Case Closed: Opening the Door to Closing Challenging Wounds

  OWM introduces Case Closed, a new column sponsored by Keneric Healthcare, Irving, TX, published to familiarize readers with several of the company’s products and provide optimal solutions to malingering wounds.

  The RTD® Wound Dressing is a patented antimicrobial hydrophilic polyurethane foam that is highly absorbent and effective in creating a wound environment conducive to healing. The polyurethane foam matrix is comprised of organic antimicrobial and antifungal active components, including methylene blue (0.25 mg/g) and gentian violet (0.25 mg/g), along with integrated silver zirconium phosphate (7 mg/g). The addition of silver to this dressing enhances the antimicrobial effectiveness and helps reduce bacterial load to improve wound healing.¹

  In this first column, the authors provide an overview of the features, product use, mechanisms of action, and antimicrobial effectiveness of the RTD® wound dressing. Subsequent installments of “Case Closed” will feature case studies that demonstrate the clinical effectiveness of this product.

Product Information

  Indications. The RTD® wound dressing is indicated for the treatment of partial-thickness to full-thickness wounds with moderate to heavy exudate, including pressure ulcers, venous stasis and arterial ulcers, diabetic foot ulcers, graft wounds and donor sites, surgical/postoperative wounds, first-degree and second-degree burns, lacerations and abrasions, and any other wound inflicted by trauma.

  RTD® is FDA cleared. It is safe and effective and does not cause skin irritation or sensitization reactions. It does not cause systemic toxicity and meets the requirements for cytotoxicity (no cell death) and is considered nonirritant.

  Foam characteristics. The RTD® dressing is made up of a proprietary, open-cell, hydrophilic polyurethane foam that, by its construction, creates a perfect environment for wound healing (see Figure 1a,b). It is flexible, soft, and ready to use, requiring no soaking or hydration, thereby saving time and effort with each dressing change.

  The active ingredients are tightly integrated into the RTD® polymer matrix, preserving the structure of the polyurethane foam and allowing for optimal absorption of exudate and infectious material. This foam dressing draws exudate away from the wound bed vertically due to the capillary wicking action of the foam, absorbing up to 20 times its weight in exudate. RTD® can hold 1,110 mg/cm², approximately 115 mL per 4 x 4 x ¼-inch dressing, making it at least 25% more absorbent than other similar foam wound dressings.² For wounds with more copious exudate, the dressing can be stacked for added absorption and vertical wicking. This dressing is versatile and can be used throughout the continuum of healing.

  Methylene blue and gentian violet. Methylene blue and gentian violet are organic substances with a strong affinity for dead cells. Methylene blue is a strong cation that attracts negatively charged bacteria, protein-rich exudate, and infectious material into the foam and does not harm healthy living cells. Gentian violet attacks primarily Gram-positive and some Gram-negative bacteria³; it is also effective against yeast and fungi. Clinical findings suggest gentian violet can help reduce pain within 15 minutes of application.⁴

  Antimicrobial silver. The RTD® dressing includes silver sodium hydrogen zirconium phosphate. This compound is tightly integrated into the foam. In the presence of wound exudate, silver ions (Ag+) are released from the dressing in an amount proportionate to the amount of exudate. The silver ions bind to the bacterial cell membrane and penetrate the cell wall, causing damage and cell death.

  Antimicrobial effectiveness. The 3 active ingredients — methylene blue, gentian violet, and silver — are >99% effective against common wound pathogens.² A recent independent laboratory study³ has shown RTD® (S1) has superior antimicrobial benefits over a dressing with methylene blue and gentian violet alone (S2), demonstrating consistently better antimicrobial activity against all organisms tested (methicillin-resistant Staphylococcus aureus, S. aureus, Pseudomonas aeruginosa, Escherichia coli, and Bacillus subtilis at 0, 4, 8, 12, 24, 48, and 72 hours) (see Figure 2).

Conclusion

  RTD® dressing provides sustained antimicrobial protection and is effective at drawing protein-rich exudate away from the wound, reducing the bacterial load and creating a healing environment. Using RTD® as the first line for treatment can help prevent wounds from becoming chronic and requiring lengthy costly interventions such as systemic antibiotics, surgical debridement, enzymatic debridement, and negative pressure wound therapy. It provides a simple ready-to-use solution for both chronic and acute wounds.

  The next 3 installments of “Case Closed” will provide a number of case studies that demonstrate the clinical effectiveness of the RTD® Wound Dressing with a variety of nonhealing and/or etiologically complex wound types.

  For more information, www.RTDWoundDressing.com.

Case Closed is made possible through the support of Keneric Healthcare, Irving, TC. The opinions and statements provided in Case Closed are specific to the respective authors and not necessarily those of Ostomy Wound Management or HMP Communications. This article was not subject to the Ostomy Wound Management peer-review process.