Clinical Use Melodie Blakely PT MS CWS Osceola
Clinical Use Melodie Blakely, PT, MS, CWS Osceola Regional Medical Center Kissimmee, Florida 1
Moistening & Handling Starts out firm when dry, easy to cut to fit Hydrated becomes velvety soft and conformable 2 Individual results may vary
How to Use Can be cut wet or dry Remove from package, moisten with normal saline or sterile water Squeeze excess fluid from dressing Apply to wound slightly overlapping edges If moisture on skin a concern, use barrier ointment in peri-wound area 3 Individual results may vary
Hydrofera Blue® Bacteriostatic Dressing 4 Individual results may vary
Hydrofera Blue® Bacteriostatic Dressing 5 Individual results may vary
Keeping it Moist 6 Individual results may vary
Re-hydrating 7 Individual results may vary
Choosing the Right Wound Critically colonized Hypergranulation tissue Thickened and rolled edges Painful wounds 8 Individual results may vary
Usage and Results Illustrated Through Cases 9 Individual results may vary
Uptake of Exudate 10 Individual results may vary
Uptake of Exudate 11 Individual results may vary
Hypergranulation Tissue 1 week difference 12 Individual results may vary
Wound Edges 13 Individual results may vary
Wound Edges 14 Individual results may vary
Hydrofera Blue Bacteriostatic Dressing® and Collagenase Santyl® Ointment 15 Hydrofera Blue® is a registered trademark of Hydrofera, LLC SANTYL is a registered trademark of Healthpoint, Ltd. Individual results may vary
16 Individual results may vary
17 Individual results may vary
Case Study #1 18 Individual results may vary
• • • 19 Individual results may vary 38 y/o hispanic male 3 year history of ulcer related to venous insufficiency. Ulcer exquisitely painful (10/10) patient would not allow any form of debridement. Gauze threads painstakingly lifted out of wound. Hydrofera Blue® Bacteriostatic Dressing applied with 3 layer compression wrap. Hydrofera Blue® is a registered trademark of Hydrofera, LLC
Patient returns for evaluation 1 week later, improvement noted in wound surface, granulation still not robust or healthy, antimicrobial foam continued along with multi-layer wrap 20 Individual results may vary
Following week, beginning to see new granulation, patient prefers to use antimicrobial foam further because pain level has decreased. Multi-layer wrap continued. 21 Individual results may vary
Week 3, wound clean, healthy, robust granulation tissue, Oasis® Wound Matrix applied (under Hydrofera Blue® Bacteriostatic Dressing at patient’s request), multi-layer wrap continued 22 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC OASIS is a registered trademark of Cook Biotech, Inc.
Week 4, pain now 0/10, able to clean up edges, Oasis® Wound Matrix continued, Hydrofera Blue® Bacteriostatic Dressing discontinued, continued multi-layer wrap. 23 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC OASIS is a registered trademark of Cook Biotech, Inc.
Week 5, excellent epithelialization. Continue same plan of care. 24 Individual results may vary
Case Study #2 25 Individual results may vary
69 y/o female, bilateral venous ulcers Ulcers reportedly 8 years old Treatments included Aquacel®Ag Hydrofiber® Wound Dressing Pt only able to tolerate tubular bandage for compression 26 Individual results may vary Aquacel and Hydrofiber are registered trademarks of E. R. Squibb and Sons, LLC
Initial application of Hydrofera Blue® Bacteriostatic Dressing 27 Continue tubular compression secondary to pain Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC
Three days later Early improvement Reduced pain Agreed to multi-layer wrap 28 Individual results may vary
Two weeks 29 Individual results may vary
Three Weeks 30 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC OASIS is a registered trademark of Cook Biotech, Inc.
6 weeks 31 Individual results may vary
Case Study #3 32 Individual results may vary
49 y/o female, hx significant for sickle cell anemia, past history of painful ulcers healed with advanced dressings and compression Reports 4 month history with current ulcers Ulcers with thickened edges Wound dressed with Collagenase Santyl® Ointment and covered Hydrofera Blue® Bacteriostatic Dressing and secondary foam dressing Compression with multi-layer wrap 33 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC SANTYL is a registered trademark of Healthpoint, Ltd.
One ulcer closed at next visit • Remaining ulcers redressed with Collagenase Santyl® Ointment and Hydrofera Blue® Bacteriostatic Dressing, and covered with secondary foam dressing • Multilayer wrap continued 34 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC SANTYL is a registered trademark of Healthpoint, Ltd.
Illustrating Collagenase Santyl® Ointment and Hydrofera Blue® Bacteriostatic Dressing 35 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC SANTYL is a registered trademark of Healthpoint, Ltd.
Ulcers closed at 4 weeks. 36 Individual results may vary
• 6 months later, recurrence at previous ulcer site • Debridement performed with ultrasonic wound therapy; some purulence noted beneath eschar • Began cadexomer iodine dressing with multilayer compression wrap 37 Individual results may vary
• One week later, ulcer cleaner, very painful • Began Hydrofera Blue® Bacteriostatic Dressing and secondary foam dressing • Continued 38 multi-layer compression Individual results may vary
• Week 3 • Dramatic pain reduction • Continued 39 same treatments Individual results may vary
• Week 4 • Significant • Changed 40 epithelialization to lite foam dressing/multi-layer wrap Individual results may vary
• Wound healed • Continued • Resumed 41 protection with lite foam dressing compression stocking Individual results may vary
Case Study #4 42 Individual results may vary
Chronic Venous Ulcer 81 year old female Virtually no medical history other than CVI Previous patient for 8 months – Referred to vascular surgeon – Lost to follow up 43 Individual results may vary
Returns 2 years later Chronically fibrosed wound No other changes in H&P 1 st week used Ag Hydrogel Wound cultured, biopsy for pathology – Negative Thick, rolled edges – Hydrofera Blue Bacteriostatic® Dressing started 44 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC
Week 2 45 Individual results may vary
Week 4 46 Individual results may vary
Week 5 47 Individual results may vary
Week 6 Foam secondary dressing beginning to denude periwound skin – moisture barrier applied 48 Individual results may vary
Week 7 49 Individual results may vary
Week 10 50 Individual results may vary
51 Individual results may vary
Week 11 52 Individual results may vary
Case Study #5 53 Individual results may vary
Chronic Venous Insufficiency 36 year old hispanic female No significant PMH or medicines 3 year history of lower extremity ulcer secondary to CVI Various treatments, mostly antibiotics, gentian violet Started Hydrofera Blue® Bacteriostatic Dressing, multilayer compression NO compression 54 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC
Week 1 55 Individual results may vary
Week 2 56 Individual results may vary
Week 3 57 Individual results may vary
Week 4 58 Individual results may vary
Returns 12/11/2008 with recurrence at previous ulcer site present for 2 months Had not been wearing compression regularly Calf / ankle measurements 8 -10 cm larger Wound debrided, cultured Started AG absorbent product with multilayer compression 59 Individual results may vary
Day 4 60 Individual results may vary
Week 1 – Hydrofera Blue® Baacteriostatic Dressing initiated 61 Individual results may vary Hydrofera Blue® is a registered trademark of Hydrofera, LLC
Week 2 62 Individual results may vary
Week 3 63 Individual results may vary
Week 4 64 Individual results may vary
Week 5 65 Individual results may vary
Week 7 66 Individual results may vary
Week 9 – Essentially healed Calf decreased 13 cm 67 Individual results may vary
Questions? 68 Individual results may vary
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