Standard dressings rein in woundcare, but new research is uncovering innovative therapies for certain conditions
"Various studies have not shown greater efficacy in wound healing when comparing antibiotic creams or other pharmaceutical agents to that of bland emollients for surgical wounds," Dr. Tran says.
In fact, the evidence suggests that physicians who treat wounds find the greatest success when they combine traditional woundcare techniques with control of patient factors detrimental to wound healing, such as smoking, post-surgical trauma, poor venous flow and infection.
"Impregnating dressings with painkillers and antibiotics is an interesting area of research. There is a new sandwich alginate dressing, with nanoparticle silver, which seems to have the dosage of silver that is toxic to bacteria but not to the fibroblasts of the skin. That is not yet FDA-approved," Dr. Cockerell says. "When it comes to wound dressings that dermatologists routinely use, there have not been a lot of new dressings released in the last several years."
On the horizon
Researchers, especially from Europe and Denmark, have been reporting on interesting dressing product trends, according to Dr. Tran.
"But, of course, the issue with the woundcare research is that there are not really many modalities that have had good, randomized, controlled trials to show effect," he says.
Dr. Tran says new and interesting products include dressings containing pain-relieving medications. He mentions Biatain-Ibu (Coloplast), which is a foam dressing with local release of ibuprofen. Another possibility is morphine gel in the dressing.
"Having the pain reliever imbedded in the dressing is mainly to create pain-free dressing changes," Dr. Tran says.
Another interesting avenue in wound dressings is Lactobacillus plantarum culture application for ulcers.
"Researchers have studied Lactobacillus plantarum culture application for ulcers in 2009, and, while it affected various cytokines in the wound bed, it did not seem to affect the overall healing rate of diabetic versus nondiabetic ulcers," Dr. Tran says.