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A changing world for patient support

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A Changing World for Patient Support:

Our Clinical Experiences with the Magic Paper

 

Lead Contact and Lead Author: Kathy Leak, Wound Care Specialist,

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Email: kathleen.leak@nhs.net

Co-Author: Sue Johnson

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Introduction

Moist wound healing has been proven to heal the majority of chronic wounds at minimal cost to the health system. Posnett et al (2008 showed that over 80%

of chronic wounds would heal within a predicted timeframe at an average cost to the system of around £1900, whilst a small number of wounds prove hard

to heal costing between £31,000-£42,000 to heal.

In 2014, we were approached by Genadyne Pharma (Aspen Medical) to test their new Nanogen Nano-structured Bio-cellulose matrix range of products. The

challenge was to use it on our most difficult wounds. Once we had tried the product and saw that it stimulated the healing of a very difficult ‘static’ wound,

we decided to expand the usage and to undertake an evaluation on 20 patients, all with hard-to-heal chronic or complex wounds. Nanogen is a plant based

collagen, manufactured from plant extracts, that have the ability to mimic the Extra Cellular Matrix (ECM) in the wound. Nanogen functions in the same way

as other collagen based products to stimulate fibroblast and cellular migration and encourage the deposition of newly formed tissue ie granulation. The other

components in Nanogen; Vitamin B,C,D,E,K: Biotin and Folic acid are used as enzyme substrates that are catalysts in many biochemical processes in the healing

of wounds. Because of the nanometric sized particles, there is an added benefit of cell signalling to the natural microcellular environment.

Methodology

Twenty patients with non-healing wounds of at least 6 months duration were entered in to a four week evaluation using Nanogen Aktiv.

After a full patient assessment including wound assessment and photography the wound was dressed with Nanogen Aktiv and an appropriate secondary

dressing (chosen by nurse). The patient was advised to change the secondary dressing after 3 days without disturbing the

Nanogen Aktiv membrane. After the initial 4 week period the wounds were dressed with appropriate moist wound healing product. Some patients then experienced

deterioration in their wounds and therefore the clinicians chose to continue with the Aktigel alongside the MWH products until healing was complete.

Results continued...

The new treatments proved to be unambiguously cost-effective and had a positive impact on patient quality of life. After successfully healing 2 static wounds

on a patient, whilst she went through a course of chemothaerapy, we recieved this text:

“I’m going to miss you all so much; I shed a tear when I got to the car. You’ve got me through the worst time of my life and my husband and I will never

be able to thank you enough”

The impact on the patient’s quality of life was amazing, she was able to carry on working throughout cancer treatments meeting government set targets.

 

Discussion

The application of Nanogen Aktigel to the Peri-wound area resulted in a pinker, healthier, more robust peri-skin.

Even after just one week of treatment with Nanogen Aktiv the wound usually changes in colour, size and increase in exudate, giving confidence that the

wound is responding to the treatment, even in wounds that have been static for months. Patients can also see this obvious improvement which gives hope to

those who had lost it.

After the first application of Nanogen Aktiv membrane most patients reported a rapid reduction in wound pain, so much so that many patients requested to

continue with the Nanogen Aktiv treatment fearing that wound pain would return.

One patient demanded to have treatment with the ‘Magic Paper’. When asked why the call it that, the patient said “that’s what the other patients call it , they

told me that when they had it put on them, it quickly got rid of the pain and was healing their wounds for the first time in years”.

Conclusion

Nanogen Aktiv does have a significant effect on kick starting hard to heal (non-healing) wounds, that previously had a history of only being maintained. It

mimics the wound ECM and stimulates epithelialisation and improves inter cellular signalling/communication, both of which have been shown to be critical

in stimulating the healing of stalled chronic wounds. It is unequivocally cost-effective, healing wounds as opposed to maintaining wounds. In practice we

have found that a two week course of Nanogen Activ followed by the Nanogen Aktigel proves most effective for healing with the added benefits of a better

cosmetic result. It improves patient concordance by reducing pain and providing hope to patients who have endured these chronic wounds for excessive periods

of time. This has a massive positive impact on the quality of life of these patients.

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