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Topic: Current Concepts in Wound Healing

Effect of limited access dressing on surface

pH of chronic wounds

Pramod Kumar , Thittamaranahalli Muguregowda Honnegowda 2
1,2
1 Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al-Jouf, Saudi Arabia.
2 Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal 576104, Karnataka, India.
Address for correspondence: Dr. Pramod Kumar, Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al-Jouf,
Saudi Arabia. E-mail: pkumar86@hotmail.com

ABSTRACT
Aim: Changes in the pH of chronic wounds can inhibit the optimal activity of various enzymes in the
wound environment, thereby delaying wound healing. The aim of the present study is to monitor the
effect of limited access dressing (LAD) on the pH on the surface of chronic wounds. Methods: A total
of 140 patients with chronic wounds of more than 4 weeks duration were divided into two groups
by simple randomization: a LAD group (n = 64) and a conventional dressing group (n = 76). Fifty-six
participants (22 in the LAD group and 34 in the conventional dressing group) were lost to follow-up
or withdrawn from the study. Results: In the LAD group (n = 42), the mean age was 38.3 ± 10.56 years
(range: 12-60 years), and the mean wound size at the time of admission was 28 cm (range: 19-40 cm ).
2
2
In the conventional dressing group (n = 42), the mean age was 35.3 ± 14.0 years (range: 17-65 years),
and the mean wound size at the time of admission was 26 cm (range: 18-39 cm ). Patients treated
2
2
with LAD showed a significant decrease in the mean ± standard deviation pH when compared with
the conventional dressing group (0.83 ± 0.52 vs. 0.41 ± 0.26, P = 0.048). Conclusion: LAD reduces the
chronic wound surface pH to a level required for the optimal function of various enzymes. This could
be a factor that exerts a beneficial effect on wound healing.
Key words:
Chronic wounds, limited access dressing, negative pressure wound therapy, wound surface pH

INTRODUCTION an influential factor in the healing process, as an acidic
environment favors wound healing. The pH of the wound
Chronic nonhealing wounds continues to pose a treatment surface may change due to various factors including
challenge to the clinician. [1‑3] Several enzymatic reactions in infection, oxygenation and topical applications of various
the wound environment are governed by the wound pH. dressing materials. Modulation of the wound pH may
Chronic nonhealing wounds may occur secondary to an therefore change the direction of wound healing. There
[4]
elevated alkaline pH. Very few studies have investigated were no studies in the literature evaluating the role of
the relationship between wound pH and the healing of negative pressure wound therapy in modulating wound pH.
[5]
chronic wounds. A study by Leveen et al. established Limited access dressing (LAD), a relatively new technique
that weakly acidic wound environments significantly that combines negative pressure and moist wound
inhibit protease activity and may potentially promote
wound healing. A subsequent comprehensive review by
[7]
[6]
Schneider et al. and Percival et al. showed that pH is This is an open access article distributed under the terms of the Creative Commons
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How to cite this article: Kumar P, Honnegowda TM. Effect of limited
access dressing on surface pH of chronic wounds. Plast Aesthet Res
DOI: 2015;2:257-60.
10.4103/2347-9264.165449
Received: 30-01-2015; Accepted: 27-07-2015

© 2015 Plastic and Aesthetic Research | Published by Wolters Kluwer - Medknow 257