{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:51:32Z","timestamp":1790607092855,"version":"4.1.0"},"reference-count":30,"publisher":"Mark Allen Group","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> To evaluate the impact of a four-step biofilm-based wound care strategy, Wound Hygiene Protocol (WHP: cleanse, debride, refashion, and dress), on hard-to-heal wounds. <\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p> This was a prospective, real-world analysis of hard-to-heal wounds managed with the WHP that incorporated Aquacel Ag+ (Convatec Ltd., UK) dressings. Data were captured electronically between April 2021 and December 2022. The primary endpoint was change in wound volume from baseline to final assessment. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A total of 693 wounds in 669 patients (median patient age: 74 years) were included in the analysis with a median treatment time of 31 days. Most health professionals were general nurses (50%) or nurse practitioners (38%). Patient homes (27%) and community clinics (27%) were the most common clinical settings. Venous leg ulcers (26%) and pressure ulcers\/injuries (17%) were the most common wound type. Duration was &gt;12 months in 21% of wounds. At baseline, the mean wound volume was 57.8cm<jats:sup>3<\/jats:sup>. At the final assessment, mean wound volume was 17.2cm<jats:sup>3<\/jats:sup>, corresponding to an 80% reduction from baseline; p&lt;0.001). At baseline, 66% of wounds were static or deteriorating. At final assessment, this had decreased to 5%, and 94% had improved or healed. Exudate levels were moderate or high in 69% of wounds at baseline which decreased to 25% at final assessment (p&lt;0.001). Suspected biofilm and local wound infection decreased from 79% and 43%, respectively, at baseline, to 18% and 3%, respectively, at final assessment (p&lt;0.001 for both). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> The WHP is a new proposed standard of care that successfully treated hard-to-heal wounds by addressing the key local barriers to wound healing. <\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2024.33.5.304","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T17:31:07Z","timestamp":1714411867000},"page":"304-310","source":"Crossref","is-referenced-by-count":12,"title":["Improving outcomes for patients with hard-to-heal wounds following adoption of the Wound Hygiene Protocol: real-world evidence"],"prefix":"10.12968","volume":"33","author":[{"given":"Rachel","family":"Torkington-Stokes","sequence":"first","affiliation":[{"name":"Convatec Ltd., Deeside, 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