Specialised Wound Care

Bettamed works at healing wounds from the inside-and-out, using 3 products in combination:

  1. Bettamed Cleanse & Recover Tablets or medicine (oral)
    Bettamed tablets (or liquid medicine) harness the potent plant properties of plants known for their vigorous growth and disease resistance. These anti-viral, ant-fungal, anti-bacterial and anti-inflammatory properties are extremely useful in helping slow-healing wounds regenerate and heal themselves.
  2. Bettamed Cleanse & Recover Cream 25g (topical)
    Chemical ointments can disturb tissue growth.
    Plant based oitments like, Bettamed’s Cleanse & Recover Cream 25g, work better at healing and encouraging new tissue formation. USE this ointment around the raw edge of the leg ulcer only.
  3. Bettamed Oxygen Spray 200ml
    Bettamed Oxygen Spray can be used for cleaning the wound. It is a natural oxygen based cleaning solution, which gives the wound much needed oxygen, to clean and heal the wound. This spray is beneficial, since it is inexpensive and does not require that the wound be wiped, which can be less painful for the patient.

Note:

Slow healing wounds need Oxygen NOT SALTWATER/ SALINE or chemical cleaning agents, which destroy tissue and can halt the healing process.
Lack of circulation, in most patients, result in low oxygen levels to the wound, which slows healing.

We have refined a treatment cycle while doing trials with clinic sisters at the various pharmacies we service. Here we rely on clinical experience to guide decision-making on dressings and debriding agents.

Wound dressings

Wound care products for lower-extremity ulcers in patients with diabetes, are very often out of the budget of many patients in South Africa.

Two key elements support the healing process:

  1. The wound care process is as important as the products used.
  2. Failure to debride diabetic or slow healing wounds appropriately, when necessary, could be considered failure to render proper treatment.

We agree with Kenneth B. Rehm, DPM, medical director of the Diabetic Foot & Wound Treatment Centers, in San Diego. He asserts that, if prevention measures aren’t taken properly, the wound will get too bad for effective treatment.

Debridement

Boiled tap water (from the COLD TAP) that has been allowed to cool, can be used to wipe- the- wound from time-to-time, to remove yellowish mucous or dried crusty mucous.

Mild infection of the wound can be treated by:

  1. Debriding (wiping and removing slough), using boiled tap water (from the COLD TAP)- which has cooled.
    Increased frequency of cleaning and Spraying with Bettamed Oxygen Spray 4-5 times per day will often reverse infection.
    Moderate infection may require:
  2. Use of antibiotics may be necessary, however, you are further increasing the risk of more drug resistant bacteria.
  3. These patients should be treated with the mildest Creams and debriding agents like Melladerm Gel (honey based), since the new flesh is easily compromised, by chemical agents.

Infected Necrotic Wounds

Mildly infected wounds are improved dramatically with the use of CERDAK Ceramic Wound Plasters used for 1 to 2 weeks to dry, clean & shrink the size of the wound. CERDAK Ceramic Plasters prevent infection by controlling moisture and removal of debris from the wound. CERDAK have different sized plasters including tips for burnt or injured fingers.

The types of wounds that this applies to is:

  • Burns
  • Leg Ulcers
  • Cuts & Abrasions
  • Contusions & Lacerations – caused by loose gravel & other debris

Physicians need to remove gangrenous, necrotic, ischemic and devitalized tissue by some method of debridement. If wet necrotic tissue, also commonly referred to as wet gangrene is present, immediate debridement is necessary. Chemical debridement, with strong chemicals, should be used with caution as the application of chemical debridement may be painful and cause underlying tissue damage. Chemical ointments should be discontinued as soon as the wound is looking red and beefy. One should then continue with a mild plant based regime like Bettamed Oxygen Spray, Cream ointment and tablets.

Venous Ulcers can be treated successfully using Bettamed; albeit a slow process to be handled with patience. The ulcer/ wound will be red in colour.
Varicose Ulcers are fundamentally faulty arterial systems in the leg, which need surgery. The ulcer/ wound is generally bluish in colour.

Facilitating A Sterile Environment

There are several factors to consider when debriding diabetic foot wounds. One is to maintain as high a level of sterility as possible. One should consider the procedure semi-sterile and maintain all reasonable measures to ensure some semblance of a “clean” or semi-sterile field. Mechanical debridement with the use of equipment that is typically reused demands extreme cleanliness and proper cleaning of all equipment to avoid cross-contamination between patients. Autolytic or enzymatic debridement typically only require topical application of ointments or wound dressings, and one can perform these debridements in a very clean fashion with minimal requirements of sterile materials aside from applicators, gauze, etc.

Pressure bandages and support stockings

Pressure bandages should not be used in patients with severe circulatory issues (eg. where there is a weak pulse in the foot). Elevation of the leg is recommended instead- during resting. Especially in the elderly, where exercise is not possible.
Occlusive or semi-occlusive dressings may cause maceration of the wound edge when they are left on too long.
The prevention of swelling (edema) and the prevention of pressure to the wound are important aspects in wound care.

  1. Pounding (or direct pressure)
  2. Rubbing (or shearing pressure)
  3. Friction (or rubbing pressure)

“You want to keep those new cells alive and you do not want to do damage by rubbing them away,” he explains. “Once you reestablish circulation, gotten rid of the bacterial infection, and once you have debrided it, now you can see the field starting to grow grass. It starts growing this granulation tissue which is red tissue that serves as a lattice framework for the new skin. The wound usually starts healing at the ends.”

A wound that has a red, beefy and clean granular base?

Bettamed Cleanse and Recover Cream allows for moist wound healing and doesn’t tend to macerate the skin like some of the other products including hydrogels.

Popular Ointments that are chemically based work well for debriding infected wounds but should be discontinued once the wound has returned to a red beefy state.

Plant based ointments like, Bettamed’s Cleanse & Recover Cream 25g, work better at healing and encouraging new tissue formation.
Wound Dressings.

We have found that standard wet-to-dry bandaging works well, and should not need to be soaked in Iodine.

Jelonet (nor paraffin gauze) does not allow enough air onto the wound. Rather pack 4-5 layers of gauze onto the wound. When changing this dressing, later- it can be sprayed with the Oxygen spray to loosen it.

Silver and honey dressings have been found to burn certain sensitised individuals.

General Care

  1. Eat a healthy diet. (Reduce salt intake to prevent swelling.)
    There are nutrients for the support of the veins. Bromelain is a protein digesting compound derived from the stem of the pineapple plant.
  2. Exercise regularly. (If you are at risk, do low impact aerobics.)
  3. Don’t cross your legs when sitting.
    If you have to sit or stand for long periods of time, alternate your position. (When standing, shift your weight from one foot to the other every few minutes. Sitting, stand from time to time, also do the movements listed below.)
  4. Elevate your legs when resting. (This is a good time to rotate your feet and to alternately flex and point them. Just these simple movements improve circulation.)
  5. Avoid wearing constrictive clothing, particularly control top pantyhose.
  6. Cool your legs morning and evening with cold water.
  7. Lose weight if needed. If you are susceptible to this problem and/or you must be on your feet a lot, consider purchasing a pair of compression hose to support your legs. Drugstore support stockings won’t do the job because the tensile strength isn’t evenly distributed over the legs.

NOTE:
Saltwater and harsh chemicals damage tissue and retard healing.