IN HEALTH

LING
EA
H
FAST

Wound Treatment With

Human Skin-Like Structure
 Contents
Introducing treetta Company 1

Wound Assessment and Selecting Dressing 2

Wound bed preparation

3
R

TEBASEPT- PHMB Antiseptic Solution

6
R

TEBASEPT - PHMB Wound Gel X

R

TEBASEPT - PHMB Wound Gel X Plus 8

Superficial and Partial-Thickness Wounds

11
R

TEBADERM – Collagen Matrix Dressing

TEBADERM PLUS Ag – Collagen Matrix Dressing with Silver 14

R

TEBABURN– Collagen Matrix Dressing with Gold 16

Cavity and Full-Thickness Wounds

18
R

TEBAGRAN – Collagen Granule Dressing

20
R

TEBAGRAN PLUS Ag - Collagen Granule Dressing with Silver

Hemostatic Agent
23
R

TEBASTOP – Hemostatic Granules

Antimicrobial foam
25
R

TEBAFLEX- Polyurethane Foam Dressings

References 28
We offer unique treatments for
different kinds of wounds

Mission and Vision

treetta Company, After 8 years of research, with the aim of creating innovation
in health and relying on the knowledge of researchers, has succeeded in
producing dressings with a Human Skin-Like Structure. Due to the special
mission of the company in the field of patient treatment, the high quality
of products is an inevitable thing and an important mission for the company.
To achieve this, treetta carries out its activities under the supervision of the
quality management system ISO 13485, ISO10002,GMP

1
Epithelializing Granulating Sloughy Necrotic Infected

Treatment aims Treatment aims Treatment aims Treatment aims Treatment aims

Promote granulation Hydrating dry Wound bed

Promote wound Provide a healthy Softening and loosening wound bed preparation
maturation and wound bed for slough Softening and Exudate management
epithelialization epithelization Manage exudate loosening Infection control
Promote angiogenesis Infection control necrotic wound Odour control
debris

Wound care objective Wound care objective Wound care objective Wound care objective Wound care objective

Moisture balance
Remove slough Antimicrobial action
Protect new tissue Protect tissue Promote autolytic
Provide a clean base Moisture balance
growth debridement
Manage exudate for granulation Odour absorption
Prevent infection

Amount of exudate Amount of exudate Amount of exudate Amount of exudate Amount of exudate

Moderate Low Moderate Low Moderate Low

Moderate Low Moderate Low
to high to moderate to high to moderate to high to moderate

R R TEBASEPT spray TEBASEPT spray

R R

TEBASEPT spray
R

TEBASEPT spray
R

TEBASEPT spray
R

TEBASEPT spray
R

TEBASEPT spray
R

TEBASEPT spray
TEBASEPT spray TEBASEPT spray R
R R
R

R R
TEBAGRAN TEBADERM Gel X Plus Gel X Gel X Plus Gel X Plus TEBAFLEX TEBADERM PLUS Ag
TEBAGRAN TEBADERM R
R R

TEBAGRAN TEBABURN
R R

TEBAGRAN
R

TEBADERM PLUSAg
R

TEBAGRAN PLUS Ag TEBAFLEX TEBAFLEX

TEBAFLEX
R
PLUS Ag R R
PLUS Ag Gel X
TEBABURN TEBAFLEX

1- Frequeny of dressing change depends on the wound exudation and varies from 24 to 72 hours
R

2- For increasing the efficiency of infection control and biofilm irrigate wounds with TEBASEPT for
15 minutes recommended .(Cleansing solutions are on page 3 )

3- Exudate reduction on every dressing change is an efficient indicator for wound healing assessment.

2
 Indications:
1406
Diabetic Foot Ulcers (DFU)
Pressure ulcers
rd
1st and 2nd and 3 degree burns 1408

Post Surgical Wounds

Radiation Ulcers
Skin Lesions
Insect bite areas
Ostomy areas
Catheter Insertions
R

TEBASEPT- PHMB Antiseptic solution

Advanced Wound Treatment Spray
Features:
Broad spectrum antimicrobial effect
Incapable of promoting bacterial resistance
Disruption of formed biofilm and
prevention of biofilm reformation
Fast acting , with prolonged residual
activity
Compatible with different dressings
Biocompatible
Highly effective against multidrug-resistant
organisms (MRSA, VRE)

3
 R

TEBASEPT contains powerful antimicrobial

compounds such as Polyhexanide (PHMB)
and an amphoteric betaine surfactant.
The combination of PHMB and betaine is
considered an ideal combination for the
treatment of wounds. PHMB is a cationic
polymer with a similar structure to
antimicrobial peptides with broad-spectrum antimicrobial effects and biocompatibility.
Betaine surfactant reduces the surface tens io n of microorga nisms to sepa rate f rom
each other and also, prevents the reformation [1] and [2].

The First Choice of Infection Prevention and Treatment

Indications First Choice Second Choice

Wounds with risk of infection PHMB Silver

Burns PHMB

Infeeted wounds PHMB Silver

Surgical site infections PHMB

Clearing acute and chronic wounds PHMB

Wounds without secretion PHMB

According to the Global Wound Treatment Guidelines 2018 in the field of infection
prevention and treatment, in a variety of wounds, the PHMB compound has been
introduced as the ideal compound and the first choice in the prevention and treatment
of infection [3].

4
Based on the latest global guidelines although
silver compounds required 24 hours to
be effective [4], PHMB compounds had
appropriate effects in the first three hours [5].
Furthermore, PHMB had much faster efficacy
on common wound microorganisms such as
Staphylococcus, Aureus, and Pseudomonas
aeruginosa, which greatly reduced the number
of bacteria in the first hours of consumption in comparison with Silver compounds Green and
blue lines are related to the PHMB compounds, purple and pink ones are related to the Witness.

Instruction to Use:

1.Soak sterile gauze in the TEBASEPT solution and apply it on the wound area
for 10 to 15 minutes, then pick the sterile gauze and then, apply appropriate wound
dressing according to the wound type.
R

2.Spray TEBASEPT solution daily on the venous, urinary, and respiratory catheters.
R

3.Spray TEBASEPT solution twice a day for elderly patients to prevent ITD.

5
Indications:
1601

Post-operative Wounds
Sutures
Traumatic Wounds
Diabetic Foot Ulcers (DFU)
and pressure ulcers
1st and 2nd degree burns
Chemical Wounds
(Acid and alkali induced)
R
Laser injury
R

TEBASEPT - PHMB Wound Gel

Advanced Wound Bed Preparation Hydrogel

Features:
Remove and prevent biofilm
Reduce healing time
Inhibits bacterial resistance
Minimizing scar formation
Wound odour reduction
Facilitate fast wound healing

6
 Decrease
·Slough
·Necrotic tissue
·Microorganisms
·Biofilms
·Granular tissue
·Reactive Oxygen Species
·Probiotics
Increase ·Inhibition of Matrix Metalloproteinase (MMPs)

TEBASEPT Gel X is an advanced cleansing hydrogel containing polyhexanide and betaine

in optimum viscosity which is used to prevent and disrupt biofilm formation [6].

Wound Before Amount Duration After

Etiology of Wound Age
Treatment Exudate of Treatment Treatment

Debridement
Pressure ulcer Low Using 1 month
Gel X

Mesotherapy
Hight Using Gel X 1 month
Surgical Wound

Ulcer Caused
by Hight Using Gel X 2 month
Abdominoplasty

Instruction to Use:

1. It is recommended that for all types of wounds, firstly, clean the wound bed
R R

with TEBASEPT spray and then, apply TEBASEPT Gel X

R

2. TEBASEPT Gel X is compatible with all types of secondary dressings due

to non-absorbable proper type of hydrogel

7
Indications:
1602 15 gr

Diabetic Foot Ulcers (DFU)

Venus Leg Ulcers
3rd Degree Burns
Pressure Ulcers
Dry and Low Exudate Wounds
Sloughy and Necrotic Wounds

TEBASEPT Gel X Plus

Advanced Wound Debridement Hydrogel

Features:
Inhibit the growth of most prevalent microorganisms including resistant
strains such as MRSA and VRE
The viscous texture of the gel makes it stay in place
Decrease bacterial counts at the beginning of the application
Provide a moist healing environment
Supports natural autolytic debridement and moist wound healing.
Non-adherent
Complete removal of bacterial biofilms
Decrease wound odor

8
Gel X Plus PHMB components:

Polyhexanide (PHMB):
The efficacy mechanisms of Gel X Plus in the killing
of gram positive and gram negative bacteria are due
to the high concentration of PHMB in its formulation.
PHMB is a positively charged (cationic) polymer,
which works against negatively charged
micro-organisms. The positively charged molecules
bind to bacterial cell membranes, which breaks down
the cell integrity and ultimately kills the bacteria.

Amphoteric Surfactan:
This surfactant results in 97% prevent and breakdown recalcitrant biofilm and faster
healing rates. Appropriate concentration of surfactant decreases the surface tension
between microorganism and prevents biofilm formation so causes easily dispersion
of microbes in solution and promoting wound healing[7].

Hydroxyethyl Cellulose (HEC):

HEC is a cellulose derivative that is present in the formulation of Gel X Plus.

The wound healing efficacy of cellulose results from its
capability to accelerate the wound healing process
through the maintenance and release of several growth
factors at the injury site such as basic fibroblast growth
factor, phosphodiesterase growth factor, and epidermal
growth factor.These growth factors promote
the migration and proliferation of dermal fibroblasts
and inhibit the proliferation of bacteria in the wound.

9
Wound Before Amount Activity Wound Duration After
Etiology of
Treatment Exudate Title Age of Treatment Treatment

Surgical Dedbridment
High use Gel X Plus
3 months 38 days
wound

Trumatic Use
wound None Gel X Plus 20 days 14 days

Instruction to Use:

1.Clean the wound with TEBASEPT or Normal Saline solution.

2.Apply Gel X Plus with suitable secondry dressing on wound bed.
R

3. Cleansing the wound bed with TEBASEPT after each dressing change.

It is recommended that the application of wound Gel X after complete debridement

in order to clean the wound, decrease the duration of treatment, and scar formation.

10
Indications:

Diabetic Foot Ulcers (DFU)

Pressure Ulcers
Traumatic Wounds
1st & 2nd Degree Burns
Tendon and Bone Exposure
Venous Ulcers
Cuts and Brasions

TEBADERM
Superficial and Partial-Thickness Non-Infected Wounds

Features:
Protein synthesis and extracellular
matrix deposition
Stimulate angiogenesis
Maintains optimum moisture balance
for wound closure
Antimicrobial effects
Wound exudation management

11
 R

TEBADERM Collagen Matrix is a human

skin-liked structure, which accelerates
the wound healing process and manages the
wound moisture by active ingredients such as
collagen and other biopolymers in the dressing
[8] and [9].
R

Clinical Trial TEBADERM

Type Before Amount Activity Duration
Wound After
of of of
wound treatment exudate Title Age treatment treatment

Stage 4 Using
Pressure Ulcer Moderate R
1years 7 month
TEBADERM

Using 1 month
DFU
Low R
4 month and
Tendon exposure TEBADERM 11 days

Second-degree Using
None R 1 day 10 days
burn TEBADERM

Using
Trauma Moderate R 2 months 20 days
TEBADERM

Using 2 month
DFU
Tendon exposure
None R 4 month and
TEBADERM 28 days

Psoriasis Using
Low 3 month 10 days
ulcer TEBADERM
R

5 cm 5 cm 10 cm 10 cm 10 cm 20 cm

12
Instruction to Use:

1.Clean the wound with TEBASEPT or Normal Saline solution.

R

2.Cut the TEBADERM wound dressing according to the wound size

with a sterile scissor.
R R

3.Soak TEBADERM wound dressing into the TEBASEPT or Normal Saline solution
R

for 3 minutes and then, apply TEBADERM to cover the wound entirely
R

4.Cover TEBADERM wound dressings with a secondary wound dressings such as

sterile gauze or suitble secondry dressing.

Dressing Change Considerations:

R

The frequency of TEBADERM changing depends on the amount of exudate.

(Varies between 24 to 72 hours)
R R

After removing the secondary dressing, first, soak TEBADERM with TEBASEPT
solution or normal saline, then remove it from the wound bed.

13
Indications:

Diabetic Foot Ulcers (DFU)

Pressure Ulcers
Traumatic wounds
1st & 2nd degree burns
Venous ulcers
Cuts and abrasions

TEBADERM PLUS Ag
Superficial and Partial-Thickness Infected Wounds

Features:
Infection treatment and sustained-release
silver formulation
Maintain optimal moisture at the
wound surface
Accelerate granulation, epithelialization
and inhibition of matrix
metalloproteinase enzymes
Reduce pain
Wound exudate management

14
14
 R

TEBADERM PLUS Ag is a collagen matrix dressing containing silver crystalline

nanoparticles, which after activation, is gradually released from the Three-dimensional
scaffold dressing and brings a sustained release formation that retains its antimicrobial
effects for up to three days. [10]
R

Clinical Trial TEBADERM PLUS Ag

Wound
Before Amount Activity Duration After
etiology treatment of Wound Age of treatment
exudate Title treatment

Diabetic Foot Debridement

Moderate using
R
6 months 1 months
Ulcer TEBADERM PLUS

Diabetic Foot Debridement

Moderate using
2 months 2 weeks
Ulcer R

TEBADERM PLUS

Diabetic Foot Debridement

Moderate using 1 Year 3 weeks
Ulcer
R

TEBADERM PLUS

Diabetic Foot Debridement

Low using 3 months 3 weeks
Ulcer
R

TEBADERM PLUS

Instruction to Use:
R

1.Clean the wound with TEBASEPT or Normal Saline solution.

R

2.Cut the TEBADERM PLUS Ag wound dressing according to the wound size
with a sterile scissor.
R R

3.Soak TEBADERM PLUS Ag wound dressing into the TEBASEPT or distilled water
R

for 3 minutes and then, apply TEBADERM PLUS Ag to cover the wound entirely.
R

4.Cover TEBADERM PLUS Ag wound dressings with a secondary wound

dressings such as sterile gauze or suitble secondry dressing.

Dressing Change Considerations:

R

Frequency of TEBADERM PLUS Ag changing, depends on amount of exudate.

(Varies between 24 to 72 hours)

15
Indications:

Burns
Infected wounds
Surgical wounds
Diabetic Foot Ulcers (DFU)
Venous ulcers
Pressure Ulcers

TEBABURN
Collagen Matrix Dressing with Gold

Features:
Powerful antioxidant and
anti-inflammatory actions
Infection treatment and broad-spectrum
antimicrobial effects
Angiogenesis and acceleration
of wound healing
Maintain the optimum moisture balance
for wound closure Patient pain
reduction

16
 R

TEBABURN dressing has shown extraordinary antioxidan effect, because of its

gold nanoparticles that quickly reduce wound inflammation. Furthermore, the presence
of collagen and other biopolymers in the dressing, stimulates the growth and mitosis of
fibroblast cells and increases cell migration, which accelerates the wound healing process
[11] and [12].
R

Clinical Trial TEBABURN

Wound Before Amount Activity Wound Duration
of After
etiology Age of
treatment exudate Title treatment treatment

Second-degree Using
High R 2 days 14 days
burn TEBABURN

Using
Burn None R
1 days 10 days
TEBABURN

Diabetic Using
High R 4 months 28 days
foot Burns TEBABURN

Hypergranule Using
Moderate R
3 months 3 Weeks
bedsore wound TEBABURN

Using
Grade 2 burns High R
2 days 14 days
TEBABURN

Instruction to Use:
R

1.Clean the wound with TEBASEPT or normal saline solution.

R

2.Cut the TEBABURN wound dressing according to the wound size with a sterile scissor.
R R

3.Soak TEBABURN wound dressing into the TEBASEPT or distilled water for 3 minutes
R
R

and then, apply TEBADERM to cover the wound entirely Cover TEBABURN .

Dressing Change Considerations:

R

Frequency of TEBABURN changing, depends on amount of exudate.

(Varies between 24 to 72 hours)

17
 Indications:

Cavity Wounds
Acute and chronic ulcers with moderate
to high exudate.
Pressure Ulcers with difficult access
Diabetic Foot Ulcers (DFU)
1st & 2nd degree burns

TEBAGRAN
Full Thickness and Cavity Non-Infected wounds

Features:
Accelerate the process of granulation
and epithelialization
Maintain appropriate moisture at the wound
surface
Exudate absorption
No tissue damage while changing
EXUDATE RELEASE
the dressing ABSORPTION COLLAGEN

Full wound surface coverage

18
 R

TEBAGRAN is a white sterile granule composed of active collagen-based biopolymers.

R

Furthermore, the absorptive nature of TEBAGRAN can effectively absorb wound exudate
and forms gel . By releasing biopolymers such as collagen and alginate on the wound
R

surface, TEBAGRAN, can promotes wound healing by various pathways such as stimulating
fibroblast mitosis as well as decreasing the activity of Metalloproteinase Matrix enzymes
at the damaged tissue [13].
R

Clinical Trial TEBAGRAN

Wound Before Amount Activity Duration After
of Wound Age of
etiology treatment exudate Title treatment treatment

Diabetic Debridement
Foot Moderate Using R
4 months 2 weeks
ulcers TEBAGRAN

Debridement
Trauma wound Moderate Using 1 day 10 day
R

TEBAGRAN

Surgical wound Debridement

Low Using 1 months 1 weeks
(cavity) R

TEBAGRAN

Surgical Debridement
wound (cavity) Low Using 2 months 9 day
R

TEBAGRAN

Instruction to Use:

1.Clean the wound with TEBABSEPT solution or Saline serum.

R

2.Pour TEBABGRAN granules onto the entire wound site in 3 mm thickness.

R

3.Cover TEBABGRAN with a secondary wound dressing such as sterile gauze or simple foam

Dressing Change Considerations:

R

The frequency of TEBABGRAN changing depends on the amount of exudate. (Varies

between 24 to 72 hours)
R R

After removing the secondary dressing, first, soak TEBABGRAN with TEBASEPT
solution or Normal Saline, then remove it from the wound bed.

19
Indications:

Infected wounds
Cavity wound
Acute and chronic wounds
with moderate to high exudate.
Pressure Ulcers
Diabetic Foot Ulcers (DFU)
1st & 2nd degree burns

TEBAGRAN PLUS Ag
Full Thickness and Cavity Infected Wounds
Features:
Antimicrobial sustain-release effects and infection treatment
Antimicrobial Long-lasting effects
Absorption of exudates and
wound discharge
Reduce the wound inflammation
Accelerate the granulation and
epithelialization process
Maintain optimal moisture on the
wound surface
Complete coverage of the wound
surface

20
 R

TEBAGRAN PLUS Ag is a white sterile granule, consisting of collagen and silver

nanoparticles that are effective in different stages of wound treatment such as inflammation
infection, and granulation. Sustained -release of silver nanocrystal has a bactericidal action
providing effective management of wound odor and exudate, thus reducing the risk
R

of colonization and preventing infection. In TEBAGRAN PLUS Ag, silver nanoparticles

due to their larger surface area provide better contact with the microorganisms. By utilizing
R

protein collagen and other biopolymers in the formulation of TEBAGRAN PLUS Ag, the
efficacy of dressing in granulating phase will accelerate and the wound healing process will
also be promoted [10] and [14].

Clinical Trial TEBAGRAN PLUS Ag

Wound Before Amount Activity Wound Duration After
of of
etiology treatment exudate Title Age treatment treatment

Surgical Using
Moderate R

TEBAGRAN PLUS
6 months 2 weeks
wounds

Pressure Using
High R

TEBAGRAN PLUS
2 Years 10 days
ulcer

Pressure Using
High R

TEBAGRAN PLUS 2 Years 3 weeks

ulcer

21
 Instruction to Use:
R

1.Clean the wound with TEBABSEPT or normal saline solution.

R

2.Cover the wound cavity with TEBAGRAN PLUS Ag.

R

3.Cover TEBABGRAN PLUS Ag with a secondary wound dressing such as sterile gauze
or simple foam.

Dressing Change Considerations:

R

TEBAGRAN PLUS Ag granules swell in presence of exudates and their volume increases.
Therefore, there is no need to fill the cavity with the powder completely.
Dressing replacement depends on the volume of wound exudate and can remain on wound
up to 3 days.
R

After removing the secondary dressing, TEBAGRAN PLUS Ag are easily removed from
the wound surface with cleansing solutions.
R

If the wound exudate is low. It is recommended that before placing TEBAGRAN PLUS
Ag on wound, the powder is disperse in normal saline solut ion, make a gel, and t hen
placed on wound cavity.

22
 Indications:

Wide range of lacerations

Trauma
Gunshots
Emergency unit
Wound debridment
Patients taking
anti-coagulation/anti-platelets

TEBSTOP
Stop Bleeding Fast
Features:
Acts fast
Accelerate clot formation
Active factor XII which in turn
accelerates the body's natural clotting ability
Minimize the risk of bleeding
Antimicrobial efficacy
No heat in the bleeding area
Insensitivity
No immune reaction
Biocompatible
Biodegradable

23
 R

TEBASTOP contains powerful components such as kaolin, chitosan, and other active
R

biopolymers in its formulation. TEBASTOP as a procoagulant acts by activating

the XII coagulation factor in blood clotting cascades and produce fibrin clot. It also
stimulates platelets in order to make platelet adhesion and aggregation.
R

TEBASTOP immediately after its application at the site of bleeding through effective
and quick hemostasis will stop the bleeding. By combining more than one hemostatic
agent that acts via more than one mechanism, and by utilizing different
nanotechnology-based approaches to enhance the surface areas, the capability of
R

the TEBASTOP to control bleeding is improved, in terms of the amount of blood loss
R

and time to hemostasis. TEBASTOP by releasing anti-microbial biopolymers leads to

decreasing the microbial loads at the site of bleeding, and by preventing infection,
R

inhibits the acute wound to become chronic. TEBASTOP along with the application
R

of pressure stops bleeding and decreases pain score and inflammation. TEBASTOP
acts immediately upon contact with blood; and ensures to stop the bleeding within
a few minutes[15] and [16].

Instruction to Use:

1.Cleansing the bleeding area

2.Place the appropriate amount of
R

TEBASTOP powder directly on the wound.

3.Fix a secondary dressing such as gauze sterile on the
bleeding site and applya maximum of 3 minutes
of pressure.

R R

After hemostasis , clean the TEBASTOP with TEBASEPT or Normal Salin from
the bleeding area.

24
 PHMB Antimicrobial Dressing

Indications:
.Chronic and acute exudative wound
.Diabetic Foot Ulcers (DFU)
.Pressure ulcer
.Venous ulcer
.Traumatic wound
.1st and 2nd degree burns
.Tracheostomy site
.Fragile and sensitive skin
.Prevention of skin damage

®
TEBAFLEX
PHMB Antimicrobial Polyurethane (PU) Foam Dressing

Features:
Effective against gram positive,
gram negative bacteria and fungi
Unique mechanism of action
Vertical absorption of exudate
Wound moisture management
Prevention of maceration
Soft and comfortable
Non-adherent, Minimizes pain during
dressing changes

25
TEBAFLEX® antimicrobial dressing is a PHMB
impregnated Polyurethane foam with a vertical
absorption of exudate, wound moisture
management, flexibility and antimicrobial
activity, which provides an ideal environment
for wound healing. The unique mechanism of
action of TEBAFLEX® is that the foam absorbs
the wound exudate and the PHMB in the foam
structure kills the bacteria by binding to the exudate [17].

Wound Before Amount Activity Wound Duration After

of of
etiology treatment exudate Title Age treatment treatment

Pressure R

Ulcer
Moderate TEBAFLEX 2 month 32 days

Pressure Low TEBAFLEX

R

3 weeks 7 days
Ulcer

Pressure R

Ulcer Low TEBAFLEX 1 month 28 days

26
Instruction to Use:

1.Cleanse the wound site with TEBASEPT® solution.

2.TEBAFLEX® can be used as a primary or secondary dressing.
3.Cut TEBAFLEX® according to the wound size
4.Place TEBAFLEX® directly onto the wound, and fixate with a bandage or other
fixation.

1.Consult a doctor if you see signs of infection and allergies, e.g., fever, the wound or
surrounding skin becomes red, warm or swollen.
2.Do not reuse.
3.TEBAFLEX® may stay in place for up to seven days depending on the condition of
wound.

27
 References:
{1} Sowlati-Hashjin, S., Carbone, P., & Karttunen, M. (2020). Insights into the
Polyhexamethylene Biguanide (PHMB) Mechanism of Action on Bacterial
Membrane and DNA: A Molecular Dynamics Study. The Journal of Physical
Chemistry B, 124(22), 4487-4497

{2} Alves, P. J., Barreto, R. T., Barrois, B. M., Gryson, L. G., Meaume, S., & Monstrey,
S. J. (2020). Update on the role of antiseptics in the management of chronic wounds
with critical colonisation and/or biofilm. International Wound Journal.

{3} C. o. W. A. U. 2018, “Axel Kramer a Joachim Dissemond c Simon Kim b Christian

Willy,” Skin Pharmacol Physiol, pp. 28-58, 2018.

{4} A. O. H. N. K. T. K. Ebert M, “A: Antimicrobial efficacy of the silver wound dressing

Biatain Ag in a disc carrier test simulating wound secretion.,” Skin Pharmacol Physiol ,
pp. 337-341, 2011

{5} A. O. B. U. e. a. Schedler K, “Proposed phase 2/step 2 in-vitro test on basis of EN

14561 for standardised testing of the wound antiseptics PVP-iodine, chlorhexidine
digluconate, polihexanide and octenidine dihydrochloride.,” BMC Infect Dis, pp.
1-143, 2017.

{6} Gray, D., Barrett, S., Battacharya, M., Butcher, M., Enoch, S., Fumerola, S., ...
& Young, T. (2010). PHMB and its potential contribution to wound management.
Wounds uk, 6(2), 40-46.

{7} Tyldesley, H.C., Salisbury, A.-M., Chen, R., Mullin, M., and Percival, S.L.
(2019). Surfactants and their role in biofilm management in chronic wounds.
Wounds Int 10, 20-24.

28
{8} Li, Manman, Mei Han, Yusheng Sun, Yingying Hua, Guifang Chen, and Liefeng Zhang.
“Oligoarginine mediated collagen/chitosan gel composite for cutaneous wound healing.”
International journal of biological macromolecules 122 (2019): 1120-1127.

{9} Joshi, R., 2021. Collagen Biografts for Chronic Wound Healing. In Collagen Biografts for
Tunable Drug Delivery (pp. 53-65). Springer, Cham.

{10} You, C., Li, Q., Wang, X., Wu, P., Ho, J.K., Jin, R., Zhang, L., Shao, H. and Han,
C., 2017.
Silver nanoparticle loaded collagen/chitosan scaffolds promote wound healing via
regulating fibroblast migration and macrophage activation. Scientific reports, 7(1),
pp.1-11.

{11} Vichare, R., Hossain, C.M., Ali, K.A., Dutta, D., Sneed, K. and Biswal, M.R., 2021.
Collagen-based nanomaterials in drug delivery and biomedical applications. In
Biopolymer-Based Nanomaterials in Drug Delivery and Biomedical Applications
(pp. 427-445). Academic Press.

{12} Shinde, R.V.,2021. Novel therapeutics and treatment regimen in wound healing.
International Journal of Herbal Medicine 2021; 9(1): 12-18.

{13} Matica, M. A., Aachmann, F. L., Tøndervik, A., Sletta, H., & Ostafe, V. (2019). Chitosan
as a wound dressing starting material: Antimicrobial properties and mode of action.
International journal of molecular sciences, 20(23), 5889

{14} Zhang, H., Peng, M., Cheng, T., Zhao, P., Qiu, L., Zhou, J., Lu, G. and Chen, J., 2018. Silver
nanoparticles-doped c o l l a g e n – a l g i n a t e antimicrobial biocomposite as potential
wound dressing. Journal of Materials Science, 53(21), pp.14944-14952.

29
{15} Sun, X., Tang, Z., Pan, M., Wang, Z., Yang, H. and Liu, H., 2017. Chitosan/kaolin
composite porous microspheres with high h e m o s t a t i c efficacy. Carbohydrate
polymers, 177, pp.135-143.

{16} Tavris, D. R., Wang, Y., Jacobs, S., Gallauresi, B., Curtis, J., Messenger, J. & Fitzgerald,
S. (2012). Bleeding and vascular complications at the femoral access s i t e f o l l o w i n g
percutaneous coronary intervention (PCI): an evaluation of hemostasis strategies. Journal
of Invasive Cardiology, 24(7), 328.

{17} Chindera, K., Mahato, M., Sharma, A. K., Horsley, H., Kloc-Muniak, K.,
Kamaruzzaman, N. F., ... & Good, L. (2016). The antimicrobial polymer PHMB
enters cells and selectively condenses bacterial chromosomes. Scientific reports, 6(1),
1-13.

{18} Atkin, L., Bućko, Z., Montero, E.C., Cutting, K., Moffatt, C., Probst, A.,
Romanelli,M., Schultz, G.S., and Tettelbach, W. (2019). Implementing
TIMERS: the race against hard-to-heal wounds. Journal of wound care 28, S1-S50.

30
TIME – Principles of wound bed preparation [18].

Clinical Proposed WBP Effect of Clinical

observations pathophysiology clinical actions WBP actions outcome

T issue non-viable Defective matrix and cell Debridement (episodic or Restoration of wound base Viable wound base
debris impair healing continuous): and functional extracellular
or >> Autolytic, sharp surgical, matrix proteins
deficient enzymatic, mechanical or
biological
>> Biological agents

High bacterial counts or
I nfection prolonged inflammation
or Inflammatory cytokines
Inflammation Protease activity
Growth factor activity
Remove infected foci
Topical/systemic:
>> Antimicrobials
>> Anti-inflammatories
>> Protease inhibition
Low bacterial counts or Bacterial balance and
controlled inflammation: reduced inflammation
Inflammatory cytokines
Protease activity
Growth factor activity

M oisture imbalance Desiccation slows epithelial Apply moisture-balancing Restored epithelial cell Moisture balance
cell migration dressings migration, desiccation
avoided

Excessive fluid causes Compression, negative Oedema, excessive fluid

maceration of wound margin pressure or other methods controlled, maceration
of removing fluid avoided

E dge of wound Non-migrating keratinocytes Re-assess cause or consider Migrating keratinocytes Advancing edge
Non-responsive wound cells corrective therapies: and responsive wound cells. of
non-advancing or and abnormalities in extracellular >> Debridement Restoration of appropriate wound
undermining matrix or abnormal >> Skin grafts protease profile
protease activity >> Biological agents
>> Adjunctive therapies

31
We offer unique treatments for
different kinds of wounds
Wound Treatment With Human Skin-Like Structur
Central Office: Teba Zist Polymer (treetta)
Second floor, No 1471, Innovation Tower
of Dr. Hesabi, Balavar Alley, North of Valiasr
Crossroad, Tehran, Iran

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