How often should I change the bandage, i.e. apply MPPT?

MPPT should be applied once daily until the wound is clean, i.e. when the wound exudate is no longer cloudy and the wound is free of slough, pus, maceration and biofilm.
Intervals up to 2-4 days between dressing changes have been used successfully. It may, however, prolong the time required to reach a clean wound compared to daily changes.
On extremely highly exuding wounds, the MPPT layer should be changed whenever it is soaked. This will typically be between 2 and 4 times during the first 24 hours. Within approx. 24 hours generally, the exuding will have reduced enough to continue care as for any other wound in need of MPPT. As a rule of thumb, this stage is recognisable when the MPPT does not longer come to have a soaked appearance within 8-12 hours after application.

How do I use MPPT?

Please see refer to Instructions for Use for a complete description.

A quick overview:
Clean the wound using saline or tap water. Use a lint free swab to help remove any undesired matter.
Gently dry the wound dabbing it using a dry lint-free swab or lukewarm air-dryer.
Sprinkle on MPPT in an even layer of 1-3mm covering the entire wound surface and edges.
Cover with a light, permeable secondary dressing facilitating the desired evaporation facilitated by MPPT.

 

Please remember:

MPPT can only work on the surfaces that it touches.

Therefore, when applying MPPT, it is really important to remember to cover the ENTIRE wound surface.

Wound surface in this case would be both the visible area when looking at the wound from a distance AND all the surfaces that appear by lifting up flaps along the sides of the wound, e.g undermined areas, as well as the surfaces lining crevices, tunnels, sinuses etc, i.e. everything that is exposed to the air and accessible within the opening of the skin.

 

The secondary dressing covering MPPT must be completely permeable.

Please see “What secondary dressing is recommended?” for further explanations and suggestions.

 

Does Acapsil contribute to the creation of antibiotic resistant bacterial strains?

No.

MPPT is not an antibiotic and it does not have any direct antimicrobial action – it does not kill the bacteria.

Bacteria have two main defence mechanisms by which they fight off the body’s immune cells: Toxins and biofilm.
MPPT removes the toxins when it absorbs the exudate thereby preventing these from attacking the immune cells; and
MPPT breaks up the biofilm thereby rendering the bacteria exposed to the body’s immune system.

Consequently, MPPT does not kill the bacteria themselves but paves the way for the body to fight back on the bacteria via many different routes.
In contrast, antibiotics inhibit a specific target in/on the bacteria themselves. As the MoA of antibiotics is usually very specific the bacteria only need a single mutation to render the antibiotic ineffective, i.e. to become resistant to the effect of the antibiotic.

After discontinuing the use of MPPT, how should I care for the wound?

MPPT is discontinued when the wound has entered the regenerative wound healing phase. The wound should now preferably be covered with a permeable, atraumatic, open-weave, contact layer dressing and a few-ply gauze on top. This protects the regenerating wound bed while still allowing the wound to breathe. An example of a suitable contact layer dressing is N-A from Systagenix or plan gauze.

Does MPPT work in conjunction with other topical products, i.e. applied directly to the wound?

No.

Any other therapies or treatments applied directly to the wound surface may impact the pumping capacity of MPPT and should be avoided.

Examples of topical therapies to avoid: all hydro-gels, collagen (powder, cream and dressing), occlusive absorbent dressings (e.g. alginates), honey, silver, topical negative pressure therapy, and topical antibiotics (ointment, cream, paste and powder).

Some dressings are impregnated with substances such as paraffin, lipido-colloids, triglycerides (fatty acids), petrolatum, other ointments etc. These should be avoided.

Systemic antibiotics can be administered concomitantly with MPPT.

Standard clinical protocol should be followed for the treatment of any clinical infection.

Does MPPT work on an infected and/or a necrotic wound?

Yes.

Procedure:

If the wound contains infection and/or necrosis, remove as much pus and slough as possible using water and a moist swab.

If the use of an antiseptic is necessary, 3% hydrogen peroxide (H2O2) is preferable. The use of H2O2 is contraindicated in very deep or large wounds due to risk of gas embolism.

Alternatively, use a 70% Isopropyl alcohol solution.

Do not use Chlorhexidine as it is cytotoxic and remains in the tissue for several days impeding healing.

After slough removal, wash with water, dry the wound gently, apply MPPT and apply a light, highly permeable secondary dressing.

Standard clinical protocol should be followed for the treatment of any clinical infection.

Systemic antibiotics can be administered concomitantly with MPPT.

Do not use topical antibiotics (e.g. ointments, gels, pastes, creams, powders) in conjunction with Acapsil as this inhibits the action of MPPT.

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