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. (220.127.116.11.24) 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.
Observing the effects of Curiosa® gel (Richter Gedeon PLC - Hungary) containing zinc-hyaluronate:
Criteria for inclusion:
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.
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.
Some medical histories in pictures – the application of Curiosa®
before / after
Patient No. 4
Patient No. 8
Patient No. 11
Patient No. 12
During the period of application:
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.