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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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Jung S, Schultz G, Mafiz AI, Bevels E, Jaskula K, Brownell K, Lantz E, Strickland A. Antimicrobial effects of a borate-based bioactive glass wound matrix on wound-relevant pathogens. J Wound Care 2023; 32:763-772. [PMID: 38060418 DOI: 10.12968/jowc.2023.32.12.763] [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: 12/18/2023]
Abstract
OBJECTIVE The antimicrobial effects of a borate-based bioactive glass matrix (BBBGM) on clinically relevant microorganisms was investigated for up to seven days in vitro. METHOD A total of 19 wound-relevant pathogens were studied using the in vitro AATCC 100 test method. RESULTS The reduction of viable Gram-negative and Gram-positive bacteria and yeasts at days 4 and 7 post-culture on the BBBGM was significant (> 4log10) in most cases. Mould counts were reduced (<2log10) during the seven-day assessment, indicating that mould viability and reproduction was inhibited. The cell count of each organism was reduced at seven days indicating that the BBBGM not only reduced the viable cell count, but that the cell count did not recover during the seven-day period, indicating a sustained reduction in pathogenic activity. CONCLUSION Based on the present results, the use of a BBBGM as a pathogenic barrier should be considered as a tool for combating pathogenic colonisation and infection in acute and hard-to-heal (chronic) wounds.
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Rippon MG, Rogers AA, Sellars L, Styles KM, Westgate S. Effectiveness of a non-medicated wound dressing on attached and biofilm encased bacteria: laboratory and clinical evidence. J Wound Care 2018; 27:146-155. [DOI: 10.12968/jowc.2018.27.3.146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mark G. Rippon
- Visiting Clinical Research Fellow, Huddersfield University, Queensgate, Huddersfield
| | - Alan A. Rogers
- Medical Communications Consultant, Flintshire, North Wales
| | - Laura Sellars
- Senior Microbiologist, Perfectus Biomed Limited, Daresbury Laboratories, SciTech Daresbury, Cheshire
| | - Kathryn M. Styles
- Senior Microbiologist, Perfectus Biomed Limited, Daresbury Laboratories, SciTech Daresbury, Cheshire
| | - Samantha Westgate
- CEO, Perfectus Biomed Limited, Daresbury Laboratories, SciTech Daresbury, Cheshire
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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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Desroche N, Dropet C, Janod P, Guzzo J. Antibacterial properties and reduction of MRSA biofilm with a dressing combining polyabsorbent fibres and a silver matrix. J Wound Care 2016; 25:577-584. [DOI: 10.12968/jowc.2016.25.10.577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- N. Desroche
- Nexidia SAS, 15 Rue de Mayence, F-21000 DIJON
| | - C. Dropet
- Nexidia SAS, 15 Rue de Mayence, F-21000 DIJON
| | - P. Janod
- Urgo Recherche Innovation et Développement, 42 rue de Longvic, F-21300 CHENOVE
| | - J. Guzzo
- UMR A, Procédés Alimentaires et Microbiologiques, Université de Bourgogne, IUVV, rue Claude Ladrey, F-21000 DIJON
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Butcher M. Efficacy of a superabsorbent dressing with Hydration Response Technology. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2015; 24 Suppl 20:S24-S30. [PMID: 26559233 DOI: 10.12968/bjon.2015.24.sup20.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Moderately and heavily exuding wounds are associated with delayed healing and an increased risk of infection. Elevated proteases found in chronic wound fluid keep a sustained state of inflammation. Superabsorbent dressings can absorb large quantities of exudate without losing their structure. Some are also able to bind and sequester proteases and bacteria within their structure. This article summarises the in-vitro and clinical evidence on the efficacy of Cutimed® Sorbion® Sachet S. The findings indicate that it helps facilitate autolytic debridement, absorbs exudate and reduces inflammation, and thus the risk of infection.
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Affiliation(s)
- Martyn Butcher
- RGN, Independent tissue viability and woundcare consultant; Student of podiatry, University of Plymouth
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Milne SD, Seoudi I, Al Hamad H, Talal TK, Anoop AA, Allahverdi N, Zakaria Z, Menzies R, Connolly P. A wearable wound moisture sensor as an indicator for wound dressing change: an observational study of wound moisture and status. Int Wound J 2015; 13:1309-1314. [PMID: 26561281 PMCID: PMC7950073 DOI: 10.1111/iwj.12521] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/19/2015] [Accepted: 09/20/2015] [Indexed: 11/27/2022] Open
Abstract
Wound moisture is known to be a key parameter to ensure optimum healing conditions in wound care. This study tests the moisture content of wounds in normal practice in order to observe the moisture condition of the wound at the point of dressing change. This study is also the first large-scale observational study that investigates wound moisture status at dressing change. The WoundSense sensor is a commercially available moisture sensor which sits directly on the wound in order to find the moisture status of the wound without disturbing or removing the dressing. The results show that of the 588 dressing changes recorded, 44·9% were made when the moisture reading was in the optimum moisture zone. Of the 30 patients recruited for this study, 11 patients had an optimum moisture reading for at least 50% of the measurements before dressing change. These results suggest that a large number of unnecessary dressing changes are being made. This is a significant finding of the study as it suggests that the protocols currently followed can be modified to allow fewer dressing changes and less disturbance of the healing wound bed.
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Affiliation(s)
- Stephen D Milne
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Ihab Seoudi
- Continuing Care Group, Hamad Medical Corporation, Doha, Qatar
| | - Hanadi Al Hamad
- Continuing Care Group, Hamad Medical Corporation, Doha, Qatar
| | - Talal K Talal
- Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Anzila A Anoop
- Continuing Care Group, Hamad Medical Corporation, Doha, Qatar
| | | | - Zain Zakaria
- Continuing Care Group, Hamad Medical Corporation, Doha, Qatar
| | - Robert Menzies
- Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Patricia Connolly
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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