Curiosin - Even chronic wound healing can be fast


The Possibility of Treatment of Chronic Wounds and Adjacent Skin with Curiosa Gel

István Rozsos MD, PhD
Vascular Surgeon
Specialist of Advanced Chronic Wound Care Techniques
Theta Medical and Aesthetic Centre, Pécs, Hungary
Lecturer at University of Pécs, Hungary

 


 

The possibilities of treatment of chronic wounds was highly limited for generations. It was only the developments of the past decades in medicine and medical technology that allowed for a more thorough investigation of pathophysiologic processes leading to the development of chronic wounds and resulted in the development of the moist wound treatment principle.

The pathological ways leading to wounds are well-known, there are numerous pharmacological and dressing therapies available. If necessary, the invasive correction of wounds can be carried out. (3.5.12.13.24) Nowadays a wide range of modern dressings is available, therefore the dresses can be appropriately adjusted to the various types and statuses of wounds. (14,15)

The role of the treatment of adjacent skin has received emphasis in international protocols as well, yet, in Hungary, generally only the passive protection of the adjacent skin is carried out in everyday practice eliminating the harmful effect of the discharge. However, this area is not healthy tissue, hence its regeneration – similarly to the healing of the wound – requires a considerably higher amount of energy from the body. That is the reason why it is of high importance to support this process and naturally the healing of the per secundam healing chronic wound with all means necessary at hand. (2,10,16,21)

The physiological effect of zinc hyaluronate can be examined well. The hyaluronic acid creates a dispersion matrix with the water molecules which replaces the missing tissue and creates a natural framework for the cells. It increases the activity of granulocytes and macrophages, enhances the proliferation of fibroblasts as well as angiogenesis. Compared with sodium-hyaluronate, zinc-hyaluronate has bacteriostatic properties as well against numerous bacteria. Its active role in the healing process of wounds has been proved unequivocally in numerous research studies. (7,11)

Our investigations were aimed at the observation of the applicability of the gel containing this active agent in the healing process of chronic wounds.

Objectives

Observing the effects of Curiosa® gel (Richter Gedeon PLC - Hungary) containing zinc-hyaluronate:

  • Wounds in the phase of epithelization
  • Granulating – in adjacent areas surrounding large ulcers
  • In supplementary treatments of treatments of inflammatory processes
  •  

Criteria for inclusion:

  • Hard-to-heal chronic wound developed as a complication of venous cardiovascular disease and/or diabetes.
  • Wound existing despite the applied treatments lasting for at least 2 months
  • There is no reason which would exclude the local application of Curiosa® gel
  • There is no known allergy to the ingredients. The moist wound treatment techniques previously applied with the patients can be continued, with the application of foam dressing the compression therapy is sustainable.
  • There is no modification in the medication previously applied with the patients

In the course of the investigation, a thorough checkup was carried out regarding the patients’ physical condition in detail every 30 days, in the course of which photo documentation was made including the sizes and other characteristic features of wounds. Thus, the analysis of the series of photographs was appropriate for a detailed, objective monitoring of wound healing (to be expressed in square centimetres) as well as of the observation of changes in perilesional skin status.

The preparation containing zinc-hyaluronate was applied by each patient in accordance with the instructions. In the course of our observations no control group was involved, in each case the assessment of efficacy was carried out with self-evaluation. With each patient changes compared to the previous status were recorded.

Results

Our investigations were concluded with the assessment of 15 patients. 4 out of 8 male and 7 female patients continued to smoke despite regularly provided information.

Changes in wound parameters

The initial wound size of the 15 patients examined decreased from an average value of 24 cm2 to 10.44 cm2 by the end of the observation period.

Based on the cumulation of the percentage of the changes of the individual wound sizes it can be established that 75% of the initial wound size healed on the average.

With 7 patients complete (100%) healing was observed in the observation period.

With 3 patients improvement over 75% was recorded.

In the course of the 4 smoking patients 50% complete (100%) healing was observable, 65% of the initial wound size healed.

The number of patients with diabetes was 5. In their cases the rate of the completely (100%) healed was 60%, 78% of the initial wound size healed.

In the cases of 6 patients there had been a confirmed deep venous thrombosis on the examined side previously, signs of post thrombotic syndrome were observable in the course of our examinations. The rate of complete (100%) healing was 50% in this group as well. 29% of the initial wound size healed.

Click on the chart to enlarge

        

Some medical histories in pictures – the application of Curiosa®

before  / after

                                   Patient No. 4

                                   Patient No. 8

                                   Patient No. 11

                                   Patient No. 12

General statements

During the period of application:

  • No phenomenon requiring the termination of the treatment occurred
  • Deterioration of wound status was not observed in any cases
  • In the direct vicinity of the wounds a distinct decrease in inflammation was highly visible
  • Simultaneously the qualitative improvement of perilesional skin areas was clearly visible
  •  

            In the appropriate indication area Curiosa® gel improves or may improve the healing dynamics of epithelizing wounds, thus the healing time of wounds decrease.

In the light of the 75% index of total wound healing in the observation period it can be established that the effects of Curios® gel was most spectacular in cases of patients with diabetes in the risk subgroups in addition to the fact that it improved previously observable healing dynamics in every subgroup.

Combined with the increasingly popular moist wound treatment techniques, Curiosa® gel is an efficient component of therapies applied so far in the granulation and epithelization phases.

In the case of chronic wounds, actual wound healing does not end at the epithelization phase. Curiosa® gel being applied in the process of the strengthening of per secundam healing wounds, our treatments result in a stronger, more resistant and more flexible skin surface.

            In the light of the physiological effects of the active agent Curiosa® gel can be applied efficiently in prevention as well as in the critical wound area of already forming threatening ulcers.

Literature

  1. A. JULL., N.WALKER, V. PARAG, P. MOLAN ÉS A. RODGERS (2008): A randomized clinical trial of honey-impregnated dressings for vanous leg ulcers, British Journal of Surgery 95: 175-182.
  2. A. VEVES, P. SHEELAN, H.T. PHAM (2002): A randomized, controlled trial of Promogran (a collagen/oxidazed regenerated cellulose dressing) vs. standard treatment in the management of diabetic foot ulcers, Arch Surg 137: 822-827.
  3. A. CAVEZZI, G. SIGISMONDI, S. DI PAOLO, P. BURESTA: Foam-sclerotherapy  Vascular diseases: 2008/2. 41-45.
  4. S. BAGHEL, R. SHUKLA, MATHUR AND R., RANDA (2009): A comparative study to evaluate the effects of honey dressing and silver sulfadiazine dressing on wound healing in burn patients, Indian J Plast Surg 42 (2): 176-181.
  5. BIHARI I.: First experience gained through laser operation of varicose veins  Vascular diseases: 2007/3. 125-129.
  6. CHEN J., HAN C., SU G., TANG Z., SU S. és LIN X. (2007): Randomized controlled trial of the absorbency of four dressings and their effects on the evaporation of burn wounds, Chin Med J 120 (20): 1788-1791.
  7. DECHART AT. et al: Hyaluronan in human acute and chronic dermal wounds, Wound Rep.REG (2008) 14, 252-258.
  8. DT. URBINK, H. VERMEULEN, A. GOOSSENS, RB. KELNER, SB. SCHRENDER, MJ. LUBBENS (2008): Occlusiv vs. gause dressings for local Wound Care in Surgical Patients, Arch Surg 143 (10): 950-955.
  9. E. OSTI (2006): Cutaneous burns treated with hydrogel (Burnshield) and a semipermeable adhesive film, Arch Surg 141: 39-42.
  10. E. SARIFAKIOGLU, N. SARIFAKIOGLU (2006): Dressing spray inhances the adhesive strength of surgical dressing tapes, Indian J Dermatol Venereol Leprol 72: 353-356.
  11. GURZO ZS., ROKSZIN T.: Coriosin treatment following minor amputations in diabetes mellitus. Vascular diseases: 2001/3. 91-95. .
  12. GYEVNÁR ZS., HARDI P., SINAY L., ARATÓ E.: A comparison of traditional  stripping and cryostripping as reflected in quality of life Vascular diseases: 2007/2. 87-90.
  13. GYEVNÁR ZS., MENYHEI G., KOLLÁR L.: An assessment of patient satisfaction following varicose vein operations Vascular diseases: 2005/3. 89-92.
  14. HUNYADI J., BIHARI I., LANDI A., CERVENÁK L., RUGONFALVI KISS SZ.: Chronic venous failure and ulcus cruris Varicose diseases: 2004/4. 123-133.
  15. HUNYADI J., HOCK M., SUGÁR I.: The concept, reasons, criteria and principles of treatment of the chronic and hard-to-heal wound Wound Treatment - Wound Healing: 2008/2. 4-8..
  16. J. W. BEAM (2009): Topic silver for infected wounds, Journal of Athletic Training 44 (5): 531-533.
  17. KOTZ P., FISHER J., MCCLUSKEY P., HARTWELL SD., DHARMA H. (2009): Use of a new silver barrier dressing, ALLEVYN Ag in exuding chronic wounds, Int Wound J 6: 186-194.
  18. MJ RAVENCROFT, HARKER J., KA BUCH (2006): A prospective, randomized, controlled trial comparing wound dressing used in hip and knee surgery: Aquacell and Tegaderm versus Cutiplast, An R Coll Surg Eng 88: 18-22.
  19. MH HOLLISAZ, KHEDMAT H. and YARI F. (2004): A randomized clinical trial comparing hydrocolloid, phenytoin and simple dressings for the treatment of pressure ulcers, BMC Dermatology 4:18.
  20. NA NASIR, AS HALIM, KK SINGH, AA DORAI, MN HANEEF (2010): Antibacterial properties of tualang honey and its effect in burn wound management a comparative study, BMC Complement Altern Med..
  21. ROBSON V., DODD S., THOMAS S. (2009): Standardized antibacterial honey (Medihoney) with standard therapy in wound care: randomized clinical trial, J Adv Nurse 65 (3): 565-575.
  22. R INGLE, J. LEVIN, K. POLENDER (2006): Wound healing with honey – a randomized controled trial, S Afr Med J 96: 831-835.
  23. R. WYNNE, M. BOTTI, H. STRADAM, I. HOLSWORTH, M. HARINOS, O. FLAVELL and C. MANTERFIELD (2004): Effects of three wound dressing on infection, healing comfort and cost in patients with sternotomy wounds: A randomized trial, Chest 125: 43-49.
  24. ROZSOS I., FERENCZY J., SZABÓ SZ. et. al. (2008): Endovenous Laser Therapy (EVLT) in the treatment of ulcus cruris Wound Treatment- Wound Healing 11, 1, 4.
  25. SUGÁR I. et al.: Wound treatment in Hungary Wound Treatment- Wound Healing 2003/2 12-16.