CS14-057 Activated Carbon Cloth in Direct Contact with VLU Granulation Speeds Healing: Suppression of Biofilm Bacteria and Detoxification of Inflammatory Exudate are Probable Mechanisms

Martin J. Winkler Sr., MD, FACS, Martin J Winkler Sr., MD, FACS, Vascular Surgeon, Omaha, NE and Sara Monica Winkler, Engineering, Student, Department of Bio Engineering Stanford University, Research Assistant, Omaha, NE

Elastic compression dressings, required to heal venous leg ulcers can complicate control of wound exudate, often giving rise to lush biofilm, macerated skin, and slippery dressings that complicates compression, slows VLU healing and makes patient miserable. We recently reported that activated carbon cloth (ACC), as a thin contact layer under elastic compression improves VLU healing by controlling exudate .1

Active carbon has unique chemistry due to a massive surface area estimated to be ~ 1000 m2 / gram that is swarming with electrons in surface orbitals. Polar molecules interact with surface electrons creating induced dipole chemical bonds, described by Fritz London a colleague of Einstein2.  These weak induced dipole bonds presumably bind organic molecules to, (1) disrupt the biofilm neighborhood by depriving bacteria of nutritional substrate from wound exudate, (2) bind bacterial exo / endo toxins and inflammatory mediators such as matrix metalloproteinases that contribute to harmful wound inflammation.3,4

This anecdotal case series asks two questions.  Does ACC in direct contact with VLU granulation under elastic compression, (1) suppress biofilm inflammation and wound exudate skin damage, and (2) improve VLU healing?


Five chronic VLUs treated with compression** and black ACC * in direct contact with wound surface.


Therapy and healing is documented photographically. All VLUs healed.


Activated carbon cloth,* as a thin antimicrobial anti-inflammatory contact dressing, in concert with compression for chronic VLUs, (1) appears to control grossly visible wound biofilm build up and to control visible  inflammatory changes, and  to move exudate away from the periwound skin, (2) appears to improve healing of chronic VLUs,  versus historical healing rates.