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A novel hydro-desloughing absorbent dressing with a non-adherent healing matrix with ionic silver - a case series analysis.

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A NOVEL POLY-ABSORBENT DRESSING WITH A NON-ADHERENT HEALING MATRIX WITH IONIC SILVER - A CASE SERIES ANALYSIS

LORRAINE GROTHIER, MARTIN TADEJ

INTRODUCTION

A soft-adherent poly-absorbent fibre dressing with ionic sliver compound (UrgoClean Ag) has been evaluated at the Provide CIC tissue viability centre. The primary mode of action of TLC healing matrix is to provide the moist environment needed to promote wound healing. Thanks to the presence of silver, TLC-Ag healing matrix also provides antibacterial and anti-biofilm activity, while fibres ensure absorbent and desloughing properties. • Removal of slough facilitates healing and reduces areas where microorganisms can attach and form biofilms effectively reducing the risk of infection (Percival, Suleman, 2015). • Gelification of the fibres when in contact with the wound exudate also ensures atraumatic removal. UrgoClean Ag was evaluated on 10 wounds in order to assess the acceptability and handling of the product as well as its ability to reduce inflammatory clinical markers produced by local infection.

METHOD

8 patients were included into this case series and 10 wounds were treated in total using the UrgoClean Ag dressing. Various types of leg ulcers were treated including mixed aetiology leg ulcers (4), venous leg ulcers (4) and pressure ulcers (2) located on the foot. • The agreed duration of treatment with UrgoClean Ag was 2 weeks. This was extended further depending on the individual needs of the patient up to a maximum of 4 weeks. In 6 out of 10 cases the treatment with UrgoClean Ag was continued beyond the initial 2 week period.

RESULTS

The study dressing’s performance was assessed according to its clinical efficacy as well as physical parameters of the product using the following criteria: • reduction in signs and symptoms of infection • ability to clean the wound bed • patients’ comfort during wear • non-adherence to the wound • ease of removal. These criteria were rated at each dressing removal and application. Significant majority of responses (91.1%) were marked between excellent and good, giving an overwhelmingly positive overall performance score. For those who rated fair and poor the wound’s depth did not warrant 100% interface contact and alternative treatment had to be introduced in 4 wounds. Clinicians conducting the case series were very impressed by completely atraumatic nature of UrgoClean Ag dressing due to TLC-Ag technology. In 6 out of 10 cases the decision to continue with the treatment was dictated by good clinical outcomes and atraumatic nature of the application and removal of UrgoClean Ag. Effective de-colonisation and de-sloughing was therefore achieved while maintaining maximum comfort for the patient receiving the treatment. Reduction in wound size was not a primary objective of this study, although in 7 out of 10 cases reduction in wound size was recorded.

DISCUSSION

UrgoClean Ag – a soft-adherent poly-absorbent fibre dressing with ionic silver compound has been designed to effectively de-colonise and clean a wide variety of wound types. This combined action in the dressing improves the efficacy of the Ag+ ions by penetrating wound debris like sloughy tissue and deconstructing biofilms allowing the antimicrobial agent to be more effective in reducing bacterial bio-burden. • This specific design is unique and novel solution for patients who have chronic wounds with 3 or more signs of local infection. UrgoClean Ag is a newly developed dressing which is primarily indicated for the wound bed preparation section within the wound healing continuum process. Its ability to de-colonise and clean at the same time is making it an excellent choice for patients who need wound debris removing rapidly. During the initial phase of the treatment it is expected to observe some fluctuation in wound size. • In this case series wound size reduction was observed in 7 out of 10 cases indicating early healing response from newly formed granulation tissue.

CONCLUSION

This case series was aiming to evaluate the efficacy and acceptability of this new technology. In 91.1% of responses clinicians and patients alike were rating the product either excellent, very good or good, and in 71.4% of cases the same level of rating was given to the ability to reduce the signs and symptoms of local infection. • This is positive response is statistically significant and strongly indicates a very good clinical efficacy of UrgoClean Ag. Wound area reduction in 7 out of 10 cases is also supporting the efficacy claim of the combined action of the soft adherent poly-absorbent fibres and TLC-Ag technology. • For 6 out of 10 patients the reduction in the inflammatory clinical markers was significant and the decision to extend the treatment beyond the initial two weeks was taken in order to maximise the clinical benefit. Larger scale clinical study is needed in order to provide more robust statistical data for further analysis.

CASE STUDY 1

Female, 54 years old, M.S, poor motor response, sensory neuropathy (no feeling waist down), osteoporosis, pressure ulcer Stage 4, healing stage 4 to anterior tibia, bandage: K Soft K Lite in figure of 8. Wound duration 7 months. Overall wound status has improved dramatically in the two weeks of trial. Dressing was also absorbent enough therefore secondary dressing was not required. UrgoClean Ag was rated as more effective when compared with previous products.

CASE STUDY 2

Male, 36 years old, venous disease, traumatic wound scraped on beer barrel 4 days prior to starting this trial. Full K Two kit latex free 25-32cm, works in a job requiring him being on his feet all day in a local pub. Long history of venous disease, with a history of previous ulcers. During the UrgoClean Ag trial the wound improved significantly, reaching 100% granulation tissue in a space of 20 days. UrgoClean Ag was rated as more effective when compared with previous products.

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