A new transforming powder dressing (Altrazeal, ULURU) is an easy-to-apply woundcare product that creates optimal conditions for healing. It has been used with excellent outcomes in a variety of acute and chronic wounds, including skin graft donor sites, pressure ulcers, venous ulcers, and diabetic foot ulcers.
Milwaukee - A transforming powder dressing (Altrazeal, ULURU) is anticipated to have a very significant positive impact on the management of acute and chronic wounds, says Jeffrey A. Niezgoda, M.D., medical director, Centers for Comprehensive Wound Care and Hyperbaric Oxygen Therapy, Aurora Health Care, Milwaukee.
The powder is sprinkled or poured onto an open wound. Due to an interaction between the proprietary particle technology (Nanoflex) and wound exudate, the material aggregates into a semisolid, opaque, flexible dressing that conforms to the surface of the wound bed.
In wounds that are not highly exudative, spraying or dripping sterile normal saline onto the powder can promote the transformation process.
In addition to its ease of application, the transforming powder dressing facilitates self-woundcare, decreases the frequency of dressing changes, is easy to remove and well-tolerated by patients, and has been shown very effective for accelerating the healing trajectory when used on a broad spectrum of acute and refractory wounds.
"When I employ a new technology in my clinic for the first time, I tend to use it on my more challenging patients. Therefore, my initial experience with the transforming powder dressing included cases of very challenging, refractory diabetic foot ulcers and venous ulcers. The initial results have been exciting because these long-standing wounds healed very quickly after switching to this dressing," Dr. Niezgoda says.
The transforming powder dressing creates a nearly ideal wound-healing environment, because it optimizes the moisture content while providing a protective barrier against external trauma and bacterial contamination. The dressing allows exudate to be transported away from the wound base to the outside environment, thereby preventing problems with maceration and establishing optimal conditions for wound healing.
"Initial studies at the laboratory bench and in animal models show that the controlled environment created with this dressing stimulates various elements of the wound healing process, including granulation tissue formation, angiogenesis, fibroblast replication, and epithelialization.
"The findings and observations in the animal models are being replicated nicely in the clinical realm where this novel dressing material has been very effective for accelerating healing," Dr. Niezgoda says.
Wounds treated with the transforming powder dressing include burns and postsurgical wounds, as well as pressure ulcers, diabetic foot ulcers, venous and arterial insufficiency ulcers.
Graft donor sites
"So far, we haven’t found any contraindications for this product, but we continue to identify situations where it is very useful. One particularly interesting application is as a dressing for split-thickness skin graft donor sites.
"Some clinicians have also reported excellent results when using it over fresh skin grafts and there is interest in its use to enable fistula care," Dr. Niezgoda says.
Once applied, the transforming powder dressing is usually maintained for several days, but it has remained intact for even longer, allowing some patients to go several weeks without a dressing change.
The dressing is easily removed with rehydration, and the removal is atraumatic as any remaining material comes off easily without adhering to the wound site.
Covering the area with a secondary dressing to reduce exposure to friction and moisture may extend the durability of the transforming powder dressing, but is not necessary. Patients can even shower or bathe, and while exposure to water may cause the dressing to become dislodged faster, many patients can be taught to apply another dressing at home.
"Most woundcare patients don’t have the option of being able to get their dressing wet, and so the opportunity to bathe or shower with the transforming powder dressing is a real luxury," Dr. Niezgoda says.
As another attractive feature, the transforming powder dressing particle technology can also be used as a platform for controlled delivery of medications to the wound site.
A clinical study is being undertaken to investigate the efficacy and anti-microbial properties of a product incorporating silver (Altrazeal™ Silver). Other line extensions are being developed. DT
Disclosure: Dr. Niezgoda discussed the new powder dressing during an industry-sponsored symposium held during the Clinical Symposium on Advances in Skin & Wound Care in Las Vegas. He has no financial interest in ULURU or Altrazeal.