consists of an advanced technology, based on the combination of an algi-
Local treatment of burns:
nate gel with a patented antibacterial
enzyme system: when bacteria come
a modern approach.
into contact with Flaminal® Forte, a se-ries of enzyme reactions are triggered that ultimately result in the production
In recent years, much research has been conducted with an aim to
of free radicals. These reactions take
optimising the local treatment of second-degree burns. With this category
place close to the bacterial cell wall. of burn we are not just concerned with closure of the wound, but rather
This means that a broad spectrum of
with rapid healing with a good aesthetic and functional end result.
bacteria is killed without damage to the dermal and epidermal cells necessary for good wound healing, i.e. without
It is, after all, important to prevent disfig-
an estimate of the healing duration can delaying wound healing.
uring hypertrophic scarring, which of-
even be accurate to a few days.
Due to its high levels of alginates in
ten occurs when wounds take too long
gel form, Flaminal® Forte has an ex-
to heal (more than 18-21 days). For the Products and dressings
cellent debriding effect and produces
treatment of these second-degree burns,
no pseudo-eschar layer in the wound
recourse is often made to Flamazine®, With a view to optimising rapidity of bed. This permits a much better clini-mainly because of its excellent anti-
healing with as few complications as cal assessment. The debriding effect
bacterial properties. In addition to this possible, we have seen an enormous and the absence of a pseudo-eschar indisputable benefit, Flamazine® also increase in new products in recent layer mean the wound is optimally pre-has a few disadvantages. The most im-
years. The development of Hydrofiber pared for laser Doppler imaging. From a
portant of these are:
dressings such as Aquacel® and vari-
therapeutic standpoint, Flaminal® Forte
- Flamazine® forms pseudo-eschar on ous foam bandages spring to mind. The combines good antibacterial properties
the wound, making correct clinical development of antibacterial dressings with maintenance of a moist wound en-assessment difficult, if not impossible;
such as modern silver-containing dress-
vironment that is optimal for healing.
- Flamazine® delays wound healing to ings (Aquacel® Ag, Acticoat®, Mepilex® Around the margin of the wound itself,
a certain extent.
Ag and Silvercel®), honey dressings and Flaminal® Forte forms a layer of alginate
This results in second-degree burns of-
products based on povidone/iodine particles, which protect the edge of the
ten not healing within the suggested pe-
have gained momentum.
wound. This product is therefore impor-
riod of 18-21 days.
An ideal product must have at least tant in helping to close the wound rap-some of the following properties:
idly, resulting in a good aesthetic and
The depth of the second-degree
1. creation of an optimum (moist)
2. debriding effect
In practice: how should burns be
Assessment of the depth of the burn 3. protection against infection
warrants the greatest attention. In sec-
4. analgesic effect
ond-degree burns, clinical assessment 5. convenience for the patient
In practice, second-degree burns should
alone of the depth of the burn is correct
be treated with the help of Flaminal®
only in 60-65% of cases. Laser Dop-
Flaminal® Forte is one of these new Forte as follows:
pler imaging, a specialist technique in products, so much so that during recent
which blood circulation of the wound years, it has been shown to score well Assessment:
can be measured, allows a more accu-
in many of these properties.
In order to implement the correct
rate assessment to be made. Examina-
treatment for this group of burns, it is
tions using this device are more than Flaminal® Forte is an alginate gel with of course important that the burn be 95% accurate. This device thus enables an antibacterial enzyme system. Flami-
correctly identified as such. The clini-
an estimation of the healing potential nal® Forte effects rapid healing without cal picture is usually a patient with of the burn. At the burns unit in Ghent, secondary infections. Flaminal® Forte very painful burns and blister forma-
tion, which may worsen in the first few of iso-Betadine® and water (10% solu-
Clinical outcome following
hours. If the blisters burst or are already tion) or Hibitane® aqueous solution
open, a very moist red to light-red (0.5%). Hair in the immediate vicinity wound bed is observed. If the wound of the wound should be shaved, to pre-bed is pressed then released, the cap-
vent subsequent infection due to diffi-
illaries fill rapidly (capillary refill) and cult hygiene.
the skin feels elastic. An additional test that can be carried out is gentle pulling All loose skin should now be carefully on any hairs present. If good resistance removed with scissors and tweezers; is felt, second-degree burns are almost blisters should be opened and com-a certainty, healing within 18 days.
pletely cut away. Open wounds should
If the wound bed has a cloudy red and again be gently disinfected and then white appearance however, the burn rinsed with water or physiological sa-may be much deeper and referral to a line solution to prevent the disinfect-specialist centre is necessary. A deep ants from causing a burning sensation.
1 second-degree burn would not heal For small burns, Flaminal® Forte can
within 21 days in any case.
now be applied with a spatula in a
burn with blisters and start of Flaminal® Forte use +
layer about 0.5 cm thick directly to
tulle gras/gauze dressing and dry sterile dressing
the wound. A layer of tulle gras dress-
Nurses should wear an apron, cap, ing and on top of this a gauze dressing mask and gloves.
should then be applied. This can all be
The patient should be made comfort-
secured with bandages and a Velpeau
able and given pain-killers, with the bandage.
burn placed on a sterile drape. Ideally, a sterile drape should be used that can For larger burns, the above method is absorb fluid when blisters are pricked impractical and may be painful. Flami-open and cut away. A pain medication nal® Forte contains alginate particles e.g. paracetamol 1 g or tramadol 50 mg that may feel a bit rough and therefore can be given half an hour before the painful if spread on. This discomfort can change. The daily maintenance dose is be prevented by preparing the dressings
2 prescribed by the doctor.
before applying them. A gauze dressing
All the required materials should be set of a suitable size should first be laid
1 day following burn incident and following
out ready, such as: sterile drapes, basin, out. A layer of tulle gras dressing is then
compresses for cleaning the burn, disin-
placed on top of the gauze dressing;
fectant, dressing materials, razor blade, the 10 cm x 7 m size dressing can be scissors, tweezers, spatula, tulle gras used and for very large burns the ver-dressing (Jelonet®) and Flaminal® Forte.
sion supplied on a roll. The tulle gras dressing is then covered with a layer
First of all, the wound should be disin-
of Flaminal® Forte. Finally, the whole
fected. This can be done with a solution structure is placed on the burn.
LDI scan; the red colouration indicates a second-degree burn that should heal in about 14 days
burn after 5 days of Flaminal® Forte use
i.e. preferably a hospital with a burns
Application of Flaminal®
Once the patient is settled, the dressing unit. It may be the case that the burn was
Forte to burns
should be removed. A layer of Flami-
in fact deeper than initially thought and
nal® Forte is still usually present on the that skin graft surgery is necessary.
Application of Flaminal® Forte to the tulle gras
wound. This layer may have gone yel-
Once the burn has healed, the new skin
dressing then application to the wound.
low or green as the exudate, necrotic requires good hydration with a mois-
If using in this way, lay out a gauze dressing,
tissue and gel have mixed together. This ture-regulating emulsion; we often use
cover with a tulle gras dressing and then apply
is normal and no reason for alarm! It Flamigel® for the first few days and then
Flaminal® Forte to this.
is important to look out for other cues Alhydran® (cream with a high aloe vera such as redness of the surrounding skin, content), Eucerin® or Nivea®. It is also
When applied, the Flaminal® Forte is in con-
unpleasant odour, severe pain and fe-
important not to apply these products
tact with the patient, followed by the tulle gras
ver, which may result from infection. in a thick layer, but instead to apply
dressing, then a sterile gauze dressing and
If in doubt, wound culture is recom-
them in thin layers several times a day.
then the securing bandage.
mended, possibly with the introduction If the burn has been open for more of antibiotics on the doctor's advice. than 16 days, the patient should be Once the dressing has been removed, referred to a specialist centre to deter-any remaining Flaminal® Forte should mine whether compression bandages be removed using soft compresses. are necessary.
The burn should then be washed with Finally, the patient should be advised to
a gentle soap such as Eucerin® cleans-
keep the burnt area out of the sun for at
ing lotion or with a disinfectant soap least one year, to prevent unsightly dis-such as iso-Betadine® Germicide. It is colouration (hyperpigmentation). If the absolutely essential to remove any new skin colour has returned to normal, the blisters and loose skin. The procedure patient can gradually start to go out in described for the first day should then the sun again as long as a high protec-be followed.
tion factor of > 50 SPF is used. For chil-dren, and of course also adults, special
UV protective clothing and swimwear
It is extremely important to inspect the can also be obtained to enjoy a pleas-burn carefully every day. If possible, ant holiday.
regular photographs should be taken, to monitor progress objectively. A daily
appraisal should be made of whether
Burns and Research Coordinator
an improvement has been made and
Plastic and reconstructive
whether the burn will epithelialise with-
in the suggested maximum duration of
18 days. If on the 12th day after the burn
Ghent University Hospital
occurred it is still uncertain whether
epithelialisation will occur, the patient
should be referred to a specialist hospital [email protected]
with a high level of experience of burns, www.flenpharma.com
application of Flaminal® Forte with spatula to small burns
ARTICLE IN PRESS Medical Engineering & Physics xxx (2006) xxx–xxx Photoacoustic monitoring of the absorption of isotonic saline solution by human mucus F.L. Dumas , F.R. Marciano , L.V.F. Oliveira , P.R. Barja , D. Acosta-Avalos a Instituto de Pesquisa e Desenvolvimento (IP&D), Universidade do Vale do Paraiba, Av. Shishima Hifumi 2911, CEP 12244-000, S˜ao Jos´e dos Campos, SP, Brazil
du Centre 60è L'actualité Rhumatologique 2015 Maison de la Chimie, 26 et 27 mars 2015 28, rue Saint Dominique - 75007 Paris r é s u M é s M.F. Kahn / t. Bardin Ph. dieudé / F. lioté / o. Meyer (=) / Ph. orcel / P. richette jeudi 26 mars 2015 8h00 ACCueil deS pArtiCipAntS