PILOT STUDY ON THE EFFECTIVENESS OF SULFUROUS THERMAL WATER IN WOUND HYGIENE: SPA WOUND CARE

PILOT STUDY ON THE EFFECTIVENESS OF SULFUROUS THERMAL WATER IN WOUND HYGIENE: SPA WOUND CARE. Serena Crucianelli1 , mario Fontana1 , Ferdinando Moretti1 , Nicholas Cocomello1 , Alessia Mariano2 , Maria Del Ben3 1 Sapienza University of Rome, Internal Medicine and Medical Specialties, Roma, Italy 2 Sapienza University of Rome, Biochemical Sciences, Roma, Italy 3 Sapienza University of Rome, Department of clinical, Internal Medicine Anesthesiological and Cardiovascular Sciences , Roma, Italy Introduction: The effectiveness of sulfurous thermal waters (STW) in the treatment of complex wounds has been known since ancient times. In recent years, the outbreak of chronic lesions with complex biofilms, colonized by multi-drug resistant germs increased the interest in not pharmacological molecules. The effectiveness of STW is related to the presence of a gas transmitter, the hydrogen sulfide, diffusing freely through the skin, elicites local and systemic effects as promoting the healing of acute, chronic and infected wounds by transforming into pentationic acid (H2S5O6). We present the results of a pilot trial evaluating the effects of raw microbiologically pure STW, in the wound hygiene Methods: The raw STW of Acque Albule spa, Italy, testing negative to the presence of pathogens, was bottled at its spring under aseptic conditions in sterile glass or chemical-proof plastic bottles. The half-life of the water was considered 7 days in absence of precipitates. Patients’ selection criteria are reported on Table 1. After Wound swab Sampling, Ph and TEWL measuring, two Topical applications of STW, 20 minutes on soaked gauzes preceded and followed Wound hygiene and macrodebris removal. Primary and secondary dressings for exudate management only, fixation and off-load were allowed. Dressing change is planned at 24-48 hours depending on the exudate. Parameters reassessment was repeated once a week until re-epithelialization. The protocol was suspended in case of wound worsening, local or systemic signs of superinfection. Results: In 45 days, 14 patients, mean age of 72 years were enrolled. Twentyone lesions were treated: 8 PU, 5 vascular ulcers, 2 IAD, 2 dehiscences, 2 vasculitic ulcers, 2 Lymphatic ulcers. Of these, 17 lesions had a positive swab, 8 were MDR microorganisms. None reported superinfections, adverse events, pain or wound worsening. 80.9% of the lesions had complete re-epithelialization within one month (Figure 1), the rest reepithelizated in 1.5 Month. TEWL and pH values progressively decreased during treatment. Conclusions: STW were effective in the wound hygiene of difficult wounds regardless of their etiology and bacterial contamination. A clinical trial on the use of the same thermal water to provide early hydrokinesis rehabilitation of wounded patients is currently being studied. References: 1. Xu M., et al. Exogenous hydrogen sulfide supplement accelerates skin wound healing through inhibition of oxidative stress and enhancement of vascular endothelial growth factor. ExpDermatol. 2019;28:776-785