Technology update The role of ALLEVYNTM


Ag in the management of hard-to-heal wounds


weeks). The primary objectives of the study were to assess dressing acceptability and dressing performance. Secondary objectives included examining changes to the wound over the course of the treatment period (median 21 days). Treatment settings included wound clinics, hospitals, patients’ homes, nursing homes, medical/nurse practices and long-stay health centres. A total of 126 patients (47% males; 53%


females) were recruited and data was captured using a case report form. The suitability of the dressings was assessed in 111 patients and were found to be acceptable for 88% of patients. For the majority of patients, the dressings were found to be either satisfactory or exceeded expectations in exudate management, bacterial barrier, ease of use, durability, patient comfort and convenience[2] Over the course of the study there was a


.


significant reduction in the percentage of patients presenting with any clinical signs of infection between the first and final assessments (p<0.001). There was a median wound area reduction of 61% (p< 0.001) with 34 patients (27%) achieving complete closure at the end of the evaluation. There was also a significant reduction in exudate levels between the initial and final assessment (p<0.001), with improvement in the appearance of the wound and condition of the surrounding skin[2] average wear time was reported as 3.8 days.


. The Week 1: Sept 5, 2008


This may be attributed to routine practice in the majority of cases, rather than the need to change the dressing because of exudate saturation or other reasons, such as the dressings becoming detached. These findings are further supported by a


recent non-randomised, prospective study by Lantis and Gendics[54]


. The study set out to


provide a new benchmark for the treatment of patients with infected hard-to-heal venous leg ulcers. The primary goal of the study was to assess the in vivo effect of ALLEVYN Ag Non-Adhesive in reducing the total bioburden from 105


cfu/g or more to less than 105 cfu/g


— the secondary endpoint was to track wound closure and other markers of wound progression. Of the 33 patients screened, 24 patients


were recruited. All had venous disease confirmed by ultrasound with a mean ankle brachial pressure index (ABPI) score of 1.1 (median: 1.2; range: 0.8–1.4), a mean ulcer duration before treatment of 70.6 weeks (median 47.7 weeks), and mean ulcer area of 20.1cm2


(median 12.3cm2 ). All wounds


were critically colonised with a bioburden of greater than or equal to 105


cfu/g. In addition,


all patients had at least three clinical signs of infection (mean 5.5 per patient), with the majority of patients exhibiting increased exudate (79%), pain (83%), local peri-ulcer erythema (75%) and oedema (92%). All of the


Week 2: Sept 19, 2008 References


28.Wolcott RD, Cutting KF, Dowd SC. Surgical site infections: biofilms, dehiscence and delayed healing. Wounds UK 2008; 4(4): 108–13.


29. Solowiej K, Mason V, Upton D. Review of the relationship between stress and wound healing: part 1. J Wound Care 2009; 18(9): 357–66.


30. Price PE, Fagervik–Morton H, Mudge, EJ, et al. Dressing– related pain in patients with chronic wounds: an international perspective. Int Wound J 2008; 5(2): 159–71.


31. Fagervik–Morton H, Price P. Chronic ulcers and everyday living: patients’ perspective in the UK. Wounds: A Compendium of Clinical Research and Practice 2009; 21(12): 318–23.


32. Mudge E, Spanou C, Price P. A focus group study into patients’ perception of chronic wound pain. Wounds UK 2008; 4(2): 21–28.


33. Gonzalez–Consuegra RV, Verdu J. Quality of life in people with venous leg ulcers: an integrative review. J Adv Nurs 2011; 67(5): 926–44.


34. James GA, Swogger E, Wolcott R, et al. Biofilms in chronic wounds. Wound Repair Regen 2008; 16(1): 37–44.


35. Skog E, Arnesjo B, Treeng T, et al. A randomized trial comparing cadexomer iodine and standard treatment in the out–patient management of chronic ulcers. Br J Dermatol 1983; 109(1): 77–83.


36. Vermeulen H, van Hattem JM, Storm–Versloot MN, Ubbink DT. Topical silver for treating infected wounds. Cochrane Database Sys Rev. The Cochrane Library, Issue 1, 2007, Oxford: Update Software.


Week 4: Oct 3, 2008 Completion: Dec 20, 2008


Figure 1 – This patient reported significant reductions in wound complications, including reduction in periwound erythema and oedema.


37. Cooper RA. A review of the evidence for the use of topical antimicrobial agents in wound care. WorldWide Wounds. Available online at: www.worldwidewounds. com/2004/february/Cooper/ Topical–Antimicrobial–Agents.html


www.woundsinternational.com


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Technology and product reviews


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