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Kathryn Vowden RGN, DPSN(TV) Clinical Nurse Specialist (Vascular and Wound Healing)Bradford Royal Infirmary Bradford, UK Peter Vowden MD, FRCS Consultant Vascular Surgeon Bradford Royal Infirmary Bradford, UKEmail: [email protected] This paper explores the concept of wound bed preparation and relates this to five key areas of care: bacterial balance, necrosis, exudate, cellular dysfunction and biochemical balance.Wound bed preparation is the inter-relationship of these elements to a global framework of care.Odour is attributed to the volatiles produced by the bacteria within a wound Wound fluid, containing bacteria and cellular debris, is readily drawn up into the Cadexomer matrix cleansing the wound bed of extra debris and bacteria, thereby helping to promote wound healing.This desloughing and removal of bacteria is believed to be responsible for the increase in wound healing and the rate of epithelialisation observed in clinical studies of chronic leg ulcers after treatment with Cadexomer Iodine.This will frequently require a multidisciplinary and structured approach to care.These changes are underpinned by our ever-increasing knowledge of the biological microenvironment within a chronic wound and centre on the inter-relationship of functionally abnormal cells, bacterial balance, inappropriate biochemical messengers and dysfunctional wound matrix components.This review gives a brief overview about the introduction and developments of polymers in medicine in general, addressing first stable polymers, then polymers with degradability as a first biological function, followed by various other functional and responsive polymers.It is shown up that biomedical polymers comprise not only bulk materials, but also coatings and pharmaceutical nano-carriers for drugs.

The main body of the review then is structured according to the medical applications, where key requirements of the applications and the currently used polymer solutions are indicated.Flivasorb® and Flivasorb® Adhesive are superabsorbent dressings particularly suited to wounds that are exuding heavily.This ‘how to’ guide focuses on how Flivasorb and Flivasorb Adhesive work and are beneficial in such patients. Exudate is derived from the fluid that has leaked from capillaries into body tissues around the wound.In this article, the practical aspects of using this framework are discussed.The formation of a healthy wound bed is a prerequisite to the use of many of today's advanced wound care products.

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