About Wounds
Wound and TopiVac

Wound and TopiVac

The term wound is derived from the Latin word "vulnus" and means disruption of the continuity of a body structure (eg skin) with or without tissue loss.

Wound; It is a health problem that requires treatment of skin and mucous membranes. Wound care and treatment takes time, cost and effort. If left untreated, it may result limb loss and death.

Wounds can be classified primarily as acute and chronic.

• Acute wounds

Traumatic wounds, Burnt wounds, Surgical wounds, Fistulas, Skin grafts, etc.

• Chronic wounds

Pressure ulcers, Diabetic ulcers, etc.

Chronic Wound

Chronic wound is the name given to all wounds that heal late or difficult or do not heal. Wounds that do not heal within about three months despite treatment are considered chronic wounds.

The wound repeats constantly. There is a local or systemic factor that prevents wound healing. Underlying diseases; Diabetes, vascular occlusion, bedsores. Accompanying factors are obesity, smoking, general condition disorder, advanced age, cancer, and some drugs used. In addition, reasons such as improper shoes and foot deformity increase the susceptibility.

Main Purpose of Wound Care

• Protecting living tissues
• To prevent further tissue destruction and infection development in the wounded area
• Speeding up recovery
• To increase the blood supply and functions of the wounded area
• To prevent complications that may occur in other organs and systems by ensuring skin integrity
• Thus, to ensure the healing of the wound, to prevent loss of limb or loss of life.

Innovative Approaches in Wound Care

• It should be more effective than existing systems
• Especially, it should increase the healing speed of chronic wounds.
• It should enable the patient to quickly return to normal productive life
• The material should save labor and economy
• It should prevent loss of limb and life

Costs in Wound Care

In economic evaluation, total cost and total benefits are compared. The total cost can be divided into three items.

1. Direct medical costs:
   • Cost of healthcare providers
2. Non-direct medical costs:
   • Patients, patient relatives, etc. costs incurred by
3. Indirect costs:
   • “Time” costs related to the treatment service (time of the patient and patient relatives)

Direct medical and non-medical costs

• Dressing costs used in the wound
• Costs of materials used in wound cleaning
• Surgical and radiological intervention costs
• Complication costs caused by the wound
• Pain relief costs
• Patient costs related to inpatient treatment
• Hospital infection costs
• Costs of caregivers
• Transportation costs of the patient or relatives to the hospital and job loss
• Disposal costs of wound material

These costs; 17-22% are material expenses, 80% are expenses related to hospital care (31-41% physician-nurse, 37-49% hospital expenses).

How Chronic Wounds Occur in Diabetes Patients?

Due to the insufficient nutrition of the tissue, the treatment becomes more difficult as a result of infection in the area that does not heal.

In diabetic patients, the problem of healing wounds arises as a result of the weakening of the defense system and deterioration of the nerves (neuropathy), especially in the legs, and blockage of the vessels.

In diabetic patients, even the wound that starts with a small rash is very important, it is the starting signal of a large chronic wound and requires careful follow-up and treatment. Outpatient chronic wounds occur in most patients with this condition. If adequate treatment is not done in patients with chronic wounds, poor results leading to amputation and ultimately death are seen.

Pressure and Bed Sores

Bed sores, more commonly defined as "pressure ulcers", begin with the deterioration of blood supply in parts of the body that are exposed to high pressure and result in scar formation. It is not possible to heal the wound unless the pressure is removed and blood supply is regulated.

Although it often occurs in bedridden patients, these wounds can develop in any area with prolonged pressure, for example on the sitting bones in wheelchair-bound people.

Burn Wounds

As medical, burn is the loss of vitality of the skin with high heat. Depending on the height of the heat or the duration of contact, the superficial, middle and deep layers of the skin can burn and become dead. Burns can be comprised because of by contact with hot water or steam, contact with hot solid materials, contact with acid or alkaline chemicals, electric current or radiation.

If the burn occurred as a result of heat, electricity, rays, friction and freezing, it is defined as a physical burn, if it is caused by acid and alkali substances, it is defined as a chemical burn.

First degree burns (epidermal burn) are superficial. They affect the top layer of the skin called the epidermis. Edema may occur and there is no blisters, which we usually call bulla on the skin. The wound is red, dry and painful. It heals in a short time without leaving a scar. Sunburns fall into this class.

Second-degree burns also affect part of the dermis, the deep layer of the skin. It is mostly occured because of hot water, contacting with flame or hot object. Tissue damage is more than 1st degree burns, they are very painful, inflammatory burns. It heals in 2-3 weeks with dressings. Sometimes it may be necessary to resort to surgical treatment methods.

Third-degree burns are those that affect the entire (all layers) of the skin. The sensation of pain in the skin has disappeared and the color of the burnt area has changed from pink-red to brown and whitish, yellowish. They do not heal spontaneously. There is a high probability of infection and edema. They require surgical intervention and good care, take a very long time to heal and leave a scar.

How Should Burn Treatment Be?

In first degree burns, there is damage to the top layer of the skin. Sunburns are this kind of burns. Cooling the skin, topical anesthetic drugs, moisturizing and oily creams can be used in treatment. The skin in the burned area is shed superficially within 1-2 weeks.

In second degree burns, the upper layer of the skin is completely burned. Healing occurs with the proliferation of cells from the sebaceous glands, sweat glands and hair follicles in the subcutaneous layer. Second degree burns are divided into two subclasses, superficial and deep, according to the amount of loss in the healing skin appendages. There is no scar in a superficial 2nd degree burn, but a deep 2nd degree burn heals by leaving a scar. Blisters in the burned area should be protected. It is followed up with appropriate dressings. The recovery period is between 1 week and 10 days in superficial burns. In deep second degree burns, recovery is between 2-3 weeks.

In third degree burns, there are no skin patches left to renew the skin. Healing occurs with the skin that develops from the burned edges and a disturbing scar develops. Skin transplantation can be applied to the burn area to prevent poor wound healing. While small areas heal by leaving scars with dressings, large areas take a long time to heal, and if infection develops during this time, life-threatening may occur. Burns in the joint and neck area may cause restriction of joint and neck movements. Skin transplantation accelerates healing and prevents the development of loss of function. Scars develop less in skin transplanted areas. Treatment of 2nd degree and 3rd degree burns should be done by a burn specialist and should be followed with closed dressings.

Treatment of Non-Healing Wounds

The best method in wound care is to prevent these wounds. If the necessary care is taken, it is possible to avoid very large injuries. Once the wound occurs, its treatment requires a very difficult and long process.

The second basic rule of chronic wounds after prevention is the treatment of the underlying causes. In other words, it is not possible to treat pressure sores without controlling the pressure distribution or diabetic foot treatment without regulating blood sugar.

The third rule is behavioral therapy. It is not possible to heal these wounds if a person with circulatory disorders continues to smoke or if a diabetic patient does not pay attention to their feet and shoes.

Care of the wound only makes sense after all. Today, it is possible to get excellent results with high-tech dressing materials. However, it is necessary for the patient and the doctor to show sufficient patience and care.

Surgery comes as the last method in wound care. From time to time, wounds may need to be cleared of dead tissue and discharge. This is called "debridement". It is a frequently used method to close the wounds with surgical methods, especially in pressure sores. Skin patches are also a common method.

In addition, stem cell applications are also used in wound treatment and successful results are obtained.

Wound Healing

When an injury occurs and an open wound has occurred, it is important to act immediately. The healing time, speed and rate of wounds depends on a number of factors. The size and type of wounds are the most important factors. However, the physical condition of the patient, the cleaning and treatment of the wound also play an important role in the healing rate of the wounds. Wounds that are not treated and maintained are more susceptible to unwanted permanent scars and infections. It is possible to heal wounds quickly, thanks to treatment with the right medications and applications.

What is Classical VAC (Vacuum-Assisted Closure) Wound Therapy?

Vacuum assisted closure (VAC) is a method of lowering the air pressure around the wound to aid healing in post-operative non-healing wounds and pressure sores in bedridden patients. NPWT is referred to as Negative Pressure Wound Therapy. It is basically based on the principle of absorbing the fluid in the wound. An adhesive, transparent film is placed on the wound and the foam with a special structure that will connect the device with the wound is combined with this film, and the liquid in the wound is drawn into the device. In this way, edema in the tissue is resolved and the number of bacteria grown in the tissue is reduced. The risk of infection is reduced by taking precautions against infection.

Thanks to this vacuum effect, the scar tissue is stimulated and wound healing is accelerated. Blood flow is accelerated and the wound area is better nourished. This is important in the healing of the stimulated scar tissue. Because tissue that is not fed and cannot get enough oxygen cannot heal. Another benefit of negative pressure therapy is that it keeps the wound clean.

The administration of the treatment is provided by a device produced in accordance with the treatment. This device; It consists of a special foam, silicone tube and reservoir. The foam is brought to the desired shape and size according to the size of the wound to be applied, and the silicone tube allows the absorbed fluid to be transferred to the reservoir.

The vacuum process is carried out with a calibrated and standardized compressor and microprocessor and a device with software. The pressure and other parameters to be applied are adjusted from the screen on the device. One of the important points in the treatment is that the procedure should be paused for a maximum of two hours. In breaks that last more than two hours, the scar tissue heals later, treatment may be adversely affected and efficiency decreases.

What is the TopiVac?

Topivac is a wound care system consisting of a device and set produced with advanced technology. Topivac system directly provides the necessary oxygen and ozone support to the wound for rapid healing, as well as providing Subatmospheric pressure by creating a negative pressure on the closure set by vacuuming on the wound.

It also performs wound irrigation and balances the moisture of the wound. It is used in the treatment of chronic wounds, burn wounds and all kinds of open wounds.

TopiVac accelerates the healing process at the cellular level by diffusing the Oxygen it gives to the wound centre directly into the cell thanks to its special wound closure pads, prevents the reproduction of bacteria and helps to strengthen the leukocyte activation in the wound area.

Thanks to ozone gas, it kills a wide spectrum of microorganisms and prevents the development of infection before resistance develops. It provides the revitalization of organic functions and the activation of the immune system at the cellular level.

Thanks to electrostimulation, it enables the skin, subcutaneous tissues and deep muscle groups to be activated by high frequency electrical stimuli. Topivac significantly accelerates the healing process in the wound and muscle tissue with the electrostimulation treatment process it can do, and reduces pain, which is an important problem for the patient, especially in chronic wounds.

Thanks to its specially designed wound closure pads, it continues the healing process by delivering oxygen and ozone under negative pressure to the wound without damaging the tissue.

TopiVac, which can offer all these features together, is a high-tech treatment system that allows all wounds, especially chronic wounds and burn wounds, to heal quickly and in suitable conditions, without the risk of infection.

In addition to negative pressure according to models, other features such as Oxygen, Ozone, electrostimulation are also available.

Consult a senior physician for any wound.