SAP-containing dressings exhibit sustained antimicrobial effects over 7 days in vitro

Superabsorbent wound dressings for the management of highly exuding wounds: a literature review

Exudate management is essential for creating a moist wound environment that promotes optimal healing, especially in highly exuding wounds, where choosing an appropriate wound dressing to handle high volumes of exudate is a key part of the wound management strategy. Superabsorbent wound dressings (SWDs) have been designed to absorb and retain large amounts of exudate. Thus, they are advocated for management of wounds with moderate-to-high levels of exudate to reduce the risk of leakage and damage to the periwound skin. The SWD category contains numerous brands with different structural and compositional designs. Those differences affect absorption capacity of the products, but also affect structural integrity, risk of leakage, adherence to the wound bed upon dressing removal etc. Herein, we aim to provide a brief overview of the clinical evidence and technical performance characteristics of the SWD category, and identify technical improvement areas. Clinical evidence within the SWD category was primarily limited to product evaluations, case series and case studies. With limited comparative clinical evidence available within this product category, we provide an overview of in vitro comparisons of technical performance characteristics related to absorption capacity, fluid retention, structural integrity, waterproofness, and ability to sequester host-derived enzymes and microorganisms. Substantial differences in in vitro performance characteristics in this product category were identified, which may have implications for their clinical performance. With the currently available in vitro evidence, there is no SWD showing superior performance across all functionalities, indicating a continued need for product development within this product category.

Optimising outcomes with 'Wound Balance' and dressings containing superabsorbent polyacrylate polymers

The ever-increasing burden of hard-to-heal wounds requires emphasis placed on early intervention to help heal wounds and improve patient quality of life. A patient's healing potential can be optimised by applying the 'Wound Balance' holistic framework for wound assessment, care planning and quality of life considerations. This holistic management can be facilitated with appropriate dressings, such as dressings containing superabsorbent polyacrylate polymers (SAPs), including RespoSorb® Silicone Border (Hartmann). SAP-containing dressings can absorb exudate and bind and lock away wound inhibitors, such as proteases and micro-organisms, reversing the factors associated with hard-to-heal wounds to enable a healing environment similar to an acute wound. Three case studies demonstrate the positive benefits of using RespoSorb Silicone Border in clinical practice. The dressings proved easy to use and comfortable, with atraumatic changes and long wear times, providing a costeffective option for patients with both acute and hard-to-heal wounds.

Systematic review and quality assessment of clinical and economic evidence for superabsorbent wound dressings in a population with chronic ulcers

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.

Antimicrobial effects of a borate-based bioactive glass wound matrix on wound-relevant pathogens

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.

Efficacy of a superabsorbent dressing with Hydration Response Technology

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.

A wearable wound moisture sensor as an indicator for wound dressing change: an observational study of wound moisture and status

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.