Neoheal^®. Hydrogel dressing for wound management

Neoheal^® is a modern and unique hydrogel dressing recommended for treatment of burns, ulcerations, bedsores and all kinds of skin damages in which humid medium is favorable.

Neoheal^® was developed by using the special Hydrogel-Technology with the innovative concept of “Moist Wound Healing”. A wound which keeps moist can heal faster because newly formed cells can divide and move faster under such environment than under a wound scab.

Hydrogel dressings Neoheal^® are an aqueous composition of natural and synthetic polymers such as: polyvinylopyrrolidone, polyethylene glycol and agar, cross-linked by a beam of electrons. Thanks to radiation processing the product features sufficient mechanical strength and is fully sterile. In the end-use form it represents 3 mm thick hydrogel sheet, containing over 90% of water.

Advantages of moist wound healing

Decreased dehydration and cell death (Neutrophils, macrophages & fibroblasts necessary for wound healing cannot thrive in a dry environment)
Increased angiogenesis
Enhanced autolytic debridement
Increased re-epithelialization (Dry crusted wounds decrease supply of blood and nutrients which results in a barrier to cell migration and slowing the epithelialization)
Decreased pain (Moist wound bed insulates and protects nerve endings thereby reducing pain)

The concept of moist wound healing was first proposed by G. Winter 50 years ago and subsequently an impressive number of studies has supported its value. The wound bed undergoes desiccation necrosis in the absence of adequate hydration, which can lead to a destructive cycle: the wound is debrided to healthy tissue, which then desiccates, creating more necrotic cellular debris to be removed. Subsequently, the wound may become deeper and larger. Various enzymes involved in autolytic debridement function only in an aqueous environment, and the various peptide growth factors and other molecules that mediate cellular repair can only be effective in solution.

Properties

Hydrogel dressing is transparent and flexible but mechanically strong enough, effectively absorbs body fluids, acts as an efficient barrier against bacteria, adheres well to the wound, enables the oxygen to penetrate through the volume of dressing to the wound surface.

Hydrogel dressings produced by KIKGEL have been applied for healing all kinds of wounds since 1992. Moreover they are used in routine medical practice in Poland and some other countries.

Clinical use of Neoheal^® dressings showed that:

the very first change of the dressing makes the burning pain cease and brings the sick person a feeling of “soothing”
during the change of the dressing, contaminations, discharges, fibrin and necrosis tissues are removed, leaving non-damaged granulation,
change of the dressings is painless,
the dressing protects the wound well against drying and external infection,
the dressing prevents skin from occuring overgrowth scars.

Neoheal^® dressings are especially recommended for skin injuries for children.They do not adhere to the wounds, clean contaminated wounds painlessly and heal them with no crusts appearing.

Advantages of NEOHEAL^® hydrogel dressing

Promotes fast healing through maintenance of an optimal moist environment
Cools, soothes local pain and discomfort
Helps protect wounds from external contamination
Absorbs wound secretions
Permeable to water vapor and oxygen but impermeable to bacteria
Does not adhere to the wound, allowing the dressing to be removed without trauma
Conforms easily to any contour of the body
Transparent to enable wound observation and assessment of healing process
Biocompatible, non-cytotoxic, non-allergenic

NEOHEAL^® creates a moist environment on the skin surface, assists in autolytic cleansing of dead tissues, and exerts a positive influence on the processes of granulation and epidermisation of the wound.

The dressing adheres well to the surface of the wound but is not adhesive, thus application and removal is painless.

NEOHEAL^® absorbs exudate from wounds and traps it, along with bacteria, in its structure. NEOHEAL^® is elastic and flexible and makes it possible to dress hard-to-access body parts such as the face and areas around joints.

The NEOHEAL^® dressing is transparent, enabling observation of the wound site or primary dressing and minimising the frequency of changing dressings. Thanks to its properties it can be used as a secondary dressing for many drugs and preparations placed directly on the wound.

The unique structure of the dressing creates a barrier to external bacteria, yet enables the skin to ‘breathe’.

The high water content of the dressing provides soothing qualities in cases of superficial burns and swelling caused, for example, by insect bites.

The dressing is non-cytotoxic and fully biocompatible.

“Sheet hydrogel was found to be a successful substitute for porcine and/or cadaver skin in a variety of burn and burn-related wounds. The product performed well as a temporary dressing used as part of the sandwich technique, as a full-face dressing in ventilated burn patients, and to promote desloughing of partial-thickness burns. Hydrogel does not appear to stimulate an inflammatory response and facilitates burn preparation for surgical debridement. It is absorbent and well tolerated by patients who report no pain associated with the dressing change or between dressing changes.”

Burd A., Evaluating the use of hydrogel sheet dressings in comprehensive burn wound care. Ostomy Wound Management. 2007;53;3:52-62.

Preparation to use

The Neoheal^® dressings are packed in moulds, covered with foil and they are placed in tight, closed foil bag. Before using the dressing, check if the bag has not been damaged or opened, otherwise the product can be not sterile. Taking out the dressing:

Tear a foil bag and take the dressing out (1)
Catch a small piece of sticking out fibre, next carefully take the hydrogel out from the mould. The foil, sticked on the top facilitates taking out of the dressing, therefore it should not be removed before taking out of the hydrogel (2)
Apply the dressing to the wound with the side which was adhered to the bottom of the mould and remove the covering foil (3)
Attach the dressing to the wound with bandage or net band (4)

Remember to use dressings suitable to size of the wound. In spite of the flexibility of the dressing, it should not be tensioned during applying on the wound and care should be taken in order to adhere it to the healthy skin around the wound. ATTENTION: The dressing taken out from the package, and not used immediately, loses its sterility and cannot be used later.

Indications

Recommended method of burn wounds healing with Neoheal^® dressing

Damaged surfaces, due to action of high temperature, should be covered as soon as possible with the Neoheal^® dressing.
Replace the dressing at first cure days every 12-24 hours.
Possibly early, at first/second day of healing, burn-bubbles should be taken off and remaining necrosis tissues should be removed. The dressing should be immediately applied on the wound.

FIRST DEGREE OF BURN WOUNDS

In case of burns without visible damage of skin cooling the injury place takes the most important action. What’s more the whole wound should be covered with Neoheal^® dressing as soon as possible. In that way the distempers of the skin physiological processes and bubbles formation are prevented. The Neoheal^® ensures proper exchange of the heat and moisture balance. It is an effective barrier against external infections. Early use of the Neoheal^® dressing makes healing process last (burns of I and II degree) approximately 7-10 days.

SECOND AND THIRD DEGREE OF BURN WOUNDS

In case of second and third degree burn wounds the Neoheal^® should be put immediately and the patient has to contact the doctor as soon as possible. The Neoheal^® dressing cools the wound, relieves pain and prevents from an infection. By the treatment of infected wounds, crusts and deep necrosis the dressing can remain for maximum 24 hours. Neoheal^® is used during skin grafts procedures: preparation of granulation tissue before putting skin graft on, protection of places after taking skin grafts out and protection of net skin grafts as well.

ULCERATIONS

Start of the treatment does not need any initial intervention. Applied Neoheal^® dressing: reduces the local pain, assists the autolysis cleaning of the wound, cleans the wound from the purulent discharge, which is absorbed into the dressing and is removed when changing the dressing, stimulates processes of growing granulation tissue. At the time of abundant exudation at first healing days it is recommended to put a layer of antiseptic gauze on the Neoheal^® dressing. Neoheal^® can be applied in compression therapy.

BEDSORES

Small bedsores (even infected) may improve after 8-14 days with treatment as well as ulcerations. In case of extensive bedsores (over 1 dm²) the Neoheal^® dressing is recommended in preparation before the surgical treatment. NOTE: By prolonged use of hydrogel dressings maceration of the skin around the wound may appear. In this case protection of the wound edges should be done by covering it with e.g. zinc ointment.

Removing of the dressing

Depending on the kind of wound and stage of the treatment, the degree of adhesion of Neoheal^® dressing to the skin and wound surface will change. In case of big amount of discharges, a replacement of the dressing every 12 hours is recommended (absorption ability is about 25 ml of discharge from 1 dm² of the wound). However maximal time recommended for keeping the dressing on the wound is 48 hours.

When applied on febrile patient or one staying in dry, over-heated rooms the dressing dries faster, than in normal conditions. In order to prevent this, the lost moisture must be completed. A poultice should be put on the whole surface of dressing (made of boiled or distilled water or physiological lotion) for 15-20 minutes. This soaking operation, restoring correct elasticity, should be performed as needed 2-4 times daily. Before the removal of the dressing it is also recommended to soak it, in order to facilitate taking it off and eliminate the risk of damage wound granulation.