Temple University School of Podiatric Medicine Journal Review Club
Article Title: Efficacy of Cadexomer Iodine in the Treatment of Chronic Ulcers: A Randomized, Multicenter, Controlled Trial
Authors: Radhakkrishnan R, Kethavath SN,...
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
The growing market for bioactive wound care products has been very interesting and exciting to me. I have been involved the past couple years as an anonymous wound panel expert, council member, and consultant for upcoming bioactive wound care dressing research. We will start seeing an increase in various biomaterials, versus gauze and superabsorbent dressing types used globally. Multifunctional-type dressings will also make waves.
Clinicians are looking for that "super power" wound dressing that will do it all. Can you imagine if there was a dressing for any wound type, any depth, any exudate amount, that will eradicate biofilms, control wound odor, reduce pain, and reduce treatment time, all while being cost-effective? Bioactive wound care dressings (or what we call the "latest and greatest") are exciting, but I always remind clinicians we must continue to go back to Wound Care Basics 101: wound bed preparation, monitoring, patient compliance, appropriate wound treatments, identifying the wound cause, and removing the cause. The pretty, cool shaped dressing is not what heals a wound.
I always describe chronic wounds of any type as being in a "state of confusion." The healing phases are basically out of order. This is where bioactive dressings and products come in to play. A wound must go through hemostasis, inflammation, proliferation, and remodeling, along with various cellular contributions. The scaffolding of the extracellular matrix (ECM) is what provides the elasticity and tensile strength to the skin structure. Various proteins such as collagen, fibronectins, elastins, and laminins make up this vital matrix to aide and complete the process of wound closure. We see the ECM damaged mostly in our geriatric population.
Biofilms are another culprit that impede wound healing progress. Most, if not all ulcers develop a biofilm over time. The protective polysaccharide matrix is produced by bacteria. 60% of chronic wounds contain a biofilm. I observe over and over again, expensive products being dumped into a wound. Many clinicians miss the boat on identifying biofilm formation.
Bioactive wound care dressings can include tissue-engineered products derived from artificial sources or natural tissues (e.g. hyaluronic acid, elastin, silicone, chitosan, alginates, collagen, antimicrobials, skin equivalents, growth factors, cell free matrices, cell containing matrices). The use of synthetic protein matrix and growth factors will also help drive future growth.
North America wins first prize for the largest market share and clinical trials overall, due to the increased number of chronic diseases, and geriatric population. The runner up is the European region. According to recent report by Industry ARC, the global bioactive wound care market will grow at CAGR of 5.56% and reach USD 4.9 Billion by 2020. Nevertheless, availability, clinical studies, high cost, and reimbursement associated with these advanced technologies all tend to suppress growth of this market.
The trick to bioactive dressings becoming successful will be user-friendliness, appropriate usage, cost-effectiveness, and patient satisfaction. Upcoming products seem to be evaluated and tested more thoroughly for specific wound types this time around. With this being said, we need to remember validation of clinical performance is paramount for effective wound management.
Bioactive Wound Care Market Analysis: By First Line Interactive Dressing (Foams, Alginates, Hydrogel, Hydrocolloids, Collagen); By Second Line Interactive Dressing (Honey, Hydrofiber, Silicone, Silver) – With Forecast (2015 – 2020)
About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.