Title

APWCA2009 - Apr 04, 2009

Author(s)
  with David W. Lee, BS; Michelle Oliver, BA

Presented at: Philadelphia, PA

Background
Atypical wounds are notoriously difficult to treat. Challenges involved in treating these wounds typically involve managing pain, an inability to debride due to Koebners phenomenon or pathergy, and decreasing inflammation both peri-wound and in the wound. The implementation of a novel powder wound dressing showed assistance in all three challenges. The physical properties of this powder wound dressing are unique due to its ability to form a solid, non-resorbable moist dressing after contact with wound exudate or saline.

Methods
The physical and chemical properties of a novel powder dressing formulated with polymer nanoparticles have previously been studied. In this case study, atypical wounds such as pyoderma gangrenosum, sickle cell ulcer developing after hallux valgus surgery, and ruptured lymphangiomas in a patient with chronic lymphedema. All of these wounds were treated with the novel powder wound dressing once weekly for four to eight weeks. When the powder interacts with wound exudates or saline solution, an instantaneous and irreversible aggregation of the powder particles occurs. This physical transformation from powder into a solid, non-resorbable moist dressing. The nano-domains of the intact dressing provide intimate contact to surface irregularities at the sub cellular level sealing the wound. Due to the intact moist dressings natural capillary forces providing a strong adhesion to the wound surface, the wounds treated in these cases were isolated from exogenous bacteria and were covered with a light secondary dressing.

Results
The ruptured lymphangiomas healed uneventfully, the pyoderma gangrenosum had a decrease in pain and increase in granular tissue formation, and the sickle cell ulcer decreased in size and pain substantially in order for a skin substitute to be utilized.

Conclusion
The properties of this novel powder wound dressing allow for application to atypical wounds of irregular shapes and causes. The dressing demonstrates the capability to remain in contact with the wound bed for periods of up to seven days between dressing changes. More importantly, it provided a painless, efficient, and protective wound treatment that not only assisted in wound closure, but also in wound preparation for further interventions.

References
1. St John J. The Design and Performance of Nanoflex" Transforming Powder Dressing: A Novel Wound Care Management System, presented at the Clinical Sympoisum on Advances in Skin and Wound Care, Las Vegas, 2008. 2. Niezgoda, J. Altrazeal" A Transforming Powder Wound Dressing: The Clinical Experience, presented at the Clinical Symposium on Advances in Skin and Wound Care, Las Vegas, 2008.