From Lab to Clinic: The Necessity of Realistic Testing Conditions in Evaluating Wound Dressing Performance Editorial Summary This editorial highlights the critical importance of employing clinically relevant testing conditions in the evaluation of wound dressings. Case examples from the published literature demonstrate potential pitfalls in the material design of wound dressings when clinically relevant testing is not undertaken. Specifically, the focus is on non-medicated wound dressings, which are claimed to have antimicrobial properties, and advanced foam products, for which superior exudate management is claimed.
Introduction
W Dr Erik Nygren Senior Scientist, Wound Care Research & Development, Mölnlycke Health Care AB Gothenburg, Sweden
Assoc Prof Matthew Malone Principle Scientist, Wound Care R&D, Mölnlycke Health Care AB & Conjoint A. Professor, Western Sydney University, Infectious Diseases and Microbiology, School of Medicine
ound dressings have become an integral component in the management of open wounds. Further, there is an expanse of choices with regards to the types of materials, formulations (biological and non-biological) and carriers, all designed with specific functions of relevance to the management of wounds. The primary goal of a dressing is to have the highest performance when used clinically on individuals with wounds, however, how is this achieved when virtually all the design features of a wound dressing are developed in the laboratory? To achieve this goal, developers must employ validated laboratory test methods during the design stages of a wound dressing to ensure that the laboratory testing mimics what occurs in real life conditions, thus maximizing the chances of the dressing performing well in the clinical setting. Unfortunately, a large percentage of dressing development, and performance evaluation, is undertaken using oversimplified and clinically irrelevant test conditions, such as the utilization of salt solutions which are supposed to mimic (but do not) wound exudate. In this review, we highlight the need for more clinically realistic testing conditions and hope to raise awareness of the necessity of adopting testing methodologies that accurately reflect realworld clinical scenarios, ultimately enhancing the reliability and relevance of wound dressing assessments.
Sydney, Australia
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Wound Masterclass - Vol 3 - September 2024
What Is the Impact of Using Test Solutions to Mimic Wound Exudate That Are Not Clinically Relevant? Wound care is a pivotal but often overlooked aspect of healthcare, yet this area has seen significant advancements with the development of innovative advanced wound dressings. Two of the most significant functions provided by advanced wound dressings are the management of exudate and/or the provision of an antimicrobial effect to manage bioburden. Despite being seen as a trivial matter by some, the absence of a material to manage wound exudate would result in the leakage of exudate onto the surrounding skin (causing maceration), clothes and linen, leading to distress and a reduced quality of life for patients.1–3 Additionally, leaving a wound open to the environment increases the risk of contamination by microorganisms or foreign material like dirt, which can negatively impact the wound. Many clinicians have thus adopted the adjunctive use of topical antimicrobial wound dressings to provide local infection management, aiming for better source control of infected tissues and, consequently, improved infection outcomes. Whether a wound dressing is optimized for fluid handling or to provide an antimicrobial action, both have the commonality of being exposed to wound exudate (often referred to as ‘wound fluid’ or ‘wound drainage’).3 So, what is human wound exudate? Is its presence a physiologic or pathologic response in open wounds? The World Union of Wound Healing Societies (WUWHS) consensus document on Wound Exudate,3 along with the recent review