Spray for treatment of chronic wounds - Home - BiologiQ reports_Granulox... · 2017-10-11 · Dr....

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Haemoglobin spray for wound healing

Spray for treatment ofchronic wounds

Haemoglobin spray for wound healing

Haemoglobin for wound healing?Case Report Selection

2012-2013

Dr. Peter Engels Case reports Granulox 2012-2013 Vers. 1/2013

Joint aetiology

¦ different primary diseases lead to a circulatory disorder¦ this results in a local oxygen deficit (hypoxia)¦ almost all chronic wounds are hypoxic

Especially wounds need a lot of oxygen! ¦ massive tissue formation, division of cells, immunoactivity require

significantly more oxygen metabolism activity within a wound thanwithin intact tissue

¦ the required additional energy is provided by consumption of oxygen.¦ the oxygen demand increases!

If the wound is missing oxygen, healing or regeneration processes arenot taking place or only delayed!

Hypoxia | Background

Problem: Partial pressure of oxygen is insufficient¦ cells need at least 20 mm Hg to survive (minimum)¦ complex metabolism activities, especially wound closure / granulation require

a minimum of 40 mmHg

Partial pressure of oxygen in mmHg

normal condition

critical zone,wound healing impossible

Most chronic woundsare in this area.

the tissue dies in most cases

¦ improvement of oxygen supply due to improvement of blood circulationwithin the frame of an adequate causal therapy

� Oxygen is provided from the inside.

¦ additional support by oxygen supply from the outside

� Oxygen from the air has to be made availablefor cellular activity at the base of the wound.

Hypoxia | Treatment options

Oxygen barrier

¦ The exudate presents a diffusion barrier for oxygen.

¦ Already a liquid film of 20 micrometer blocks 95% of the diffusion.

� Even though sufficient oxygen is availablewithin the air, it can‘t get to the base ofthe wound due to the diffusion barrier. Therefore the oxygen requirement ofthe cells can‘t be fulfilled.

Modified equation by Einstein and Smoluchowski

20Distance of source x

Bild aus Keynote Speech

Oxygen barrier

The exudate prevents the supply of oxygen from thesurrounding air to the base of the wound.

Dr. Peter Engels Case reports Granulox 2012-2013 805.08.2013

¦ use of a natural oxygen transporter

¦ transporter takes oxygen from the surfacedown to the base of the wound

¦ unloading at the base of the wound

¦ transporter takes again oxygen from the surface

¦ rotating procedure

� Principle of simplified diffusion!

Principle of haemoglobin

Principle of Haemoglobin

Haemoglobin as transport moleculetakes oxygen to the base of the wound.

1 g hemoglobin transports1 liter oxygen within one day

GRANULOX®

¦ 12 ml ¦ Medical Device class III¦ Patented

¦ Easy to use

¦ Registered in Mexico (since October 2011)¦ Trans-European CE-certification

Clinical studies

Case Reports

� Various successful treatments of different wound types arereported by several users

� Venous leg ulcers� Diabetic foot ulcers� Arterial leg ulcers� Secondary healing wounds� Burns

Case 1

�43 year old male patient�Venous leg ulcer

� Wound existed for 8 years, several relapses� Start of treatment February 2012� Start of Granulox application: March 2012� Successful end of therapy: June 2012

Chronic wound management of a venous leg ulcer patient with complication of Budd Chiari Syndrome (paper submitted)

Case 1

21.02.2012

Start of treatment

Case 1 Compression therapy

Case 1 End of therapy after 115 days

Case 2

� 85 year old male patient� Diabetic foot ulcer

� Interdigital DI-II left.� Diabetes mellitus� pAOD� Arterial Hypertension� Wound persisted for 7 months� Treatment with: Iruxol paste, Alginate, Hydrocoloid, Polyurethan

Case 2 Start of Granulox application & Silicone foam

Case 2

Case 2 End of treatment after - 73 days- 24 changes of bandages

Case 3 (a&b)

� 62 year old patient� Arterial leg ulcer (right leg)

� pAOD IV, right� lower leg amputation 05/11� Diabetes mellitus� Chronic nicotine abuse� Wound persisted for 7 months� Treatment with : Hydrocolloid, Alginate, Alginate-Ag,

Polyurethane Foam

Case 3a Start of treatment with Granulox & non-adhesive foam

Case 3a

Case 3a End of treatment after - 89 days- 27 changes of bandages

Lower leg prothesis pressure mark (3b)

� Wound persisted for 6 weeks� Treatment with : Hydrocolloid, Alginate, Alginate-Ag,

Polyurethane Foam

Case 3b Start of treatment

Case 3b End of treatment after - 53 days- 17 changes of bandages

Case 4 a&b

�72 year old female patient�Venous leg ulcer, left leg

� Persisted for 6,5 years� Varikose at the left leg� Multiple allergies

Case 4a Lower leg (outer left)

Case 4a

Case 4a Treatment successful after 58 days

Case 4b Lower leg (inner left)

Successful closure within 114 days

Case 5

� 62 year old patient� Venous leg ulcer (right)

� CVI� Diabetes mellitus� Arterial hypertension� Wound maintained for 6 months� Treatment with: Iruxol, Repithel gel, Hydrocolloid, Alginate,

Case 5 Start of treament

Case 5 End of treatment after - 78 days- 25 changes of bandages

Case 6

� 68 year old patient� Diabetic foot ulcer (right)

� IDDM� CVI� Nicotine abuse

� Wound existed for 7 months

� Treatment: Hydrocolloid, Hydrogel, Alginate , Alginate-Ag, Foam, Surgical debridement

Case 6 Start of treatment with Granulox, Alginate & polyurethane foam dressing

Case 6 End of treatment after- 50 days- 15 changes of bandages

Case 7

�85 year old female patient�Arterial leg ulcer (right leg)

� pAOD grade II – III� Stenosis of A carotis interna (right)� Multiple allergies� Wound since 7 years

Case 7 Start of Granulox treatment & non adhesive foam

Case 7 End of treatment after - - 169 days- - 50 changes of bandages

Case 8

� 69 year old female patient� Arterial leg ulcer (lateral right leg)

� pAOD Stadium IV (right)� Diabetes mellitus� Two closures of By-passes since 2010� Hodgin – Lymphoma , Polychemotherapy� COPD � C2 –associated liver chirrosis� Wound exists for 28 months� Treatment: everything !!

Case 8 Treatment result after 67 days

Case 9

� 65 year old female patient� Diabetic gangrene at the left big toe

� Diabetes mellitus� pAOD Stadium IV � Obesity� 07/12 Amputation of the left big toe, trans-metatarsal resection� Split-skin graft� Wound persisted 8 weeks

Case 9 Treatment with Granulox & silicone foam dressingfor 59 days

Case 10

� 55 year old male patient� Arterial leg ulcer & diabetic gangrene

� Diabetic gangrene ( Dig. 3.4.5.right foot with necrosis of filament)� foot phlegmone� Diabetic polyneuropathy� Lower leg amputation (left)� Diabetes Mellitus Type II� Obesity

Case 10 Treatment success within …

Case 10 42 days (outer wound) & 66 days (inner wound)

Case 11

� 56 year old female patient� Diabetic foot gangrene

� Diabetes mellitus� Colon Ca./ Chemo therapy� MRSA in wound� Amputation D I + II� Negative pressure therapy without success

Case 11 Therapy result after 98 days

Case 12

� 53 year old male patient� Post surgical wound healing dysfunction

� Pre-peritoneal Lipoma� Lipoma-resection 02/12� partial mucosectomy� Nicotine abuse� Depression � Psoriasis� Allergic asthma� Wound existed for 8 months� Therapy before hospital visit: repeated daily shower of the

Case 12 Successful wound closure after 41 days

Case 13

� 44 year old male patient� Neck carbuncle

� Surgery 02/12� Wound persisted for 9 weeks� Therapy before hospital visit: Repeated daily showering of the

Case 13 Start of treatment with Granulox & silicone foam dressing

Case 13

Case 13 End of therapy after 29 days & 9 c. o. b.

Case 14

� 74 year old male patient� Post surgical impairment of wound healing (after OP)

� Abdominal wall phlegmons� Multiple wound revisions after incisional hernia reparation� MRSA� Wound persisted for 13 months� Therapy: Negative pressure therapy, Alginate , Foam dressings

Case 14

End of therapy after 111 days & 37 c.o.bs.

Start of treatment with Granulox & non-adhesive PU foam

Case 15

� 75 year old female patient� Decollement, pretibial left lower leg

� Maligne Melanoma right foot, toe DII� Liver metastases� Radiation� Situation after fall at home� Previous treatment: not known

Case 15 Successful treatment after - 40 days- 12 changes of bandages

Case 16

�38 year old female patient�Abscess left forearm

� Abscess split 01/12� Revision 02/12� Allergic asthma� Wound persisted for 2 months� Previous Treatment: surgical debridment & dry dressings

Case 16 Treatment with Granulox, silicone foam(absorbent dressing pads)

Case 16 End of treatment after 78 days and 23 c.o.bds.

Case 17

�64 year old male patient�Circular saw injury

� Laceration and detachment of skin, � left hand, finger D1

Case 17 Treatment period of two weeks

Case 18

�25 year old patient� Incised wound

� Right hand, finger D II � Skin necrosis

Case 18 Treatment period of two weeks

Case 19

�84 year old female patient

� Wound infection after:� Radial head implant 05.08.2011� Plate dislocation and Radial head – pseudo arthrosis 8/2011� Wound revision and negative pressure therapy 9/2011

Case 19

Case 20

�58 year old male patient�Venous leg ulcer

� left lower leg� CVI� Diabetes Mellitus

Case 20

Case 21

�36 year old male patient�Bacterial secondary infections of the lower leg

� right lower leg (Relapse) � Diabetes mellitus Type 2 � Obesity

Case 21

Case 22

�28 years old male patient�Burn, Grade 2A

� Right hand� Finger DIII

7605.08.2013

Case 22 Finger, DIII

Case 23 a & b: Burning of both upper legs

� 85 years, patient� Burn of upper leg

� Diabetes mellitus� pAOD� Arterial hypertension

� Wound persisted for 4 weeks� Treament with: Flamazine

Case 23aRight leg

Start of treatment with Granulox& non-adhesive PU foam dressing

Case 23a End of treatment after- - 53 days- - 17 changes of bandage

Case 23bLeft leg

Start of treatment Granulox& non-adhesive PU foam dressing

Case 23b

Case 23b End of successful treatment after � - 53 days- - 17 changes of bandages

Thank you for your attention

Spray for treatment of chronic wounds - Home - BiologiQ reports_Granulox... · 2017-10-11 · Dr....

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