Zinc-Coated Foam With Negative Pressure Wound Therapy in the Treatment of Challenging Wounds

A New Alternative Interface Material

Oğuzhan Aydoğdu, MD; Umut Tuncel, MD; Murat Gümüş, MD; Alper Kurt, MD; Nuray Oztürk, MD; Ibrahim Alper Aksakal, MD; Nizamettin Güzel, MD; Uğur Recep Çelik, MD; Unal Erkorkmaz, PhD

Disclosures

Wounds. 2016;28(11):395-403. 

In This Article

Abstract and Introduction

Abstract

Objective. The aim of the study was to present the authors' clinical observations on zinc-coated foam with negative pressure wound therapy (NPWT).

Materials and Methods. Ninety-four consecutive patients treated with zinc-coated foam with VAC therapy were retrospectively reviewed. Nonhealing wounds of at least 6 months duration with high to moderate exudate that required open wound management to secondary intervention were included in this study. The evaluation criteria consisted of the measurement of wound surface area, length of overall treatment time, and a clinical observation of granulation tissue formation in the wound bed.

Results. In all wounds, there was a significant decrease of the wound surface area, and wound exudate was obtained at the end of the treatment. There was a statistically significant difference between pretreatment and posttreatment measurements (P < 0.05). In all wounds, granulation tissue formation was clinically observed by day 6. Of the 94 wounds, 72 were surgically closed and 22 healed secondarily. The follow-up period averaged 12 months, and it was uneventful with no sign of complications from the use of the material.

Conclusion. The results of the retrospective study demonstrate zinc-coated foam with NPWT can be safely used as an effective and alternative interface material in the treatment of challenging wounds.

Introduction

Zinc plays an essential role in immune function, antioxidant defense mechanism, and wound healing.[1,2] It has been shown that reepithelialization might be delayed by zinc deficiency,[3] which can increase the time for wound closure and decrease wound strength.[4,5] This effect can be reversed by the use of a zinc-based adhesive dressing.[1] In addition, zinc has been used as a topical agent to treat diaper rash and as a nutritional supplement in patients with bedsores, ulcers, and incisional wounds.[6–9] In the form of a semi-adhesive tape, zinc was also found to be extremely useful in the treatment of partial-thickness burns.[1] Although the role of zinc in wound healing has been investigated since the 1950s, the mechanisms by which zinc affects healing processes are not clear.[5]

Negative pressure wound therapy (NPWT) is commonly used in prospective or retrospective clinical and experimental studies, and it is well known that it promotes wound healing in acute and chronic challenging wounds.[10,11] This therapy provides a moist wound-healing environment, increases granulation tissue formation, removes edema, and stimulates angiogenesis and blood flow to the wound margins.[12,13] The prime mechanism of NPWT essentially depends on its microdeformation effect on the wound bed that directly stimulates dermal cell proliferation and promotes healthy granulation tissue formation and vascular remodeling in living skin.[14,15]

Polyurethane foam and antimicrobial gauze are commonly used interface materials with NPWT since its first years of use in general practice. In addition, various numbers of clinical and experimental studies with different alternative interface materials such as a loofah sponge or silver-impregnated foam have also been documented in the literature.[15,16] In the literature, Günal et al[16] have suggested additional materials coating the foam, such as silver, can contribute to faster bacterial clearance and healing times in the management of challenging, difficult-to-heal wounds.

Zinc-coated foam as an interface material with NPWT was first introduced to the authors' institution in 2012, and they observed significantly improved outcomes by using this material in the treatment of chronic, nonhealing, or acute wounds. In order to present these observations, the authors conducted a preliminary, noncomparative study to share the results of using this material in the management of wounds from different etiologies. Consequently, the objective of this study was to verify the efficacy of zinc-coated foam as an interface material with NPWT in various challenging wounds.

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