RTD Advanced Wound Care

Any damage or break to the skin or underlying tissue. 

• Close Wounds – Where tissues are damaged but not exposed to exterior environment. (Ex. bruising, hemorrhage)
• Open Wounds – Where the protective body surface has been broken, permitting entry of foreign material to tissues. 

Depending on healing time, wounds can be further classified into:

• Acute Wounds – Wounds which move through healing within a normal, predicted timeframe.
• Chronic Wounds – Starts out as an acute wound, but does not follow the normal stage of healing, lengthened and stalled recovery with no sign of improvement 

Stage 1 - Hemostasis

• Blood clots will form to control and stop the bleeding at wound site

Stage 2 - Inflammation

• Blood vessels will leak fluids (exudate) to prevent infection and transport repair cells to the wound

Stage 3 - Proliferation

• Promotion of granulation - New tissues and blood vessels will start to be rebuilt

Stage 4 - Maturation

• New tissue will gain strength and flexibility, and wound will close

Our body excretes exudate during Stage 2 of wound healing and is mainly made up of water, saline chloride, proteins and various types of cells. Exudate normally promotes a moist wound environment, and facilitates migration of repair cells across the wound bed (WBC, macrophages etc.).

The amount of exudate produced differ per wound. (Ex. Large deeper wounds tend to excrete more exudate).   

However, over-excretion of exudate may adversely affect healing, this is due to:

• Maceration – Skin breakage due to moisture
• Bacterial contamination / Infection – Which lives off the rich nutrients of exudate

Within minutes of skin breakage, microbes would already be in contact with the wound bed. Over time, almost 60% of wounds are infected with biofilm, which is the main cause of chronic wounds.

Biofilm is a colony of microbes which formed a thin translucent layer of multi-species bacteria on wound bed. The bacteria does this by emitting a chemical signal to other microbes to migrate towards the protein-rich wound bed.

• Biofilm is hard to eliminate with treatments and antibiotic, due to the multi-species spectrum and given its 3 protective layers: Sacrificial bacteria, Dormant bacteria and Worker bacteria

These layers circulate oxygen, exudate/moisture and nutrients throughout the bacteria colony.

Traditionally, there are 3 stages when treating wounds:

1. Cleansing - Once assessed, infected wound bed is deluged in solutions or antibacterial washes

• RISK - Wound bed is saturated with too much moisture from liquid solutions and medications. 
• This will cause delayed healing and wound closure.

2. Treatment - Antimicrobial medication is delivered to treat the wound, then covered in dressing or gauze

• RISK - Saturated gauze will not be able to absorb the wound’s natural exudate excretion – a good breeding ground for bacteria. 
• This will cause higher level of cost & traffic over time - excess labor & attention.

3. Healing - Wound bed is now covered and saturated, and will anticipate healing and closure

• RISK - Since traditional gauzes and wound dressing are not absorbent and can be soaked easily, killed microorganisms and bioburden will remain in place. Thus, active and dead microbes are retained in moist wound bed and will further breed wound infection.
• This will cause patient inconvenience, and pain of constant dressing changes.

Upon contact with the wound bed, the RTD dressing is dry. But very quickly it would detect and absorb excreted excess exudate by the body. The absorbed exudate would trigger the ionization and proportionate release of the 3 antimicrobial components (MB, GV & SI) to the wound. 

Note: 

• All 3 antimicrobial components are tightly bound into the foam structure and only with proportionate release to what the body needs. Thus, will not flood wound bed with excessive solutions. 
• Components of the RTD are integrated into foam structure, not soaked/dipped. 

The defeated and fluidized biofilm / bio-burden will now be rapidly absorbed by the capillary suction action of the open cell, medical-grade PU foam. Absorption clears out toxins and debris away, physically cleaning the wound, preventing further antimicrobial resistance.

Absorbed infected exudate and bio-burden are tightly retained within the capillary tube-ways of the RTD foam, without the possibility of reverting back to wound. Once absorbed, microorganisms are rendered impotent by the continuous attack of the concentrated antimicrobial components (MB, GV & SI) at the core of the RTD foam. Bioburden are absorbed and physically kept away from wound bed, and removed at every dressing change.

Interactive Ingredients: Silver, Methylene Blue, Gentian Violet and CST Foam

• Draws protein rich exudate away from wound; creates a favourable wound healing environment
• Effective antimicrobial and anti fungal properties; reduces bacterial load due to singlet oxygenation
• Early and sustained antimicrobial protection; sequential use removes biofilm
• Analgesic; significant pain reduction reported
• Non-cytotoxic; use throughout the continuum of care for all four stages of wound healing
• Cost effective; reduces healing time; use up to 3 days
• One dressing for all your needs

Proprietary Technology: Active Ingredients are Integrated into Foam Matrix

• Open cell structure; wicks exudate vertically
• Absorbs 1,110 mg/sq. cm; holds 20 times of it's weight in exudate
• Interactive ingredients are tightly bound with the foam
• Regulates wound bed moisture; little to no maceration

Polyurethane Foam is Soft Pliable and Surface Conforming

• Easy to use, Ready to apply. No need to hydrate before use
• Can be easily cut to size of wound bed and peri-wound
• Versatile; can be used for multiple wound types

Steps to use an RTD foam:

• Proper cleansing should be applied to open wound per facility protocol, before application of RTD. 
• RTD could be cut, layered or rolled depending on wound size, type and level of exudate excretion. 
• RTD to be secured with a secondary dressing (non-occlusive adhesive or medical tape). 
• RTD dressing should be in direct contact with wound. No foam hydration necessary.
• Recommended to change dressing up to 3 days, unless already saturated.

On a normally healing wound, a foam can be used up to 3 days. This depends on the amount of exudate absorbed or upon the advice of a health professional. 

In cases of extra-heavy exudate excretion, the RTD foam can also be stacked on top of each other for vertical wicking to reduce the frequency of redressing the wound.

RTD is flexible enough to be cut into wound size, rolled for tunneling wounds or stacked when used in a wide variety of wounds. 

For example, if the dressing becomes saturated before the desired dressing change, a second dressing may be place on top for continued absorption and vertical wicking.

  The RTD foam absorbs and retains 20x its own weight in exudate and bioburden (4x4 ¼ dressing holds 115ml). RTD provides 10,000 open pores per square inch of foam.

No, only those silver wound dressings that deluges excessive silver components to wound discolour the skin to grey. All our 4 components will not discolour the skin.

Wounds with medium to heavy exudate absorbed into the foam will not adhere to the wound due to foam moisture. However, in cases of light exudate, saline or sterile water can be applied to the foam upon removal. Or a thin layer of petroleum component or a silicone thule can be applied upon foam application. Both these solutions will not affect the effectiveness of RTD. 

RTD can be used for 1st to 2nd degree wounds. RTD is not indicated for 3rd degree wounds.

RTD™ is a proprietary highly absorbent antimicrobial foam (latex-free) with Methylene Blue (0.25 mg/g), Gentian Violet (0.25 mg/g) and Silver Sodium Zirconium Phosphate. (7 mg/g).