gure 1. December 17, 2007 gure 2. December 24, 2007 gure 3. January 2, 2008 gure 4.

January 10, 2008 gure 5. January 21, 2008 gure 6. January 31, 2008 gure 7. February 15, 2008
A Novel Matrix Dressing Impregnated With Polyhydrated Ionogens (PHI) To Heal Chronic Wounds: A Case Study
McIntosh, Donnie E. M Ed, BN, RN and de Lemos Yee, Olen BSN, RN. The Good Samaritan Society Canada, Edmonton, Alberta.
Introduction
Mrs. K, a resident in a continuing care facility for the
past nine years, acquired a pressure ulcer on her left
heel caused by friction, shear and pressure in
February, 2007. The wound quickly deteriorated to a
stage III classication and had reached a Pressure Sore
Status Tool (PSST) score of 44. The wound continued to
deteriorate over the next 10 months, with episodes of
improvement and deterioration; eventually becoming
stalled. Due to the lack of resolution of this wound,
Mrs. K was selected as an ideal candidate for the
novel matrix dressing impregnated with polyhydrated
ionogens (PHI).***
GOALS AND OBJECTIVES
To determine the effect of a new matrix dressing
impregnated with polyhydrated ionogens (PHI) on a
challenging wound
To advocate for residents with chronic wounds that
do not respond to treatment
To provide front line staff with the opportunity to
engage in product evaluation and enhance their
scope of practice as related to data collection and
monitoring
References: 1. Bryant, R and D.P. Nix, Acute and Chronic Wounds-
Current Management Concepts. 3rd Ed. (2007) 145
Acknowledgements: The development of this project was made
possible by an unrestricted education grant from 3M Canada.
*** 3MTM TegadermTM Matrix Dressing 0805-2037
Purpose Methods Results Discussion
Our purpose in completing this course of treatment
was to advocate on behalf of our residents with stalled
healing of their challenging wounds. This gave us the
opportunity to explore a new technology that may not
only address this issue for this particular resident but
to enhance our options for those residents who may
develop wounds in the future. The matrix dressing is
impregnated with PHI ointment containing a unique
blend of metal ions. The warmth and moisture from
the wound environment activates the release of the
PHI into the wound bed. The ointment helps to down-
regulate specic metalloproteases (MMPs) that prohibit
healing, thereby balancing the wound environment and
accelerating healing.
Mrs. K is a 96 year old woman with a history of senile dementia, hiatal hernia, glaucoma, hypertension,
emphysema and dysphagia. A pressure ulcer developed on the left heel in February 2007. The team selected
several treatment modalities including: a low air loss surface, ofoading heel boots, nutritional supplements,
a repositioning slider sheet due to limited mobility, and a variety of dressing protocols as determined by the
interdisciplinary wound team.
Dressing treatments included calcium alginates, absorptives, antibacterials, hydrogels, foams and protective
barrier wipes to the wound perimeter. Tubi-grip was applied to successfully manage mild edema. Staff were
reminded to use the repositioning sheet at all times.
The Pressure Sore Status Tool (PSST), developed by
Barbara Bates-Jensen, addresses 15 wound
characteristics and provides an overall status
of the wound. The scores range from 13 to 65,
with 65 representing wound degeneration.
1

The initial assessment indicated a score of 44/65,
and one month later had deteriorated to 55/65.
On December 17th the new matrix dressing
impregnated with PHI was introduced. The wound
measured 5cm x 3cm. It was bleeding with an
edematous periphery. Undermining was present with
a large amount of exudate and little epithelialization.
Daily dressing changes were conducted
over a 2 month period. The wound was cleansed
with normal saline, the matrix dressing impregnated
with PHI applied directly to the wound and covered with
a gauze dressing. The application was very simple.
After the rst two weeks of treatment,
there was a notable improvement in
wound status, and at the end of the trial
(2 months) the wound measured
3cm x 2cm, with a PSST score of 13/65.
Following treatment there was very little
exudate, extensive epithelialization and
granulation evident over the wound base.
Before this new dressing was applied
the resident would demonstrate pain by
withdrawing her foot during dressing
changes and moaning. With the matrix
dressing impregnated with PHI she did not
withdraw her foot, nor did she moan.
These photos clearly depict the wound
status and track the progress of the
wound toward healing. A review of
numerous care approaches over many
months supports the efcacy of the matrix
dressing impregnated with PHI towards
healing, where other advanced wound
care products failed.
The participation of the interdisciplinary
wound team in this evaluation was
enthusiastic. Data collection photos
and wound monitoring were carefully
orchestrated by the unit RN, and the
ultimate goal of moving this challenging
wound towards healing was achieved.
Front line staff reported high satisfaction
with ease of use, resident comfort during
the procedure, and wound healing
progression. The cost/benet aspect of
this advanced dressing clearly supports
the acceptability of the product.
The staff were impressed with this
dressing and have requested that it be
added to the specialty products they are
able to select when treating challenging
wounds. They also reported the residents
daughter was favourably impressed with
the results and the previously challenging
relationship with staff improved
signicantly. The daughter stated that
she felt her mothers quality of life had
improved, particularly as pain
was minimized.
Conclusion
The 10 month experience
with high quality products
demonstrated limited
healing progress. The
improved rate of healing
over a 2 month treatment
period with the matrix
dressing impregnated with
PHI best promoted a
healing environment.
This lead to a positive
outcome for both the
resident and staff.
65
60
55
50
45
40
35
30
25
20
15
10
5
0
DATE ASSESSED
P
S
S
T
S
C
O
R
E
Fe
b
. 2
4
/0
7
M
a
r. 2
1
/0
7
A
p
ril 0
5
/0
7
A
p
ril 2
1
/0
7
M
a
y 0
1
/0
7
M
a
y 1
6
/0
7
Ju
n
e
0
1
/0
7
Ju
n
e
2
6
/0
7
Ju
ly 1
4
/0
7
A
u
g
. 0
1
/0
7
S
e
p
t. 1
5
/0
7
O
ct. 1
5
/0
7
N
o
v. 0
1
/0
7
D
e
c. 1
5
/0
7
Ja
n
. 1
5
/0
8
Fe
b
. 0
1
/0
8
Fe
b
. 1
5
/0
8
M
a
r. 0
1
/0
8
M
a
r. 1
9
/0
8
M
a
r. 2
9
/0
8
A
p
ril 2
1
/0
8
Pressure Sore Status
44
56
54
46 46
45
44
15
14.5 14
55
57
48
27
13
58
60
54 54 54
24