Serendipity: Use of a Novel Powder Wound Dressing in the Treatment of Lower Extremity Venous Wounds Reduces Pain

Clinical Problem:  Wound pain is a significant issue for many patients with chronic wounds. 80% of patients with venous leg ulcers (VLUs) experience pain.¹Its sequelae include fatigue, alterations in interpersonal relationships, sleep disturbances, and depression^{2, 3}.

Methods:  Seven patients with VLUs were treated with a novel powder wound dressing (PWD)* during an initial evaluation of this dressing’s utility in wound management. All patients had failed previous attempts at various advanced dressings including bioengineered skin, or split thickness skin grafts. All had varying levels of non-adherence to the systemic plan of care – including inconsistency with compression garments/dressings, management of glucose, and routine, consistent dressing changes. Wound stasis presence ranged from 3 to 27 years. All patients reported pain as an inhibiting factor with adherence with recommended regimen and wound sizes had not decreased in several months.

Results: All patients reported serendipitous and unexpected improvements in pain levels using a numerical pain scale within 15 minutes of PWD application. As a result, this group of chronic wound patients increased adherence to the recommended treatment plan – including compression, the mainstay of VLU treatment. All patients reduced oral pain medications and had slow, steady decreases in wound size and drainage.

Conclusion: The mechanism of sudden reduction of wound pain after dressing application may have several explanations including bacterial toxin binding, high moisture vapor transmission rate, or Substance P blockade. Regardless of the physiological mechanism, the serendipitous reduction of pain in this group, and its subsequent impact of patient adherence and quality of life measures warrant further study for the treatment regimen.

*Altrazeal™ Transforming Powder, Uluru, Inc., Addison, Texas