Cath Lab Digest

Zinc/iron solution stimulates epithelialization of acute partial thickness wounds

Alex Cazzaniga, BS; Stephen Davis, BS; and Patricia Mertz, BA, University of Miami School of Medicine Department of Dermatology and Cutaneous Surgery, Miami, Fla.

Zinc has been shown to be beneficial in the wound healing process; however, the combined role of zinc and iron has not been studied. The purpose of this study was to evaluate a new zinc/iron solution (ZIS) on the healing of partial-thickness wounds. Ten pigs received multiple partial-thickness wounds and received one of the following treatments: 1) 0.003% ZIS, 2) vehicle, 3) untreated air exposed. Wounds were treated by sterile four-ply gauze saturated with each agent and then covered with a polyurethane dressing. Wounds were treated daily. Five wounds were excised on days 3 to 8 and evaluated for complete epithelialization using a well-described salt-split technique. A total of 540 wounds were evaluated. All wounds that received any treatment epithelialized sooner than untreated air exposed. The 0.003% ZIS enhanced complete epithelialization as compared to wounds treated with vehicle alone. This data demonstrates that a new zinc/iron agent is effective at stimulating healing which may have important clinical implications.

A leg ulcer prevention program following healing

George Cherry, DPhil; Janice Cameron, RGN, ONC, MPhil; and Susan Poore, RN, Wound Healing Institute, Oxford, UK

Prevention of recurrence should be an integral part of leg ulcer management. An on-going program of care following healing was developed to reduce the incidence of re-ulceration. The authors' "healed ulcer" clinic was established more than 20 years ago. The primary objectives of the healed ulcer program include fitting compression stockings, maintaining healthy skin, patient education, and regular examination of pedal pulses and Doppler ultrasound to check for the onset of arterial disease. A survey of all patients in the healed leg ulcer program was undertaken over a 2-year period to assess the recurrence rate. A total of 110 patients attended the healed ulcer clinic during the first study year. These patients had been healed by 4 months to 19 years. At the end of the first study year, 14 patients no longer attended the clinic; five people died and nine had ill health. The remaining 96 patients continued to attend regularly every 4 to 6 months. No patients were lost to follow-up during the second year. The results of the survey over the 2-year study period found 75 (78%) patients remained healed at the end of the second year. In the group of 21 (22%) patients that had recurrence of their ulcer, 14 patients had one episode of breakdown and were healed again within 3 to 5 months, and seven patients had various underlying medical problems complicating healing and requiring interventions from other specialities. The authors conclude that time spent on a leg ulcer prevention program following healing can reduce recurrence and prove to be a huge cost saving to the health service.

In vitro evaluation of the bactericidal activity of three wound antiseptics against biofilms of common wound pathogens

Anna Drosou, MD; Alejandro L. Cazzaniga, BS; Stephen C. Davis, BS; Julie L. Silver, and Patricia M. Mertz, BA, Department of Dermatology, University of Miami School of Medicine, Miami, Fla.

Biofilms (associations of adherent bacteria living in a polysaccharide matrix) have been found in wounds1,2 and are protected from antimicrobials.³ The purpose of this evaluation was to examine the effect of antiseptics on cells living in biofilms.