Modern dressings promoting the healing of VLU. (A) Ulcer areas in patients with infected (red line) and non-infected (blue line) at different time points. (B) Trends in the ulcer area in different patients. (C) Initial state of the wound. (D) Dressing application of cell foam dressing with through holes (ROCF-CC). (E) Dressing replacement. Reproduced with permission from Harding et al. ( 2016) and McElroy et al. ( 2018). Alginate dressing, AQUACEL ® Ag dressing, Urgotul ® Silver dressing, ALLEVYN ® Hydrocellular foam dressings, Mepilex ® foam dressing O'Meara S., Martyn-St James M. (2013). Alginate dressings for venous leg ulcers. Cochrane Database Syst. Rev. 4:CD010182 Foam dressings are semipermeable and either hydrophilic or hydrophobic with a bacterial barrier (Sedlarik, 1994). They are composed of polyurethane or silicone-based, rendering them suitable for handling moderate-to-high volumes of wound exudate (Marks and Ribeiro, 1983). Foam dressings provide thermal insulation and maintain moisture to the wound, and prevent damage to the wound at the time of removal. These dressings may also be used as secondary dressings with hydrogel or alginate dressings, in conjunction with a topical antimicrobial agent for infected wounds (Davies et al., 2017)Moreover, polyaniline/polyurethane foam dressing carried an anti-biofilm lichen metabolite usnic acid indicated an improved antibiofilm activity of conducting polymer (dos Santos et al., 2018). Bugmann P., Taylor S., Gyger D., Lironi A., Genin B., Vunda A., et al.. (1998). A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial. Burns 24, 609–612. 10.1016/S0305-4179(98)00095-3 [ PubMed] [ CrossRef] [ Google Scholar]

Hopper G. P., Deakin A. H., Crane E. O., Clarke J. (2012). Enhancing patient recovery following lower limb arthroplasty with a modern wound dressing: a prospective, comparative audit. J. Wound Care 21, 200–203. 10.12968/jowc.2012.21.4.200 [ PubMed] [ CrossRef] [ Google Scholar] Bioactive dressing promoted angiogenesis in DFU. (A) Synthesis and biological function of the fluorinated ethylenepropylene (FEP) hydrogel scaffold containing exosomes. (B) Immunofluorescence images of the wound bed stained withα-smooth muscle actin(α-SMA) at day 7. (C) The number of new blood vessels at day 7. (D) Images of wound healing in mice in different groups. (E) Wound closure rate in different groups during wound healing ( ** P< 0.01). Reproduced with permission from Wang et al. ( 2019). Comfifast offers single stretch in the radial direction and is the standard product of choice for dressing retention and for wet and dry wrapping in the treatment of atopic eczema. Appropriate secondary dressings are C-View (film) or Biatain Silicone (foam) depending on the exudate level, location and skin state Collagen and oxidised regenerated cellulose matrix, applied directly to wound and covered with suitable dressing.Lammoglia-Ordiales L., Vega-Memije M. E., Herrera-Arellano A., Rivera-Arce E., Aguero J., Vargas-Martinez F., et al.. (2012). A randomised comparative trial on the use of a hydrogel with tepescohuite extract (Mimosa tenuiflora cortex extract-2G) in the treatment of venous leg ulcers. Int. Wound J. 9, 412–418. 10.1111/j.1742-481X.2011.00900.x [ PMC free article] [ PubMed] [ CrossRef] [ Google Scholar] Dawkins H. (2017). Non-healing venous leg ulcer. Br. J. Nurs. 26, S26–S27. 10.12968/bjon.2017.26.Sup20a.S26 [ PubMed] [ CrossRef] [ Google Scholar]

Meaume S, et al. Quality of life in patients with leg ulcers: results from CHALLENGE, a double-blind randomized controlled trial. Journal of Wound Care. 2017; 26 (7): 368-379. The use of this dressing does not dispense with the need for appropriate systemic antibacterial treatment for infected wounds, in accordance with local treatment protocols. Cutimed Sorbact can be used for all contaminated, colonised and infected, exuding wounds such as pressure, diabetic foot and venous leg ulcers. Also suitable for traumatic and post-operative wounds. Imanishi K., Morita K., Matsuoka M., Hayashi H., Furukawa S., Terashita F., et al.. (2006). Prevention of postoperative pressure ulcers by a polyurethane film patch. J. Dermatol. 33, 236–237. 10.1111/j.1346-8138.2006.00057.x [ PubMed] [ CrossRef] [ Google Scholar] Recently, a multi‐centre, open label randomised controlled trial found that Urgotul ® Silver worn under compression bandaging promoted healing of critically colonised venous leg ulcers, when compared with a non silver control (Urgotul ®). A total of 102 patients from 24 centres were included in the efficacy analysis with at least three of five following clinical signs present: pain between two consecutive dressing changes, periwound erythema, oedema, malodour and heavy exudation. The treatment period lasted 8 weeks with patients in the treatment group receiving Urgotul ® Silver for the first 4 weeks followed by Urgotul ® for the following 4 weeks. The control group received Urgotul ® for 8 weeks (22).

PROPERTIES

If clinical signs of local infection are noted, treatment can be changed to an antibacterial dressing, dependent on clinical judgement. In diabetics, the incidence of DFUs is approximately 5–10%. It is one of the most common chronic complications and the cause of lower extremity amputation in patients with diabetes mellitus (Brennan et al., 2017). DFUs as a common type of non-healing or chronic wounds are attracting considerable attention in the medical field (Khanolkar et al., 2008). Currently, the selection of the most appropriate treatment is challenging. During this process, multiple types of dressings are applied to the treatment of DFUs (Saco et al., 2016). One such method is the application of various kinds of modern dressings. Treatment with suitable dressings is an important part of the management of DFUs. When prescribed with a compression bandage system for venous leg ulcers, UrgoTul Absorb and UrgoTul Absorb Heel may be left in place for up to 7 days dependent on wound condition and local protocol. The use of UrgoClean Ag does not dispense with the need for associated mechanical debridement when required.

Edmonds M, Lázaro-Martínez JL, Alfayate-García JM, Martini J, Petit JM, Rayman G, Lobmann R, Uccioli L, Sauvadet A, Bohbot S, Kerihuel JC, Piaggesi A. Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Lancet Diabetes Endocrinol. 2018 Mar;6(3):186-196.

Film dressing (Airwall), silver-containing hydrofiber, film dressing (3M™ Cavilon ® No Sting Barrier Film), Mepilex ® Lite dressing Cover UrgoTul Ag/Silver with a secondary dressing suitable for the location and level of wound exudate. Sigal ML, Addala A, Maillard H, Chahim M, Sala F, Blaise S, Dalac S, Meaume S, Bohbot S, Tumba C, Tacca O. Clinical evaluation of a new TLC-NOSF dressing with poly-absorbent fibers for the local management of exuding leg ulcers, at the different stages of the healing process: Results from two multicentric, single-arm, prospective, open-label clinical trials. J Wound Care 2019: 28(3) :164-175 Jeffcoate W. J. (2012). Wound healing–a practical algorithm. Diabetes Metab. Res. Rev. 28( Suppl. 1), 85–88. 10.1002/dmrr.2235 [ PubMed] [ CrossRef] [ Google Scholar]