Patrick Brosnan, Alexander Waite, Jim Mellor, Breda Cullen, Systagenix, Gargrave, UK.

1. Aim
Methodology
The evidence hierarchy
Total Fluid Handling; in Vitro
Evidence Based Assessment of
Moist Wound Healing Dressings:
In vitro, In vivo and Clinical
Patrick Brosnan, Alexander Waite, Jim Mellor, Breda Cullen, Systagenix, Gargrave, UK.
EP497
EWMA May 2013
C1385‐4
Introduction
Clinically supportive evidence provides the
basis for selection and correct use of wound
care products. Different types of supportive
data are available including; in vitro / in vivo
laboratory studies, reviews, case reports,
clinical evaluations and randomised clinical
trials (RCT). However there is debate over what
qualifies as sufficient evidence to make an
informed decision concerning dressing
selection.
Clinical Trial
Non‐Comparative Clinical Evaluation
Conclusion
Results

2. 013 Aim
nvestigation sets out to conduct a comprehensive review of published clinically
rtive evidence underpinning a hydropolymer foam wound dressing* and to
mine the clinical relevance of the in vitro model.
Methodology
s study we review the strength of evidence available for a hydropolymer moist
d healing dressing. There is a clear hierarchy of supportive data:
1: RCT
2: Case studies/series and clinical assessment
3: Laboratory based in vitro and in vivo analysis
dition we looked to see if data generated in vitro could be confirmed in clinical
ce and if models used to assess dressings in vitro are clinically relevant.
Results
ce is available from multiple levels from laboratory based analysis to RCTs. Although
are deemed to hold the highest clinical significance, it is important also to
wledge the significance of non‐clinical evidence that although not clinically sourced

3. 013 The evidence hierarchy:
A Moist Wound Healing Dressing
Lab Studies‐
in vitro, in vivo, ex vivo
Editorials, opinions
Case series, Case studies
Cohort studies, Clinical research
Clinical Trials
Meta analyses
Level 3
Level 2
Level 1

4. 013 Total Fluid Handling; in Vitro
uid handling of moist wound healing dressings is defined as both the absorbent
ty and the moisture vapour transmission rate (MVTR) and can be assessed using the
Standard Paddington Cup Test Method (BS:EN 13726).
3) After storage
the apparatus is
weighed again,
weight = y
2) The
“Paddington Cup”
with sample +
water is weighed
weight = x
4) Water is
drained and the
apparatus
weighed
weight = b
MVTR = x‐y /storage time/ area
Absorbent Capacity = b‐a /storage time/ area
Total Fluid Handling = MVTR + Absorbent Capacity

5. 013 Total Fluid Handling; in Vitro (continued)
fluid handling of the hydropolymer dressing was shown to be greater than that of
14,392
4,302 4,336
3,880
9,159
10,312
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
TIELLE Plus with Comfort Foam Allevyn Adhesive Allevyn Gentle Border
(g/m2/24h)
MVTR Absorbent
Capacity
Hydropolymer Dressing* Foam Dressing 1 Foam Dressing 2
Results

6. 013
The prevention of Heel Pressure Ulcers
Using a Hydropolymer Dressing in Surgical Patients; Clinical Trial.
ots, T.C.M. & Apotheker, B.F.G. Journal of Wound Care 2004, 13(9), 375‐378
m of the study was to investigate whether a hydropolymer foam dressing* could
the prevalence of heel pressure ulcers during hospital stay and following surgery.
rgical patients were split into two groups depending on risk assessment and
on of surgical procedure;
1: Hydropolymer dressing (surgery >90min & high risk patient)
2: No hydropolymer dressing (surgery <90min & lower risk patient)
Aim
Results
s study the number of group 1 (from 117 patients) that developed a heel ulcers was
.5%).
ate of heel ulcer formation in similar patients prior to preventive measures was
%. This equates to a 76.7% reduction.
tive care with a hydropolymer dressing and education can greatly reduce the

7. 013
A Non‐Comparative Multicentre Clinical Evaluation
of a New Hydropolymer Adhesive Dressing
A., Lane, C., Walsh, J., Whittaker, S., Ballard, K., Young, S.R. J Wound Care 1999, 8(10):489‐492.
dy evaluates the performance of a non‐adherent hydropolymer dressing* in acute and chronic
s, in the presence of bleeding and/or low exudate, with respect to adherence to the wound
ents (75 wounds) were recruited in a multicentre, non‐comparative 4‐week clinical study,
g 32 chronic wounds and 43 acute wounds with the non‐adherent hydropolymer dressing .
parameters were measured at each dressing change.
Results
The non‐adherent hydropolymer
dressing was considered pain‐free
and easy to remove, correlating
with low incidence of adherence
to the wound bed.

8. 013
Conclusion
gh critical appraisal of the combined published evidence both in vitro and in vivo we
rive a better overall understanding of how a dressing or material performs. In
on different variants of a material may provide distinct benefits which may be more
priate for different clinical situations. This suggests that all available evidence should
sidered to facilitate more appropriate dressing selection.