VENOUS LEG ULCER

MaxioCel - 100% Chitosan Wound Dressing on Venous Leg Ulcer

Center

Rajalakshmi Clinic, Bangalore-India: Dr. Vivekananda

Case Studies

Wound before using Maxiocel

Case Studies

Using Maxiocel on the wounds

Case Studies

Wound improvement after 2 weeks

Patient details:- 61 years , Male
Diabetes:- No
Nicotine Consumption:- No
Localized Infection:- Yes
Nutritional Status:- Well-nourished
Co-morbidities:- Immuno-compromised
Previous Medication:- Immunotherapy
Wound History:- Patient suffering from Multiple Foot Ulcers for more than 1 year (Chronic) Ulcers were on both foot which measured 60mm X 40mm X 5mm (length X width X depth) Patient was being treated with collagen dressings with high pain score

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done2
Frequency of MaxioCel dressingsAlternate days
MaxioCel Variant used10cm X 10cm
Final day wound conditionAt the end of 2 weeks, there was desloughing and wound was granulated

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Venous leg ulcers (VLUs) are defined as open lesions between the knee and ankle joint that occur in the presence of venous disease. They are the most common cause of leg ulcers, accounting for 60-80% of them. The prevalence of VLUs is between 0.18% and 1%. Over the age of 65, the prevalence increases to 4%. On average 33-60% of these ulcers persist for more than 6 weeks and are therefore referred to as chronic VLUs.*
  • Maxiocel is a non-woven microfibre dressing made up of 100% Chitosan, is a highly absorbent antimicrobial dressing with pain reduction and scar improvement properties. It can be used for moderate to heavily exuding wounds of varied depth,
    shape and size.
  • Overall, Maxiocel was also found to be an excellent chitosan wound dressing in patients suffering from Venous Leg Ulcers.

MAXIOCEL - 100% CHITOSAN
WOUND DRESSING ON ARTERIAL ULCERS

Center

Safdarjung hospital, Delhi-India: Dr. Deepak

Patient details37 years , Male
DiabetesNo
Nicotine ConsumptionYes
Localized InfectionYes
Nutritional StatusWell - nourished
Co-morbiditiesNone
Previous MedicationNone
Wound HistoryPatient suffering from Leg Ulcers (above ankle) for 5 months Ulcers were on the foot measured 2.5cm X 1.5cm X 0.5cm (length X width X depth) Patient was in extreme pain and did not accept any treatment

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type
Case Studies

Wound before using Maxiocel

Case Studies

Using Maxiocel on the wounds

Case Studies

Wound improvement after 2 weeks

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done4
Frequency of MaxioCel dressingsTwice a week
MaxioCel Variant used2.5cm X 30cm
Final day wound conditionAt the end of 2 weeks, there was epithelization and scar improvement

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Arterial ulcers (AUs) are defined as open lesions between the knee and ankle joint that occur in the presence of venous disease.
  • They are the most common cause of leg ulcers, accounting for 60-80% of them. The prevalence of AUs is between 0.18% and 1%. Over the age of 65, the prevalence increases to 4%. On an average 33-60% of these ulcers persist for more than 6 weeks and are therefore referred to as chronic AUs.*
  • Maxiocel is a non-woven microfibre dressing made up of 100% Chitosan, is a highly absorbent antimicrobial dressing with pain reduction and scar improvement properties. It can be used for moderate to heavily exuding wounds of varied depth, shape and size.
  • Overall, Maxiocel was also found to be an excellent chitosan wound dressing in patients suffering from Venous Leg Ulcers

MAXIOCEL - 100% CHITOSAN
WOUND DRESSING ON POST-TRAUMATIC LEG ULCERS

Center

Safdarjung hospital, Delhi-India: Dr. Deepak

Patient details26 years , Male
DiabetesNo
Nicotine ConsumptionYes
Localized InfectionYes
Nutritional StatusMalnourished
Co-morbiditiesNone
Previous MedicationThe patient was not taking any medication
Wound HistoryPatient suffering from Venous Leg Ulcers (in the ankle) for 2 months (Chronic) Ulcers on the ankle measured 5cm X 3cm X 0.5cm(length X width X depth)

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type
Case Studies

Wound before using Maxiocel

Case Studies

Using Maxiocel on the wounds

Case Studies

Wound improvement after 2 weeks

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done4
Frequency of MaxioCel dressingsTwice a week
MaxioCel Variant used10cm X 10cm
Final day wound conditionAt the end of 2 weeks, there was epithelization and scar improvement

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Post-traumatic leg ulcers (TLUs) are defined as open lesions between the knee and ankle joint that occur in the presence of venous disease. They are the most common cause of leg ulcers, accounting for 60-80% of them. The prevalence of TLUs is between 0.18% and 1%. Over the age of 65, the prevalence increases to 4%. On an average 33-60% of these ulcers persist for more than 6 weeks and are therefore referred to as chronic TLUs.*
  • Maxiocel is a non-woven microfibre dressing made up of 100% Chitosan, is highly absorbent antimicrobial dressing with pain reduction and scar improvement properties. It can be used for moderate to heavily exuding wounds of varied depth, shape and size.
  • Overall, Maxiocel was also found to be an excellent chitosan wound dressing in patients suffering from Venous Leg Ulcers

MAXIOCEL – 100% CHITOSAN WOUND DRESSING ON
FEMORAL DEEP VEIN THROMBOSIS

Center

INDO VASC Hospital , Ahmedabad-Iindia: Dr. Srujal Shah

Patient details65 years , Female
ComorbiditiesDiabetes & Hypertension
Patient symptoms Patient suffering from extreme pain and exudating wounds
Diagnostic Evaluation Stage 1 – Emergency IVC filter placement.
Stage 2 – Open Venous Thrombectomy
Stage 3 – Wound debridement for dead ischemic calf muscles
Stage 4 – VAC Therapy for large calf wound
Stage 5 – Suturing under LA with drain
ConfirmedMassive ilio femoral DVT presented as phlegmesia cerulea dolens
No of Maxiocel used & Duration4 Maxiocel ; results received in 2 weeks
Case Studies
Case Studies

Wound before using Maxiocel

Case Studies
Case Studies

Woundafter using Maxiocel and
complete healing seen

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Venous thromboembolism (VTE) is the most serious and potentially fatal complication that can arise from DVT. Venous conditions are implicated in compromised wound healing. Postthrombic syndrome is caused by persistent outflow occlusion, scarred or incompetent valves, and dependent positioning of lower extremities. Both venous ulceration and chronic venous insufficiency are exacerbated by increased venous hypertension; thus, often postthrombotic syndrome is demonstrated even in the absence of DVT Consequently, patients with venous ulcers should have their venous disease carefully evaluated to determine if past or present increased venous hypertension is contributing to delayed healing. One study demonstrated the most important factor affecting ulceration and ambulatory venous pressure in post DVT patients was valvular incompetence. Ulceration did not occur in patients with persistent occlusion and competent valves. Similar findings of the importance of valvular competence were reported in another study assessing long-term sequelae of DVT. Because 80% to 85% of all leg ulcers are associated with venous hypertension, compression and leg elevation remain key factors in alleviating symptoms and promoting healing.
  • MaxioCel is a non-woven microfibre dressing made up of 100% Chitosan, is highly absorbent antimicrobial dressing with pain reduction and scar improvement properties. It can be used for moderate to heavily exuding wounds of varied depth, shape and size.
  • Overall, MaxioCel was also found to be an excellent chitosan wound dressing in patients suffering from Femoral DVT

MAXIOCEL – 100% CHITOSAN WOUND DRESSING ON
DIABETIC FOOT INFECTION ( AMPUTATION )

Center

INDO VASC Hospital , Ahmedabad-India: Dr. Srujal Shah

Patient details45 years , Male
ComorbiditiesDiabetes & Hypertension
Patient symptoms K/c/o DM, uncontrolled
Diagnostic Evaluation Presented with DFI involving right great toe with exposed tendon and osteomyelitis of phalangeal bones. Vascularity was normal.
ConfirmedSevere diabetic foot infection
No of Maxiocel used & Duration5 Maxiocel ; results received in 2 weeks
Case Studies
Case Studies
Case Studies
Case Studies
Case Studies

Course of wound healing with Maxiocel over 2 weeks

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • The management of DFI includes wound debridement and drainage, antimicrobial therapy, pressure offloading, and appropriate wound dressing as the mainstays of treatment. Additionally, providing coordinated management which utilizes multidisciplinary foot teams consisting of a diabetologist, an infectious disease specialist, a surgeon, a podiatrist, and other specialists with skills relevant to managing DFI has been shown to improve outcomes.1,8 Even with current treatment, diabetic foot ulcers are still a leading cause for amputation, accounting for approximately 85% of all lower extremity amputation cases, with the presence of infection increasing the chance for amputation by 50% compared to patients with uninfected foot ulcers.
  • MaxioCel is a non-woven microfibre dressing made up of 100% Chitosan, is highly absorbent antimicrobial dressing with pain reduction and scar improvement properties. It can be used for moderate to heavily exuding wounds of varied depth, shape and size.
  • Overall, MaxioCel was also found to be an excellent chitosan wound dressing in patients suffering from Femoral DVT

MAXIOCEL – 100% CHITOSAN WOUND
DRESSING ON MULTIPLE CHRONIC VENOUS ULCERS

Center

INDO VASC Hospital, Ahmedabad-India: Dr. Srujal Shah

Patient details92 years , Female
ComorbiditiesDiabetes & Hypertension
Patient History Chronic Venous Insufficiency (CVI) & multiple bilateral Chronic Venous Ulcers (Since 3 years)
Patient symptoms Patient suffering from extreme pain and exudating wounds
Diagnostic Evaluation Venous doppler
ConfirmedOld, recanalized DVT & Venous hypertension
Wound Size & Wound Desicription6 cm x 10 cm ; 5 cm x 5 cm ; 3 cm x 3 cm
 Pale granulation and minimal slough
Case Studies
Case Studies

Venous ulcer before use of wound dressing

Case Studies
Case Studies

Application of chitosan wound dressing

Case Studies
Case Studies
Case Studies

Complete wound healing within four weeks

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Considering old age, poor nutrition and immobility it was decided to go for medical management and start skin grafting.
  • Wound management started with Chitosan Wound Dressing along with compression bandages.
    After the first dressing there was significant reduction in pain.
  • After 5 days, there was an improvement in the wound site with reduced secretion and pink granulation.
  • Complete wound healing was achieved with 6 dressings. (4 weeks)
  • Significant patient satisfaction and reduced pain score.
  • Overall, Maxiocel was also found to be an excellent wound dressing in patients with Chronic Venous Insufficiency and Bleeding wounds

BURN CAUSED BY HOT WATER,
TREATED WITH SCARLESS SOLUTION

May 1st 06
Case Studies
Case Studies
Case Studies
Case Studies
June 2nd 06

SUPERFICIAL BURN WITH STEAM TREATED
WITH SCARLESS SOLUTION
FROM 21 TO 24 JANUARY 2006

Case Studies

BURN CAUSED BY STEAM CAR RADIATOR
TREATED WITH SCARLESS SOLUTION
FROM APRIL 10 TO MAY 06, 2005

Case Studies
Case Studies
Case Studies
Case Studies

BURNS CAUSED BY MILK
TRAITED WITH SCARLESS SOLUTION
FROM 5 AGUST14 APRIL 2006.

5 April 06
Case Studies
9 April 06
Case Studies
14 April 06
Case Studies
13 May 06
Case Studies

BRULURE CAUSEE PAR DE L’HUILE CHAUDE
TRAITEE AVEC SCARLESS SOLUTION
12 AU 25 APRIL 2006.

12 0ctober 06
Case Studies
25 0ctobre 06
Case Studies
30 Octobre 06
Case Studies
04 March 07
Case Studies
Case Studies
Case Studies
Case Studies
Case Studies

MAXIOCEL-100% CHITOSAN WOUND DRESSING ON
ISCHEMIC WOUND (LEG ULCER)

Center

Manipal Hospital, Bangalore-India: Dr. Venkatesh Reddy

Patient details26 years , Male
DiabetesNo
Nicotine ConsumptionNo
Localized InfectionYes
Nutritional StatusMalnourished
Co-morbiditiesNone
Previous Medication6 months localised treatment with gauze and saline along with compression bandages
Wound HistoryPatient suffering from Chronic Ischemic ulcer located on left leg (Anterior Tibia area), wound edges attached, measurements being 15cmx4cmx0.5cm (lengthxwidthxdepth)

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type
Case Studies

Wound before MaxioCel treatment

Case Studies

Wound improvement after 8 days

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done4
Frequency of MaxioCel dressingsAlternate days
MaxioCel Variant used10x05cm (2 units per dressing)
Final day wound conditionNo signs of localised infection in wound, granulated with early signs of epithelialization without scarring

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Ischemic ulcers (wounds) can occur when there is poor blood flow in your legs. Ischemic means reduced blood flow to an area of the body. Poor blood flow causes cells to die and damages tissue. Most ischemic ulcers occur on the feet and legs. These types of wounds can be slow to heal.
  • The shown patient has had multiple digit amputations in the past and was undergoing treatment with saline and gauze dressings from the past 6 months.
  • MaxioCel treatment was initiated and within 4 dressings(alternative days), significant improvements were seen.
  • The treatment was continued at a local clinic and the ulceration has healed completely with no signs of Scarring.

MAXIOCEL-100% CHITOSAN WOUND DRESSING ON
PLANTAR SURFACE WOUND

Center

Manipal Hospital, Bangalore-India: Dr. Venkatesh Reddy

Patient details62 years , Male
DiabetesYes
Nicotine ConsumptionNo
Localized InfectionYes
Nutritional StatusWell nourished
Co-morbiditiesNone
Previous MedicationDiabetic medication from 10 years, localised treatment with Saline and Gauze from past 3 months
Wound History3 month old non healing chronic ulcer on left leg palm and metatarsal area, measurements being 6cmx3cmx0.5cm (Lengthxwidthxdepth)

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type
Case Studies

Wound before MaxioCel treatment

Case Studies

Wound after 12 days of MaxioCel treatment

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done6
Frequency of MaxioCel dressingsAlternate days
MaxioCel Variant used10x05cm (2 units per dressing)
Final day wound conditionGranulated wound progressing towards epithelialisation, no signs of localised infection.

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Increased plantar pressures and associated ulcers need to be treated by off-loading of the plantar surface. Useful off-loading mechanisms include reduction of walking speed, alteration of foot rollover during gait, and transfer of load from affected areas to other areas of the foot or the lower leg. These plantar off-loading mechanisms could result in an optimization of treatment.
  • Wound treatment was done using MaxioCel for a period of 12 days, 6 dressings were done on alternative days. The wound circumference was significantly reduced along with healthy granulation.
  • Overall, MaxioCel was found to be an excellent wound dressing in patients suffering from plantar surface wounds.

MAXIOCEL-100% CHITOSAN WOUND DRESSING IN A
BREAST CAVITY WOUND AFTER ABSCESS REMOVAL

Center

Sai Shradha Hospital, Mumbai – India: Dr.J.S.Majithia

Patient details29 years , Female
DiabetesYes
Nicotine ConsumptionNo
Localized InfectionYes
Nutritional StatusWell nourished
Co-morbiditiesNone
Previous MedicationTreatment-Saline and Hydrogen peroxide with gauze dressings
Wound History7 days old cavity wound in right breast with measurements being L=30mm ,D= 80mm ,W= 40mm, high exudation after removal of breast abscess , pain score were high throughout the week.

Initial wound bed evaluation

Infection (Local Factors)YesNo
Exudate
Erythema
Malodorous
Pain
Oedema
ExudateDryLowMediumHigh
Levels
ExudateWateryCloudyThickPurulentRed
Type
Case Studies

Wound before using Maxiocel

Case Studies

Using Maxiocel on the wounds

Case Studies

Wound improvement after 4 dressings

Tissue type

Case Studies

Wound management goals

ParametersYesNo
Debridement
Infection Prevention
Exudate Management
Optimum Moisture Maintenance
Protect granulation tissue / Epithelializing tissue

End Report

No of MaxioCel dressings done4
Frequency of MaxioCel dressingsDaily
MaxioCel Variant usedMX2530
Final day wound conditionFinal day wound condition –Pain managed, Cavity size significantly reduced as wound is granulating, exudate levels reduced by 70%

Result

Patient Outcome with MaxiocelEase of Application/RemovalAntimicrobial barrierWound adherenceConformabilityWound scar improvementPain management
Excellent
Good
Fair
Poor

Discussion

  • Most breast abscesses occur as a complication of mastitis, a bacterial infection that causes the breast to become red and inflamed.
  • Mastitis usually affects breastfeeding women, but it can sometimes occur in women who are not breastfeeding.
  • Small breast abscesses can be drained using a needle and syringe. For larger abscesses, a small incision may be needed to drain the pus.
  • In the shown case, the patient was suffering with a deep cavity wound in the right breast with high levels of discomfort due to increased pain score and delayed healing post breast abscess removal.
  • MaxioCel rope variant was used for the treatment regime and within 4 dressings over a period of 8 days lead to significant reduction in wound size, wound exudates as well as pain scores