The case reports included in this document explore the use of Granulox
®
haemoglobin spray (infirst Healthcare) for
the treatment of patients with chronic and acute wounds. The importance of oxygenation and tissue perfusion to the
wound-healing process have been well researched (Bishop, 2008), and it is recognised that oxygen demand increases
during the process of tissue repair (Howard et al, 2013). However, underlying comorbidities that patients with wounds
might have, such as chronic venous insufficiency (CVI), peripheral artery occlusive disease and diabetes, lessen the
oxygen supply via the vascular system. In addition, oxygen from outside might be prevented from reaching the wound
bed due to the physical barrier of exudate production. Haemoglobin naturally binds and then releases oxygen. Thus, the
use of Granulox, a water-soluble, red haemoglobin spray, allows oxygen to be uniformly distributed in exudate, where
it binds oxygen from the surrounding air and carries it to the wound bed, diffusing it into cells. In this way, an increased
supply of oxygen is provided to accelerate and support wound healing.
The wounds included in this series of case reports demonstrate the versatility and ease of use of this new treatment
modality. In addition, the positive impact that Granulox had on patient quality of life can be seen by the patients’
reduction in pain and improvements in activities of daily living, as their longstanding wounds started to heal.
References
Bishop A (2008) Role of oxygen in wound healing.
J Wound Care
17(9):
399–402
Howard MA, Asmis R, Evans KK, Mustoe TA (2013) Oxygen and wound care: a review of current therapeutic modalities and future direction.
Wound Rep Regen
21(4):
503–11
The case reports in this document were kindly provided by Mike Green, Diabetes Specialist Podiatrist, Birmingham Community
Healthcare NHS Trust (
case reports 1–4
) and Luxmi Mohamud, TissueViability Clinical Nurse Specialist, Guys and St Thomas NHS
foundation Trust (
case reports 5–6
). Patient permission was given for all photographs taken.
The views expressed in this document are those of the authors and do not necessarily reflect those of the
Journal of
Community Nursing
or infirst Healthcare Ltd
.
The use of Granulox
Summary of case evaluations
Case reports
Patient
comorbidities
Wound type, location
and duration
(if known) at
presentation
Patient pain
rating at
presentation *
Patient pain
rating at the
end of the
evaluation *
Results seen after
introducing Granulox
®
Time to wound
healing after
introduction of
Granulox
®
Diabetes,
unhealthy
lifestyle
Ischaemic toe
wound, >12 months’
duration
7
4
Wound steadily
decreased in size. Pain
levels also reduced
7 months
Blindness,
propensity
to falls,
hypertension,
smoker
Ischaemic foot ulcer,
16 months’duration
Reduction in pain and
exudate volume
6 weeks
Rheumatoid
arthritis, smoker,
high cholesterol
levels,
hypertension
Two ulcers on
the toe
Reduction in pain
and odour, slough
in wound beds dried
up, facilitating gentle
debridement
12 weeks
Smoker
Traumatic heel
wounds to both feet
11
4
Reduction in pain
and promotion of
epidermal growth
Right heel healed
after 8 weeks; left
heal continuing to
progress to healing
Chronic venous
insufficiency,
deep vein
thrombosis,
previous history
of drug abuse
Chronic leg ulcer,
4 years’duration
8
1
Steady improvement
in wound tissue, and
volume and colour
of exudate. Increased
patient confidence
8 weeks
Cardio-
pulmonary
respiratory
disease,
hypertension,
myocardial
infarction
Dehisced sternal
wound
8
1
Reduction in odour
and exudate volume
significantly improved
patient quality of life
While not
completely closed,
by week 8 wound
exhibited 100%
granulation tissue
* where‘1’= least pain and‘10’= worst pain on a verbal pain scale
Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
