in removing sloughy tissue and promoting wound healing, regardless of wound type or infection status. These results are consistent with previous clinical evidence and support their intended use.
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