News and views

TELUS and healthphone to attend‐3^rd World Union Congress

Canadian telecommunications company and first time Congress exhibitor TELUS will demonstrate their Mobile Wound Care™ technology in their booth at the upcoming World Union Congress in Toronto, June 4‐8, 2008.

Wound care can account for more than 40% of home care visits. In partnership with health software company Healthphone, TELUS delivers home and community‐based applications including Mobile Wound Care, equipping front line care providers with tablet PCs that enable them to document wound assessments, measure and track wound healing progress, take colour digital photos of the wound, update wound care visit forms, and transmit information via the internet from the point of care to wound specialists. Importantly, this communication is transmitted over a secure network to ensure privacy and security of the patient data. By enabling instant access to patient records, treatments and schedules, communication among clinicians is improved and wound specialists can provide timely wound care recommendations to patients in the community.

Clinical benefits of Mobile Wound Care include enhanced access to scarce specialized wound care resources, improved accuracy of diagnoses, reduced heal times, reduced travel time in a home care environment for both the care provider and the patient, and reduced delays to treatment.

By using the technology at the point of care, nurses, wound care specialists and physician users are collaborating, and all have access to evidence‐based tools to promote best practices and support consistent clinical practice. Clients will have an electronic record with all past and current wound assessments, digital images of the wound, treatment records and communication amongst the interdisciplinary team.

About TELUS

TELUS (TSX: T, T.A; NYSE: TU) is a leading national telecommunications company in Canada, with $8.9 billion of annual revenue and 10.9 million customer connections including 5.3 million wireless subscribers, 4.5 million wireline network access lines and 1.1 million Internet subscribers. TELUS provides a wide range of communications products and services including data, Internet protocol (IP), voice, entertainment and video. Committed to being Canada’s premier corporate citizen, we give where we live. Since 2000, TELUS and our team members have contributed more than $91 million to charitable and non‐profit organizations and volunteered more than 1.7 million hours of service to local communities. Eight TELUS Community Boards across Canada lead our local philanthropic initiatives. For more information about TELUS, please visit www.telus.com

About healthphone solutions

Healthphone develops health industry solutions that use every‐day Microsoft technology to empower people with relevant health information when and wherever it is needed. Healthphone is Microsoft’s Global Lead Solution Partner for long term condition management. Headquartered in Seattle, Healthphone has offices in Australia, Canada and Singapore, and a development centre in New Zealand. Please visit www.healthphonesolutions.com

MedX health the phototherapy experts break into the wound care arena

MedX Health, a Canadian company, listed on the Toronto Stock Exchange are experts in the area of phototherapy.

Phototherapy is an umbrella term that can include light from low level lasers as well as superluminous diodes, also known as light emitting diodes (LEDS). How does MedX Phototherapy work? When the photons of light penetrate the skin and underlying tissue, they are absorbed by the cell, and converted into energy, thereby the cell membrane permeability is altered, this triggers a cascade of cellular events including:

• • Stimulation of ATP
• • Stimulation of respiratory chain
• • Increased DNA and RNA synthesis
• • Increased levels of beta endorphins and serotonin
• • Enhanced collagen synthesis

MedX Phototherapy devices are positioned directly on the skin with gentle pressure applied. Generally there is no discomfort or sensation associated with treatment.

The affects of MedX Phototherapy treatment can be:

Local: with a direct benefit over the affected injury.

Regional: with positive effects seen in the surrounding tissue.

Systemic: broader effects evident through increased cell membrane permeability and chemical mediators carried in the blood, lymphatic and nervous systems. Phototherapy is an effective, non‐invasive, drug‐free solution that has been used for over 30 years and is supported by over 3,000 clinical papers. MedX Health designs, develops and distributes innovative phototherapy technology that has been tested for safety and effectiveness and has been approved for use in North America.

The technology has gone through stringent testing and has been deemed safe for use by the following regulatory bodies ‐ US FDA and Health Canada, Therapeutic Products Directorate, Medical Devices Bureau.

MedX Health recently carried out a clinical study in chronic wounds and found significant improvement in both wound healing and also prevention of wound recurrence in those with skin at risk.

Please visit MedX Health at the 3^rd Congress of World Union of Wound Healing Societies (Booth 1134) to find out more regarding our move into the chronic wound care arena, in addition to attending our satellite session on Thursday 3^rd June, 5.45‐6.45 pm.

New patient survey shows that wound dressings with Safetac soft silicone adhesive technology reduce pain at dressing changes

A report of a large multi‐national survey, recently published in the Wounds UK journal, shows clinically significant patient benefits of specific advanced wound dressings. The results show that the use of dressings with Safetac soft silicone adhesive technology resulted in reduced pain at dressing changes compared with advanced dressings with traditional adhesives. The Pain on Removal Cases (PORC) survey involved over three thousand patients with a variety of wounds from 20 countries. More than 90 percent of the patients indicated that they preferred dressings with Safetac technology to their previous dressing regimen.

Pain is a major factor affecting quality of life and overall health for the large group of patients who suffer from chronic wounds. The highest levels of pain are often experienced at dressing changes. The use of inappropriate and sometimes aggressive adhesives on dressings can cause trauma to the healing wound bed and the skin around the wound. As a consequence of this trauma, dressing removal can be very painful. This is a major concern for both patients and healthcare personnel.

“In recent years, wound pain management has been more in focus. There is a clear need for minimising pain at dressing change,” said Dr. Richard White, Professor of Tissue Viability at the University of Worcester in UK. “The PORC survey illustrates the benefits of using dressings with Safetac technology in terms of reducing pain.”

The survey was conducted in order to assess patients‘ pain experience when using different advanced dressings with traditional adhesives compared with advanced dressings with Safetac soft silicone adhesive technology. It involved both trauma and pain assessment at dressing changes. The patients were initially treated with a traditional adhesive dressing (a polyurethane, an acrylic or a hydrocolloid‐based adhesive).

At the first visit, the severity of trauma to the wound and surrounding skin was assessed. In addition, the patients were asked to record their pain level (before, during and after dressing removal) by using a Visual Analogue Scale, (VAS), ranging from 0 (no pain) to 10 (unbearable pain).

At the second dressing change visit, Mepilex dressings with the Safetac technology were applied to the wounds, and the same assessment process was repeated.

The survey reveals a reduction in the levels of pain associated with dressings with the Safetac technology when compared to advanced dressings with traditional adhesives.

“Pain can lead to increased stress in patients and has been implicated in a delayed healing process,” said Richard White. “Hopefully the results of this preliminary survey will contribute to increase awareness among healthcare providers of the importance of recognising and managing patients’ pain during wound dressing related procedures.”

Mölnlycke launches first silver dressing with Safetac^® technology

Mölnlycke Health Care has introduced a new silver dressing, Mepilex Ag, following requests from nurses and healthcare professionals. Mepilex Ag is a novel antimicrobial dressing, which combines silver with Safetac^® soft silicone technology. It absorbs exudate and maintains a moist wound environment. Mepilex Ag is designed to target bacteria and protect the skin.

Mepilex Ag is comfortable for the patient as it conforms to difficult to dress areas. The unique Safetac^® soft silicone adhesive technology used in the dressing makes it atraumatic both during wear and upon removal. This enables Mepilex Ag to be changed without causing additional pain to the patient or trauma to the wound and surrounding skin. Mepilex Ag also prevents maceration by sealing the surrounding skin of the wound.

Mepilex Ag is designed management of low to moderate exuding wounds. It is ideal for use on patients with wounds that do not heal normally such as leg and foot ulcers, pressure ulcers and partial thickness burns. Mepilex Ag inactivates wound related pathogens within 30 minutes¹ and for up to seven days.² Mepilex Ag can inactivate a wide range of pathogens, including MRSA.³

Mölnlycke health care hosts two symposia during WUWHS 2008 congress

Focusing on Managing Patients Pain at Dressing Related Procedures

Wound‐related pain has a major impact on patients‘ quality of life. Pain at dressing changes is a well recognized problem which has gained an increased awareness in recent years. In order to support clinicians in their every day practice, WUWHS will launch a new consensus document with recommendations that facilitates best practice regarding minimising pain at dressing related procedures during the congress. In addition, Mölnlycke Health Care will host two symposia during the WUWHS congress in Toronto with the objective to provide the latest in managing wound care patients’ pain with the best tools available.

WUWHS release of new best practice document

During the WUWHS congress the second consensus document on principles of best practice regarding minimizing pain at dressing relating procedures will be released. It is an update of new scientific evidence since the first consensus document from the WUWHS in 2004. The second consensus document is an educational initiative by the WUWHS, supported by Mölnlycke Health Care. It is meant for anyone involved in dressing related procedures and the principles are based on the consensus opinion of an international renowned expert group. The document contains ten consensus statements which provide important tools to help healthcare professionals with the implementation of assessment, documentation and treatment of wound‐related pain.

Symposium minimizing pain at dressing related procedures

The conclusions of the consensus document constitute a framework for the first symposium hosted by Mölnlycke Health Care taking place on Wednesday, June 4 from 12:30 to 2:00 p.m. at the Main auditorium. Bringing together leading experts in wound care, it will highlight the importance of addressing patients’ pain and provide strategies to minimize pain at dressing related procedures. In addition, new evidence that support soft silicone atramautic dressings will be presented.

The symposium will be co‐chaired by Professor Keith Harding, Head of Department and Director of the Wound Healing Research Unit at Cardiff University in United Kingdom, and Dr. Diane Krasner, Wound Ostomy and Continence Nurse and Special Projects Nurse from York, Pennsylvania in USA.

Why is pain important? Dr. Krasner introduces the symposium with this question and shares her long standing expertise on the topic.

The second speaker is Professor Patricia Price, a Chartered Health Psychologist, working as Academic Director of the Wound Healing Research Unit at Cardiff University in United Kingdom. Professor Price will present findings of a multinational survey investigating patients’ suffering from chronic wounds and their experience of pain at dressing change.

This will be followed by a presentation held by Professor Gary Sibbald expert in wound care and healing together with Wound Care specialist Kevin Woo. They will present new consensus statements including new evidence on pain. Sibbald is Professor of Medicine and Public Health Sciences at the University of Toronto, Canada and Director of Dermatology Day Care and Wound Healing Clinic at the Women’s College Hospital in Toronto. Woo is a Clinical Researcher and a Nurse Practitioner in the Wound Care Program at Women’s College Hospital in Toronto.

The final presentation will advise on how you can make a difference regarding wound pain in your practice. Christina Lindholm Professor of Clinical Nursing at Kristianstad University in Sweden and Wendy White, Nurse Consultant at Wendy White Wound Care in Lake Haven, New South Wales, Australia will discuss this important topic.

Lunch and learn session ‐ways to reduce pain

The lunch and learn session hosted by Mölnlycke Health Care will provide an opportunity for an interactive discussion with renowned wound care specialists on strategies to reduce pain for patients suffering from chronic and acute wounds. In addition, the session will provide practical examples of how soft silicone dressings can help minimize pain at dressing related procedures. The session will take place on Saturday, June 7, from 12:45 to1:45 p.m. in room 105 on the 100 Level of the North Building of the Metro Toronto Convention Centre.

The overall objective is to raise the awareness of wound related pain in different indications including burns, oncology wounds and venous leg ulcers.

The lunch and learn session is chaired by Christina Lindholm Professor of Clinical Nursing at Kristianstad University in Sweden. Speakers include Herbert Meites and Pamela Savage. Herbert Meites is MD, F.A.C.S and Medical Director of the department of Wound & Hyperbaric Medicine and the Paul Silverstein Baptist Burn Center at Integris Baptist Medical Center in Oklahoma City, USA. Pamela Savage is a clinical nurse specialist in medical oncology at Princess Margaret Hospital in Toronto, Canada. Savage is also Assistant Clinical Professor at the School of Nursing, Faculty of Health Sciences, at McMaster University in Hamilton, Canada.

About Safetac technology

Safetac is a patented soft silicone adhesive technology designed for wound dressings. The soft silicone layer is extremely soft and adheres gently to the surrounding skin. Dressings with Safetac technology are easily removed without causing trauma either to the wound or to the surrounding skin. This leads to an undisturbed wound healing and to minimised pain for the patient.

About Mölnlycke health care

Mölnlycke Health Care is a world leading manufacturer of single‐use surgical and wound care products and services for the professional health care sector.

The Surgical Division offers peace of mind in the perioperative environment by providing a range of outstanding products such as drapes, sets and staff clothing, surgical powder free gloves, skin antiseptics and customised procedure trays, along with various services. The brand names are BARRIER^®, Biogel^®, HibiAntisepticsTM and ProcedurePak^®.

The Wound Care division offers gentle and effective wound healing and provides a range of unique products based on the patented soft silicone technology, Safetac^®: e.g. Mepilex^® wound dressings and Mepitel^®, together with surgical, absorbent and fixation dressings, e.g. Mepore^®. The assortment also has supplementary portfolios in compression, dermatology and orthopedics, as well as a product for hard‐to‐heal wounds, Xelma^®, extracellular matrix protein. Mölnlycke Health Care started operations as an independent company in 1998 and was acquired from Apax Partners by Investor in January 2007. The company has about 5500 employees and manufacturing plants in Belgium, the Czech Republic, Finland, Malaysia, Thailand and the U.K.

Mölnlycke Health Care is headquartered in Gothenburg, Sweden. For more information, please visit http://www.monlycke.com

Contacts:

Molnlvcke Health Care:
Helena Thiel
Helena.thiel@molnlycke.com+46 31 722 32 49
Media inquiries:
Kristina Ebenius Schwartz Communications
molnlyckewoundcare@schwartz-pr.com
+46 8 599 085 00

WUWHS introduces second consensus document at congress in Toronto ‐ the ten commandments for management of wound related pain

The third congress of WUWHS marks the release of the second consensus document on principles of best practice on minimizing pain at dressing relating procedures. This document is yet another important step to improve patient care and alleviate wound‐related pain.

The document is an educational initiative from WUWHS, supported by Mölnlycke Health Care. It is building on the first pain document from the WUWHS, released in 2004, and contains an update of new scientific evidence. However, new scientific findings are not of much use if they are not incorporated into daily clinical practice. This document can be viewed as practical tool enabling healthcare providers assess and manage wound‐related pain.

Over the course of developing the document, ten easy‐to‐overview consensus statements emerged. All are based on the opinion of a renowned international expert working group from several clinical disciplines. Here are the ten pillars of wound care:

• 1 Identify and treat the cause of the chronic wound and address concerns expressed by the patient, including a pain assessment at each visit
• 2 Evaluate and document pain intensity and characteristics on a regular basis (before, during and after dressing related procedures)
• 3 Cleanse wound gently, avoid the use of abrasive wipes and cold solutions
• 4 Select an appropriate method of wound debridement and include the potential for causing wound‐related pain
• 5 Choose dressings that minimize trauma/pain with application and removal
• 6a.  Treat infections that may cause wound‐related pain and inhibit healing
• 6b.  Treat local factors that may induce wound‐related pain (e.g. inflammation, trauma, pressure, maceration)
• 7 Select an appropriate dressing to minimize wound‐related pain based on wear time, moisture, balance, healing potential and peri‐wound maceration
• 8 Evaluate each patient’s need for pharmacological (topical/systemic agents) and non‐pharmacological strategies to minimize wound‐related pain
• 9 Involve and empower patients to optimise pain management
• 10 Healthcare providers should ensure wound‐related pain control for every patient

Each statement is followed by an overview of scientific evidence supporting them in combination with practical tips and tools that can be used, such as pain assessment scales and an easy‐to‐use mnemonic to help memorize pain assessment strategies.

Wound‐related pain greatly affects patients’ quality of life in many ways. Since the pain can vary over time, it is important to measure it continuously. As many as 40 percent of patients think the worst thing with living with an ulcer is painful dressing changes. In order to tackle pain at dressing change, the document therefore focuses on appropriate choice of dressings in two of its ten statements (e.g. 5 and 7). Several factors contribute to pain at dressing change.

Inappropriate aggressive adhesives can cause trauma to the wound and peri‐wound skin on removal. By instead choosing dressings with advanced adhesives such as for instance Soft silicone, an undisturbed wound healing and minimized pain can be achieved.

It is also important to choose a type of dressing that will provide the right amount of fluid handling to maintain a moist wound environment. A right balance of wound moisture is critical to achieve optimal wound healing and to minimize the risk of maceration and pain.

The best practice document is for anyone involved in dressing related procedures. Effective pain management requires the participation of healthcare providers, patients and policy makers. Communicating and utilizing the best practice guide may provide a difference in alleviating wound‐related pain and improving wound care.

First patients treated in dermaPACE device investigation device exemption (IDE) clinical trial

The first U.S. patients have been treated as part of the Investigation Device Exemption (IDE) clinical trial evaluating Pulsed Acoustic Cellular Expression (PACE™) Technology, using the dermaPACE™ device, for the treatment of diabetic foot ulcers.

SANUWAVE has initiated a randomized multi‐center prospective controlled study to evaluate the efficacy and safety of the dermaPACE device. Patients in the active study arm receive 4 treatments over a 2 week period with the dermaPACE device which exposes the ulcer to pulsed acoustic energy waves.

“We’re very excited to have the opportunity to try this innovative technique with our patients,” said Alexander Reyzelman, DPM, of San Francisco, California who performed the first procedure.

“Our goal is to restore function and quality of life to diabetic patients who have been stricken with this debilitating condition by liberating them of the burden of chronic wound care and preventing amputation,” said Christopher M. Cashman, SANUWAVE President and CEO. “As our clinical trial continues, we know that we are getting closer to giving the healthcare community a real solution to a demanding medical problem.”

SANUWAVE, Inc., the leading provider and developer of Pulsed Acoustic Cellular Expression (PACE) technology, received full approval from the FDA to initiate a multi‐center, prospective, randomized clinical trial utilizing its novel dermaPACE device in the treatment of diabetic foot ulcers. As part of the IDE approval, SANUWAVE may enroll up to 18 sites with an enrollment of 180 patients during the trial.

According to Peter Sheehan, M.D., a senior faculty member at the Mount Sinai School of Medicine and a member of the Board of Directors of both the American Diabetes Association and the Wound Healing Society, “In the United States, we have 21 million people with diabetes and 54 million with pre‐diabetes, placing 25% of our population at risk for complications of diabetes. So when you factor in that 15% of people with diabetes can expect to get a non‐healing ulcer in their lifetime, there’s obviously a big clinical need. Any intervention should prove cost effective. It costs roughly $60,000 for lower limb amputation, and the hospitalization alone can cost $16,000 ‐ $20,000 for a patient with a diabetic foot ulcer.”

The dermaPACE device received CE Mark approval in March 2007 for the treatment of acute and chronic defects of the skin and subcutaneous soft tissues e.g. post‐operative wound healing defects, post‐traumatic wounds, deep partial thickness burns, decubitus ulcers, diabetic ulcers, and arterial ulcers. Early European results are very encouraging. The biological working mechanism of dermaPACE is based on the application of high energy pulsed acoustic waves to the affected area. PACE produces stresses at a cellular level which lead to an observed immediate increase in microcirculation and a signal for the cellular release of specific proteins (cellular expression) including angiogenic growth factors that have been clinically shown to result in new supportive blood vessel growth, also known as neovascularization. The combined effect has been shown in animal studies and human pilot studies to have a positive outcome on chronic wound conditions.

European experience with pulsed Acoustic Cellular Expression (PACE™) technology

Pulsed Acoustic Cellular Expression (PACE) Technology has been developed based on early scientific and clinical evidence of the beneficial wound healing effects of extracorporeal shock wave technology (ESWT). The dermaPACE™ device has been developed specifically for PACE wave applications. SANUWAVE™ received CE approval in March 2007. This approval is for the application of pulsed acoustic high‐energy pressure waves on acute and chronic defects of the skin and subcutaneous soft tissues ‐ e.g. post‐operative wound healing defects, post‐traumatic wounds, deep partial thickness burns, decubitous ulcers, diabetic ulcers, and arterial ulcers.

Extracorporeal shock wave technology (ESWT) was introduced to medical practice nearly 30 years ago for use in lithotripsy, and subsequently it became evident that ESWT also had bone and soft tissue healing effects. Pulsed Acoustic Cellular Expression, known as PACE Technology was developed based on proprietary shock wave energy parameters and a specific defined protocol designed to optimize efficacy in the treatment of soft tissue injury. The dermaPACE device utilizes an Applicator to direct high‐energy PACE waves into the wound bed. As the PACE waves penetrate the microcirculatory system, there is an immediate acute inflammatory response resulting in an increase in functional capillary perfusion and vessel permeability index. More leukocytes begin to roll and stick to the vessel walls, finally transmigrating through the vessel wall into the wound bed tissues. Increasing leukocyte activation assists in the inflammatory phase of wound healing by triggering vessel endothelial cells and initiating pro‐angiogenic factor production. These events effectively allow the wound to move through the inflammatory phase and into the proliferation phase. The cells that make up the wound bed are also affected by PACE waves. The PACE waves apply shear forces to the cells. In response to these physical stresses, cells produce and release growth factors and cytokines into the intercellular space. eNOS expression in combination with endothelial VEGF and vWF up‐regulation, as well as co‐expression of PCNA lead to increased cellular proliferation and tissue regeneration. Almost immediately after PACE application and over the next few weeks an angiogenic response will initiate the revascularization process to create new capillaries within the wound bed, improving hemodynamics of tissue microcirculation and facilitating wound healing.

Several animal studies have reported the effect of PACE waves on soft tissue defects. These promising results led to the development of human pilot studies to determine safety and effectiveness of PACE Technology to initiate healing processes in patients with acute and chronic soft tissue conditions.

In the last decade this technology has been used to successfully treat tendinopathies, long bone fracture, non‐union or delayed‐union fractures, and avascular necrosis. Shock wave technology has also been shown to have healing effects in several wound indications. Some of the first results were reported by Haupt et al. ¹ This study, using a porcine model, demonstrated the effects of ESWT at different energy levels and treatment protocols on inflicted, irradiated and non‐irradiated partial thickness wounds. Significant enhancement of wound healing was shown in the lower shock wave energy levels in both the acute and irradiated (chronic model) wound conditions. SANUWAVE developed PACE Technology to maximize the benefits of shock wave specific to chronic wound conditions. Further research conducted at the Cleveland Clinic has reported a 13% increase in functional capillary density without damage to the vessels or an increase in inflammatory infiltrates following PACE application.² Using TUNEL (terminal deoxynucleotidyl transferase‐mediated dUTP nick end‐labeling) a decrease in apoptosis and tissue regeneration was observed after pulsed acoustic wave treatment.³ Further, these applications may significantly increase the efficacy of antibiotics in combating difficult infections.⁴ Clinical publications have reported the biological response of initiation and acceleration of wound healing in burns,⁵ traumatic wounds and reconstructive skin flaps,⁶ and diabetic wounds.⁷

After receiving CE mark approval for dermaPACE in March 2007 the preclinical data triggered the interest of many physicians and wound nurses, resulting in several small trials. The success of these trials can be surveyed at the WUWHS, where three independent European groups present their results. Van Acker et al, from the University of Gent, will present 12 cases of diabetic foot ulcers of which 7 achieved full wound closure within 15 weeks. Bots et al, from the University of Genk, evaluated the affect of PACE applications for the treatment in diabetic foot ulcers over a period of six weeks in 11 patients. dermaPACE has proven to be effective not only for diabetic foot ulcers but also for venous and arterial ulcers as demonstrated by Knerl et al, from the Sisters of Mercy Hospital in Linz, Austria reported providing data on 10 cases with various etiologies.

Previously Jeschke and Petschke et al, from the University of Innsbruck, presented the beneficial effects of dermaPACE treatments in 11 diabetic patients suffering from chronic foot and leg ulcers at the Wound Care Congress in Houston, Texas, USA in October 2007. During this study, the average reduction in wound size was from 5.1+/‐5.5cm² to 0.4+/‐0.5cm². All patients experienced improvement, and 63% of patients achieved over 92% closure within 27 days, 75% of patients achieved complete closure within 62 days. Interestingly, this study reported that the initial wound size and depth did not correlate with wound closure time. These early European reports give rise to hope that PACE will be valuable treatment option for difficult to treat chronic wounds.

Pulsed Acoustic Cellular Expression offers an improved standard of care that may shorten a lengthy conservative therapy healing process and may make later operative measures, such as amputation, unnecessary. Given that conservative therapy or standard of care may not be effective for all patients, PACE is a preferable alternative that carries little risk. PACE has been shown to reduce wound size and increase the rate of wound closure, which would improve the quality of life for a patient.

SANUWAVE, Inc. is a global medical technology company focused on the development and utilization of Pulsed Acoustic Cellular Expression (PACE) technology for advanced wound care, orthopedic, cardiovascular and spine/neurological conditions. Headquartered in Alpharetta, GAwith international offices in Lengwil, Switzerland and Tokyo, Japan; SANUWAVE is undertaking extensive research into the biological mechanisms and cellular effects of ESWT and PACE, to include anti‐inflammatory response, angiogenesis promotion, and bactericidal capabilities.

Coloplast introduces a total wound pain management consensus at the World Union Congress 2008 in Toronto

Pain is a subjective and common experience for people living with chronic wounds. Up to 80% of patients with chronic wounds experience persistent pain between dressing changes.

Although persistent wound pain does not necessarily have a definite trigger, it is often associated with the cause of the wound and local changes in the wound environment. A sudden emergence of wound related pain or an increase in existing pain is often linked to infection, tissue trauma and other key factors that adversely affect wound healing. Despite the importance of pain as a key clinical indicator, it has traditionally been neglected by healthcare providers with a lack of documentation and treatment.

In addition, more and more professionals realize it is no longer adequate to concentrate on pain during dressing change alone to optimize wound healing and patient comfort.

Coloplast is a platinum sponsor of the Third Congress of the World Union of Wound Healing Societies. The objective of the congress in providing evidence‐informed information that facilitates best practice and optimal patient care is very true to what we have committed ourselves to provide as part of our proven wound management offerings.

At the Congress we will be hosting a satellite symposium on how to assess and manage total wound pain, including persistent pain between dressing changes and procedural related pain.

The symposium presents a Wound Pain Consensus developed by an International and interprofessional panel and peer‐reviewed by the WUWHS scientific board. Best practice sharing within the audience will be facilitated in an interactive way.

All aspects of assessing and documenting wound pain and patient centered concerns are dealt with in the symposium. It will differentiate pain in relation to its origin whether it being due to tissue damage, local infection, dressing change related procedures and provide guidance on how to effectively manage the wound pain with different origins through examples of usage of a new and proven Biatain range of foam dressings (Coloplast A/S), which is also introduced at the congress.

A safety review on topical use of Ibuprofen and new results from a large scale, international, comparative study in a real life setting with a foam dressing with ibuprofen (Biatain Ibu, Coloplast A/S) will be presented and discussed.

The symposium is chaired by Professor Gary Sibbald (MD, FRCPC and chair of the Congress) from Canada and involves an International panel with Diane Krasner (Ph.D, RN) from US, C. Richard Chapman (Professor, Ph.D) from US, Sylvie Meaume (M.D. Derm.) from France and Marco Romanelli (Professor, M.D., Ph.D, EWMA president) from Italy.

The symposium “Assessment and Treatment of Wound Pain” is held on Wednesday June 4^th 2008, 4:30‐6:00 pm.

Coloplast host a satellite symposium at the World Union Congress 2008 ‐ “How do you integrate evidence into everyday practice?”

With the increasingly advanced wound treatments being developed, the healthcare professional needs reliable clinical evidence to support the optimal choice of treatment. However, there is not a strong tradition for producing and publishing clinical evidence for new wound treatments and when confronted with unpublished references, it may be difficult to judge whether research results are scientifically valid.

At Coloplast we aim to support our products with peer‐reviewed clinical evidence and over the years the extent of published clinical evidence for Coloplast wound dressings has increased.

Coloplast is a platinum sponsor of the Third Congress of the World Union of Wound Healing Societies. The objective of the congress in providing evidence‐informed information that facilitates best practice and optimal patient care is very true to what we have committed ourselves to provide as part of our proven wound management offerings.

Therefore we will host a satellite symposium on how to integrate evidence into everyday practice.

The objective of this symposium is to provide the audience with knowledge, tools and motivation for integrating evidence into everyday practice. It opens with education in how to read and interpret publications and extracts the relevant key findings. These learning‘s will be used on and illustrated by examples of different clinical evidence.

Guidance in how to utilize the obtained knowledge and implement evidence‐based practice concludes the symposium. Interactions and knowledge sharing with the audience will end the symposium.

In more detail, the symposium includes three elements:

Interpreting clinical evidence

Although theory and practice are inextricably linked they are often seen as separate which has significant consequences for the dissemination and implementation of research findings. The aim is to educate in how to interpret different types of evidence and estimate the relevance and value to the clinician.

Clinical evidence by example

Clinical research is essential when aiming at implementing best practice in wound and skin care. To support the introduction of new treatments, clinical investigations should be performed to support evidence‐based practice. This part will take the audience through examples of relevant evidence at different levels; a case study on InterDry Ag; a randomized clinical trial on Biatain; a health economic analysis on Biatain Ag; a RealLifeStudy on Biatain Ibu.

Implementing evidence into everyday practice

In defiance of the growing evidence base, the realization of evidence‐based practice does not occur automatically. Evidence should be accompanied by education and training. The aim is to provide useful tools for how to practice wound care with an evidence based approach.

The symposium is chaired by professor Finn Gottrup (MD, DMSci) from Denmark and involves an International panel with Heather L. Orsted (RN, M.Sc.) from Canada, Madeleine Flanagan (Principal Lecturer, M.Sc.) from United Kingdom, and Deborah Netch (RN, Ph.D) from US.

The symposium “Integrating Evidence into everyday Practice” is held on June 5^th 2008, 4:45‐5:45 pm.

Convatec launches it’s new Versiva^® XC™ gelling foam dressing in Canada and the United States

Versiva^® XC™ Gelling Foam dressing, developed to manage the challenges of chronic wounds, has just been launched in both Canada and the United States.

Combining the simplicity of foam with the benefits of Hydrofiber^® Technology, Versiva^® XC™ dressing is designed to protect peri‐wound skin and reduce the risk of maceration, whilst supporting ulcer healing in a protocol of care.¹ Versiva^® XC™ Gelling Foam dressing delivers superior fluid retention (p < 0.05) relative to traditional foams² and conforms closely to the wound surface, minimising space between the dressing and the wound bed³ (in in‐vitro testing).

Versiva^® XC™ Gelling Foam dressing is available in adhesive and non‐adhesive formats for use in many types of wounds and is designed for flexibility and conformability. The outer foam/film layer is also waterproof, and provides a bacterial and viral barrier**, with a wear time of up to 7 days* or changed when clinically indicated.

A variety of clinical and scientific studies have been conducted, which demonstrate the benefits of Versiva^® XC™ dressing to patients with exuding leg ulcers and pressure ulcers.

* Please see package insert for complete Directions for use.

** Provided the dressing remains intact and there is no leakage.

Versiva and Hydrofiber are registered trademarks of E.R. Squibb & Sons, L.L.C. XC is a trademark of E.R. Squibb & Sons, L.L.C.

TTS Medical named as U.S. & canandian distributor for innovative wound care product.

Trio Healthcare Ltd. a UK based supplier of advanced silicone based medical devices for stoma care, incontinence care and wound care applications has chosen TTS Medical as their exclusive distributor for the US and Canadian markets after extensive discussions at Medica in Dusseldorf last November and more recently at Arab Health in Dubai in January.

“We’re very excited about the launch of this new line of skin barrier and medical adhesive remover products as they are regarded as the industry leader in Europe where patient feedback has been phenomenal. We feel it is a unique offering in the skin care arena for both the US and Canada” said Stephen O’Hare, Vice‐President of TTS Medical.

Silesse™ a hypoallergenic formulation creates a comfortable but durable barrier between the skin and the medical adhesive used in adhering stoma pouches, sheath catheters and wound care dressings and tapes, which protects the skin from exudates and adhesives.

Niltac™ a silicone based technology releases the adhesives in dressings and tapes in seconds to easily disable all medical adhesives without causing pain or trauma.

The combined use of both Silesse™ and Niltac™ will result in a hugely improved quality of life for patients reliant on medical adhesives for their particular pathology.

One of the considerations for choosing TTS Medical was their familiarity with Epidemolysis Bullosa (E.B.) a rare genetic disease characterized by the presence of extremely fragile skin and recurrent blister formation, resulting from minor mechanical friction or trauma. “In the UK both Silesse™ and Niltac™ have been used by E.B. patients with tremendous success” said Ben Curtis Commercial Director for Trio Healthcare Ltd. “The fact that TTS Medical already had E.B. customers for another product they carry, and were familiar with this rare disease, gives them existing routes to market” Curtis added.

TTS Medical is targeting a launch date of June 19^th in Denver at the EB Patient Care Conference where both Trio and TTS Medical will sponsor a poster presentation highlighting the clinical studies done on both Silesse™ and Niltac™.

Later that week the launch will continue at the Wound Ostomy and Continence Conference in Orlando.

For additional information on the Silesse™ and Niltac™ product line contact Stephen O’Hare on 678 391 6570 or email: stephenohare@tunkeytrading.net

About

TTS Medical

A division of Turnkey Trading Solutions, a registered Georgia corporation, that facilitates European companies looking to break into the US market, offering a menu of services from front office support through fulfillment and billing. www.turnkeytrading.net

Trio healthcare

A UK‐based supplier of advanced new healthcare products specializing in silicone based medical devices for stoma care, incontinence care and wound care applications. www.triohealthcare.co.uk

Gaymar sponsors consensus panel on skin changes and care for end‐of‐life patients

Consensus Panel: Skin Changes At Life’s End (SCALE) to Outline Issues, Recommend Next Steps ORCHARD PARK, N.Y.; April 23, 2008 – Gaymar Industries today announced the launch of a dedicated interprofessional panel focused on skin changes at end of life and the unique challenges facing caregivers in the diagnosis, evaluation and treatments of this condition.

Launched on April 4–6, 2008 in Chicago, the Consensus Panel: Skin Changes At Life’s End (SCALE) brought together clinicians, caregivers, medical researchers, legal experts, academicians and leaders of professional organizations to examine the issues surrounding end‐of‐life (EOL) skin changes. In a forum made possible by an educational grant from Gaymar Industries, Inc., the panel discussed the nature of EOL skin changes – including the Kennedy Terminal Ulcer – and possible definitions; the need to educate clinicians and the public on the social, legal and financial ramifications of this condition; and suggested research into the etiology, diagnosis and recommended pathways of care.

In the coming months, the Consensus Panel will identify an agenda for moving forward and publish a paper documenting the panel’s findings and recommended next steps.

“With the U.S. Centers for Medicare and Medicaid Services preparing to discontinue reimbursement for hospital‐acquired pressure ulcers this October, clinicians and administrators have increased their focus on the prevention and treatment of this condition,” said Dr. Thomas Stewart, president of Gaymar Industries. “EOL skin change is a unique phenomenon that will receive closer scrutiny in the years to come, and this panel was formed to better define the challenges that lie ahead to map out a long‐term strategy for addressing them.”

For more information on the Consensus Panel (SCALE) or to learn more about opportunities to participate in this initiative, please contact Cynthia Sylvia.

The role of Juven in wound healing

Nutrition plays an important role in wound healing, repair of soft tissue injuries and recovery from surgery. Research has demonstrated that nutritional state and wound healing are strongly associated. Collagen synthesis is required for complete wound healing and resolution of muscle injury. Although the wound healing process is complex, the ultimate outcome of any healing process is repair of a tissue defect. Control of wound collagen synthesis has been an indefinable goal, and in many clinical instances, the goal is to increase the collagen deposition as a means of enhancing wound strength and integrity. Recent research supports the use of specific nutrients in order to enhance collagen deposition at the wound site. Juven is a combination of the metabolite of the amino acid leucine, b‐hydroxy‐b‐methylbutyrate (HMB), and two amino acids, arginine and glutamine. Juven is a medical food that has been shown to enhance collagen formation at the wound site³ and contains ingredients that have been studied in modulation of protein synthesis.

A double‐blind, randomized study examined the effect of HMB, arginine, and glutamine supplementation on wound collagen accumulation. A total of 35 healthy, volunteers 70 years or older were enrolled.³ Elderly subjects were randomized to receive daily supplementation of Juven or a control product. Supplementation with Juven led to a significant increase in collagen deposition (as reflected by hydroxyproline content). This provides a safe nutritional means for increasing wound repair in patients.

Abbott

Abbott Laboratories is a global, broad‐based health care company devoted to discovering new medicines, new technologies and new ways to manage health. The full portfolio of Abbott brands spans the continuum of care, from nutritional therapies and laboratory diagnostics to medical devices and pharmaceutical treatments.

Abbott Nutrition is a division of Abbott Laboratories, and is a market leader in providing innovative and superior nutrition worldwide for people of all ages. Abbott Nutrition develops and markets a wide range of science‐based products including: infant formulas, adult medical nutritionals, and performance nutritionals. Abbott Nutrition products are marketed through Abbott Nutrition International (ANI) outside the U.S.

Abbott Nutrition’s globally recognized brands include the Similac^® brand of infant formulas; the Gain^® brand of growing‐up milks for older babies and toddlers; the PediaSure^® brand of nutritionals and snacks for children; and the Ensure^® brand of adult nutritionals.

Additionally, Abbott Nutrition is a leader in disease specific medical foods clinically shown to address the distinct dietary needs of people with serious health conditions or special nutrient requirements, such as Glucerna^® for people with diabetes and Juven^® for people who need to build lean body mass and support healing.