István Roz
sos MD, PhD, MBA
Vascular Surgeon
Specialist of Advanced Chronic Wound Care Techniques
Theta Medical and Aesthetic Centre, Pécs, Hungary
Lecturer at University of Pécs, Hungary
The application of zinc-hyaluronate in the cases of chronic – hard-to-heal – wounds. So that you should be prepared for the treatment of wounds. In other words, how to treat your hard-to-heal wounds in your home with periodic medical surveillance.
Wound types
In the spring issue of our periodic publication you could read about household accidents. Events of this nature ending with such wounds tend to occur quite unexpectedly, therefore it is essential that we should be familiar with the ways of treatment of wounds.
But what happens if the ’unexpected guest’ stays with us longer and becomes a real burden for everyone? Following this line of thought, chronic hard-to-heal wounds on the leg are considered such embarrassingly persistent, unexpected and rather unpleasant guests.
These wounds can be divided into three large groups.
Firstly, we can point out leg and foot ulcer which is based on the typically common and widespread venous cardiovascular disease (or in everyday speech varicose). This disease is called ulcus cruris in medical jargon. These wounds can be found most frequently on the lower leg in the area around the ankles. In the advanced stage of the disease a serious swelling of the leg (oedema) and venous inflammation can frequently be observed. In case of efficient treatment of the underlying disease and the existence of appropriate hygiene conditions, wound treatment with the observation of the physician’s instructions can be carried out safely and successfully also in the patient’s home environment.
The second large group consists of chronic wounds caused by arterial diseases (blood vessel narrowing), which can often lead to a necrosis of the deeper layers of the involved tissue. These wounds are also called gangrenes and appear most frequently on the toes and the feet and may result even in serious infectious conditions. Therefore, the domestic treatment of such chronic wounds is not recommended, their appropriate care and treatment can be ensured only with the necessary institutional background and surgical interventions are often necessary for proper healing.
The third large group related to the limbs is those of chronic wounds based on small vessel and small nerve degeneration accompanying diabetes, which occur mostly on the sole and on other areas which are exposed to increased pressure. In cases in which the diagnosis is accompanied by considerable arterial vascular lesion, similarly to gangrenes, institutional treatment is necessary. However, in 80% of chronic wounds based on diabetes factors entailing hypesthesia are predominant. In such cases domestic wound treatment can be carried out successfully with periodic medical surveillance.
Prevention
The conditions necessary for the healing of chronic wounds are extremely diverse, yet, there are several common characteristics in them the knowledge of which means enormous help in the elaboration of therapeutical plans.
With venous patients as well as in the cases of patients suffering from diabetes for years great emphasis should be placed on prevention, which means that we have to do everything to avoid injuries and prevent the development of potential wounds. Accidents are also usually avoidable with appropriate care, attention and the observation of the rules.
It is obvious that the detection and appropriate treatment of the underlying disease or underlying diseases is an essential and necessary prerequisite, which is a specialist’s task. Consequently, if we detect and recognize the nature of the underlying disease and underlying diseases efficiently as situations meaning the source of danger, the possibility of the development of complications can be decreased significantly as well.
How can we prevent the development of chronic wounds? The most important tasks to be carried out are: besides the rather strict treatment and care of the underlying disease (varicosity, deep venous thrombosis, small nerve necrosis accompanying diabetes) the treatment of the skin surface at the endangered areas by providing the active agents crucial for the regeneration of the skin layers. The flexibility and vitality of the skin are rather important factors of our lives and health. A wide range of preparations by numerous renowned laboratories can be found in drugstores, which we may also know from cosmetic advertisements.
A piece of good advice
The two most important aspects in the domestic treatment of wounds: the protection of the cleaned wound from superinfection and the facilitation of rapid epithelization.
The chances of the development of wounds can be decreased considerably by improving the resistance potential of the endangered skin areas threatened by the development of wounds and by facilitating their regeneration.
Each factor (e.g. food rich in protein and energy, proper circulation at the critical areas of the limbs as well, proteins and nutrient elements – e.g.: zinc – taken in besides ingestion and reaching the critical area) which can be of help in terms of wound healing or the wound healing mechanism of the body is also appropriate for the prevention of the formation of wounds. The appearance and growth of these chronic wounds can be traced back to the lack of the necessary factors.
In the course of this logical sequence we have now arrived at a possible role of zinc-hyaluronate. It is well-known that the skin with impaired circulation becomes vulnerable as a result of a loss of the flexibility of its structure. These areas heal only with a lot of difficulties or do not heal at all. Ensuring the basic physiological functioning and proper local treatment of the skin decreases the possibility of the formulation of chronic wounds to a considerable extent – this is a possible way of prevention.
How can prevention be implemented in everyday practice?
The first step of the regular tasks to be carried out on a daily basis is keeping the endangered skin surfaces clean.
Wipe the skin dry then spread the preparation on the skin surface evenly and wait until it has imbibed and dried.
Following this step, we apply the elastic bandage or the elastic compression stockings.
The above procedure may be repeated during the day. Regularity is important as well as ensuring the circulation of the limbs. In addition, an average of 3 litres of fluid intake per day should also be kept in mind.
At his point we will stop for now. So far we have reviewed the types of wounds and from the triad of wound treatment (prevention, treatment, follow-up care) we have become familiar with the concept of prevention. Utilising the dramaturgic tools of exciting series we hereby promise that in our next publication the treatment of chronic –hard-to-heal – wounds will be presented. In the next part we will also touch upon zinc-hyaluronate – as the Jolly Joker of wound treatment –, which can enhance the process of regeneration in practically every phase of wound healing.