|Absorption of exudate|
Here we distinguish
|See wound cleaning|
|Adhesion with the wound|
Basically LIGASANO® doesnīt adhere to wounds, because itīs always a moist wound care (see alsoPromotion of blood flow ). Sometimes it can happen in practice though, that LIGASANO® adheres to wounds persistently. In the following you get a chart about the causes known to us and their countermeasures:
The LIGASANO® padding is thinner than 2 cm, therefore too much air comes to the wound, the exudate evaporates too fast and dries up.
LIGASANO® should be at least 2 cm thick, as measured from the bottom of the wound, to ensure a moist and warm environment.
LIGASANO® has partly no wound contact, exudate cantīt be absorbed and adheres on the one hand to the wound and on the other hand to LIGASANO®.
Please keep always an eye on wound contact on the whole surface. Therefore insert LIGASANO® with slight compression into the wound. Donīt fear compression! (seePressure tension)
In the case of wounds which discharche only less, as superficial burns or abrasions, the issued blood resp. exudate may dry up.
In most cases it is helpful to moisten LIGASANO® on the side of the wound, e.g. by Ringerīs solution, to increase the moisture content.
Additional ointments, gel or drugs which are drying out, are used at wound treatment. They adhere with skin resp. wound and LIGASANO®:.
In single cases this adhesion is desired. By the adhesive effect of the gel an accelerated debridement shall obtain.>br>If this adhesive effect is not desired, please examine whether ointment, gel or drug is really neccessary or whether an other preparation is on-hand.
Additional ointments, gel or drugs are used, that have a desiccant effect on the wound itself. A moist and warm wound environment canīt develop.
Please examine if ointment, gel or drug is really neccessary or whether another preparation, that isnīt desiccative, is on-hand.
During the granulation phase LIGASANO® was too long into the wound; regenerated tissue is sprouted into the cell structure of LIGASANO®.
At the treatment with LIGASANO® wounds often granulate surprisingly quick and vigorous. In such cases please shorten the interval of dressing change reasonable.
Generally: should LIGASANO® adhered to a wound, please dry it from the outer side and press the wet with pumping movements into the material, so that it softenes the dehydrated blood or exudate as far as LIGASANO® can be removed easily.
LIGASANO® white is partly permeable to air. Therewith from a thickness of 2 cm on a sufficient thermical isolation is guaranteed, without hindering the exchange of gas during the wound treatment.
By the present knowledge LIGASANO® white is allergy neutral. However skin reaction appear occasionally.
Counter measure: Save LIGASANO® toward displacing with skin, fix it at the body. See also
|Please klick here.|
|In LIGASANO® not contained.|
|Change of dressing|
During the phase of wound cleaning the wound mostly weeps strong - and thatīs the way it should be! The fluency of exudate cleans the wound from the depth through the pores of the wound ground, even dry necroses are dissolved and flushed out.
|See also Repose of the wound - disturbation of the wound by change of dressing|
Wounds which donīt clean or only badly. The cause are wound healing impairments (see alsoWound healing impairments) that must be treatened, to reach the wound healing.
LIGASANO® is neutral to allergies, stimulates the blood flow in the skin-to-skin contact through its mechanical stimulus; it has a controlled absorption effect and a quickly reducing compressive stress. These effects have to be considered in every application. In the case of carcinoma the promotion of blood flow could have a negative effect; but real contra-indications are not known to us.
You have to differ between
All in all the items 1 to 4 are meaningless if the balance in item 5 comes out positive. A real serious comparison is certainly only possible at item 1 to 3, because item 4 and 5 is dependent decisively upon the general environment and the condition of the patient. There is a endless number of different preconditions, two real comparable patients are hard to find.
|Deep wound with narrow opening|
Deep wounds with narrow opening, e.g. fistlulae or wounds with pockets, tender to heal superficial and to encapsulate an infection. The after-effect is, that the wound bursts open after a short time, possibly at another point of the body surface. The goal is, that the wound really granulates from bottom to top resp. from the inside to the outside. Therefore the wound dressing always has to reach down to the bottom of the wound.
Completely fill out the wound with the LIGASANO® - wound band (art. 15370) with slight compression.
Firstly explore direction and depth of the wound, so that you can reliable reach the bottom of the wound. Generously cover the wound environment with a LIGASANO® sheet, 1-2 cm thick.
The wound strip should assume a zigzag pattern in the wound.
Changing the wound dressing is quick and simple. A premature, superficial closure of the wound will prevented.
|Durability of LIGASANO®|
It is almost the same as in the case of salt and pepper; they also need a durability date. Theoretically LIGASANO® would be durable endless, if it is reliable protected against UV radiation and moist. From the production date on we guarantee a durability of 5 years, if it is stored in an appropriated way. Donīt apply LIGASANO®, if it is yellowed or if it crumbles.
At the moment an often used term that sounds good but says nothing but exudate is absorpted by a suitable wound dressing. The earlier term for this was absorption ability or effect. In connection with LIGASANO® we speak about controlled absorption effect (seeWound cleaning ).
Fistulae are best treated with the LIGASANO® (white) wound band. The sterile wound strip with the size 300 x 2,5 x 0.4 cm can easily applicated with a pair of forceps and it assumes a zigzag pattern in the wound. If the fistula isnīt ramified too much, you can treat the wound without chirurgical intervention.
Schematic description of an exemplary fistula treatment with LIGASANO® (white) wound band sterile (art. 15370) 300 x 2,5 x 0.4 cm.
In every case the fixation of LIGASANO® (white) must be permeable to air, never occlusive.|
Here are some possibilities, with the autorīs subjective assessment.
Practice score D
Fixation with adhesive plaster strips
Poor adhesion, may exert traction on small areas of skin.
Even "skin-friendly" plaster strips place stress on the skin on removal.
Practice score C
Large-area, air-permeable adhesive plaster
e.g. Fixomull stretch
Relatively expensive, good adhesion, stress on skin on removal.
Practice score B
Stretch net pants, fixation pants, tubular net bandage, tubular bandage
No stress on skin, simple to change, can be reused.
Disadvantage: Generates traction on textiles; when the patient moves in bed, fixation and LIGASANO® may shift.
Practice score A
Nylon stockings or parts of it
Very low-priced (-.40 to -.90 ), may be reused.
The cheapest nylons are the best quality for this application, because they are wide-meshed and air-permeable. May be cut as required, thus replacing any fixation pants and tubular bandages.
Advantage: The nylon material slides smoothly over textiles, but adheres to LIGASANO®. Even when the patient moves around in bed, LIGASANO® remains in place.
Foamed (=expanded) plastics (EPS, EPP, PVC, PVA, PUR, etc.) are usually named foam. Other foamed (expanded) materials are in language use named e.g. "foam rubber" (=latex), "cellular caoutchouc" resp. "cellular rubber". At bakerīs ware, for example bread, rolls, pastries, etc. it concerns foamed (=expanded) dough.
|Foam for wound dressings|
For wound dressings made of foam, for the most part polyurethane (abbrev. PUR) has become accepted. PUR foam has the outstanding advantage that it can be produced in endless many variations (density, elasticity, cell size, cell structure, hydrolysis properties, etc.). Mainly used are are in continuous processes made polyurethane- and polyesterurethane soft foams.
|Gel and LIGASANO®|
|See below Ointments|
|GREEN CLIMATE GRID®|
An alternative Term forLIGASANO® green
|History LIGAMED®, LIGASANO® white, LIGASANO® green|
LIGASANO® was developed from the then medical superintended of the Dermatological department of the Klinikum Nuremberg and his assistant medical director Dr. Karl-Heinz Galli. This was at the end of the 7th decade in the last century.
|LIGASANO® is free of latex.|
Main field of application: ventilation of the skin, air-conditioning of the skin, patient positioning
Main field of application: wound healing, prevention, care of the skin
|Mechanical stimulus (see also Promotion of blood flow )|
While LIGASANO® white is in contact with wound and skin it produces by its surface properties and the involuntary motions of the body a mechanical stimulus that promotes the blood flow.
|Modern wound care|
A modern term used for wound dressings with additional properties. Example: Hydrocolloides, alginates, activated charcoal dressings, etc. Especially in the case of chronic wounds this term diverts from the really necessary measures. It seem like the "modern wound care" in fact could heal wounds. but this is naturally incorrect. (seeWound healing impairments ). Fact is that you have to make the patientsīorganism able to heal the wound. On chronic wounds you have to give your special attention to remove the wound healing impairments.
This "modern wound treatment" that is placed into the foreground, fulfils in the process of wound healing only a secondary task.
|Moist wound care (see also Adhesion with the wound )|
The LIGASANO® wound treatment is always a moist wound care. The moist isnīt brought in from outside, as many other preparations do, but is generated in the wound itsself.
|MRSA - Methicillinresistant Staphylococcus aureus|
Staphylococci, Staphylococcus aureus too, belong to the normal colonists of skin and mucous membranes. About 20 to 60% of the people take in this germ in a relatively great number in the nasal and pharynx area. In the case of medical stuff you have to proceed even greater carrier rates. On the other hand staphylococcus aureus can under certain circumstances cause life-threatening infections. As a typical pyogenic germ it can take part in the developement of abscesses, furuncles, wound infections and impetigo contagiosa. Moreover this germ can cause osteomyelitis (inflammation of the bone marrow), pneumonia (inflammation of the lungs), sepsis (blood poisoning) and endocarditis (inflammation of the heart muscle).
|Source: health department|
A dietetic treatment that is abounding in nutrients esp. in albumines, may help to dam up bed sores, reports Marion Hönig, a oecotrophologist of the German society for nutrition medicine and dietetics in Bad Aachen, Germany. According to an topical study of the Humboldt University in Berlin (Germany), 37% of the patients in the contacted hospitals and even 65% of the inhabitants of nursery homes are endangered to get a pressure ulcer.1
|Leaflet Appropriate Diet|
|Ointments, change of potency of LIGASANO®|
Ointment or gel can constipate the pores of LIGASANO® and change the nature of its surface. The controlled capillar effect and the desired mechanical stimulus may influenced negatively or even abolished.
|Ointments, durability of LIGASANO® against|
By the concurrent use of ointments, liquors, etc. you have to check if LIGASANO® is persistant against it.
|Ointments, solutions, drugs: interaction with LIGASANO®|
As a matter of principle there are no interactions of ointments, solutions and drugs with LIGASANO®. However ointments or liquors may cause different effects by different circumstances.
|Perspiration on LIGASANO®|
By skin contact with LIGASANO® white the local blood flow is promoted; in the case of lying patients this leads to a normalisation of the body temperature. (At lying position the blood circulation doesnīt need to overcome gravity, because heart and circulation are at the same level. The blood pressure is falling, especially peripheral the body temperature declines for about 1° C.)
For an optimal effect please pay attention to the following:
One of the "silver bullets" in the plastics industry with nearly unlimited possibilities in variation and use. LIGASANO® white and LIGASANO® green are polyurethanes.
|Prescription of LIGASANO®|
In Germany LIGASANO® white, LIGASANO® green and LIGASANO® black are dressings able to prescribe, if they are prescribed and used as such ones.
"Pressure causes an identical counter-pressure", accordingly Newton says. If an elastic material is deformed under pressure, it presses back with the same counter-pressure. This is called pressure tension.
|Wound care quick and easy|
|Always cut LIGASANO® (white) somewhat larger than the wound diameter and somewhat thicker than the wound depth and insert it into the wound with slight compression.|
|The goal: wound contact on the complete surface|
|Compression is reduced rapidly, the required contact remains.|
|Promotion of blood flow|
Poor blood circulation is the most frequent cause for the development of chronic wounds and simultaneous the main cause, why this kind of wounds heal not or only badly. See alsoWound healing impairments.
If a region of the body is not or not enough supplied with blood, it becomes necrotic or a wound developes, that doesnīt heal up.
LIGASANO® white causes a local promotion of blood flow where it has contact to skin resp. wound and therefore reduces the risk to develope a wound caused by poor blood flow or promotes its healing in all phases of wound healing. By the size of application beyond the wound resp. risked area the effect of the local measure is added. The supply of the wound with nutrients, oxygene and antitoxines is improved, products of metabolism are carried off. The cleaning of the wound from germs, coats and even dry necroses is achieved by a naturally strengthen sectretion of the wound. See also Wound cleaning.
The effect to stimulate the blood flow is achieved by a mechanical stimulus, that results from the special surface properties of LIGASANO® white in contact with wound or skin and from the involuntary body movements (muscle reflexes, breathing, heart beat).
|Abbrevation for polyurethane.|
|PVC (polyvinyl chloride)|
|LIGASANO® is free of PVC.|
|Repose of the wound - disturbation of the wound by change of dressing|
The wound shall be disturbed as less as ever possible, to promote an unhindered healing process. That is absolutely correct, but nevertheless for the LIGASANO® wound therapy we recommend also in the granulation phase a daily change of dressing. How can fit this together?
|LIGASANO® doesnīt contain any softener.|
Protect LIGASANO® against UV radiation, moist, fire, glowing fire and temperatures over 70°C, see also our userīs manual.
|Lars Koschorrek, physician|
|What is leg ulcer?|
Leg ulcer is a poor healing (chronic) deep wound at the lower legs and feet.
|How do leg ulcers come into being?|
Venous leg ulcer run to ca. 80% of all leg ulcers. They are the consequence of a chronic venous weakness (chronic venous insufficiency). Often the predisposition to a venous weakness runs in a family. The veins enlarge and elongate themselves and constitute varices. These dilatation effects, that the valves of the venous system donīt function (close) properly. By this blood can flow back and accumulates in the veins. This congestion leads to a oedema (accumulation of water in the tissue) and after a certain time to an induration of the connective tissue (sclerosis). Both changes lead to an undersupply of the tissue with blood and nutrients, particularly at the inner side of the ankles and the front of the lower leg. Later this can lead to leg ulcers.
More rare leg ulcers develope by disturbations of the arterial blood circulation. The arteries transport the blood from the heart to the tissues of the body to provide them with oxygen and nutrients. If the blood circulation is considerable weakened for example by a heavy arterial calcification (arteriosclerosis), leg ulcers may develop.
|How to become aware of leg ulcers?|
|Venous leg ulcers|
|Arterial leg ulcers|
|How leg ulcers are diagnosed?|
To diagnose a leg ulcer isnīt difficult for an physician. But is is important for the therapy to know the triggered cause.
|How to treat leg ulcers?|
|Venous leg ulcers|
Arterial leg ulcers|
If you treat an ulcer the topmost goal must be to eliminate all factors that caused the development of the ulcer and hinder its healing.
What can you do by yourself?||
Venous leg ulcers||
Arterial leg ulcers||
And the prognosis?|
By the correct treatment leg ulcers heal completely mostly during a few month.
Leitlinien der Deutschen Gesellschaft für Phlebologie
Braun-Falco: Dermatologie und Venerologie
Herold: Innere Medizin
Dr. med. Katharina Larisch
|Water vapour permeability|
The water vapour permeability is measured only at relatively impermeable materials, as for example foils. For this, it is not possible to specify a reasonable value for LIGASANO®.
|Wound healing impairments|
Wound healing impairments impede the wound healing and are the cause for chronic wounds.
A further wound healing impairment is improper treatment. In fact it is relatively simple to hinder a wound to heal by wrong treatment.
See also Repose of the wound - disturbation of the wound by change of dressing.
A modern term that - especially in the case of chronic wounds - takes off from the really required measures. It sounds like the treatment of a wound could heal the wound, but this is not true.