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M. Veličković V, Macmillan T, Lones E, Arlouskaya Y, Prieto PA, Webb N, Crompton A, Munro I, Carvalho VF, Attila S, Bárdos D, Lin Y, Chiao H, Probst S. Systematic review and quality assessment of clinical and economic evidence for superabsorbent wound dressings in a population with chronic ulcers. Int Wound J 2024; 21:e14750. [PMID: 38468367 PMCID: PMC10928240 DOI: 10.1111/iwj.14750] [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] [Received: 10/06/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 03/13/2024] Open
Abstract
Effective exudate management is key for optimal ulcer healing. Superabsorbent dressings are designed to have high fluid handling capacity, reduced risk of exudate leakage, fluid retention under compression, and to sequester harmful exudate components. This study aimed to systematically identify existing evidence for the clinical efficacy and cost-effectiveness of superabsorbent dressings for the treatment of moderate-to-highly exudating chronic ulcers of various etiologies. The aim is focused on examining the 'class' effect of all superabsorbers, not any particular dressing. Clinical and cost effectiveness systematic reviews were conducted, searching Embase, MEDLINE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. The Cost Effectiveness Analysis Registry and Econ papers were also searched for the economic review. Outcomes of interest included ulcer closure, dressing properties, hospital- and infection-related outcomes, safety, and economic outcomes. Fourteen studies were included in the clinical systematic review. Eleven were case series, with one randomised controlled trial, one retrospective matched observational study, and one retrospective cohort study. The studies investigated eight superabsorbent dressings and were heterogeneous in their patient population and outcomes. Superabsorbent dressings may result in favourable outcomes, including reductions in frequency of dressing change and pain scores. As most studies were case series, drawing firm conclusions was difficult due to absence of a comparator arm. The economic systematic review identified seven studies, five of which were cost-utility analyses. These suggested superabsorbent dressings are a more cost-effective option for the treatment of chronic ulcers compared with standard dressings. However, the small number and low quality of studies identified in both reviews highlights the need for future research.
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Affiliation(s)
- Vladica M. Veličković
- Evidence Generation DepartmentHARTMANN GROUPHeidenheimGermany
- Institute of Public Health, Medical Decision Making and HTAHall in TirolAustria
| | | | | | - Yana Arlouskaya
- Evidence Generation DepartmentHARTMANN GROUPHeidenheimGermany
| | - Pablo Arija Prieto
- Evidence Generation DepartmentHARTMANN GROUPHeidenheimGermany
- Erasmus Universiteit Rotterdam, Erasmus School of Health Policy&ManagementRotterdamNetherlands
| | | | | | | | - Viviane Fernandes Carvalho
- Nursing DepartmentUniversidade GuarulhosGuarulhosBrazil
- Medical Affair DepartmentHARTMANN GROUPBarueriBrazil
| | - Szijártó Attila
- Department of Surgery, Transplantation and GastroenterologySemmelweis UniversityBudapestHungary
| | - Dávid Bárdos
- Department of Surgery, Transplantation and GastroenterologySemmelweis UniversityBudapestHungary
| | - YunNan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiungTaiwan
- School of Post‐Baccalaureate Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - HaoYu Chiao
- Department of Surgery, Plastic and Reconstructive SurgeryTri‐Service General Hospital (Medical Centre), National Defense Medical CenterTaipeiTaiwan
| | - Sebastian Probst
- Geneva School of Health Sciences, HES‐SO University of Applied Sciences and Arts Western Switzerland, Geneva, SwitzerlandUniversity Hospital GenevaGenevaSwitzerland
- College of Medicine Nursing and Health SciencesUniversity of GalwayGalwayIreland
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Atkin L, Barrett S, Chadwick P, Callaghan R, Rippon MG, Rogers AA, Simm S. Evaluation of a superabsorbent wound dressing, patient and clinician perspective: a case series. J Wound Care 2020; 29:174-182. [DOI: 10.12968/jowc.2020.29.3.174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: The primary objective of this study was to evaluate the fluid management capabilities of a superabsorbent wound dressing (Zetuvit Plus Silicone), with secondary objectives related to parameters that support whether the dressing enables undisturbed healing. Method: This study was an open labelled non-comparative study. Patients included in the study were selected by the clinical investigator(s) according to whether the patient required a dressing for the management of moderately to highly exuding wounds. Results: A total of 50 patients were included in the study. Results related to the primary objective demonstrated that the superabsorbent wound dressing was able to absorb all levels of exudate across the range (low to high). At each assessment time point these results show that in 98% of assessments the superabsorbent dressing was rated as ‘very good’ (91%) or ‘good’ (7%) at exudate management. Secondary objectives relating to wound bed preparation, healing and management of pain were also positive. Additionally, at the end of each patient treatment, the dressing's fluid management capabilities were rated overall as ‘excellent’ (100% of cases). There was little pain associated with the wound or at dressing change throughout the study and its flexibility/conformability allowed for comfort and patient satisfaction aligned with increased quality of life. Additionally, inclusion of a silicone adhesive layer allowed painless and atraumatic removal of the dressing, increasing patient comfort, both during wear and at dressing removal, and supported the description of enabling undisturbed wound healing. Conclusion: The superabsorbent wound dressing achieved the primary objective relating to wound exudate management in all the assessments undertaken in this study. In addition, the silicone interface allowed for undisturbed healing as evidenced by little or no adherence of the dressing to underlying tissue, preventing damage to periwound skin. Overall, the superabsorbent wound dressing with the addition of the silicone interface could offer advantages over other superabsorbent polymer dressings (that might adhere to the wound surface) or silicone wound dressings (that might not have the absorbent properties of this type of dressing).
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Affiliation(s)
| | - Simon Barrett
- Tissue Viability Nurse Specialist; Humber NHS Foundation Trust, The Grange Hessle, 11 Hull Road, Hessle, HU13 9LZ
| | | | | | - Mark G Rippon
- Visiting Clinical Research Fellow; Huddersfield University
| | - Alan A Rogers
- Medical Communications Consultant; Flintshire, North Wales
| | - Sue Simm
- Clinical Consultant; Luna Consultants
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Zepon ΚM, Marques MS, Hansen AW, Pucci CDAF, Morisso FDP, Ziulkoski AL, do Nascimento JHO, Magnago RF, Κanis LA. Polymer-based wafers containing in situ synthesized gold nanoparticles as a potential wound-dressing material. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 109:110630. [PMID: 32228905 DOI: 10.1016/j.msec.2020.110630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/19/2019] [Accepted: 01/02/2020] [Indexed: 12/19/2022]
Abstract
Polymer-based wafers containing gold nanoparticles (AuNP) were prepared using κ-carrageenan (κC), locust bean gum (LBG) and polyvinyl alcohol (PVA) at ratios of 42/22/13% w/w and 35/15/17% w/w. The synthesized AuNPs were evaluated for their particle size and morphology. The produced wafers containing AuNPs were investigated for their physicochemical, morphological, mechanical, and swelling properties. In addition, bacterial barrier activity and in vitro cytotoxicity were also evaluated in this study. The AuNPs obtained were spherical in shape (~ 10-15 nm in diameter) and exhibited a single bell-shaped UV-vis absorption band centered ~ 540 nm. FT-IR spectra of the wafers containing AuNPs exhibited a shift of ν(O=S=O) absorption band toward a lower wavenumber and a shift of ν(OH) absorption band toward a higher wavenumber due to the coordination of OH groups to AuNPs and their interaction with O=S=O groups of κC, respectively. SEM images confirmed the porous structure of the produced wafers, being the surface area, mechanical properties, and swelling behavior directly affected by changing both the initial amount of [Au+3] and the composition of the wafers. Lastly, the produced wafers showed non-toxicity to NIH-3T3 fibroblast cells, and they also serve as a bacterial barrier. These findings endorsed the claim that the produced wafers containing AuNPs could be a promising material for wound dressing applications.
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Affiliation(s)
- Κarine Modolon Zepon
- Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina, 88701-000 Tubarão, SC, Brazil; Pós-Graduação em Tecnologia de Materiais e Processos Industriais, Universidade Feevale, 93525-075 Novo Hamburgo, RS, Brazil.
| | - Morgana Souza Marques
- Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina, 88701-000 Tubarão, SC, Brazil; Pós-Graduação em Tecnologia de Materiais e Processos Industriais, Universidade Feevale, 93525-075 Novo Hamburgo, RS, Brazil.
| | - Alana Witt Hansen
- Laboratório de Citotoxicidade, Instituto de Ciências da Saúde, Universidade Feevale, 93525-075 Novo Hamburgo, RS, Brazil
| | | | - Fernando Dal Pont Morisso
- Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, 90610-000 Porto Alegre, RS, Brazil
| | - Ana Luiza Ziulkoski
- Laboratório de Citotoxicidade, Instituto de Ciências da Saúde, Universidade Feevale, 93525-075 Novo Hamburgo, RS, Brazil
| | | | - Rachel Faverzani Magnago
- Pós-Graduação em Engenharia Têxtil, Universidade Federal do Rio Grande do Norte, 59072-970 Natal, RN, Brazil
| | - Luiz Alberto Κanis
- Pós-Graduação em Ciências da Saúde, Universidade do Sul de Santa Catarina, 88701-000 Tubarão, SC, Brazil
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Barrett S, Callaghan R, Chadwick P, Haycocks S, Rippon M, Stephen-Haynes J, Simm S. An observational study of a superabsorbent polymer dressing evaluated by clinicians and patients. J Wound Care 2018; 27:91-100. [DOI: 10.12968/jowc.2018.27.2.91] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Simon Barrett
- Humber NHS Foundation Trust, The Grange Hessle, 11 Hull Road, Hessle, HU13 9LZ
| | | | - Paul Chadwick
- National Clinical Director at the College of Podiatry, College of Podiatry, Quartz House, Mill Street, London
| | - Sam Haycocks
- Advanced Podiatrist, Salford Royal (NHS) Foundation Trust, UK
| | - Mark Rippon
- Visiting Clinical Research Fellow, Huddersfield University, Medical Marketing Consultant Daneriver Consultancy Ltd, Holmes Chapel, UK
| | - Jackie Stephen-Haynes
- Professor and Consultant Nurse in Tissue Viability, Birmingham City University and Worcestershire Health & Care Trust, UK
| | - Sue Simm
- Clinical Development Manager, Hartmann UK
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Tickle J. Introducing a new superabsorbent dressing to manage wound exudate. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2017; 26:S38-S45. [PMID: 29120681 DOI: 10.12968/bjon.2017.26.sup20.s38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The production of wound exudate is a natural and normal consequence of healing. However, when the constituents, volume and consistency of the exudate alter, problems can occur. This article discusses the different types of exudate and its impact on both the patient and the clinician and outlines appropriate exudate assessment and effective management and dressing selection. If these are performed appropriately, this can improve quality of life for the patient and save time and money for healthcare providers.
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Affiliation(s)
- Joy Tickle
- Tissue Viability Specialist, Shropshire Community NHS Trust
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