Woulgan Bioactive Beta-Glucan Gel is a treatment for both acute and chronic wounds where wound healing is slow, 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 slowed 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 weeks[3].
Additionally, in VLUs a published algorithm suggests that <40% healing in 4 weeks indicates the risk of non-healing with standard care[4].
Indications
When wound healing is slow 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
Watch a short description below on how Woulgan works and how it should be used.
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.
If you’d like to download and/or print this user guidance, you can do so here.
References
- 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.
- 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.
- 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
- 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.