Discussion
The wound treatment under discussion is a novel dressing using common, ordinary materials in an uncommon way. The ingredients used to make this dressing were gauze, viscous lidocaine, polymyxin/bacitracin antibiotic, and oil of wintergreen. Gauze was the substrate, often discounted, but yet very versatile and useful. Gauze can be shaped to any size or form, can be used to moisten or dry a wound, and can easily be combined with other products. Viscous lidocaine not only provided lidocaine for pain relief, but the viscous part is a hydrogel which brings advantages such as maintaining moisture and promoting autolytic debridement. It also controls the pH, making a slightly acidic wound dressing. The chosen antibiotic has broad antibacterial activity and Kaye noted it hastened wound healing. Also, in vitro studies with the novel dressing show inhibition of some common wound pathogens, including E. coli, S. aureus, P. aeruginosa, and C. albicans. The oil of wintergreen is a natural oil added to the antibiotic ointment in small amounts for odor control. Both of the reviews, Study A and Study B, reported that when using the novel dressing there were no new infections, odor was controlled, and pain was relieved or reduced.
While the original goals of treating pain and preventing infection were met, a surprising outcome was the improved healing of wounds. Initially, there was no goal of healing in terminally ill patients; however, wounds improved and even healed in this very fragile group of patients. All the wounds had prior treatment, some with surgery, and most with multiple types of dressings, such as wet-to-dry gauze, hydrocolloids, alginates, silver dressings, or VAC. In all cases, this was the first treatment that had worked to help heal the wound. And in all cases, healing was not expected due to that patients conditions, some with terminal wounds. The results seen with this treatment method were surprising to observers, with more than 40% of the wounds healed or healing at the end of the study period. Because of the success with the hospice patients, this method was used with non-hospice patients as well. The current study reports the results of healing in the hundreds of wounds treated with this method compared to reported results in Study A and Study B.