Defning a holistic pain-relieving approach to wound care via a drug free polymeric membrane dressing

Abstract

Wound care practice continuously demonstrates that healing cannot be adequately controlled if a patient's experience of pain is not managed effectively. Current pain management guidelines do not account for the holistic treatment of pain emanating from a wound-an environment of uncontrolled or rogue inflammation, neuropathy and neuroischaemia. This article investigates how polymeric membrane dressings can interact with the pathology of wounds to correct abnormalities in pain pathways of the nervous system and dampen problematic ongoing pain to enhance the clinical picture of wound healing.

Randomized controlled trial comparing the combination of a polymeric membrane dressing plus negative pressure wound therapy against negative pressure wound therapy alone: The WICVAC study

“…Various efforts have been made to decrease wound tissue damage and pain during dressing change, including the use of different primary wound fillers, administration of topical analgesics, or placement of various interface dressings . As shown in several studies before, PMD is a nonadherent dressing, which combines anti‐inflammatory and pain‐relieving properties. Reduction of pain and inflammation is an important aspect of wound management and essential for an improvement of patient quality of life.…”

“…Evidence suggests that the PMD may reduce the inflammatory response at the wound site and in the surrounding tissues with an associated decrease in bruising and swelling. The PMD may also modify pain‐signaling pathways by inhibiting the function of nociceptors, and absorbing sodium ions from the skin and subcutaneous tissues below the dressing…”

Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples

“…A prospective crossover study 7 and case series 8,10,12 have shown PMDs continuously cleanse wounds. Overviews, literature reviews, and case series 18,19,32,34,35 support that PMDs release a nontoxic surfactant cleanser 41 to break the chemical bounds between the wound bed and adhering slough, dirt, or other substances that may impair healing. As shown in case series and reviews, 15,19,32,35,36,38 the hydrophilic (water-loving) components of PMDs (the substrate and glycerol, a bacteriostatic simple sugar) pull nutrient-filled, enzyme-rich fluid from the body into the wound bed, enhancing both healing and autolytic debridement.…”

“…[42][43][44] The literature shows these common interventions are rarely necessary when PMDs are used. 8,13,18,31,34,35 Because PMDs are nonadherent, reviews and case reports 8,12,14,18,31,36 show the dressing change process is quick and easy.…”

Cellulose based thin films as a platform for drug release studies to mimick wound dressing materials

“…Currently, wound care is one of the fastest growing markets for medical materials World Wound Care Markets (2011). Novel approaches in wound dressing design aim at either enhancing the healing efficiency of defective tissues or at decreasing the sensation of pain that accompanies many different wound types through inclusion of analgesic or anesthetic drugs (Davies and White 2011;Kitchener 2010;Benbow 2010;Bell and McCarthy 2010;Romanelli et al 2009). One of the most promising approaches to achieve the latter comprises the incorporation of desired drugs into polysaccharides (and their derivatives), which already have an important position in the wound dressing market.…”