References
Enhanced exploration of the mode of action of a five-layer foam dressing: critical properties to support wound healing
Abstract
Objective:
The aim of this in vitro experimental series was to explore the mode of action of a hydrocellular polyurethane foam dressing (HPFD) and how its advanced features support beneficial interactions with the wound bed to address common barriers to wound healing, thus supporting improved clinical outcomes.
Method:
Multiple in vitro microbiological tests were performed, assessing prevention of bacterial ingress, surface removal of bacteria, bacterial sequestration and retention into the dressing in a clinically relevant environment. Odour molecule concentrations were measured using gas chromatography and further assays explored matrix metalloproteinase (MMP)-9 retention in the dressing using enzyme linked immunosorbent assay.
Results:
The HPFD demonstrated marked reductions in bioburden levels across multiple tests. These included prevention of bacterial ingress for seven days, removal of surface bacteria and absorption into the dressing. Further tests identified that most bacteria were sequestered into the hyperabsorbent layer (90.5% for
Conclusions:
Proactive management of the wound environment with an appropriate advanced wound dressing, such as the HPFD examined in these in vitro investigations, can not only help to minimise the barriers to healing, as observed across this test series by direct interaction with the wound bed, but may, as a result, provide an ideal environment for wound progression with minimal disturbance.
Optimising the wound bed to facilitate improved healing in hard-to-heal (chronic) wounds is well known, and has been the focus of wound education and practice since the concept was conceived over 20 years ago.1,2 Recent updates to these principles of wound bed preparation reiterate the importance of balancing removal of necrotic tissue, infection and inflammation, and moisture balance in the wound.3–5 While important new technologies and adjuncts are continually added to the armamentarium of health professionals (HPs), many interventions require removal of these known barriers to wound healing in order to function optimally.3,5
Moisture balance is critical for wound healing; excessive levels of moisture can lead to tissue maceration and too little may restrict autolytic debridement, cellular migration and delivery of growth factors.1,6 The presence of maceration or dry, excoriated skin also plays an important role in disturbance of the periwound area, further adversely effecting wound healing.7 Furthermore, wound exudate can be an important carrier of proteases. Matrix metalloproteinases (MMPs) play an important role in the wound healing process; however, elevated MMPs, such as MMP-2 and MMP-9 specifically, have been associated with delayed wound healing and are found in 54.5% of wounds;8,9 thus protease management is important in optimally balancing wound parameters.10
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