WOUND CARE CHALLENGES
As a major cause of delayed wound healing, biofilm triggers nonstop inflammation, which generates excess MMPs that degrade ECM.1-5 Controlling the healing environment is even more of a challenge when patients are noncompliant.6,7
Inability and/or unwillingness to adhere to treatment plans for chronic wounds is a major barrier to healing.
- Many patients with lower-extremity chronic wounds are unable to change their own dressings6
- Patients with chronic wounds fear touching their own wounds and prefer that their doctor or nurse exclusively control their care6,7
- When treatments do force patients to change their own primary dressings, wounds can be exposed to bacteria in the home that can lead to contamination
Healthcare studies show that patient adherence improves when treatments require less intervention.8 PuraPly AM can help eliminate at-home primary dressing changes between weekly debridements.9
BIOBURDEN & BIOFILM
- Biofilm has been considered the most important single cause of persistent, delayed healing2
- Biofilm triggers continuous immune-mediated inflammation in wounds1-3
Weekly sharp debridement is essential but, alone, does not control microbial growth or prevent biofilm re-formation. It should be combined with an optimal barrier that contains a broad-spectrum antimicrobial and provides a sustained effect against bioburden and biofilm regrowth.2
PROLONGED, ELEVATED INFLAMMATION
- The prolonged inflammatory response to biofilm is ineffective and poorly orchestrated, causing damage to host tissues2
- Increased neutrophils and macrophages accumulate, but fail to engulf, biofilm and secrete proteases, including MMPs2,4,5
- Persistent inflammation results in imbalance of excess proteases (eg, MMPs), decreased inhibitors (eg, TlMPs), and increased ROS4,5
- Inflammatory protease levels may be 100 times higher in chronic vs acute wounds5,10
- Excess and imbalanced MMPs break down ECM, degrade healing proteins, and prolong the inflammatory phase of healing3,5
However, native ECM inhibits a wide range of MMPs, helping to address the proinflammatory proteolytic environment that stalls wounds.11
- ECM degradation prevents proper formation of the scaffold needed for cell migration and formation of granulation tissue12
- Imbalance of ECM degradation and deposition perpetuates wound chronicity4
However, the cross-linked, dual layers of PuraPly AM resist ECM degradation in the wound.5,13
ROS=reactive oxygen species;
TIMPs=tissue inhibitors of metalloproteinases
Please refer to the PuraPly AM Instructions for Use for complete prescribing information.
- Frykberg RG, et al. Adv Wound Care. 2015;4(9):560-582.
- Schultz G, et al. Wound Repair Regen. 2017;25(5):744-757.
- Gibson D, et al. Wounds Int. 2009;1(1):1-6.
- McCarty SM, et al. Adv Wound Care. 2013;2(8):438-447.
- Carpenter S, et al. Wounds. 2016;28(6 suppl):S1-S20.
- Fife C, et al. Wounds. 2007;19(10):255-257.
- Zulec M, et al. Int J Environ Res Public Health. 2019;16(4):e559.
- Atreja A, et al. MedGenMed. 2005;7(1):4-11.
- PuraPly Antimicrobial [package insert]. Canton, MA: Organogenesis Inc; 2020.
- Trengove NJ, et al. Wound Repair Regen. 1999;7(6):442-452.
- Negron I, et al. Int Wound J. 2014;11(4):392-397.
- Brett D. Wounds. 2008;20(12):347-356.
- Brantley J, et al. Wounds Int. 2016;7(3):1-5.