Does A New Cellulose Dressing Have Potential In Chronic Wounds?

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The XCell Cellulose Wound Dressing reportedly provides both hydration and absorption to achieve the moisture balance that wounds require for optimal healing.
A 66-year-old Hispanic female presented with a non-healing ulcer to the plantar aspect of the left hallux (as shown above).
Here one can see the XCell dressing applied to the wound. A month later, there was resolution of the ulceration, according to the author.
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Author(s): 
By Barbara J. Aung, DPM

The patient lives one hour from the clinic and has missed several appointments, but I maintained phone contact weekly to stress to the patient the need for follow-up and to remind her of the signs of worsening of the condition.
Two months later, the wound was unchanged. I obtained a wound biopsy and requested quantitative analysis. At this point, I initiated the antimicrobial XCell wound dressing along with continued sharp debridement. The patient began performing dressing changes herself with the XCell dressing, followed by normal saline moistened gauze and Kling every other day.
Results of quantitative analysis was 2.2 x 10^6 bacteria, gram positive cocci. I did not initiate an oral antibiotic based on the clinical exam and my clinical experience.
A month later, the exam showed resolution of the ulceration so I discontinued the wound care regimen and fit the patient for multi-density insoles and extra depth shoes. I encouraged the patient to continue nonweightbearing to prevent reoccurrence until she receives her new insoles and shoes.

In Conclusion
This biosynthesized cellulose wound dressing, which has a dual moisture handling capability to donate moisture to dry surfaces and absorb fluid from a highly hydrated environment, shows promise in caring for diverse wounds. The ease of application and the ability to leave the dressing in place for up to seven days allows the private practice clinician to offer wound care services within his or her own practice, and schedule follow up care that is more manageable on a weekly basis.
Does this mean we only need to have one type of wound care dressing available in our clinics? That remains to be seen. However, the concepts that originated this material are founded in sound science and as I have used the wound dressing in a wide variety of cases, I have found it useful in almost every case. As always, we cannot forget the need for sharp debridement, when appropriate, as well as a complete and comprehensive history, physical exam, and clinical assessment of the patient and the wound to determine why the wound has gone from an acute wound to a chronic wound.
All wounds need some sort of dressing and XCell may be able to play a more significant role as the first choice, regardless of the wound type, due to its pure nature to hydrate dry necrotic areas, cleanse wound margins and to absorb excess exudate when present.

Dr. Aung is in private practice in Tuscon, Ariz. She currently serves on the Diabetes Advisory Committee of the American Podiatric Medical Association and is a PPOD (podiatry, pharmacy, optometry, dental) Workgroup Member for the CDC-NIH National Diabetes Education Program.

Editor’s Note: For a related article, see “Achieving Adjunctive Success With Wound Dressings” in the July 2003 issue of Podiatry Today or check out the archives at www.podiatrytoday.com.

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