Impact of the wound hygiene concept on wound contraction: an experience by ‘Vulnologia ASL3 Regione Liguria’

Definition of the problem: Non-healing wounds have increased in the post-covid period, representing a major social problem. Goal: Implement existing strategies with a four-step strategy, Wound Hygiene (WH) to manage non-healing wounds and improve our clinical outcomes and patient outcomes. Organizational difficulties were also considered. Materials and Methods: The WH allowed us to contrast the biofilm and allow the recovery of the reparative processes. We evaluated the progress of 101 wounds, with different aetiology and localization and which showed no signs of improvement for at least 3 weeks. Wound treatment was carried out according to the latest guidelines. We have improved our practical approach by giving greater prominence to the four phases proposed in the WH: from cleansing to dressing with Carboxymethylcellulose sodium with Silver and antibiofilm agents (CmcNaAg+) of potentially biofilmed wounds. We recorded the weekly % of wound shrinkage. As a control we considered 44 lesions treated with the same advanced dressing (CmcNaAg+) but without using the WH Technique. Results: We noted i) a decrease in the number of accesses, from 3 to 1 per week in 30% of the wounds; ii) a greater speed of contraction of the area (the % of weekly contraction went from 0.04 in the group treated without WH to 0.14 in the group managed with WH with an increase of 63%); iii) a decrease in days of care (the number of days of treatment went from 154 in the group treated without WH to 71 in the group managed with WH with a decrease of 54%. (Fig. 5)) Conclusions: We believe that this approach could be a useful strategy to improve the management of potentially biofilmed wounds, strengthening the clinical reasoning of each operator. Wound Hygiene has made it possible to bring theory closer to practice for a more rapid achievement of the therapeutic objective.