HydroTherapy: A simple approach to Wound Management

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2 Copyright Paul Hartmann Pty Ltd material may not be reproduced or used without written permission HydroTherapy: A simple approach to Wound Management HARTMANN Education

3 Agenda Agenda Acute vs Chronic wounds: understand the difference The healing process The importance of wound bed preparation Simplified approach to wound management Product selection

4 Wound classification Acute wounds Surgical wounds Traumatic wounds Cuts & lacerations Grazes & abrasions Skin tears Grazes Cuts Surgical incisions Wound Healing Heal in predictable phases Have excellent potential to heal despite dressing choice Complications are rare Good patient compliance Skin tears Burns Blisters

5 Wound classification Chronic wounds Venous leg ulcers Arterial leg ulcers Diabetic foot ulcers Pressure Injuries Wound Healing Underlying cause Healing by second intention Persistent inflammation Complications are common Poor patient compliance

6 The healing process

7 Stages of wound healing Inflammation - Clear & protect ( 1-4 days)

8 Stages of wound healing Proliferation new growth & regeneration (2-24 days)

9 Stages of wound healing Maturation remodeling (24 days 2 years)

10 Acute vs Chronic wound healing Understanding the difference Clinical challenges of chronic wounds: searching for an optimal animal model to recapitulate their complexity Robert Nunan, Keith G. Harding, Paul Martin Disease Models and Mechanisms : ; doi: /dmm

11 Wound Bed Preparation

12 Wound Bed Preparation 2015 Person with a Chronic Wound Identify & treat the cause Address Patient/family patient/family Centred centred Concerns concerns Determine Healability: Healable, Maintenance, Non healable/palliative Local Wound Care Debridement Inflammation/Infection Moisture Balance Edge Effect Sibbald RG. Optimizing The Moisture Management Tightrope with Wound Bed Preparation Advances in Skin & Wound Care 2015;Oct 2015 Vol 28;

13 TIME Concept I= Infection/Inflammation T= Non viable tissue Dead tissue covering wound bed Red & Inflamed edges Dry wound bed E= Edge of wound M= Moisture balance

14 The wound bed is out of balance Dead cells Bacterial growth Old blood & debris MMP activity

15 What are MMPs? MMPs (Matrix metalloproteinases) are enzymes that play an important role in wound healing They break down tissue on the wound bed to clear the wound of unwanted cells, bacteria and debris In a healthy wound they are controlled by Tissue Inhibiting Matrix Metalloproteinases (TIMPs) allowing the wound to progress and heal In a chronic wound, higher levels, persist longer and the wound bed gets out of balance Creates a highly destructive wound environment

16 A Simplified Approach

17 Wound Dressings A wound dressing is only ever providing the best environment for the body to heal itself!

18 How do I choose the right dressing? Hydrogel Film

19 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds HydroClean Plus Hydrotac Comfort Zetuvit Plus Puetter Pro2 Hydrofilm Peha-haft Acute wounds Atrauman Ag Atrauman silicone Or Atrauman Zetuvit Plus Making the complex simple * This is a guide to product selection and doesn t replace a clinical judgement

20 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds HydroClean Plus Hydrotac Comfort Zetuvit Plus Puetter Pro2 Hydrofilm Peha-haft

21 Hydroclean Plus: Your first choice dressing to debride all wounds Unique mode of action

22 Acute vs. chronic wound fluid Growth factors White Blood Cells Enzymes Nutrients Bacteria Debris MMPs Dead cells Acknowledgement: Wendy White Wound CNC

23 Hydration Maceration

24 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds HydroClean Plus Hydrotac Comfort Zetuvit Plus Puetter Pro2 Hydrofilm Peha-haft

25 HydroTac: Your first choice to support granulation & epithelialisation

26 HydroTac New Design and Dual Mechanism of Action hydrated polyurethane gel (moisturizing wound contact layer) absorbent polyurethane foam semi-permeable protective film HydroTac regulates the optimal moist wound environment by absorption of wound exudate and active release of moisture HydroTac technology promotes concentration of growth factors thus it accelerates the epithelial wound closure

27 HydroTac Start 0h Ctrl 6h HGF 25 ng/ml HGF 25 ng/ml after hpu absorption

28 Faster epithelialization of wound when using HydroTac In Vivo Test results A B In Vivo studies by Smola 2015 In (A) the epithelial tip of wounds treated with hydrated polyurethane contact layer (component of HydroTac), keratinocytes migrated much further from the wound border (white arrows) compared to wounds which were dressed with inert silicone contact layer (B) (p = 0.015).

29 HydroTherapy Two preparations = One successful therapy

30 Copyright Paul Hartmann Pty Ltd material may not be reproduced or used without written permission Acute Wound Management 1.Treat infection 2.Support Granulation/Epithelialisation

31 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds Atrauman Ag Atrauman Silicone Zetuvit Plus Peha-haft

32 Atrauman Ag Reliably stops bacteria Low adherent silver wound contact layer Safe Convenient Gentle

33 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds Atrauman Ag Atrauman Silicone Zetuvit Plus Peha-haft

34 Atrauman Silicone Atraumatic protection A new silicone wound contact layer to protect sensitive skin NEW Maximum patient comfort Easy to use Cost effective

35 Copyright Paul Hartmann Pty Ltd material may not be reproduced or used without written permission Acute & Chronic Wound Management 3. Exudate Management 4. Fixation

36 Exudate Management Zetuvit Plus: Absorbency, comfort, savings Outstanding absorbency Superior patient comfort Excellent cost-effectiveness Did you know? The 20x40cm pad can absorb up to 787 mls!

37 Fixation Peha-Haft: Latex free self adhesive light bandage Secure, latex free Non-adhesive but cohesive Cost-effective

38 HARTMANN: A simplified approach to wound management Based on the colour of the wound bed Inflammation Proliferation Complement if needed Cleansing Debridement Granulation Epithelialisation Exudate mngt Compres sion Fixation Chronic wounds TenderWet Plus Hydrotac Comfort Zetuvit Plus Puetter Pro2 Hydrofilm Peha-haft Acute wounds Atrauman Ag Atrauman silicone Or Atrauman Zetuvit Plus Making the complex simple * This is a guide to product selection and doesn t replace a clinical judgement

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