Intelligent Wound Care Solutions

Intelligent Wound Care Solutions
Advanced Active Letpospermum Honey dressings aid and support
autolytic debridement and moist wound healing1, 2, 3, 4
Provides structural tissue and an environment for wound healing.
Provides viable cellular material, structural tissue as an environment
for wound healing.
Gold Standard of care for off-loading diabetic foot ulcers. A essential
step to improve healing rates.5
Redefining moisture wound healing
Protection against opportunistic pathogens including MRSA
Antimicrobial management and control
A Continuum of Intelligent Wound Care Solutions
AMNIOTIC ALLOGRAFT SUSPENSION
n
n
Supports autolytic debridement1-4
Helps maintain a moist wound
environment optimal for healing1-4
n
n
rovides a natural environment to
P
jump start the healing process in a
stalled chronic wound
xcellent handling & comfortability to
E
the wound bed
n
Retains viable cellular material
n
Can be applied into the surrounding tissue
of hard to reach areas of the wound bed
n
old standard
G
in off-loading
n
ovel next-generation
N
moisture management
n
arrier protection against
B
opportunistic pathogens
n
asy application in
E
under 10 minutes
n
Increased absorption capability
n
n
Gel locking capabilities
on-leaching, non-toxic,
N
and non-resistant
n
nforced
E
patient compliance
n
Up to 7-day Antimicrobial
management and control
n
Optimal absorption and
gelling profile
Helping to Remove the Barriers that Delay Wound Healing
Derma Sciences is a Tissue Regeneration Company at the forefront of research and innovation for the management of
acute and chronic wounds, and burns. The products we bring to the market are in the best tradition of evidence-based medicine,
helping clinicians around the world, remove the barriers that delay wound healing and improve clinical outcomes.
With you in mind, our portfolio has grown to provide clinicians with solutions to assist with tissue regeneration - from the start of a
wound through to wound closure. From MEDIHONEY®, to XTRASORB®, to BIOGUARD®, ALGICELL® Ag, TCC-EZ® and now,
AMNIOEXCEL® and AMNIOMATRIX®, our intelligent, evidence-based products help to advance healing for patients suffering
from complex chronic or acute wounds such as diabetic foot ulcers, venous leg ulcers, pressure ulcers and burns.
1
Innovation and Education
Wound clinicians face an array of challenging situations that arise from numerous health-related
and environmental factors, and there is no single technology appropriate for all wound types and
etiologies. For this reason, Derma Sciences has developed a full portfolio of products to support
your needs from the start of a wound through to closure.
Our mission is to provide you with superior products that address every stage of your patients’
therapy and the educational support to make best practice decisions for your patients’ wound care.
Available to access on your computer, tablet or smart phone, please utilize the Derma Sciences
eLearning Portal on our website as the place to go for current and viable information pertaining
to your patients’ wound care management needs. Access Webinars and Video libraries with ease;
view all the evidence pertaining to the brands you know, use and trust; view, download or print
the Novel Technology Product Literature; or sign up to request a Live CE program at your facility
by a Derma Sciences Clinical Field Specialist.
Your skills and our science bring new genius to advancing wound care
n
Addressing wound management issues, from moisture balance to infection control
n
Balancing
technologies according to co-morbidities, wound characteristics and
other ancillary factors
n
Gaining control of the wound environment to help support optimal clinical outcomes
n
Treating the wound and the patient – leading not only to healing, but to comfort as well
www.dermasciences.com/e-learning
2
Combating trends
It is estimated that there are approximately 6.5 million
Americans who now suffer every year from chronic wounds.6
These wounds are treated at a cost of approximately
$25 billion dollars.7
Approximately 50% of these wounds will go on to heal in an
appropriate amount of time. The other 50% have the potential to
stall, requiring advanced techniques for effective management.
3
Advancing Wound Care
Across the Spectrum
Diabetic Foot Ulcer Wound Care and Off-loading Protocol*
VIP PRINCIPLES: Vascular Management / Infection Control and Prevention / Pressure Relief!
GOALS!
Ensure Adequate Vascular
Status!
Debridement!
Infection Control and
Prevention!
Protect from Maceration and
Contamination!
Off-Loading: Prevent Pressure
and Shearing Forces!
Healing!
BARRIERS!
Age, co-morbidities, obesity,
nutrition, surgical candidacy
Necrotic Tissue,
Elevated pH
Bioburden
Excessive wound exudate/
MMPs
Patient adherence and
activity level
Failure of the wound to
progress
Completely!
Closed Wound!
Consult with Vascular
Consultant ###
Aids autolytic
debridement
& healing
Aids autolytic
debridement
Absorption, fluid handling and moisture management
SOLUTIONS!
Moist wound healing has become a growing specialty. We are now able to identify and
manage a multiplicity of factors that affect a wound’s ability to progress toward healing.
Even wounds that will follow an appropriate healing trajectory can greatly benefit from novel
discoveries that support the moist wound healing environment. The challenging wounds
– those that become chronic and stalled – can be managed effectively by removing the
barriers that delay wound healing, which will save limbs, shorten hospital stays and provide
greater patient comfort and Quality of Life.
Protect against opportunistic pathogens
Manage
infection
AMNIOTIC ALLOGRAFT SUSPENSION
Enhance healing with advanced treatment
Enhance healing with advanced treatment
Off-loading
PROGRESSION TO WOUND CLOSURE!
The overall goal for wound bed preparation is to remove the factors that delay healing.
Setting goal-oriented strategies can help you gain control over your patients' wound
environment and get them back on track towards healing. Appropriate goals such as
optimizing the physiologic wound healing environment (e.g., debridement, cleansing,
protection from infection, off-loading, moisture management), and providing systemic
support (e.g., edema reduction, nutrition, hydration) are foundational to the process.
As a tissue regeneration company committed to advancing clinical outcomes in wound
healing, Derma Sciences has designed a portfolio of products that work synergistically,
providing clinicians with innovative solutions that can address clinical need throughout the
continuum of care.
Our mission is to support clinical need and provide our customers with superior products
that address every stage of a patients’ therapy and the tools to make best practice
decisions for your patients’ wound care.
4
Stalled wounds by numbers
Those that typically don’t heal 15% in two weeks.8
If a Pressure Ulcer does not reduce in size at least
19.5% in one week it may not heal in a timely fashion.9
If a Venous Leg Ulcer does not show at least 30%
reduction in two weeks, it is probable that it will
not be healed at 6 months.10
If a Diabetic Foot Ulcer does not show a 30% reduction
in size in two weeks of treatment there is only a 9%
chance it will go on to healing in three months.11
5
About MEDIHONEY® Dressings
MEDIHONEY® is the global leading line of medical-grade honey products for the
management of wounds and burns.
Global leading line of medical-grade honey
products for the management of wounds
and burns.
Derived from the Leptospermum species of plant in New Zealand, these unique
dressings have properties which are beneficial throughout all phases of wound
healing.12,13,14 MEDIHONEY® dressings offer a full line of dressing solutions, providing
versatility for varying wound and wound management needs.
How MEDIHONEY® dressings helps to promote healing
Wounds can be challenging to manage due to a multitude of co-morbid and
cascading factors.12 These factors include necrotic tissue, elevated levels of pH which
can alter the composition of wound exudates, and recurring physical trauma.
Mechanisms of Action
Gel
Paste
1. High Osmolarity12-16
n
Provides an optimally moist environment conducive to wound healing
n
Assists with autolytic debridement by promoting an outflow of wound fluid helping
to soften and liquefy necrotic tissue
2. Low pH
HCS
Calcium Alginate
Honeycolloid
n
MEDIHONEY® has a low pH of 3.5-4.5
n
Helps to lower pH levels within the wound17-19
n
Lowering wound pH has been shown to have wound healing benefits.19
(Hydrogel Colloidal Sheet)
6
The Body of Evidence Supporting the
Clinical Efficacy of MEDIHONEY® Dressings
Mechanisms of Action
High Osmolarity
There are over 160 pieces of evidence including 8 RCTs,
47 peer-reviewed published studies and papers
and 105 posters and conference proceedings
showing MEDIHONEY® dressings is an
effective product for promoting the removal of
necrotic tissue and healing.
n
Randomized Controlled Trials (RCT)
n
Peer-Reviewed Published in vivo Studies
and Papers
n
Presented in vivo Posters and Conference Proceedings
Wound bed with slough,
eschar and elevated pH
High Osmotic pull bathes wound
and low pH impacts wound pH
Non-viable tissue
is removed
No other honey brand has this many pieces of evidence!
Low pH
CAUSES OF
STALLING
MEDIHONEY
ACTION
RESULT
Non-viable/
Necrotic Tissue
Osmotic activity
Aids in autolytic debridement12-16
An increased amount of wound fluid helps
to soften and liquefy necrotic material,
while the body’s own enzymes work to
further break down the necrotic tissue pH
modulation16,17
pH modulation
The low pH of MEDIHONEY® helps
to lower the pH within the wound
environment17,18, which has been shown to
have wound healing benefits.19
4
6
idic
Ac
7
8
Alk
ali
n
10
3
pH
9
e
High pH
5
Healing
Breakdown
pH
pH SPECTRUM
7
About Amniotic Tissue
The natural human amniotic membrane is an attractive option for treating
complex and chronic wounds because of its non-immunogenic,20 anti-inflammatory21
and anti-bacterial22 properties. The tissue also provides a matrix for cellular migration
and proliferation and a number of essential growth factors and cytokines.23
Dehydrated human
amnion-derived
tissue allograft with
intact extracellular matrix
AMNIOTIC ALLOGRAFT SUSPENSION
During pregnancy the amniotic membrane, fluid and cells act as a biologic
system whose primary function is to (i) protect the fetus; and (ii) aid in fetal
growth and development.
In addition to its structural properties, the placental membrane and amniotic
fluid have been found to contain a rich source of proteins, cytokines, growth
factors and other chemical compounds, all of which are essential for fetal
growth and development. Amniotic fluid also contains cells that are capable of
differentiating into all three germ layers of the human body.24 Specifically, amniotic
fluid derived stem cells have been shown to be broadly multipotant, capable of
differentiating into adipogenic, osteogenic, myogenic, endothelial, neurogenic and
hepatic cells lineages.25
Donor Suitability & Safety Testing
A next generation
cryopreserved human
amniotic liquid allograft
8
From donor qualification to pre-release lot testing, our processor is committed
to patient safety. Please read our package insert for all the details.
About AMNIOEXCEL®
About AMNIOMATRIX®
The Extracellular Advantage
AMNIOMATRIX® is an Amniotic Allograft Suspension derived from
the components of the amniotic fluid and morselized amnion. It is
cryopreserved and the proprietary processing method preserves the
viable cellular materials, cytokines, and growth factors.
AMNIOEXCEL® is an Amniotic Allograft Membrane composed of an
epithelial layer, basement membrane and compact layer. Dehydrated
using our patent pending DryFlex® processing technology for a highly
malleable and conformable product providing intimate contact with the
wound bed and ease of application. This extracellular matrix is fully
resorbable and provides a natural environment to enhance soft tissue
reconstruction and regeneration.
Amniotic Extracellular Matrix (ECM) is a composition of collagen,
fibronectin and proteoglycans that provides a natural matrix to support
angiogenesis, granulation tissue formation and new collagen deposition
during tissue repair and regeneration.
Product Benefits:
n
N
ot side specific, can be applied on any side
n
Immune Privileged: rarely evokes an immune
response in the human body
n
D
ehydrated using our patent pending DryFlex®
processing technology for a highly malleable and
conformable product providing intimate contact with the wound bed
and ease of application
n
T
erminally sterilized to achieve SAL 10-6
This morselized tissue matrix includes residual proteins, carbohydrates,
hyaluronic acid, growth factors, and other chemical compounds
naturally present in amniotic fluid and tissue to provide a liquid tissue
matrix that is derived from those components essential for fetal growth
and development.
Product Benefits:
n
Immune-privileged: rarely evokes an immune response in the
human body
n
P
resence of residual cells may provide ancillary clinical benefits to
the patient
n
V
iable cellular material, amniotic fluid
components & morselized amnion
jump starts the healing process in
stalled wounds
9
About Total Contact Casting
MedE-Kast
®
Off-Loading Evidence vs. Practice
n
Experts recognize TCC as the Gold Standard and Preferred method for off-loading 5, 26-33
n
TCC is supported by Level I evidence, including numerous RCTs, meta-analyses’
Helping More People Heal Faster
TCC has been shown to heal 90% of
DFUs in about 6 weeks26-32
and many consensus documents.33
n
90% healing rates demonstrated in multiple RCTs, most healing times 5-8 weeks.26-32
A Gap Between Evidence and Practice
n
A Gap between evidence and practice (Results from a 5 year retrospective analysis
with over 25,000 DFUs)34
n
The most used method of off-loading employed by practitioners is the least effective
n
Only 3.7% of eligible DFUs received TCC. TCC patients have half the amputation
rate (Non-TCC 5.2%, TCC 2.2%)
Types of off-loading used at the 2.2%
of visits that had off-loading documented34
TCC-EZ® casting system
10
MedE-Kast® total contact cast
Option
Visit Count
%
1. Postoperative shoe
2. TCC
Shoe modification
DH walker
Half shoe
Custom insert
1803
781
652
469
266
259
37.0
16.0
13.3
9.6
5.4
5.3
TCC cuts amputation rates in
½
68,000 diabetic lower-extremity
amputations in 2009.35
#1
The ease of the market leading TCC-EZ® makes its use practical in clinical settings.
TCC-EZ® offers a one-piece, roll-on, light weight, woven design that is faster and easier
to use than traditional systems. The ease of application can lead to fewer complications.36
n
n
n
n
n
n
n
4 times as many patients were casted in clinics using TCC-EZ® 5 vs. traditional TCC
TCC-EZ® can be applied in under 10 minutes36
Enforced Patient Compliance
Requires minimal training time36-37
Takes less than ¼ of the amount of time of traditional systems37
Lightweight woven design offers a more comfortable fit
Allows for customized fit on every application
Cast liner sock
and felt padding.
Choice for TCC
Single layer cast sock,
with hardening resin.
Lightweight,
customized boot.
MedE-Kast MedE-Kast Ultra
®
®
Derma Sciences is the only company to give you the flexibility of the quick and easy TCC-EZ® casting system and a traditional
Total Contact Cast that has been specifically designed and proven to off-load.36
The traditional MedE-Kast® and MedE-Kast® Ultra Total Contact Cast Systems provide a healthcare provider with the necessary
components to apply a total contact cast in one simple kit. The MedE-Kast® Ultra Total Contact Cast System contains two
pre-made splints to help make the application process easier and faster.
11
About xtrasorb®
Advanced technology dressings that
redefine...absorption, fluid handling and
moisture management
XTRASORB® is a line of novel, super-absorbent wound dressings. The core
super-absorbent polymer technologies dramatically improve the capabilities of the
dressings versus conventional moist wound dressings. Whereas other absorbent
dressings (including foams, ABD pads, and other cellulose-based dressings) rely on
spaces within the dressings to fill with fluid, XTRASORB®’s super-absorbent polymers
bind fluid and convert it to a gel. This distinct advantage makes XTRASORB®
dressings ideal for use under compression.
The XTRASORB line offers a full range of absorption and fluid management capability:
XTRASORB®­HCS:For dry to moderately exuding wounds – with and
without adhesive border
XTRASORB® Foam:For moderately to heavily exuding wounds – with and without adhesive border
XTRASORB® Classic: For heavily and extra heavily exuding wounds
xtrasorb® Education
HCS
(Hydrogel Colloidal Sheet)
Foam
Classic
XTRASORB®: Redefining Moist Wound Healing
Designed to exceed the performance of the market-leading brands, making optimal care
easier for clinicians and patients, the XTRASORB® line of products are powered by a
patented super-absorbent polymer (SAP) platform technology.
12
XTRASORB® HCS, Foam and “Classic” dressings outperform other standard
moist wound healing dressings on multiple clinical dimensions.38
Provides the hydration of a hydrogel while
absorbing up to four times more liquid than
competitive hydrocolloid dressings 38
Total Fluid Handling at 55% RH, g/sqm/24h
1800
n Moisture Vapor Loss
n Absorption
900
0
Novel hybrid hydrogel/hydrocolloid
dressing that gels as it absorbs,
locking in wound fluid to keep
its harmful components away
from the patient’s wound and
surrounding tissue.
n
These dressings pull fluid directly
to the back of the dressing then
converts it into a gel, retaining it
in a controlled area.
Absorbent core with super-absorbent
polymer fibers that absorb large
quantities of wound exudate,
forming a gel that binds and locks
the exudate away from the wound.
Absorption: Each dressing format absorbs more fluid than conventional standard
Duoderm®
Signal
Test performed using Inverted Paddington Cups. Modified Test Methodology BS EN:13726-1:2002 Part 3.3. This determines Total Fluid Handling (=
Absorption + Moisture Vapor Loss) of different dressings, measured in grams per square metres per 24 hours. Tests carried out at 55% Relative Humidity.
38
Relative absorption & retention following failure under compression
90
dressings designed for similar wound types.38 This increases time between
dressing changes, reducing costs and minimizing disruption to the wound bed.
n
F
luid Handling and MMP Sequestration: The SAP technology of XTRASORB®
ensures that wound fluid will be locked into the dressing, reducing maceration. It
can also directly absorb bacteria and matrix metalloproteinases (MMPs) or reduce
their function by sequestering the co-factors (metal ions) they need to operate,
thus helping you get control over the wound environment.39
M
oisture Management: Maintaining an optimal moist wound interface while
absorbing whatever the wound condition dictates allows XTRASORB® dressings
to deliver proper moisture management and balance.
n Absorbed & lost
Fluid Absorbed, Retained or Lost (g)
n
Tegaderm®
Hyrocolloid
n Absorbed & retained
60
30
0
Foam
Allevyn®
Gentle
Tegaderm®
Foam
PolyMem®
Mepilex®
Classic
Dressings are held under a 5kg weight (corresponding to approx. 40mmHg). Flow rate of Ca Saline at 3ml/h (representative of a very high level of exudate). The
experiment determines the amount of fluid taken up by each dressing up until the time that the dressings are unable to continue to absorb all the fluid being
delivered to them. The experiment is allowed to run for 30 minutes beyond this failure point to ensure that the latter is the case. Measurements are then taken
at that time. Each dressing is subsequently rolled 3 times with a 2.5kg roller to determine proportions of free and bound fluid.
Duoderm is a registered trademark of ConvaTec, Inc. Tegaderm is a registered trademark of 3M. Allevyn is a registered trademark of Smith & Nephew.
Mepilex is a registered trademark of Mölnlycke Health Care. PolyMem is a registered trademark of Ferris Manufacturing Company
13
About bioguard®
BIOGUARD® Barrier Dressings have a cationic biocide - polyDADMAC - bound to
the dressing substrate which acts as a physical barrier of protection against a broad
spectrum of opportunistic pathogens including MRSA.
Stand Guard: Barrier protection against
opportunistic pathogens including MRSA
Non-leaching: polyDADMAC is bound to the dressing substrate. It does not leach,
causing a zone of inhibition on the dressing, which can lead to resistance or toxicity
issues to healthy cells.40
Non-toxic: BIOGUARD® is able to provide >5-log kill of pathogens within the dressing
without adversely affecting wound cells, which could otherwise delay wound healing.41
Sponges
Conforming Bandage
Gauze Sponge
Non-Adherent
Dressings
14
Non-resistant: is an advanced biocide with a high charge density and molecular
weight polyDADMAC - up to 100x larger than PHMB. Due to its size, bacteria do not
develop resistance.40
Ready-Cut Gauze
Burn Dressing
Packing Strips
Island Dressings
The Importance of Non-Leaching for Healthy Healing
Traditional Gauze
BIOGUARD
®
Samples of gauze dressing were
inoculated with 2 ml of PBS
containing 1 x 104 cfu of E. coli
then incubated for 15 hours at
37°C on tryptic soy agar (Difco)
containing 0.01% TTC. Red color
indicates areas of bacterial growth.
The Proof is in the Dressing
Method of Action
Adoption of antimicrobial gauze bandages for
standard use in heavily exudating wounds
Cationic biocides act through a physical mechanism of action. They attract bacterial cells
and bind rapidly to the cellular envelope and physically disrupt the cell wall structures
causing the membrane to fragment, leading to cell breakdown. (See Fig.3).
Bernd Liesenfeld1*, David Moore1, Robert Nappo2, Lisa Youngblood2, Gregory Schultz1, 3
Shands at the University of Florida, 2 Quick-Med Technologies, 3 University of Florida,
* Corresponding Author
The Symposium on Advanced Wound Care, Spring 2012 IR-26
1
Additionally, the higher the charge density, the more likely the biocide effects will maintain their
effectiveness in high levels of exudate or other bodily fluids.7
Background
Gauze bandages and pads are commonly used as dressings for
patients with large wounds. A disadvantage of traditional gauze
bandages is the absorption of exudate into the dressing. Exudate
absorption often contributes to development of high levels of
bacteria in the dressing. With plain cotton gauze, in order to
maintain clean, non-contaminated dressings, dressing changes
need to happen more frequently and can cause disruption to
wound healing.
Figure 3.
Figure 1.
Change graphics - see email to Laurie Larr
Case 1 – Donor site
managed with
traditional gauze
Figure 4a shows a Donor Site
treated with the standard gauze
dressings that are metallic
green in color and a strong odor
is present. Figure 4b shows
the same Donor Site after 24
hours of treatment with the
BIOGUARD gauze bandages.
It is apparent that exudate is
present but the color and odor
have improved.
Attract
Disrupt & Destroy
Bind
Broad spectrum, fast acting, long lasting barrier protection
1
Figure 2.
Time
Staph.
Aureus
E. Coli
P.
Aeruginosa
10 min.
99.99415%
99.99763%
99.98564%
30 min.
99.99878%
99.99972%
99.99746%
4 hrs.
99.9999%
99.99981%
99.99996%
12 hrs.
99.9999%
99.99997%
99.99996%
Bacteria
ATCC#
% Reduction
Staphylococcus aureus
12600
>99.9999%
Klebsiella pneumoniae
13833
>99.9999%
Proteus vulgaris
13115
>99.9999%
Enterococcus faecalis
19433
>99.9999%
Listeria monacytagenes
13932
>99.9999%
MS-2
>99.87%
Bacteriophage
(RNA virus)
*Tested in 10% bovine serum (except viruses) after 18 hours of exposure
15
About Algicell® Ag
Powerful antimicrobial strength and
superior absorption that’s highly
cost effective
Antimicrobial silver dressings in absorbent/gelling formats have become the leading
category of “active” moist wound dressings worldwide. Our key offering in this
space, ALGICELL® Ag, provides caregivers with an alternative to the market leading
brand that delivers superior performance at a more cost-effective price level.
The effectiveness of a silver dressing is influenced by many factors: the type of silver,
the length of its antimicrobial activity, its absorptive capabilities and more. ALGICELL®
Ag addresses these key issues powerfully.
n
1.4% Ionic silver provides long-lasting, measured release for 7-day effectiveness
n
ALGICELL® Ag offers optimal absorption capability
n
Effective against a broad range of bacteria
n
ptimal gelling capability ensures that the dressing doesn’t stick or leave fibrous
O
residue in the wound bed
ALGICELL® Ag’s Stronger When Wet Gelling Profile
Rope Dressing
Sheet Dressing
n
Gels well and is stronger when wet
n
Remains intact and facilitates ease of removal
n
Minimizes fibrous residue
nHelps
maintain a moist environment,
conducive to wound healing
ALGICELL® Ag
SILVERCELL®42
(Dressings are magnified 600% after saturation with
hypertonic saline solution)
16
A Cost Effective Alternative
Up to 7-day, broad spectrum
effectiveness43, an optimal gelling profile
and absorption capability
% Reduction
0
24 hrs - Day 1
Cost Savings
USUAL DRESSING*
72 hrs - Day 3
25
n
NURSING
COST
50
90
100
All > 99.99%
% Reduction
0
All > 99.99%
120 hrs - Day 5
168 hrs - Day 7
DRESSING
MATERIAL
COST
n
STUDY DRESSING**
N
ursing time for complete
dressing change @ $25.00
per hr (both cover and
primary dressing)
n
N
umber of complete dressing
changes weekly = 7
n
N
umber of complete dressing
changes weekly = 2
n
3
0 minutes per dressing@ $25.00
per hr = $87.50
n
3
0 minutes per dressing change
@ $25.00 per hr = $
25.00
N
ursing time for assessing
cover dressing and
changing prn
n
N/A
n
n
C
over dressing changed daily along
with primary dressing, therefore, all
costs are included above
N
umber of just cover dressing
changes = 5
n
5
minutes per dressing change @
$25.00 per hr = $10.40
TOTAL NURSING COST
$87.50
$35.40
Cost silver absorbent dressing
$14.00 ea
$9.00 ea
Weekly cost for silver dressing
7 @ $14.00 = $98.00
2 @ $9.00 = $18.00
Cost per cover dressing
$1.45 ea
$1.45 ea
Weekly cost per cover dressing
7 @ $1.45 = $10.15
5 @ $1.45 = $7.25
25
TOTAL DRESSING MATERIAL COST
$108.15
$25.25
50
TOTAL NURSING AND DRESSING MATERIAL COST PER WEEK
$195.65
$60.65
90
$195.65 (USUAL DRESSING)
100
- $60.65 (STUDY DRESSING)
TOTAL COST SAVING PER WEEK: $135.00
All > 99.99%
99.68% 99.99% 99.99% 99.99%
Staphylococcus
aureus
Pseudomonas
aeruginosa
Escherichia coil
Candida albicans
* Aquacel Ag®, ConvaTec, a Bristol Myers Squibb Company
**ALGICELL® Ag, Derma Sciences, Inc., Princeton, New Jersey
C
onnie Johnson, RN, WCC, DAPWCA, Director Wound Care Team, Morristown, NJ, Wound Care Team @ Madison Avenue;
Andrea McKenna, LPN, Pressure Ulcer Prevention Coordinator; A Cost-Effective Alternative: Investigating Absorbent Gelling
Calcium Alginate Dressings with Antimicrobial Silver, EPUAP in Birmingham UK in 2008
17
Traditional Advanced Wound Care Products
In addition to our ongoing focus on unique advances in wound care, Derma Sciences is dedicated to providing a full
line of products that offer you the best solutions for a wide variety of situations and needs.
Dermagran®
Advanced Wound Care Products
Dermagran® Ointment
A pH balanced skin protectant formulated with
Derma Sciences’ proprietary zinc-nutrient
technology, and containing vitamin A, calcium,
and magnesium. For abrasions, skin tears, partial
thickness pressure ulcers, and preventative skin
care.
Dermagran®-B Hydrophillic
Wound Dressing
Provides either a primary cover or filler for chronic
and acute wounds. Contain Derma Sciences’
zinc-nutrient dressing formulation, balanced pH
technology, vitamins A and B6, calcium and magnesium. For
pressure ulcers (Stages II - IV), tissue trauma, surgical incisions,
partial thickness thermal burns, diabetic and venous stasis ulcers.
18
Dermagran® Amorphous Hydrogel Dressing
Part of our Dermagran® family, and contains the same
zinc-nutrient technology. For Stage I-IV pressure sores,
surgical incisions, thermal burns, cuts, abrasions, and
venous stasis ulcerations.
Dermagran® Moisturizing Spray
pH balanced skin protectant with ionic zinc,
A
vitamins A and B6, calcium and magnesium, that
conditions the skin before application of Dermagran®
Ointment or another appropriate dressing. For Stage I
pressure ulcers, abrasions, and preventive skin care.
Dermagran® Wound Cleanser with Zinc
A gentle skin and wound cleanser that contains
both zinc and vitamin B, with one of the lowest
cytotoxic formulations on the market. Designed
to cleanse, and prepare the wound bed with an
optimal environment for wound healing. The
multi-use spray bottle is designed so that the
protective cap does not need to be fully removed
in order to operate, increasing ease of use.
Wound Cleansers
Primaderm® Wound Cleanser - Non-Sterile
Non-sterile, preserved dermal cleanser for multi-use.
Non-cytotoxic formula. Use when extra cleansing power is
needed. Contains Poloxamer 188, an effective surfactant
known to be gentle on tissue. For pressure ulcers, stasis
ulcers, diabetic foot ulcers, post-surgical wounds, first and second
degree burns, cuts, abrasions, and minor irritations of the skin.
Primaderm® Dermal Wound Cleanser – Sterile
Sterile non-cytotoxic dermal cleanser for single-use, making
it the cleanser of choice for traumatic acute wounds. Use
when extra cleansing power is needed. Contains Poloxamer
188, an effective surfactant known to be gentle on tissue.
Can also be used for pressure ulcers, stasis ulcers, diabetic foot
ulcers, post-surgical wounds, first and second degree burns, cuts,
abrasions, and minor irritations of the skin.
Silver Antimicrobial Wound Care Dressings
Silverseal Wound Contact Dressing
®
Provides a topical antimicrobial barrier that can be
left in place for up to seven days, and reduces the
bacteria and fungi counts on and around the wound
surface. For management of incisions, skin grafts, donor sites,
lacerations, abrasions, pressure sores, chronic wounds, chronic
ulcers, dermal ulcers, vascular ulcers, and diabetic ulcers.
Hydrogel Dressings
Aquasite® Amorphous Hydrogel Dressing
For rehydrating sloughy or necrotic tissue and
enhancing autolytic debridement on minimally
draining wounds. Used to fill uneven and difficult
to reach spaces. For Stage I-IV pressure sores,
surgical incisions, thermal burns, cuts, abrasions, and venous
stasis ulcerations.
Aquasite® Impregnated Gauze
For rehydrating sloughy or necrotic tissue and
enhancing autolytic debridement on minimally
draining wounds. Ideal when a sterile, moist
packing for full thickness wounds is necessary. For Stage
I-IV pressure sores, surgical incisions, thermal burns, cuts,
abrasions, and venous stasis ulcerations.
Calcium Alginate Dressings
Algicell® Calcium Alginate Dressing
Alginate dressings can be used to cover or fill
wound areas while absorbing moderate to large
amounts of wound drainage and may help control minor
bleeding. Algicell dressings are made of a proprietary blend of
gluconic and manuronic acids and, just like our ALGICELL® Ag,
ALGICELL® offers an optimal gelling profile.
19
Ordering Information
Order Code Description Packaging unit/Case
HCPCS*
31805 0.5 oz tube 10/box, 4 boxes/case A4649
31815 1.5 oz tube 1/box, 12 boxes/case A4649
Non-Adhesive
31622 2.4" x 2.4" 10/box, 5 boxes/case A4649
31644
4.33" x 4.33" 10/box, 5 boxes/case A4649
31688 8" x 8" 5/box, 4 boxes/case A4649
31612 8" x 12" 2/box, 5 boxes/case A4649
1.8" x 1.8" 10/box, 5 boxes/case A4649
31722 2.8" x 2.8" (4.3" x 4.3" with adhesive border) 10/box, 5 boxes/case A4649
31744 4 ½" x 4 ½" (6" x 6" with adhesive border)
10/box, 5 boxes/case A4649
31012 ¾" x 12"
5/box, 4 boxes/case A4649
31022 2" x 2"
10/box, 10 boxes/case A4649
31045 4" x 5" 10/box, 5 boxes/case A4649
31222 2" x 2"
10/box, 10 boxes/case A4649
31245 4" x 5" 10/box, 5 boxes/case A4649
31422 2" x 2" (3 ½" x 3 ½" with adhesive border) 10/box, 10 boxes/case A4649
31445 4 ½" x 4 ½" (6" x 6" with adhesive border)
10/box, 5 boxes/case A4649
31505 0.5 oz tube 10/box, 4 boxes/case A4649
31515 1.5 oz tube 1/box, 12 boxes/case A4649
31535 3.5 oz tube 1/box, 12 boxes/case A4649
MEDIHONEY Dressings
®
Gel
HCS
Fenestrated - Non-adhesive
31618 Adhesive
Calcium Alginate
Honeycolloid
Non-Adhesive
Adhesive
Paste
20
Order Code Description Packaging unit/Case
HCPCS*
AMNIOEXCEL® Amniotic Allograft Membrane
25015 1.5cm x 1.5cm (2.25cm2)1/box
25012
12mm disk
25013
15mm disk
25023 2cm x 3cm (6.0cm2)
1/boxQ4137
25044 4cm x 4cm (16.0cm2)
1/boxQ4137
25048 4cm x 8cm (32.0cm2)1/box
3.5cm x 3.5cm
4cm x 8cm (32.0cm2)
5cm x 5cm
10cm x 10cm
12 mm disk
15 mm disk
18 mm disk
Q4137
Q4137
AMNIOMATRIX® Amniotic Allograft Suspension
25510 0.25 ml
1 vial
Q4139
25520
0.50 ml
1 vial
Q4139
25530
1.0 ml
1 vial
Q4139
25540 2.0 ml
1 vial
Q4139
25550
3.0 ml
1 vial
Q4139
21
Ordering Information
Order Code Description Packaging unit/Case
HCPCS*
Casting Systems
TCC23000
TCC23001
TCC23002
TCC23005
TCC23051
TCC24000
TCC24001
TCC24002
TCC24005
TCC24014
TCC24016
TCC24024
TCC24026
TCC24051
TCC24214
TCC24224
TCC25050
10 Casting Systems 3" with 2 Regular Boots
1/case
10 Casting Systems 3" with No Boot
1/case
Casting System 3" Single Application
1/case
5 Casting System 3" with 1 Regular Boot
1/case
5 Casting System 3" with No Boot
1/case
10 Casting Systems 4" with 2 Regular Boots
1/case
10 Casting Systems 4" with No Boot 1/case
Casting System 4" Single Application
1/case
5 Casting System 4" with 1 Regular Boot
1/case
10 Casting Systems 4" with 1 Large Boot
1/case 10 Casting Systems 4" with 1 Large Charcot Boot
1/case 10 Casting Systems 4" with 1 Extra Large Boot
1/case 10 Casting Systems 4" with 1 Extra Large Charcot Boot1/case
5 Casting System 4" with No Boot
1/case
10 Casting Systems 4" with 2 Large Boots
1/case
10 Casting Systems 4" with 2 Extra Large Boots
1/case
5 - 3" and 5 - 4" with 2 Regular Boots
1/case
TCC25051
5 - 3" and 5 - 4" with No Boot
1/caseQ4038
Boots
TCC21100
Regular Boot
1 boot
N/A
TCC21114
Large Boot
1 boot
N/A
TCC21116
Large Charcot Boot
1 boot
N/A
TCC21124
Extra Large Boot
1 boot
N/A
TCC21126
Extra Large Charcot Boot
1 boot
N/A
Tcc-ez®
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Q4038
Tools
TCC2SAW
Cast Removal Saw
TCC2SAWSSBSaw Replacement Stainless Steel Blades (4 Blades)
TCC2VACFLT
Dust Vacuum Disposable Filter Cartridge
TCC2VAC
Cast Removal Dust Vacuum
TCC2SPRL
Cast Removal Spreader Large
N/A
N/A
N/A
N/A
N/A
Casting Systems
TCC2MDKK
TCC2MDKKS
TCC2ULTR
TCC2ULTRS
Q4038 and Q4037
Q4038 and Q4037
Q4038 and Q4037
Q4038 and Q4037
MedE-Kast®
22
Case of 10 Casting Systems
Casting System - Single Application
Ultra Case of 10 Casting Systems Ultra Casting System – Single Application
1/case
1/case
1/case 1/case
Order Code Description Packaging unit/Case
HCPCS*
86322 2.3" x 2.3" 10/box, 4 boxes/case A6234
86344 4.3" x 4.3" 10/box, 4 boxes/case
A6235
86388 8" x 8" 5/box, 8 boxes/case A6236
86433
3" x 3" 10/box, 4 boxes/case A6237
86466
6" x 6" 10/box, 4 boxes/case A6238
86122 2" x 2" 10/box, 4 boxes/case A6209
86144
4" x 4 ¾" 10/box, 4 boxes/case A6210
86188 Adhesive
8" x 8" 5/box, 8 boxes/case A6211
86233
3.2" x 3.2" 10/box, 4 boxes/case A6212
86244 4 ½" x 4 ½” 10/box, 4 boxes/case A6212
86266
6" x 6" 10/box, 4 boxes/case A6213
89533 3" x 3" 10/box, 10 boxes/case
A6251
89545 4" x 5" 10/box, 10 boxes/case A6252
89569 6" x 9" 10/box, 5 boxes/case A6253
XTRASORB® Super Absorbent Dressings
HCS
Non-Adhesive
Adhesive
Foam
Non-Adhesive
Classic
Coming
in March
Non-Adhesive
23
Ordering Information
Order Code Description Packaging unit/Case
HCPCS*
Gauze Roll
97322 6-Ply, 4.5" x 4.1 yds 1 roll/pkg, 100 pkgs/case
A6266
Conforming Bandage
97241 97341 97441 2" x 4.1 yds 3" x 4.1 yds 4" x 4.1 yds 1 roll/pkg, 100 pkgs/case
1 roll/pkg, 100 pkgs/case
1 roll/pkg, 100 pkgs/case
A6266
A6266
A6266
50 dressings/tray, 24 trays/case (1200 dressings)
100 dressings/tray,
30 trays/case (3000 dressings)
A6222
BIOGUARD® Barrier Dressings
Gauze Sponges
97412 12-Ply, 4" x 4", 2’s 97208 8-Ply, 2" x 2", 2’s A6222
Packing Strips
97831 97832
97833
¼" x 5 yds ½" x 5 yds 1" x 5 yds 12/cs
12/cs
12/cs
A6266
A6266
A6266
Non-Adherent Dressings
97334 3" x 4" 97338
3" x 8" 50/box, 18/cs
50/box, 12/cs
Island Dressings
97041
97042
97045
97048
4" x 10" 4" x 14" 4" x 5" 4" x 8"
25/box, 4 boxes/cs
25/box, 2 boxes/cs
25/box, 8 boxes/cs
25/box, 4 boxes/cs
Ready Cut Gauze
97118
100-Ply,18" x 18" 10/pkg, 100 pkgs/case
A6222
A6223
A6223
A6223
A6223
A6223
ALGICELL® Ag Silver Antimicrobial Dressings
24
88512 ¾" x 12" 5/box, 4 boxes/case
A6199
88522 2" x 2" 10/box, 10 boxes/case
A6198
88544 4 ¼" x 4 ¼" 10/box, 5 boxes/case
A6197
88545 4" x 5" 10/box, 5 boxes/case
A6197
88548 4" x 8"
5/box, 4 boxes/case
A6197
88582 8" x 12" 5/box, 4 boxes/case
A6198
Ordering Information
Order Code Description Packaging unit/Case
HCPCS*
Ointment
DT-4 DG-4 4 oz tube 4 oz jar 12 tubes/case 12 jars/case A6250
A6250
B-Hydrophilic
SPD-03 SPD-20 SPD-21 SPD-24 3 oz tube 2" x 2" impregnated gauze (sterile) 4" x 4" impregnated gauze (sterile) 8" x 4" impregnated gauze (sterile) 12 tubes/case
25/box, 8 boxes/case 15/box, 4 boxes/case 15/box, 4 boxes/case A6261
A6231
A6231
A6232
Amorphous Hydrogel
DH-03 3 oz tube 12 tubes/case
Moisturizing Spray
DM-4 4 oz spray 12 bottles/case A6250
Wound Cleanser
WC-04 4 oz bottle 12 bottles/case A6260
SS-BWCD-0404 SS-BWCD-0408 SS-BWCD-0816 SS-EBW-0466 4 ¼" x 4 ¼", Wound Contact Dressing 4" x 8", Wound Contact Dressing 8" x 16", Wound Contact Dressing 4" x 66", Burn Wrap
10/box, 10/case
10/box, 10/case 5/box, 9/case 1/pouch A6207
A6208
A6208
A6208
2" x 2" 4" x 4"
4" x 8"
¾" x 12" Alginate Rope ¾" x 36" Alginate Rope 10/box, 4 boxes/case 10/box, 4 boxes/case 10/box, 4 boxes/case 10/box, 4 boxes/case
1/bottle, 12 bottles/case
A6196
A6196
A6197
A6199
A6199
1 fl oz Bellows DermaGran
Silverseal®
Calcium Alginate Dressings
88022 88044 88048 88112 88100 Hydrogel Dressings
Aquasite® Amorphous
81110 12/case A6248
Aquasite® Impregnated Gauze
53022 2" x 2" 53044 4" x 4" 53048 4" x 8" 10/box, 4 boxes/case 10/box, 4 boxes/case
10/box, 4 boxes/case A6231
A6231
A6232
Primaderm® WC
69201 69202 500 ml/17.3 oz Spray Bottle 118 ml/4.15 oz Squirt Top Bottle 12/case 12/case A6260
A6260
Primaderm® Dermal
69101 118 ml/4.15 oz Squirt Top Bottle 12/case A6260
Wound Cleansers
www.dermasciences.com
Derma Sciences, Inc.
214 Carnegie Center, Suite 300
Princeton, NJ 08540
(p) 800 445 7627
(f) 609 514 8554
References:1. Bateman S, Graham T (2007) The Use of MEDIHONEY on surgical wounds post-CABG. WOUNDS UK. Vol 3. 76 – 83. 2. Gethin G. (2007) Leptospermum scoparium Honey vs. Hydrogel to deslough venous ulcers: A randomised controlled trial. EWMA. 3. Regulski M (2008) Chronic lower extremity venous ulceration – Use of a
Leptospermum honey impregnated alginate to facilitate wound closure. SAWC. 4. Simon A, Sofka K, Wiszniewsky G, Blaser G, Bode U, Fleischhack G. (2006) Wound care with MEDIHONEY in paediatric haematology-oncology. Supportive Care in Cancer. 14. (1): 91-7. 5. Snyder RJ, et al. The Management of Diabetic Foot Ulcers through Optimal
Off-loading. Building Consensus Guidelines and Practical Recommendations to Improve Outcomes. Journal of the American Podiatric Medical Association. Vol 104. No. 6. Nov/Dec 2014 6. Chandan K. Sen, PhD et al, Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy, Wound Repair Regen. 2009 Nov–Dec;
17(6): 763–771. 7. Petrie NC, Yao F, Eriksson E. Gene therapy in wound healing. Surg Clin N Am 2003; 83(3):194-9. 8. Bell AL, Cavorsi J. Noncontact ultrasound therapy for adjunctive treatment of nonhealing wounds: retrospective analysis. Phys Ther. 2008;88:1517–1524. 9. Van Rijswijk L, Polansky M. Predictors of time to healing deep
pressure ulcers. Wounds. 1994;6(5):159–165. 10. Falanga V, Sabolinski ML. Prognostic factors for healing of venous ulcers. WOUNDS 2000;12(5 Suppl A):42A–46A. 11. Sheehan et al. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial. Plast
Reconstr Surg. 2006 Jun;117(7 Suppl):239S-244S. 12. Acton C, Dunwoody G. The use of medical grade honey in clinical practice. British J Nursing 2008;17(20): S38-S44. 13. Dunford C. The use of honey-derived dressings to promote effective wound management. Professional Nurse 2005; 20(8):35-383. 14. Chaiken, N. Pressure ulceration
and the use of Active Leptospermum honey for debridement and healing. Ostomy Wound Management 2010;56(5), 12-14. 15. Kamaratos AV, Tzirogiannis KN, Iraklianou SA, Panoutsopoulos GI, Kanellos IE, Melidonis AI. Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers. Int Wound J. 2012 ; 9: 1-7. 16.
Sare J. Leg ulcer management with topical medical honey. British Journal of Community Nursing 2008; 13(9):S22-316. 17. Gethin G, Cowman S. Changes in surface pH when a honey dressing was used. Wounds UK Conference Proceedings; 13-15 November 2006. Wounds UK, Aberdeen. 18. Milne SD, Connolly P. The influence of different
dressings on the pH of the wound environment. J Wound Care. 2014 Feb;23(2):53-4, 56-7. 19. Leveen H, Falk G, Borek B, Diaz C, Lynfield Y, Wynkoop B, Mabunda GA et al. Chemical acidification of wounds. An adjuvant to healing and the unfavourable action of alkalinity and ammonia. Annals of Surgery. 1973. 178(6): 745-50. 20. Ueta M,
Kweon M-N, Sano Y, Sotozono C, et al. Immunosuppressive properties of human amniotic membrane for mixed lymphocyte reaction. Clin Exp Immun 2002; 129:464-470. 21. Hao Y, Ma DH, Hwang DG, Kim WS, Zhang F. Identification of antiangiogenic and anti-inflammatory proteins in human amniotic membrane. Cornea 2000; 19: 348-352.
22. Kjaergaard N, Hein M, Hyttel L, Helmig RB, Schonheyder HC, Uldbjerg N, Madsen H. Antibacterial properties of human amnion and chorion in vitro. Eur J Obst Gyn & Reprod Bio 2001; 94: 224-229. 23. Parolini O, et al. Human term placenta as a therapeutic agent: from the first clinical applications to future perspectives. In: Berven E,
editor. Human placenta: structure and development. Hauppauge, New York: Nova Science Publishers, 2012: 1-48. 24. De Coppi, P. et. al., Isolation of amniotic stem cell lines with potential for therapy. Nature Biotechnology 2001; Vol. 25, No. 1: 1274-1280. 25. Id. at 1274. 26. Armstrong DG, et al. Off-loading the diabetic foot wound. Diabetes
Care 24:1019-1022, 2001. 27. Bloomgarden ZT: American Diabetes Association 60th Scientific Sessions, 2000. Diabetes Care 24:946-951, 2001. 28. Coleman W, Brand PW, Birke JA: The total contact cast, a therapy for plantar ulceration on insensitive feet. J Am Podiatr Med Assoc 74:548 –552, 1984. 29. Helm PA, Walker SC, Pulliam
G: Total contact casting in diabetic patients with neuropathic foot ulcerations. Arch Phys Med Rehabil 65:691– 693, 1984. 30. Baker RE: Total contact casting. J Am Podiatr Med Assoc 85:172–176, 1995. 31. Sinacore DR, Mueller MJ, Diamond JE: Diabetic plantar ulcers treated by total contact casting. Phys Ther 67:1543–1547,1987. 32.
Myerson M, Papa J, Eaton K, Wilson K: The total contact cast for management of neuropathic plantar ulceration of the foot. J Bone Joint Surg 74A:261–269, 1992 8. 33. Walker SC, Helm PA, Pulliam G: Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location. Arch Phys Med Rehabil 68:217–221,
1987. 34. C. E. Fife, MD, et all, Diabetic foot ulcer off-loading: The Gap Between Evidence and Practice: Data from the U.S. Wound Registry. Advances in Skin and Wound Care, 27(7) p. 310-316, 2014. 35. National Diabetes Data Group: Diabetes in America, Vol. 2. Bethesda, MD, National Institutes of Health (NIH publ. no. 95-1468) 36.
Jensen J, Jaakola E, Gillin B, Riley EK, TCC-EZ® - Total Contact Casting System Overcoming the Barriers to Utilizing a Proven Gold Standard Treatment. DFCon, March 2008, Los Angeles, USA, Poster. 37. Bohn G. Cost Effectiveness and Implementation of an Easy to Apply Total Contact Casting System for Diabetic Grade 2 Neuropathic Foot
Ulcers in a Multi Physician Clinic, Clinical Symposium on Advances in Skin and Wound Care, October 2009, San Antonio, USA, Poster. 38. In-house data. 39. Tarlton, John F. and Munro, Hugh S. Use of Modified Superabsorbent Polymer Dressings for Protease Modulation in Improved Chronic Wound Care. WOUNDS 2013;25(2):51- 57. 40.
Albina Mikhaylova, PhD; Bernd Liesenfeld, PhD et al, Bacterial resistance issues in wound care and wound dressings; SAWC 2009, Poster LB-051. 41. In-house data. 42. SILVERCEL® is a registered trademark of ETHICON, Inc. 43. ALGICELL® Ag Antimicrobial Effectiveness Study: Report No. MG120_000/S. May 24, 2007. Data on file.
©2015 Derma Sciences, Inc. All rights reserved. MEDIHONEY® is a trademark of Comvita New Zealand Ltd and is used with permission by Derma Sciences, Inc. AmnioExcel®, AmnioMatrix® and DryFlex are trademarks of their respective owners. Bioguard®, Xtrasorb®, Algicell® Ag, and TCC-EZ® are registered trademarks of DermaSciences, Inc.
*Please consult product specific coding guide
Disclaimer: This has been prepared for providers choosing Derma Sciences products and intended for informational purposes only. It does not represent a guarantee, promise or statement by Derma Sciences Inc. concerning levels of reimbursement, payment or charges. It is not intended to increase or maximize reimbursement. The decision
as to procedure code selection, completion of a claim form, amount to bill, is exclusively the responsibility of the provider
CATAWCBROCHURE