Resolution of Recalcitrant Wounds with Maltodextran Powder

 

Chronic wounds are problematic, especially in homecare where variables are not easily controlled.  In the following, treatment with maltodextran powder led to healing.Case Study #1:  Fifty-three year old diabetic male status right 5^th toe amputation. FBS ranged from 110s-180s. Initial measurements:  7cm (L) x 4.5cm (W) x 0.5cm (D).  He was treated with NPWT then transitioned to silver alginate. Within three days, densely adherent biofilm was noted. Maltodextran powder was initiated after one week and the biofilm resolved with healing within 10 weeks. Case Study #2:  Eighty-eight year old female status post AVR due to AS. Her chest wound was closed with surgical glue but dehisced. Initial measurements: 0.5cm (L) x 0.6cm (W) x 1.9cm (D). Silver alginate was initiated. Two weeks later, wound measurements increased to 0.8 (L) x 1.1cm (W) x 0.3cm (D). Maltodextran powder was started with healing in less than three weeks. Case Study #3:  Eighty-four year old female with a three month old traumatic leg wound. Initial measurements: 1cm (L) x 0.5cm (W) x 1.0cm (D) with 1cm of undermining at 12:00. Collagenase was used. There was swelling and purulent drainage. Management was changed to a silver fabric for an antimicrobial packing strip. After 3 days, treatment changed to silver alginate for absorption. Within two weeks, the wound closed to a pinpoint with an underlying cavity so the surgeon re-opened it. The measurements were: 3cm (L)  x 0.5cm (W) x 1cm (D). The wound decreased to 1.4cm (L) x 0.3cm (W) x 0.8cm (D) after 2 weeks but stalled. Maltodextran powder was utilized with healing in under 4 weeks. In various recalcitrant wounds, maltodextran powder proved effective. It is unclear whether this was pH related or if there was an element of topical wound nutrition, but regardless, the wounds progressed on to healing.