Cath Lab Digest

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Ostomy Wound Management invited its Editorial Board members to voice their opinions on what have been the most important recent (past 5 to 10 years) clinical innovations and observations in the wound, ostomy, and continence healthcare niche. Their insights reflect years of experience and enthusiasm for adapting to change, a concept clinicians often are accused of avoiding. Not only are these practitioners keeping up with advancing technology, redefined approaches, and increasing regulatory/legislative directives, but they also are incorporating, indeed thriving on, enhanced options and their ability to provide better care. The editors thank the respondents and encourage readers to dialogue at www.o-wm.com.

Innovative Products/Technology

  Stem cell therapy. According to emerging research, the wound healing potential of stem cell therapy is amazing. To be able to turn on and off these cells and turn cells from one kind to another is fascinating. The potential opportunities in taking wounds to closure with this therapy are much anticipated.

  Tissue engineering/bioengineered skin. Tissue engineering, including bilayered epidermis, cultured fibroblasts, and collagen products from animals, can be utilized to improve wound healing outcomes in cost-effective ways.

  Negative pressure wound therapy. NPWT was mentioned by several respondents. Use of NPWT is blossoming—and now the evidence base and number of vendors is increasing. This technology has seen huge success in the wound care arena as a device that has had a variety of applications, positive outcomes, and a cost-benefit ratio that is acceptable to healthcare payors. At the same time, it is an innovation that is overused: in a number of instances and indications involving NPWT use, more traditional moisture-retentive dressings can do a similar job without the expense and hassle associated with NPWT. Having said that, wound edema reduction and management of intra-abdominal compression syndrome are areas where NPWT excels.

  Innovative technology in pressure redistribution. A new manufacturing process, variable pressure foaming (VPF™, FXI) results in a viscoelastic polyurethane open-cell foam with 40% higher air flow than traditional technology. Surface modification technology (SMT™, also FXI) is a technique used to generate high levels of pressure redistribution in known high-risk areas, such as the heels and trochanter. When used together, these two processes produce a support surface superior to traditional viscoelastic mattresses. One Board member’s acute care facility achieved zero incidence of pressure ulcers for more than 90 days using this support surface.

  Back to the future. Several respondents noted the rediscovery of ancient approaches—ie, the use of silver and honey for wound care. As we approach the post-antimicrobial age, interventions that do not require the use of antibiotics will remodel future care; it has been noted that most medical honeys will heal a wound. A few thousand years of practical use finally resulted in an FDA device. Just like the movies, it is back to the future.

  Incontinence products that help prevent skin breakdown. The most important innovation in wound care in recent years is the development of sophisticated, dynamic products that help protect moisture-vulnerable skin due to incontinence and thus aid in the prevention of skin breakdown and pressure ulcers.