User Guidance

Woulgan Bioactive Beta-Glucan Gel is a treatment for both acute and chronic wounds where wound healing is stalled, or is anticipated to heal slower than normal or is at high risk of becoming stalled. Woulgan has a unique formulation with gel properties and beta-glucan which reactivates stalled healing and accelerates the healing process.1, 2

 

It is recommended to initiate Woulgan treatment after 4 weeks with standard care when the response is not satisfactory.
It has been documented that a diabetic foot ulcer showing less than 40% size reduction in 4 weeks has a 91% risk of not healing in 12 weeks3.
Additionally, in VLUs a published algorithm suggests that <40% healing in 4 weeks indicates the risk of non-healing with standard care4.

 

Indications

When wound healing is stalled or is anticipated to be slower than expected in:

  • Diabetic foot ulcers
  • Leg ulcers
  • Pressure ulcers
  • Open post-operative wounds
  • Partial thickness burns
  • Graft and donor sites
  • Abrasions and lacerations

 

Wound conditions suitable for Woulgan treatment

  • Dry to medium exuding.
  • Partial to full thickness. Full thickness wounds might not heal with secondary intention.
  • Fibrin – up to 75 % of the wound surface can be covered with dry or moist fibrin. The hydrogel properties will dissolve the fibrin.
  • Necrosis – the wound can be covered with up to 75% yellow or black necrotic tissue. Before applying Woulgan debride according to local practice.
  • Fistulas – Woulgan can be used in fistulas, although some fistulas will not heal without surgery.
  • Tendons and bones can be exposed. Woulgan will not harm these structures, but when tendon and bone are visible, the wound might not heal with secondary intention.
  • Undermining – can be present.

 

Precautions

  • The effect of Woulgan might be reduced if the patient is treated with systemic steroids or immune suppressive treatment.
  • Infection; a clinical infection should be treated according to local guidelines, but Woulgan can be used in conjunction with antimicrobial therapies.


Contraindication

  • Known allergy to any of the components in Woulgan.

 

How to apply

  • Wound cleansing according to local practice
  • Debride if appropriate
  • Protect the wound edges, if applicable
  • Cover the wound surface with a thin layer of Woulgan
  • Apply a suitable secondary dressing of choice and fixate
  • Any foam dressing or wound contact layer can be used
    • Avoid using superabsorbent dressings
  • Apply compression or offloading if indicated
  • Apply new Woulgan at every dressing change
  • Typically twice per week

 

Look for these clinical improvements:

  • Cleaner wound bed
  • Healthier wound tissue
  • Smaller size
  • Less depth

 

Treatment period

    • Reassess after 4 weeks of Woulgan treatment and holistic patient care.
    • If none of the above improvements are seen, consider discontinuing Woulgan treatment.
    • When improvements are evident, continue for a second 4-week period or until healed. After 8 weeks treatment with Woulgan, assess healing and return to standard of care if appropriate.
    • If the healing progression stalls or plateaus again, start another 4-week period of Woulgan treatment, assess and continue with Woulgan if improvements are seen.
    • If the wound deteriorates, the treatment should be discontinued. Assess possible reasons for deterioration; patient condition, clinical infection, changes in use of compression/ off loading or changes in use of cleansing agents or cover dressings.

 

Clinical observations when Woulgan is used

    • An increase in signs of inflammation can be expected, do not confuse this with infection.
    • Sometimes an increase in exudate may occur after a few days.

 

Woulgan is not:

        • A biofilm remover.
        • But Woulgan can be used after debridement and may prevent new biofilm formation.
        • A treatment for infected wounds, if the wound is clinically infected:
        • Treat the infection according to local practice.
        • Woulgan may be used at the same time as long as exudate level is low to moderate.

 

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  1. Can activation of body’s own key cells in wound healing, wound macrophages, make a positive contribution in the treatment of chronic wounds? Ingrid Skjaevelend and Rolf E Engstad, SÅR, volume 21 no 4.

  2. Macrophage stimulating agent soluble yeast B-1,3/1,6-glucan as a topical treatment of diabetic foot and leg ulcers: A randomized, double blind, placebo-controlled phase II study. Zykova et al, Journal of Diabetes Investigation Volume 5, Issue 4 2014.

  3. Sheehan P, Jones P, Giurini JM, et al. Percent changes in wound area of diabetic foot ulcers over a 4 week period is a robust predictor of complete healing in 12 week prospective trial. Plast. Reconstr Surg 2006; 117(7 suppl): 239S-244S

  4. An evidence based algorithm for treating venous leg ulcers utilizing the Cochrane database of systematic reviews, Howard M Kimmel et al. WOUNDS. 2013;25(9):242-250.

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