Evaluation of Altrazeal transforming powder dressing on stage 2-4 pressure ulcers: a clinical case series.

OBJECTIVE: Pressure ulcers (PUs) are hard-to-heal, open wounds that affect millions of adults worldwide. Patients experience physical, mental, social and financial impairment. On average, <50% of stage 3 and 4 PUs heal by the sixth month. Treatment of PUs is highly variable due to a patient's comorbidities, demographics and wound characteristics. Because of this, there exists no standard dressing for PUs. Altrazeal transforming powder dressing (TPD, Uluru Inc., US) offers a promising new form of wound treatment; however, little evidence exists for TPD in the treatment of hard-to-heal PUs. This case series sought to examine the effect of TPD in hard-to-heal PUs that have previously undergone unsuccessful standard of care (SoC) wound therapy. METHODS: This case series used retrospective data from patients with stage 2-4 PUs that failed to heal after SoC therapies. Factors examined were: number of dressing changes; time between dressing changes; time to wound closure; and pain level. While data were assessed for all patients, we focused on the six particular cases that most clearly illustrated the effect of TPD on wound healing. RESULTS: Each of the 21 patients treated with TPD experienced successful and expedited wound closure. Stage 4 PUs took an average of 87 days with approximately six dressing changes to closure. Stage 3 PUs took an average of 41 days with approximately four dressing changes, and stage 2 PUs an average of 13 days to closure with approximately one dressing change. In the cases presented herein for which pain scores were reported, each showed a reduction in pain from an 8 or 9/10 to a 1 or 2/10 with the first dressing change. CONCLUSION: In this case series, TPD effectively reduced pain and healed PUs that had previously failed SoC interventions. We suggest future prospective studies in order to more effectively measure the wound healing capability and healthcare utilisation of TPD for treatment of PUs.

Treatment of upper- and lower-extremity vitiligo with epidermal grafts after CO2 laser resurfacing with systemic and topical steroids.

Vitiligo is an acquired condition that presents as sharply demarcated white macules. It affects 1-2% of people of all races, regardless of gender or age. Although the disease does not have any systemic complications, it is of great concern, particularly in darker-skinned individuals. We treated 14 patients with vitiligo involving the upper and lower extremities. Surgical therapies were used in conjunction with medical therapy to achieve repigmentation after the disease was stabilized.