Hence, exudate management is a key issue in chronic wound therapy, particularly given that exudate from chronic wounds has a composition different from that of acute wound fluid.
Several studies have shown that exudates from non-healing wounds contain significantly elevated levels of protease activity, increased formation of free radicals, and abundant amounts of proinflammatory cytokines, while concentrations of growth factors and protease inhibitors are markedly decreased.
Clinically, the wound edge may be non-advancing or “undermined” as a result of non-responsive wound cells or abnormal protease activity.
Debridement, skin grafting, biological agents, and other adjunctive treatment options have been suggested as corrective therapies to increase cellular migration and restoration of an appropriate protease profile.
In certain conditions, such as venous leg ulcers or wounds associated with lymphedema, excessive amounts of exudate are present and may lead to complications, such as maceration of the surrounding skin, skin breakdown, wound enlargement, and increased pain.
Exudate from chronic wounds has a composition that is considerably different from that of acute wound fluid.
This restores the wound base as well as functional extracellular matrix proteins and clinically leads to a viable wound base.
Supported by the European Wound Management Association, Schultz et al developed a strategy called TIME, which suggests methods for reinforcing the natural healing process while eliminating aggressive and proliferation-inhibiting activities.Moisture balance is critical in wound care, ie, while excessive fluid generation causes maceration at the wound margins, dryness will hamper the migration of epithelial cells.Application of moisture-balancing dressings, negative pressure wound therapy (NPWT), or other fluid removal methods, as well as compression, will control disproportionate release of exudate, avoid maceration, reduce edema, and prevent wound desiccation to enable optimal conditions for cell migration and proliferation.Consequently, the treatment of chronic ulcers is complex.After thorough wound diagnostics, therapy of the underlying disease (eg, metabolic control of diabetes, prevention of chronic venous insufficiency, slowing the progression of atherosclerosis) and general systemic treatment (eg, anticoagulant treatment, systemic antibiotic therapy, anti-inflammatory therapy, treatment inhibiting immunologic reactions, vasodilator treatment, rheology-improving drugs, and protein, vitamin, and microelement supplements) have to be initiated before local therapy can be effective.Keywords: chronic wounds, exuding, dressings, clinical efficacy This clearly indicates that most chronic wounds are the expression of an underlying physiological condition or systemic disease, such as chronic venous insufficiency, increased mechanical pressure, and vascular, nervous, or metabolic tissue damage.Therefore, the patient history should include: a description of how the wound occurred; any past history of wounds, including previous diagnoses and response to treatment; family history of chronic wounds and/or poor healing; any dermatologic condition that predisposes to ulceration; assessment of edema; consideration of pain; evaluation of systemic conditions that may predispose to wound development or poor healing, including human immunodeficiency virus/acquired immune deficiency syndrome, sickle cell anemia, Raynaud’s syndrome, rheumatologic disease, chemotherapy, anemia, weight loss, viral hepatitis, illicit drug use, transfusions, or neurologic disorders; previous hospitalizations and surgeries; and all systemic and topical medications used by the patient.If the wound tissues are adequately moist with minimal exudate production, then the applied dressing should maintain the tissue hydration status without too much absorption as this would desiccate the wound.Such moisture-retentive dressings retain moisture or have a low enough moisture vapor transmission rate (less than 35 g/m For instance, achieving or maintaining a moist environment does not mean that a wound should be covered in fluid.Effective in management of moderate to heavily exudating wounds. Please read product description for full and accurate details.Made of nonadherent, highly absorbent, lint-free, polyurethane foam. Effective in management of moderate to heavily exudating wounds. Please read product description for full and accurate details.