Meeting report: stepping up to customised wound care

Second session — Results of the European RCT 'Earth study': Sylvie Meaume, MD, GerontologistDermatologist, Head of the Clinical Gerontology Department, Wound Care Unit, Hospital Rothschild APHP, University of Paris, UPMC, France The second session focused on the role of dressings in wound desloughing. The study by Sylvie Meaume et al (2014)[5] on ‘Evaluation of two fibrous wound dressings for the management of leg ulcers: Results of a European randomised controlled trial (EARTH RCT)’ compared the efficacy of UrgoClean® and a Hydrofiber® dressing (Aquacel®, ConvaTec) in the treatment of venous or mixed leg ulcers. This randomised, multicentre clinical trial was conducted in three European countries. Aquacel was selected as the control dressing due to its high level of absorbency and marked gelling capacity, which offer autolytic properties that are conducive to effective local wound debridement. The primary endpoint for this study was the percentage of relative wound area reduction at week 6, while secondary endpoints were relative slough Session one — State of the art in desloughing: Luc Téot, MD, Plastic Surgeon, Wound Healing Unit, Lapeyronie Hospital, Montpellier University, France Debridement is an integral part of wound management and involves removing all non-viable tissue from a wound, which can act as a nidus of infection and can delay the formation of granulation tissue in the wound bed. Chronic wounds often contain necrotic or sloughy tissue that can enhance the growth of bacteria, delaying wound healing. The availability of nutrients and oxygen, and the presence of ischaemic tissue combine to ensure this is an ideal environment in which both aerobic and anaerobic bacteria can multiply[1], increasing the risk of infection. Debridement of sloughy/necrotic tissue is vital when reducing the bacterial burden within the wound[2,3]. According to Luc Téot, debridement is essential and a range of debridement techniques are used at present, including autolytic, biosurgical (maggot therapy), hydrosurgical, mechanical, sharp, surgical and ultrasonic. Each of these methods requires varying levels of clinical expertise and have their advantages and drawbacks in terms of patient acceptability and ease of use[4]. To achieve successful debridement a combination of techniques may be required. Karl-Christian Münter, symposium chair A one-hour symposium was held by Urgo Medical on Thursday 15th May 2014 at the annual European Wound Management Association (EWMA) Conference in Madrid, entitled ‘Stepping up to customised wound care’. The objective of the session was to highlight the benefits of a sequential treatment in chronic wounds. This is an important concept that creates an individualised approach to wound management and dressing choice, recognising the need to tailor treatment to the different phases of healing. Chaired by Dr KarlChristian Münter, Germany, four eminent speakers focused on the evidence in the form of randomised controlled trials (RCTs) — including double-blind — clinical studies and clinical experience of using both UrgoClean® and UrgoStart® dressings for managing wounds at the inflammation, proliferation (granulation) and maturation (epithelialisation) stages of the healing process.