Driver Mick, Harries Dave, Hayes Diane, Puzey Ros

1. Mick Driver - Specialist Diabetes Podiatrist, North Lincolnshire and Goole NHS Foundation Trust
Diane Hayes & Dave Harries – Tissue Viability Nurses, Birmingham Community Healthcare Trust
Roz Puzey - Plastics Nurse Specialist, Derby Hospitals NHS Foundation Trust
A NEWLY FORMULATED ANTI-BIOFILM
SILVER CONTAINING DRESSING*:
SUMMARY OF A MULTICENTRED EVALUATION.
References:
1. European Wound Management Association (EWMA). Position Document: Hard-to-heal wounds: a holistic approach. London: MEP Ltd, 2008.
2. International consensus: Optimising wellbeing in people living with a wound. An expertworking group review. London: Wounds International, 2012. Available from: http://www.woundsinternational.com
3. Alhede M & Alhede M. (2014) The biofilm challenge. European Wound Management Association (EWMA) Journal. 14(1): p54 – 58.
*AQUACEL® Ag+ Dressing & **AQUACEL® Ag Foam Dressings are a trade mark of ConvaTec Inc, all dressings were provide free of charge for the purpose of this evaluation.
We would like to acknowledge Dale Copson & Maria Poole - Medical Affairs Specialists (ConvaTec Ltd) for their support in developing this poster. © 2014 ConvaTec Inc
Background
Effective management of chronic wounds is dependent on identifying and managing factors that may affect an individual’s ability to heal.
For example, age, aetiology, wound duration and presence of a bioburden.1 While these are important elements, many people living with
wounds focus on the psychosocial implications, which often negatively impact their quality of life.2 A newly formulated anti-biofilm
hydrofiber dressing* was evaluated to assess its ability to optimise wound healing and improve patient outcomes and experience.
Method
Results
Conclusion
Six patients from three NHS organisation’s with chronic wound stasis, where the presence of biofilm was suspected to be a factor
inhibiting wound progression were selected. The chronicity of these wounds ranged from 18 months to 10 years, previous dressing
included a selection of non antimicrobial dressings (alginates, hydrofiber and foams) and antimicrobial dressings (iodine, honey and
silver). Wound bed preparation was undertaken as per local protocol and dressings were changed according to clinical need. Wounds
were treated with the new anti-biofilm hydrofiber dressing* for up to twenty changes, or a period of four weeks, whichever was completed
first. Formal reviews were undertaken throughout to ascertain patient satisfaction and monitor the dressing’s exudate, infection and
biofilm management properties.
It had been suggested that biofilm-forming bacteria is equivalent to chronic infection.3 The significance of biofilms is evidenced by a
dramatic increase in scientific publications on the topic, with some 600 publication on wounds with biofilms in 2013 alone.3
Early indications suggest this new anti-biofilm hydrofiber dressing* has the potential to offer an effective solution in the management of
chronic stagnant wounds, where the presence of exudate, infection and biofilm are suspected to be a factor inhibiting wound progression.
• The absorbency of the dressing effectively managed wound exudate, resulting in a reduction in the frequency of dressing changes
• Appeared to have managed the bioburden by eliminating suspected biofilm and prevented their reformation
• Positively impacted on the patients’ experience due to its ability to initiate wound progression with minimal pain or discomfort.
The anti-biofilm hydrofiber dressing* demonstrated successful clinical outcomes (Graphs 1 and 2), practitioners and patients commented
positively on all the attributes being evaluated:
Clinical case example on a 10 year old wound
Following surgical intervention for bowel cancer in 2002, this 75 year old female underwent
further surgery to her sacrum and buttocks after having necrotizing fasciitis. Post procedure
the wound was successfully treated with negative pressure wound therapy and a split skin graft
was applied to cover the exposed area. A few years later a small area of the graft site broke
down and an ulcer developed. The ulcer was treated with a variety of dressings, including
various antimicrobials, alginates, hydrofiber and foams. Despite every effort, there was minimal
progression and the wound became stagnant. Unfortunately the cancer returned and
chemotherapy was commenced. Following an out-patient review she agreed to try the new
anti-biofilm hydrofiber dressing* (Figs 1-5 illustrate the progress). Progress was observed
within 4 weeks. However, due to the complexity of this particular patient and the chronicity of
the wound it was agreed to continue with the new anti-biofilm hydrofiber dressing* outside of
the initially agreed period of evaluation.
Fig 1. On application
Wound bed covered
with a thick slimy layer
of sloughy tissue and
biofilm was suspected.
Fig 2. Week 3
Sloughy layer begun to
soften and new
granulation tissue
visible. Current regime
continued.
Fig 3. Week 6
Progress continued,
and the current
regime continued.
Fig 4. Week 10
Dressing plan changed,
patient commenced on
silver-containing foam
dressing** to minimise
the risk of re-infection.
Fig 5. Week 25
Wound virtually healed.
Sadly the patients
overall medical status
deteriorated and she
passed away a few
weeks after.
Graph 1. Clinical outcome summary from all 6 patients
 Wound dimensions not recorded for one of the patients

Graph 2. Overall wound progression from all 6 patients