NEWS BRIEFS
March 1, 1999
NEWS BRIEFS
Company manages details, cost of catastrophic care
Burns and other catastrophic injuries have proved difficult to manage in the past, as their infrequent nature gives health care providers little experience in managing these events. The complications and costs of catastrophic care can skyrocket.
Now a company based in Lynnwood, WA, Avandel Healthcare, has created an innovative way to care for burns and other catastrophic injuries. According to Avandel representative Laurie Lord Hambrecht, RN, BSN, the company provides a clinical approach to burn care by creating outcome plans based on best-of-medicine protocols, and oversees the care of those cases as directed by the guidelines of its management program. As catastrophe manager, the company networks with centers of excellence to coordinate overall planning and care delivery with state-of-the-art partners. Hambrecht says Avandel’s approach creates a tighter link between the clinical and financial aspects of burns and other catastrophes.
More information is available directly from Avandel Healthcare, 3400 188th St. SW, Ste. 570, Lynnwood, WA 98027. Telephone: (888) 478-6300. Web site: www.avandel.com.
Silicone sheets painlessly reduce pediatric scarring
Most children are incorrigibly curious and love an adventure. Unfortunately, incautious children often put themselves at risk of injury from accidents — and the scars that accident wounds can leave behind. Parents and caregivers will be glad to know scarring can be kept to a minimum using pure silicone sheeting now available at the local pharmacy.
Once available only by prescription or in hospitals and burn centers, these thin, pliable sheets, named ReJuveness Pure Silicone Sheeting, can be applied to a wound once it has closed. "Since it is painless and has no side effects, it makes it perfect for use on children," says Laurie J. Polis, MD, director of the Soho Skin and Laser Dermatology Group in New York City and advisor to ReJuveness.
ReJuveness may eliminate or reduce the need for painful and expensive surgeries or injections to minimize scars. "In many cases, doctors and their patients felt that the scar reduction procedure was worse than living with the scar itself," Polis says. "Unless a scar is completely obvious, such as on the face, or physically uncomfortable, I don’t think I would recommend these invasive procedures for a child." She says the best bet is to try silicone sheeting first.
Electrostatic field may be active principle
While no one knows exactly how silicone sheeting helps reduce scars, the prevailing scientific belief is that an electrostatic field forms between the sheet and the surface area of the skin. Over a period of time, ranging from several weeks to months, the electrostatic field helps lighten, flatten, and smooth the scar painlessly and without side effects. According to Polis, "At no time is any silicone ever released into the skin from the sheet."
Of the 62 million new scars formed each year in America, about 9 million are considered either hypertrophic or keloid. Hypertrophic scars are red and raised within the wound site, while keloids are red, raised, and expanded beyond the wound site. While these scars, which result from abnormal healing, can affect anyone, they’re more common among those with darker skin tones, such as African-Americans and Asian-Americans. Family history of these types of scars can also play a role, and hormones — such as the fluctuations that occur during puberty — may be implicated as well.
Paul Striker, MD, attending plastic surgeon at the New York Eye and Ear Infirmary and at the Center for Specialty Care in New York City, uses Rejuveness extensively, and has this to say about the product: "I’ve found it extremely efficacious in reversing heavy scarring. It’s cost-effective, there’s no risk, and it avoids a surgical correction. Very often, when someone’s had a cut on the leg or the face that would traditionally require a surgical correction or painful injections of cortisone, I’ve been able to get that scar flattened and the coloration improved by just the application of the silicone sheeting at home. I’ve been universally successful if my patient complies."
Striker does a lot of eyelid surgery and laser resurfacing in his practice. "If I see that scar starting to get a little reactive, I immediately apply the Rejuveness," he says. "I don’t have the scientific studies to prove that it’s preventing scarring, but my professional opinion is it’s very helpful. The nice thing about this is there’s no bottom line.’ The worst you can get is a little rash from sweating, and then you stop for a day or two. With surgery, you can get infection or failure or complications, and cortisone injections are painful."
This is good news for parents who would like to reduce unsightly scars on their children for any number of reasons: the scar brings back bad memories, makes the child feel self-conscious, restricts movement, or is easily irritated and itchy. Polis emphasizes that immediate care for a wound is imperative to prevent foreign-body contamination and infection. Equally important are getting sutures if necessary, and avoiding plastic surgery, ear piercing, and tattoos if there is a history of this type of hypertrophic or keloid scarring.
For more information about the product and problem scarring, check out the company’s Web site at www.rejuveness.com.
Curative, Novartis create educational program
Curative Health Services and Novartis Pharmaceuticals are collaborating on an educational program to give Curative’s Network Wound Care Center medical and clinical associates the latest clinical and research information on Apligraf, Novartis’ bilayered living skin equivalent.
Apligraf was approved by the Food and Drug Administration last May for treatment of venous leg ulcers, which affect between 600,000 and 1 million people in the United States, more than 90% of whom are over age 50. The product, which is flexible and functions much as natural skin layers do, was shown in clinical trials to heal even longstanding venous leg ulcers (wounds in existence for more than a year) more effectively and faster than compression therapy alone, as reported in the Archives of Dermatology.1
Curative is capturing and tracking outcomes data on Wound Care Center patients treated with Apligraf. "Apligraf looks promising for specific patient groups and provides another option to be considered in developing a treatment plan for each individual patient. However, long-term effectiveness will need to be established," says John Vakoutis, Curative’s president and CEO.
Curative, a disease management company in the treatment of chronic wounds, manages more than 150 Wound Care Centers nationwide. The company also provides services to health care providers through a nationwide network of wound care programs that offer interdisciplinary wound care. Headquartered in Basel, Switzerland, Novartis and its affiliates own exclusive worldwide marketing rights to Apligraf, which was developed and is manufactured by Organogenesis in Canton, MA.
For further information, contact Curative Health Services, 150 Motor Parkway, Hauppauge, NY 11788. Telephone: (516) 232-7000.
Reference
1. Falanga V, et al. Rapid healing of venous ulcers and lack of clinical rejection with an allogenic cultured human skin equivalent. Arch Dermatol 1998; 134:293-300.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content