Clinical Resource
The management of a Neuro-ischaemic Diabetic foot ulcer using ActivHeal® PHMB Foam
Donna Welsh
Advanced Podiatrist Diabetes
Clinical Resource
The management of a Neuro-ischaemic Diabetic foot ulcer using ActivHeal PHMB Foam
Donna Welsh
Advanced Podiatrist Diabetes
BACKGROUND
The prevention and effective management of wound infection is a high priority for clinicians as infection is a significant problem and can result in delayed healing. Prompt recognition and early management of infection in the diabetic foot is imperative. PHMB has been used for a number of years as an antiseptic agent, however it has been recently added to wound care products. PHMB is a mixture of polymers and a synthetic compound which is similar to the antimicrobial peptides (AMP’s) found in the majority of living organisms, where they provide an innate immune response. AMP’s have a similar mode of action to penicillin and cephalosporin antibiotics (Sorenson et al, 2003).
PHMB works by inhibiting bacterial cell metabolism and binding to the bacteria’s phospholipid (outer) membrane. (Kingsley & Kiernon, 2012). Advanced Medical Solutions have launched an antimicrobial foam into the ActivHeal® range as ActivHeal® PHMB foam. The polyurethane pad contains the antimicrobial substance, PHMB, which is released in the presence of exudate and is effective against a broad spectrum of microorganisms that are frequently associated with bacterial colonisation, infection of wounds or wounds at risk of infection. The case study will explore the management of a Neuro-ishaemic diabetic ulcer to the hallux and heel, using the ActivHeal® PHMB Foam.

METHOD
RESULTS
Wound at Initial Assessment

Wound at Week 1

Wound at Week 8

CONCLUSION
References
Hinchcliffe, R. Browning, J. Andros, G. Apelquist, J. Boyhoi, E. Fitridge, R. Mills, J. Reekers, J. Shearman, C. Zierler, R. Schaper, N. (2016) Effectiveness of revascularisation of the ulcerated foot in patient’s with diabetes and peripheral artery disease: a systematic review. Diabetes Metab Res Rev. 32, Suppl 1. 136-146.
Kingsley, A. Kieron, M. (2012) Suprasorb X and PHMB Made easy. Wounds UK. Feb 2012.
Sorenson, O. Cowland, J. Theilgaard-Monch, K. Liu, L. Ganz, T. Borregaard, N. (2003) Wound Healing and expression of antimicrobial peptides, polypeptides in human keratinocytes a consequence of common growth factors. Journal of Immunol. 170 (11): 5583-9.
Swanson, T. Grothier, L. Schultz, G. (2014) Wound Infection made easy. Wounds International. Available from: www.woundsinternational.com
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