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Dissemond J, Aare K, Ozer K, Gandhi D, Ryan JL, DeKoven M. Aquacel Ag Advantage/Ag+ Extra and Cutimed Sorbact in the management of hard-to-heal wounds: a cohort study. J Wound Care 2023; 32:624-633. [PMID: 37830837 DOI: 10.12968/jowc.2023.32.10.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To compare Aquacel Ag Advantage/Ag+ Extra (Aquacel Ag+) (Convatec, UK) and Cutimed Sorbact (Sorbact) (Essity, US) dressings indicated for the treatment of patients with venous leg ulcers (VLUs), diabetes foot ulcers (DFUs) and pressure injuries (PIs) for clinical performance and outcomes using real-world evidence in Germany and the US. METHOD This study was a chart audit review of patients who used either Aquacel Ag+ or Sorbact dressings in the 24 months prior to October 2022. Healthcare providers with access to electronic medical records and charts were asked to capture data via patient record forms. The quantitative data were analysed. RESULTS Findings in Germany were comparable between Aquacel Ag+ and Sorbact with regards to wound description, management and treatment outcomes, including percent area reduction and wound closure. A difference was that a greater proportion of Sorbact patients required surgery (0% versus 11%; p=0.039). In the US, a greater proportion of wounds were worsening before dressing in the Aquacel Ag+ cohort (49% versus 34%; p=0.010). A multinomial logistic regression yielded the result that patients who received Aquacel Ag+ were 3.53 times more likely to have the wound completely healed (p=0.033). CONCLUSION Both Aquacel Ag+ and Sorbact dressings are widely used in Germany and the US for patients with VLUs, DFUs and PIs. Our study found two important differences: patients who used Aquacel Ag+ were less likely to need further surgery in Germany; and in the US, there were significantly higher odds that wounds would completely heal with Aquacel Ag+ dressings compared to Sorbact.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Essen University Hospital, Essen, Germany
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Husmark J, Morgner B, Susilo YB, Wiegand C. Antimicrobial effects of bacterial binding to a dialkylcarbamoyl chloride-coated wound dressing: an in vitro study. J Wound Care 2022; 31:560-570. [PMID: 35797260 DOI: 10.12968/jowc.2022.31.7.560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Wound dressings that inactivate or sequestrate microorganisms, such as those with a hydrophobic, bacteria-binding dialkylcarbamoyl chloride (DACC) surface, can reduce the risk of clinical infections. This 'passive' bioburden control, avoiding bacterial cell wall disruption with associated release of bacterial endotoxins aggravating inflammation, is advantageous in hard-to-heal wounds. Hence, the full scope of DACC dressings, including the potential impact of higher inoculum densities, increased protein load and different pH on antibacterial activity, needs to be evaluated. METHOD The Japanese Industrial Standard (JIS) L 1902 challenge test was used to evaluate the antimicrobial activity of the DACC-coated dressing against several World Health Organization (WHO)-prioritised wound pathogens (e.g., meticillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, microorganisms with extended-spectrum beta-lactamases and Acinetobacter baumannii), the effect of repeated bacterial challenge in an adverse wound environment, and antimicrobial performance at wound-related pH. RESULTS High antibacterial activity of the DACC-coated dressing against the WHO-prioritised bacteria strains by its irreversible binding and inhibition of growth of bound bacteria was confirmed using JIS L 1902. At increased inoculation densities, compared to standard conditions, the DACC-coated dressing still achieved strong-to-significant antibacterial effects. Augmenting the media protein content also affected antibacterial performance; a 0.5-1 log reduction in antibacterial activity was observed upon addition of 10% fetal calf serum. The pH did not influence antibacterial performance. The DACC-coated dressing also sustained antibacterial activity over subsequent reinfection steps. CONCLUSION It can be assumed that the DACC-coated dressing exerts beneficial effects in controlling the wound bioburden, reducing the overall demand placed on antibiotics, without using antimicrobial substances.
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Affiliation(s)
| | - Bianka Morgner
- Department of Dermatology, University Hospital Jena, Erfurter Straße 35, D-07740 Jena, Germany
| | | | - Cornelia Wiegand
- Department of Dermatology, University Hospital Jena, Erfurter Straße 35, D-07740 Jena, Germany
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Review of the Latest Methods of Epidermolysis Bullosa and Other Chronic Wounds Treatment Including BIOOPA Dressing. Dermatol Ther (Heidelb) 2021; 11:1469-1480. [PMID: 34269966 PMCID: PMC8484405 DOI: 10.1007/s13555-021-00578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Indexed: 11/20/2022] Open
Abstract
Epidermolysis bullosa (EB) is a hereditary genetic skin disorder, classified as a type of genodermatosis, which causes severe, chronic skin blisters associated with painful and potentially life-threatening complications. Currently, there is no effective therapy or cure for EB. However, over the past decade, there have been several important advances in treatment methods, which are now approaching clinical application, including gene therapy, protein replacement therapy, cell therapy (allogeneic fibroblasts, mesenchymal stromal cells), bone marrow stem cell transplant, culture/vaccination of revertant mosaic keratinocytes, gene editing/engineering, and the clinical application of inducible pluripotent stem cells. Tissue engineering scientists are developing materials that mimic the structure and natural healing process to promote skin reconstruction in the event of an incurable injury. Although a cure for EB remains elusive, recent data from animal models and preliminary human clinical trials have raised the expectations of patients, clinicians, and researchers, where modifying the disease and improving patients’ quality of life are now considered attainable goals. In addition, the lessons learned from the treatment of EB may improve the treatment of other genetic diseases.
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Abstract
Biofilms are responsible for stimulating and maintaining wound inflammation, increasing infection risk and delaying wound closure. Appropriate biofilm management is required to fight against local and systemic infection and to restore balance to the wound environment. The most effective way to remove biofilms involves the use of mechanical techniques, with the wound dressing representing an important component of this strategy. Wound dressing fibres, such as polyacrylate fibres, have been shown to be effective in affecting biofilm architecture by disrupting the biofilm matrix. This helps enhance the efficacy of antimicrobials, such as silver. Focusing an antibiofilm strategy on active agents alone does not constitute a sustainable approach to biofilm management. Furthermore, adding too many active chemicals into a wound can be highly detrimental to the wound bed, and potentially may have both short- and long-term biological concerns. Particular attention on the characteristics and key features of wound dressings is discussed in this paper. The aim of the paper is to review the ideal characteristics of wound dressings, in conjunction with antimicrobials, that are considered a fundamental part of an antibiofilm strategy and growing requirement for enhanced wound healing.
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Affiliation(s)
- Steven L Percival
- 5D Health Protection Group Ltd, Liverpool Bio-innovation Hub, Liverpool, UK
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Jeffery SLA. The use of an antimicrobial primary wound contact layer as liner and filler with NPWT. J Wound Care 2018; 23:S3-S14. [DOI: 10.12968/jowc.2014.23.sup8.s1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Steven LA Jeffery
- Consultant Plastic and Reconstructive Surgeon, Queen Elizabeth Hospital Birmingham, Professor of Wound Study, Birmingham City University
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Totty J, Bua N, Smith G, Harwood A, Carradice D, Wallace T, Chetter I. Dialkylcarbamoyl chloride (DACC)-coated dressings in the management and prevention of wound infection: a systematic review. J Wound Care 2017; 26:107-114. [DOI: 10.12968/jowc.2017.26.3.107] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J.P. Totty
- Clinical Research Fellow, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - N. Bua
- Academic Foundation Doctor, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - G.E. Smith
- Clinical Lecturer, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - A.E. Harwood
- Research Fellow, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - D. Carradice
- Consultant Vascular Surgeon, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - T. Wallace
- Clinical Lecturer, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
| | - I.C. Chetter
- Professor of Vascular Surgery and Consultant Vascular Surgeon, Academic Vascular Surgical Unit, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, UK
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Powers JG, Higham C, Broussard K, Phillips TJ. Wound healing and treating wounds: Chronic wound care and management. J Am Acad Dermatol 2016; 74:607-25; quiz 625-6. [PMID: 26979353 DOI: 10.1016/j.jaad.2015.08.070] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/12/2015] [Accepted: 08/15/2015] [Indexed: 12/15/2022]
Abstract
In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers.
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Affiliation(s)
| | - Catherine Higham
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Karen Broussard
- Division of Dermatology, Vanderbilt University, Nashville, Tennessee
| | - Tania J Phillips
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts; SkinCare Physicians, Chestnut Hill, Massachusetts
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Thomas M, Hamdan M, Hailes S, Walker M. Manuka honey as an effective treatment for chronic pilonidal sinus wounds. J Wound Care 2011; 20:528, 530-3. [PMID: 22240847 DOI: 10.12968/jowc.2011.20.11.528] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- M. Thomas
- Department of General and vascular Surgery, West Cumberland Hospital, UK
| | - M. Hamdan
- Department of General and vascular Surgery, West Cumberland Hospital, UK
| | - S. Hailes
- Department of General and vascular Surgery, West Cumberland Hospital, UK
| | - M. Walker
- Department of General and vascular Surgery, West Cumberland Hospital, UK
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Affiliation(s)
- Martyn Butcher
- University of Plymouth Honorary Tissue Viability Research Nurse, Northern Devon Healthcare Trust, UK
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10
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Affiliation(s)
- Richard White
- Tissue Viability, Institute of Health and Society, University of Worcester
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Dressings with TLC-NOSF Technology. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pre-clinical evidence. J Wound Care 2011. [DOI: 10.12968/jowc.2011.20.sup1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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