Case Report Selection 2012-2013 - Bio-Mac Group Case 1 24.07.2013 Dr. Peter Engels Case reports...

Granulox®

Dr. Peter Engels Case reports Granulox 2012-2013 124.07.2013

Case Report Selection2012-2013

Starting point:Wound exudat is a -


Wound exudat is a efficient barrier for oxygen exchange, an prohibits an external oxygen supply from the air.

Oxygen barrier

Please take Haemoglobin


Substance: haemoglobin

Status: purified, aqueous solution

Function: Binding and Release of oxygen

Question: Can haemoglobin bind and release oxygen outside of erythrocyts?

Yes it can!!!

Principle: Haemoglobin as O2 shuttle


Equably distributed haemoglobin in the wound exudat, binds the oxygen at the surface and release it at the wound ground

Bypass of oxygen barrier

High oxygen partial pressure

Low oxygen partial pressure

Clinical study results


Case Reports


• Various successful treatments of different wound types are reportedby several users

• Venous leg ulcers• Diabetic foot ulcers• Arterial leg ulcers

• Secundary 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)

Start of treatment


21.02.2012

Compression therapy


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 maintained for 7 months• Treatment with: Iruxol paste, Alginate, Hydrocoloid, Polyurethan foam

Start of Granulox application & Silicone foam


13

Case 2


14

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 nictotine abuse• Wound persists for 7 months• Treatment with : Hydrocolloid, Alginate, Alginate-Ag, Polyurethane Foam

16

Start of treatment with Granulox & non-adhesive foam


17

Case 3


18



Lower leg prothesis pressure mark (3b)


• Wound persisted for 6 Wochen • Treatment with : Hydrocolloid, Alginate, Alginate-Ag, Polyurethane Foam

20

Start of treatment




Case 4 a&b


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

• Persists since 6,5 years• Varikose left leg• Multiple allergies

Lower leg (Left outer, 4a)


Case 4a


Treatment successful after 58 days


Lower leg (inner left, 4b)


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,

28

Start of treament


29



30

Case 6


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

• IDDM• CVI• Nicotine abuse

• Wound exists for 7 months

• Treatment - Hydrocolloid, Hydrogel, Alginate , Alginate-Ag, Foam Surgicaldebridement

31

Start of treatment with Granulox, Alginate & Polyurethane foam




33

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

Start of Granulox treatment & non adhesive foam


End of treatment after 169 Tagen & 50 chang. o. band.


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 !!

Treatment result after 67 days


24. Juli 2013Krankenhaus Nordwest 38

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 since 8 weeks

Treatment with Granulox & silicone foam for 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

Treatment success within …


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

Therapy result after 98 days


45

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 exists for 8 months• Therapy before hospital visit: repeated daily shower of the wound

46

Successful wound closure after 41 days


47

Case 13


• 44 year old male patient• Neck carbuncle

• Surgery 02/12• Wound since 9 weeks• Therapy before hospital visit: repeated daily shower of the wound

48

Start of treatment with Granulox & silicone foam


49

Case 13


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


51

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 for 13 months• Therapy: Negative pressure therapy, Alginate , Foam dressings

52

Start of treatment with Granulox & non-adhesive PU foam


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

53

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

Successful treatment after 40 days and 12 c.o.bs.


55

Case 16


• 38 year old female patient• Abscess left forearm

Spaltung 01/12 Revision 02/12 Allergic asthma Wound exists for 2 months Previous Treatment: surgical & dry dressings

56

Treatment with Granulox, (absorbent dressing pads) silicone foam


End of treatment after 78 days (23 c.o.b)


Case 17


• 64 year old male patient• Circular saw injury

• Laceration and detachment of skin, left hand D1

Treatment period of two weeks


Case 18


• 25 year old patient• Incised wound, right hand, finger D II • Skin necrosis

Two weeks treatment


Case 19


• 84 year old female patient• Woundinfekt after:• Radial head implant 05.08.2011• Platten dislocation und Radial head –pseudo arthrose nach Monteggia # re.

Mit Osteosynthesseund Cerklage am.20.08.2011

Wundrevision und VAC-Verband 02.09.2011


Case 20


• 58 year old male patient• Venous leg ulcer, left lower leg

• CVI• Diabetes Mellitus

24.07.2013Nesat Mustafi 64



Case 21


• 36. J. Patient• Erysipel Re. US (Rezidiv) • Diabetes mellitus Typ 2 insulinpflichtig• Adipositas



Case 22


• 28. J. Patient: Finger DIII Re.

• Verbrennung 2A D III Re.

Finger DIII Re.


70

Case 23 a & b: Verbrennung am Oberschenkel rechts


• 85 J. Patient

• Diabetes mellitus• pAVK• Arterielle Hypertonie• Z.n. Plaqueruptur thorakale Aorta Pers descendes mit Hämatothorax li.• Z.n. endovaskulärer Implantation einer Stentprothese am 03.2010• Postoperativ Verdacht auf Myelonischemie mit Beinparese re.• Wunde seit 4 Wochen bestehend• Behandlung mit : Flamazine salbe

71

Beginn der Behandlung mit Granulox Wundspray und nichtklebenden Polyurethanschaum


Ende der Behandlung nach 53 Tagen und 17 VW


73

Beispiel 4: Verbrennung am Oberschenkel links


• 85 J. Patient

• Diabetes mellitus• pAVK• Arterielle Hypertonie• Z.n. Plaqueruptur thorakale Aorta Pers descendes mit Hämatothorax li.• Z.n. endovaskulärer Implantation einer Stentprothese am 03.2010• Postoperativ Verdacht auf Myelonischemie mit Beinparese re.• Wunde seit 4 Wochen bestehend• Behandlung mit : Flamazine Salbe,

74

Start of treatment Granulox & non-adhesive PU foam dressing



End of successful treatment after 53 days (17 c.o.bs)


Thank you for your attention


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Case Report Selection 2012-2013 - Bio-Mac Group Case 1 24.07.2013 Dr. Peter Engels Case reports...

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