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Evaluation of a chitosan dressing in the management of hard-to-heal wounds

23 February 2023
Volume 32 · Issue 4


It is vital that as tissue viability teams, we are constantly striving to improve service delivery, healing rates and positive patient outcomes. In 2021 the author's team were introduced to a unique bioactive microfibre gelling (BMG) dressing, MaxioCel®, which uses chitosan to maintain a cohesive structure to increase fluid handling, antimicrobial and wound-healing properties. Method: Following Isle of Wight NHS Foundation Trust guidelines and with patient consent, 11 patients with chronic wounds of various aetiologies and wound durations were enrolled in a multicentre, clinical 4-week evaluation. Results: Over a 4-week evaluation period, all patients showed a significant improvement in wound healing parameters including average tissue type, condition of periwound skin, patient comfort, exudate levels. The assessments demonstrated a significant decrease in necrotic and sloughy tissue (from >75% at the start of treatment), replaced with healthy granulation and epithelial tissue (>80% by week 4). Significant reduction in pain score was also reported in all patients, with average pain score at the start of the evaluation reducing from 5.8 ± 2.7 to a score of 2.5 ± 1.9 within 3 weeks. Conclusion: The complicated wounds seen in this study were previously non-healing and MaxioCel, with BMG technology, demonstrated both significant clinical improvement and a positive impact on patient quality of life within just 4 weeks, resulting in its addition to the team's woundcare formulary.

The management of chronic or hard-to-heal wounds such as pressure ulcers, lower limb diabetic or venous ulcers, or wounds stalled in their healing trajectory such as open trauma or some surgical wounds, is an ever-increasing challenge. Although there is the financial burden to the NHS, hard-to-heal wounds taking a protracted period to heal often result in long-term morbidity for patients, negatively impacting on their quality of life (Guest et al, 2015; Guest, 2021; Sen, 2021). The cost of wound care to the NHS across the UK, originally suggested as comparable to the management of obesity in 2012/13 (£8.3 billion) (Guest et al, 2020), has now overtaken obesity costs and is approaching the combined cost of managing osteoarthritis and rheumatoid arthritis (£10.2 billion in 2017) (Guest, 2021). Dressings remain the mainstay and most accessible option for the management of hard-to-heal wounds. It is therefore important that clinicians have access to dressings that can be effective in wound progression while ensuring that patient comfort and quality of life remain acceptable.

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