5 ways wound treatment

1. an wound treatments effectively control pain?
n be better controlled with wound treatments
ntain a pain relieving agent. Lidocaine has been
to safely reduce pain when applied topically to
s at low levels. [7] [8] [9]
If used in its viscous form,
low enough percentage to be below toxicity
nd also forms a hydrogel, which adheres well to
ounds.The addition of lidocaine could theo-
y inhibit wound healing because it affects the
matory response. However, adding an antimi-
agent could help combat this.
gel also provides secondary benefits. It has
bserved to promote the body’s natural auto-
ocess, which may promote healing. [10] [11]
The
n also controls pH, making the wound dressing
acidic, which also promotes healing. [12] [13]
The
rizing effect of the hydrogel may also provide
nal pain relief, as moist wounds tend to be less
than dry ones. [6]
Why is infection control important?
As many as 30% of wounds become infected.[17]
Con-
trolling this is very important to patients and health
care providers for a variety of reasons.Infections can
cause slowed healing,greater pain,and increased
wound odor,which can have a significant negative
effect on patients and health care providers.[18] [19]
When a wound becomes infected with micro-organ-
isms,the area inflames to combat the infection.This is
a normal part of the healing process.However,without
proper decontamination,inflammation can be pro-
longed,causing the patient discomfort.[18] [19]
Prolonged inflammation caused by infection can also
delay healing,in some cases resulting in self-sustaining
inflammation.This can cause chronic wounds that fail
to heal entirely.Chronic wounds may contain microbes
living in biofilms,which are more resistant to antimi-
crobial treatment.[20]
Unchecked infection can in some
cases lead to sepsis,which can cause fever,chills,and
even death.[19] [20] [21]
Infection control can also reduce the presence of odors
in wounds.Because wound malodor is usually caused
by the presence of microbes,taking measures to slow
microbe replication can reduce the severity of the
smell.[16]
How can wound treatments control infection?
The complications of wound infection make it imper
ative that wound treatments minimize infection risk
at all stages.The first step in preventing infection is
wound cleaning and debridement.This reduces bac-
terial levels in the wound and removes dead or dying
tissues.[18] [19]
Although these techniques have been shown to be
effective [18]
additional treatments can help reduce th
risk of infection further.This can be accomplished
through the addition of antimicrobial agents to the
wound dressing.
A simple mixture of polymixin and bacitracin has be
reported to inhibit pathogens and improve wound
healing.[22]
In vitro efficacy testing showed that four
major wound pathogens were inhibited: Escherichia
coli,Staphylococcus aureus,Candida albicans,and
Pseudomonas aeruginosa.[23]
The application of lido-
caine has also been shown to inhibit microbial growt
when applied for periods above two hours,which ma
further reduce the risk of infection.[24]
oms
ssing that com-
e pain, wound
oting healing. It
ve goals in mind
aintain a higher
effective wound treatment of partial and full thickness wounds:
en and antibiotics to help patients maintain a better quality of life.
e patient discomfort and helps wounds heal.
ymixin to promote healing, reduce patient discomfort, and reduce odor
olution
rs assurance that they are always treating their patients consistently and
reparation.
on control, and pain relief means patients spend less time in the hospital,
nd do not have as high a rate of readmission.
d like to learn more about WoundPal:
Visit our website at
WoundPal
ing embarrassment and discomfort. Chronic wounds
present an even greater problem, as victims must live
with a lower quality of life indefinitely.
Wounds are also responsible for staggering health care
expenses in the United States.Treatment of pressure
ulcers, the most common chronic wound, costs hospi-
tals, patients, and caregivers over $9.1 billion
annually. [3]
Much of this expenditure is due to the
time intensive nature of wound care. Nurses must
change dressings regularly, address patient discomfort,
and in many cases prepare custom dressings. With
wound incidence increasing at a rate of 10% each year,
these costs are only expected to grow. [4]
This affliction greatly affects quality of life for patients
and care costs for health care providers. In order to
manage this problem, effective wound treatment that
reduces symptoms and promotes healing is needed.
ing among the most
help keep the wound
to some extent, but t
to reduce patient sym
wound healing. Mos
not exploited all pos
comfort and help he
This has led some ca
ferent treatments to
These self-made pro
time and money by
and effort hours reg
may also be inconsis
cacy, as there is no s
Palliation should no
workers need a singl
reduces wound symp
can be achieved by c
combines treatment
of patient discomfor
treatments that incr
will offer 5 ways tha
healing, reduce wou
Wound Care
Made Simple
®
5 ways
wound treatments can
promote healing, reduce
wound symptoms, and
lower health care costs
combined
palliative and
curative wound
treatment
SPECIAL
REPORT

2. WoundPal
5 ways wound treatments can promote healing,
reduce wound symptoms, and lower health care costs
A special report on combined palliative and curative wound treatment
Introduction
Wound Care Insights
Wounds affect 35% of hospice patients and many
more in hospitals and other treatment facilities. [1] [2]
These wounds cause patients a great deal of pain, can
become infected, and may produce a strong odor, caus-
ing embarrassment and discomfort. Chronic wounds
present an even greater problem, as victims must live
with a lower quality of life indefinitely.
Wounds are also responsible for staggering health care
expenses in the United States.Treatment of pressure
ulcers, the most common chronic wound, costs hospi-
tals, patients, and caregivers over $9.1 billion
annually. [3]
Much of this expenditure is due to the
time intensive nature of wound care. Nurses must
change dressings regularly, address patient discomfort,
and in many cases prepare custom dressings. With
wound incidence increasing at a rate of 10% each year,
these costs are only expected to grow. [4]
This affliction greatly affects quality of life for patients
and care costs for health care providers. In order to
manage this problem, effective wound treatment that
reduces symptoms and promotes healing is needed.
Wound treatments can be palliative and curative
There are over 3,000 wound dressing available today,
with dry gauze or gauze soaked in a saline solution be-
ing among the most popular. [5]
These treatments may
help keep the wound clean and aid the healing process
to some extent, but they lack the qualities necessary
to reduce patient symptoms and actively promote
wound healing. Most popular wound dressings have
not exploited all possible methods to increase patient
comfort and help heal the wound.
This has led some caregivers to combine a range of dif-
ferent treatments to create their own custom solution.
These self-made products cost health care providers
time and money by forcing them to spend resources
and effort hours regularly preparing solutions.They
may also be inconsistent in their ingredients and effi-
cacy, as there is no standardized preparation process.
Palliation should not exclude healing. Health care
workers need a single wound treatment that both
reduces wound symptoms and promotes healing.This
can be achieved by creating a wound dressing that
combines treatments that address the major causes
of patient discomfort, pain, odor, and infection, with
treatments that increase the rate of healing.This paper
will offer 5 ways that such a treatment could promote
healing, reduce wound symptoms, and lower costs.
Wound Care
Made Simple
®

3. 2
1. Pain control improves
patient comfort
Why is addressing wound pain important?
Wound pain can cause severe discomfort for patients
and severely limit their ability to take part in everyday
activity.That’s why controlling pain should be one of
the most important functions of an effective wound
treatment. However, most wound care products do not
help manage pain.
There is also evidence to suggest that chronic pain can
actually slow healing, extending patient discomfort
and increasing the cost of wound treatment. Severe
pain can cause vasoconstriction, which impairs healing.
Those in pain also often have decreased respiratory
movement, which can lead to low level hypoxia, fur-
ther slowing the healing of wounds. [6]
Aside from improving patients’ lives, pain management
incorporated into the wound dressing can benefit
health care providers. Patients who are experiencing
less pain will likely require less attention from nurses,
giving them more time to spend caring for patients
and performing other duties. Wound treatments that
contain a pain relieving agent may also reduce health
care expenses. If the patient is experiencing less pain,
they are less likely to require additional pain medi-
cations, which may be more costly than the wound
treatment.
How can wound treatments effectively control pain?
Pain can be better controlled with wound treatments
that contain a pain relieving agent. Lidocaine has been
shown to safely reduce pain when applied topically to
wounds at low levels. [7] [8] [9]
If used in its viscous form,
it is of low enough percentage to be below toxicity
levels and also forms a hydrogel, which adheres well to
open wounds.The addition of lidocaine could theo-
retically inhibit wound healing because it affects the
inflammatory response. However, adding an antimi-
crobial agent could help combat this.
Hydrogel also provides secondary benefits. It has
been observed to promote the body’s natural auto-
lytic process, which may promote healing. [10] [11]
The
solution also controls pH, making the wound dressing
slightly acidic, which also promotes healing. [12] [13]
The
moisturizing effect of the hydrogel may also provide
additional pain relief, as moist wounds tend to be less
painful than dry ones. [6]
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

4. 3
2. Odor control reduces patient
embarrassment and isolation
Why is controlling wound odor important?
Wound odor is a vital problem for patients and health
care workers, but it is often ignored or poorly ad-
dressed by wound treatments. Malodor can be a signif-
icant challenge for patients and health care workers.
Wound odor can be a source of embarrassment for
patients and seriously affect their quality of life. When
wounds emit an unpleasant scent, they can also af-
fect other nearby patients.This can force health care
workers to isolate the patient, which can cause further
discomfort and embarrassment.
The effects of malodor can make it impossible for
wound patients to participate in the activities of every-
day life.That’s why it is critical that wound treatments
help to reduce odor.
How can wound treatments control odor?
Wound odor has traditionally been treated only by
cleaning and dressing the wound with gauze.This
practice does help reduce odor by lowering microbe
levels. Other treatments, such as deodorizers, venti-
lation, and charcoal dressings have been employed to
reduce odor, but are lacking. [14]
However, more can be
done to reduce malodor and improve patient comfort.
Wound odor can be further reduced in two ways: by
controlling the source of the smell, usually microbes,
and by masking the scent. Effective wound treatments
should do both.
Effective odor control agents:
Oil of Wintergreen
To reduce noticeability of smell
Antimicrobials
To control source of smell
To mask the scent, oil of wintergreen can be used.
This offers a pleasant aroma and can help reduce the
noticeability of the malodor. It may also help reduce
pain. Oil of wintergreen contains between 85-99%
methyl salicylate, which metabolizes into salicylic
acid in the body and has been show to provide mild
pain relief. [15]
Wound treatments can also reduce odor by targeting
a source of the scent: microbes. By including antibi-
otics in the wound dressing, microbe growth can be
suppressed, which may help to reduce malodor. [16]
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

5. 4
3. Infection risk control
improves patient outcomes
Why is infection control important?
As many as 30% of wounds become infected. [17]
Con-
trolling this is very important to patients and health
care providers for a variety of reasons. Infections can
cause slowed healing, greater pain, and increased
wound odor, which can have a significant negative
effect on patients and health care providers. [18] [19]
When a wound becomes infected with micro-organ-
isms, the area inflames to combat the infection.This is
a normal part of the healing process. However, without
proper decontamination, inflammation can be pro-
longed, causing the patient discomfort. [18] [19]
Prolonged inflammation caused by infection can also
delay healing, in some cases resulting in self-sustaining
inflammation.This can cause chronic wounds that fail
to heal entirely. Chronic wounds may contain microbes
living in biofilms, which are more resistant to antimi-
crobial treatment. [20]
Unchecked infection can in some
cases lead to sepsis, which can cause fever, chills, and
even death. [19] [20] [21]
Infection control can also reduce the presence of odors
in wounds. Because wound malodor is usually caused
by the presence of microbes, taking measures to slow
microbe replication can reduce the severity of the
smell.[16]
How can wound treatments control infection?
The complications of wound infection make it imper-
ative that wound treatments minimize infection risk
at all stages.The first step in preventing infection is
wound cleaning and debridement.This reduces bac-
terial levels in the wound and removes dead or dying
tissues.[18] [19]
Although these techniques have been shown to be
effective [18]
additional treatments can help reduce the
risk of infection further.This can be accomplished
through the addition of antimicrobial agents to the
wound dressing.
A simple mixture of polymixin and bacitracin has been
reported to inhibit pathogens and improve wound
healing. [22]
In vitro efficacy testing showed that four
major wound pathogens were inhibited: Escherichia
coli, Staphylococcus aureus, Candida albicans, and
Pseudomonas aeruginosa. [23]
The application of lido-
caine has also been shown to inhibit microbial growth
when applied for periods above two hours, which may
further reduce the risk of infection. [24]
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

6. 5
4. Active dressings
reduce costs
U.S. health care spending was $2.8 trillion in 2012 and is expected to grow by 5.8% annually until 2022. [25] [26]
Of these costs, an estimated 4% is spent on wound care, with that proportion expected to rise in the coming
years. [27]
Hospitalization, nursing time, and supplies all contribute to the costs of wound care, with nursing time
being the primary factor. [27]
How active dressing reduce health care costs
Active dressings provide several benefits over traditional dressings.They create a moist wound environment and
modulate cellular activity.They also need to be changed less frequently than traditional dressings.This can re-
duce the time nurses spend on each individual patient, lowering the overall costs of wound management. Wound
infections are also an important factor in cost reduction. Infections lengthen stays by an average of 11 days,
increasing healing costs considerably. Because active dressings also reduce the chance of infection and accelerate
healing, patient stays are able to be kept to a minimum. [27]
The chart below (fig. 1) shows the results of a study conducted comparing the costs of an active dressing to a tra-
ditional gauze dressing.The active dressing was found to reduce costs to healing by 44%. The total costs of the
materials were also lower, even though the cost of each individual dressing materials was higher [28]
fig. 1
Total Cost per
Patient over 28 days
TraditionalActive
$318
$781
Cost of Active Dressing VS Traditional Dressing
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

7. 6
5. Palliative goals are consistent
with curative goals
As has already been shown, there is no reason why
palliative goals and curative goals should be mutually
exclusive. In many cases they can complement each
other. Effective wound treatment must address patient
symptoms of odor, pain, and infection, while promot-
ing healing.
Where do palliative and
curative goals intersect?
Hydrogel maintains moisture and promotes
autolytic debridement
The hydrogel contained in viscous lidocaine offers
several palliative and curative benefits. It promotes
healing by creating a moist environment that pro-
motes autolytic debridement.[10] [11]
It also reduces
wound pain by moisturizing the area and reducing
sensitivity. [6]
Lidocaine reduces pain, promotes healing, and reduces
risk of infection
Lidocaine helps reduce pain, one of the most
serious side effects of wounds. Aside from improv-
ing patient quality of life, this also has a curative
function. Wound pain may inhibit healing by
causing vasoconstriction and decreased respiratory
movement. [6]
Lidocaine also has been shown to
inhibit microbial growth if applied over a period of
two hours or more, which could reduce the risk of
infection and further promote healing. [24]
Antimicrobial agents reduce infection, promote healing,
and reduce odor
Antimicrobial agents can also have both palliative
and curative functions. By inhibiting the growth
of pathogens, they can reduce the risk of infection.
This helps wounds heal, reduces odor, and reduces
patient pain and discomfort.[16] [21]
By using a single, multitasking dressing, rather than
multiple solutions, nurses and caregivers can save time
applying and preparing wound dressings. A premade
solution may also improve the consistency of the treat-
ment by reducing potential variations in ingredient
ratios.
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

8. 7
Observational studies have shown that by using pal-
liative and curative treatments in a wound dressing,
health care professionals may be able to address wound
symptoms while promoting healing. One study, con-
ducted in a nursing home over a year, looked at the
effects of wounds treated with gauze prepared with a
lidocaine and antibiotic solution. It found that 95% of
wounds treated with this preparation were healed in
12 weeks. [29]
Although comparison is difficult between
two studies, that is a marked increase over the expected
healing rates of traditional wound dressings, as found
by a study conducted at the University of
Pennsylvania. (Fig. 2) [30]
Studies show the effectiveness of these treatment
methods in nursing homes
A second observational study, conducted at a hospice,
found that patients treated with the lidocaine and an-
tibiotic preparation over a 30 month period had pain
and odor well controlled. It also found that wounds
were healing at a much better rate compared to those
treated with traditional dressings. (Fig. 3) [29]
Studies show the effectiveness of these treatment
methods in hospices
fig. 3
PercentHealingor
Healed
Sacrum
Percent healing,
Other treatments
Percent healing,
Hospice
treatment
Heel Leg Foot Other Total
0%
10%
20%
30%
40%
50%
fig. 2
PercentHealing
Nursing Home
treatment
Penn Study -
Venuous Ulcers
Penn Study -
Diabetic Ulcers
Healing Rates of Novel Dressing VS Other Treatments
Healing Rates of Novel Dressing
VS Penn Study Data
Weeks
4 8 12 16 20 24
0%
20%
40%
60%
80%
100%
WoundPal
Wound Care
Made Simple
®
Treatment Area
Wound Care Insights

9. 8
Use WoundPal dressings to promote healing
and reduce wound symptoms
WoundPal is a multi-tasking active dressing that com-
bines all ingredients necessary to reduce pain, wound
odor, and risk of infection, while promoting healing. It
was designed with palliative and curative goals in mind
to help wounds heal and let patients maintain a higher
quality of life.
WoundPal has everything needed for effective wound treatment of partial and full thickness wounds:
Odor Control
Using Oil of Wintergreen and antibiotics to help patients maintain a better quality of life.
Pain Management
With lidocaine to reduce patient discomfort and helps wounds heal.
Infection Control
With Biatracin and Polymixin to promote healing, reduce patient discomfort, and reduce odor
Premade Consistent Solution
Gives health care workers assurance that they are always treating their patients consistently and
saves time on dressing preparation.
Promotes Healing
Using hydrogel, infection control, and pain relief means patients spend less time in the hospital,
require less attention, and do not have as high a rate of readmission.
If you’d like to learn more about WoundPal:
Visit our website at
WoundPal.com
WoundPal
Wound Care
Made Simple
®
Wound Care Insights

10. 9WoundPal
Wound Care
Made Simple
®
References:
[1] Tippett A. Wounds at the End of Life, Wounds 2005; 17(4):91-98.
[2] Reifsnyder J, Hoplamazian L. Incidence and Prevalence of Pressure Ulcers in Hospice, Journal of Palliative Medicine, Vol. 8, No. 1, Feb. 2005, p. 244.
[3] Berlowitz, D, VanDeusen Lukas, C, et. al. Preventing pressure ulcers in hospitals: a toolkit for improving quality of care. Rockville, MD: Agency for
Healthcare Research and Quality; April 2011. AHRQ Publication No. 11-0053-EF. http://www.ahrq.gov/professionals/systems/long-term-care/resources/
pressure-ulcers/pressureulcertoolkit/index.html. Accessed September 10, 2013.
[4] Cuddigan J, Berlowitz D, Ayello E. Pressure Ulcers in America: Prevalence, Incidence, and Implications for the Future: An Executive Summary of the
National Pressure Ulcer Advisory Panel Monograph. Advances in Skin & Wound Care: The Journal for Prevention and Healing. July/August 2001; Volume
14 Number 4: pp. 208-215.
[5] Understanding Wound Dressing, Wound Educator, http://woundeducators.com/resources/wound-dressings/. Accessed September 10, 2014.
[6] Pediani, Ramon, What has Pain to do With Surgical Wound Healing. http://www.worldwidewounds.com/2001/march/Pediani/Pain-relief-surgi-
cal-wounds.html Accessed September 10, 2014.
[7] Brofeldt B T, Cornwell P, Doherty D, Batra K, Gunther R A. Topical lidocaine in the treatment of partial-thickness burns. J. Burn Care Rehabilita-
tion. 1989 Jan-Feb; 10(1):63-8.
[8] Alekseev A A, et al. Activetex® Wound Dressings in Burn Treatment. Annals of Burns and Fire Disasters, Vol. XV, N. 1, March 2002.
[9] Christensen T, Thorum T, Kubiak E. Lidocaine Analgesia for Removal of Wound Vacuum-Assisted Closure Dressings: A Randomized Double-Blinded
Placebo-Controlled
[10] Rutterman M, Maier-Hasselmann A, Nink-Grebe B, Burckhardt M. Local Treatment of Chronic Wounds. Deutsches Arzteblatt International, 2013;
110(3):25-31.
[11] Brolmann F, et al. Evidence-based decisions for local and systemic wound care, British Journal of Surgery 2012; 99:1172-1183
[12] Milne, S, Connolly, P; The influence of different dressings on the pH of the wound environment. Journal of Wound Care. Vol 23, No. 2, February 2014, pp
53-57.
[13] Gethin G. The Signifigance of Surface pH in Chronic Wounds. Wounds International,.http://woundsinternational.com/pdf/content_124.pdf, Accessed
September 10, 2014.
[14] Fleck Cynthia, Palliative Dilemmas: Wound Odour. Wound Care Canada. Volume 4, Number 3, 2006
[15] Wintergreen Essential Oil is Mother Nature’s Aspirin. http://www.experience-essential-oils.com/wintergreen-essential-oil.html. Accessed Novemver 10,
2013.
[16] Poteete V. Case study: eliminating odors from wounds. Decubitus. 1993 Jul;6(4):43-6
[17] Lindholm C. Pressure Ulcers and Infection—Understanding Clinical Features. Ostomy Wound Management. Vol. 49, Issue 5A, May 2003. pp. 4-7.
[18] Prevention and management of wound infection. Department of Violence and Injury Prevention and Disability, World Health Organization. http://
www.who.int/hac/techguidance/tools/guidelines_prevention_and_management_wound_infection.pdf. Accessed September 10, 2014.
[19] Wound Infection in Clinical Practice: An International Consensus. World Union of Wound Healing Society. http://www.woundsinternational.com/pdf/
content_31.pdf. Accessed 9/10/2014
[20] Edwards R, Harding KG. (2004). Bacteria and wound healing. Curr Opin Infect Dis 17:91-96
[21] Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF. Impaired wound healing, 2007 Clin Dermatol 25:19-25
[22] Kaye E T. Antibacterial Therapy: Topical Antibacterial Agents. Infectious Disease Clinics of North America, Vol 14, No 2, June 2000.
[23] Laboratory testing of inhibition of novel dressing against a panel of micro-organisms, using Kirby-Bauer Standard Antimicrobial Susceptibility Test,
conducted by NAMSA, April 2006.
[24] Berg J, et al. Antibacterial properties of EMLA and lidocaine in wound tissue biopsies for culturing.. Wound Rep Reg (2006) 14 581-585.
[25] National Health Expenditure Projections 2012-2022, Centers for Mediare & Medicaid Services, http://www.cms.gov/Research-Statistics-Da-
ta-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2012.pdf . Accessed September 10, 2013.
[26] Wilson K. Health Care Costs 101. http://www.chcf.org/publications/2014/07/health-care-costs-101.Accessed September 10, 2013.
[27] The Economic Costs of Wounds. http://www.smith-nephew.com/australia/about-us/what-we-do/advanced-wound-management/economic-cost-of-
wounds/
[28] Payne W, et al. A Prospective Randomized Clinical Trial to Assess the Cost Effectiveness of a Modern Foam Dressing VS a Traditional Saline. Ostomy
Wound Management, Vol. 55, Iss. 2, 2009.
[29] Tippett AW, Palliative Wound Treatment Promotes Healing, Symposium on Advanced Wound Care, 2007.
[30] University of Pennsylvania, College of Medicine, Reported study results of venous and diabetic ulcers, 2000.
Wound Care Insights