Wound Care generic product solutions Onboarding 2014 Basic

Wound Care generic product solutions On-boarding 2014

Basic requirements for a good dressing* A. Absorb excess exudate and toxic substances B. Maintain high humidity at the wound/dressing interface C. Allow gaseous exchange D. Demonstrate impermeability to micro-organisms E. Insulate the wound from low temperature effects F. Show freedom from particles and other contaminants G. Allow removal without trauma at dressing change *) As defined by Turner, T. D. “Current and future trends in wound management 1: Wound healing and traditional surgical dressings” Pharmacy International 1985 p. 117 -119 2014

Dry versus moist wound healing Occlusive dressing Epidermis No dressing 1. Moist environment 2. Stratum corneum 3. Scab 4. Epithelialisati on 2014 Page 3

Dry versus moist wound healing Traditional dressings Moist wound healing dressings Dry wound healing Moist wound healing 2014 Page 4

Early experiences with moist wound healing 1962: George Winter compared the healing rates of wounds in pigs. He found that wounds maintained in a moist environment healed twice as fast as wounds that were allowed to dry out and form a scab 1963: Confirmed as effective for humans by C. D. Hinman & H. Maibach. This momentous discovery was termed ”Moist Wound Healing” (MWH) MWH can be provided by occlusive and semi-occlusive dressings 2014 Page 5

Newest evidence supports moist over dry wound healing Meta-analysis of controlled studies: • all diagnoses of chronic wounds • all types of advanced wound dressings Findings: Significant superiority of advanced compared to conventional dressings in complete wound healing The chance for complete healing was 52% higher with advanced dressings. (not dependent on diagnosis or on additional causal treatment) 2014 Page 6

Facts about wound healing • Moist wound healing does not cause maceration of the skin • Moist wound healing does not force wound infections • Atmospheric oxygen is not essential for wound healing • Scarring is not essential for wound healing • There is a need for wound pain treatment • Moist wound healing is cost effective 2014 Page 7

Summary of different wound environments Dry Wound environment Moist Wound environment Wet Wound environment Environment Dry Moist Wet Speed of healing Slow Fast Slow Advantage Cheap Cost effective Optimal for wound healing and patients’ quality of life Cheap Remarks Dressing sticks to wound Painful Optimal dressing Reduced wound pain Risk of maceration and leakage 2014 8

Using a holistic approach for wound management Medicine Fluids Alcohol Nutrition Smoking Oxygen Immobility Disease Exercise Pain Psycho-social factors 2014 Page 9

Moist Wound Healing dressings 09. 05. 2014 Page 10

Foam dressings 2014 Page 11

Foam dressings • Appropriate for low, medium and high exuding wounds • Primary or secondary dressing • Absorb wound exudate while maintaining a moist wound environment • Semi-permeable top film allows transmission of oxygen and water vapour, whilst providing a barrier against fluid and contaminants including bacteria • Moisture vapour transmission prolongs the dressing wear time by increasing the total fluid handling capacity • Combine high absorption and high retention (ability to hold exudate within dressing) also under pressure • Suited for use under compression therapy • Can contain active ingredients e. g. • Silver indicated for infected wounds and wounds at risk of infection • Ibuprofen indicated for painful wounds 2014 Page 12

Hydrocolloids 2014 Page 13 13

Hydrocolloids • Appropriate for low to moderately exuding chronic wounds and superficial acute wounds • Primary or secondary dressings • Adhesive mixed with moisture absorbent molecules • Viscous gel formed on contact with exudate which absorbs exudate but does not adhere to the wound • Adhesive on peri-wound skin allows long wear time • Semi-permeable top film allows transmission of oxygen and water vapour and acts as a barrier against water and contaminants e. g. bacteria 2014 Page 14 14

Alginates 2014

Alginates • Appropriate for wounds with slough, and moderate to heavily exuding partial to full thickness wounds • Require secondary dressing • On contact with wound exudate the alginate fibres swell and form a soft, cohesive gel • These fibres make alginates highly absorbent, with the gel promoting moist wound healing • Can contain active ingredients, for example: • silver for infected wounds or wounds at risk of infection 2014

Hydrocapillary dressings 2014

Hydrocapillary dressings • Appropriate for high exuding wounds • Can be used under compression dressings • Contains superabsorbant hydrocapillary pad • This pad is highly absorbant • Absorbs exudate vertically and distributes horizontally • Hydrocolloid top film • Acts as water-resistant and bacteria-protective • Acts as an adhesive and a non-adhesive wound contact layer 2014

Contact layers 2014 Page 19

Contact layers • Appropriate for low, medium, and high exuding chronic and acute wounds • Used with absorbent secondary dressings or under compression • Protects tissue from direct contact of other dressings • Allows exudate to pass through for absorption by secondary dressing • Often covered in petrolatum • Acts as a non-adherent, thin layer • Absorbs exudate to maintain a moist wound environment 2014 Page 20

Hydrogels 2014 Page 21 21

Hydrogels • Appropriate for dry and sloughy necrotic wounds as well as wounds with a mix of necrotic and granulated tissue • Must be used with a secondary dressing • May be used throughout the healing process to provide a moist healing environment • Viscous and cohesive gel, which leads to gentle debridement • Hydrates necrotic tissue, and absorbs excess exudate, slough and debris • Easy to clean the wound 2014 Page 22 22

REMOVE PAGE IF NOT RELEVANT All Coloplast wound dressings are modern wound dressings supporting moist wound healing Comfeel® Plus Transparent For visual control of skin and wound Management of exuding non-infected wounds Debridement of necrotic wounds Purilon ® For effective and gentle debridement 1 st line treatment: Protection of skin at risk and in initial wound phases Biatain® Silicone For general purposes Final stages of healing and newly healed skin Biatain® Silicone Lite For increased mobility Comfeel® Plus Transparent Biatain® Non-Adhesive For extra fragile skin For visual control of skin and wound Biatain® Adhesive For extra adhesion Comfeel® Plus For protection of skin and wound Specialised treatment: Biatain® Alginate Page 23 For sloughy wounds and cavity Biatain® Soft-Hold When difficult to bandage Biatain® Super Physiotulle ® For protection of fragile tissue For highly exuding wounds Biatain® lbu For painful wounds For protection of skin and wound

ADJUST PRODUCTS TO LOCAL MARKET All Coloplast wound dressings are modern wound dressings supporting moist wound healing Comfeel® Plus Transparent For visual control of skin and wound Management of exuding non-infected wounds Debridement of necrotic wounds Purilon ® For effective and gentle debridement 1 st line treatment: Protection of skin at risk and in initial wound phases Comfeel® Plus Biatain® Non-Adhesive Biatain® Adhesive Specialised treatment: Page 24 Comfeel® Plus Transparent For extra fragile skin For extra adhesion Biatain® Alginate Biatain® lbu Comfeel® Plus For painful wounds For protection of skin and wound Final stages of healing and newly healed skin For sloughy wounds and cavity filling Biatain® Super Physiotulle ® For protection of fragile tissue For highly exuding wounds For visual control of skin and wound

2014 Page 25