Technology and product reviews Page Points 1. Alginate dressings have been in clinical use since the 1940s
2. However, alginate dressings appear to have lost ground to other wound dressings that also absorb exudate — while there are 19 alginate dressings available in the UK, there are 65 foam dressing products
3. This may simply reflect that many wounds are producing less exudate, thus not prompting the use of an alginate dressing. However, it may also reflect an opportunity for renewed interest in alginate use
FUTURE DEVELOPMENTS Alginate dressings have been in clinical use since the mid 1940s and in commercial production for almost 30 years. However, alginate dressings appear to have lost ground to other wound dressings that also absorb exudate — while there are 19 alginate dressings available in the UK, there are 65 foam dressing products[4]
. Recent
surveys of dressing use show relatively low use of alginate dressings compared with foam products, for example, Vowden and Vowden [20]
noted that
across one English health care district (Bradford), 87 pressure ulcers were dressed with a foam product while only five were covered with an alginate dressing. This may simply reflect that many wounds are producing less exudate, thus not prompting the use of an alginate dressing. However, this may also reflect an opportunity for renewed interest in alginate use. In the future it may be feasible to achieve
increased fluid-handling capacities in alginate dressings with additional benefits such as antimicrobial capability, given the ability to introduce silver and other components. Further development of alginate dressings may also lie in exploring other areas where they may interact with wound healing. In 2010, Thomas[1]
posed a number of questions, which References
12. Ravnskog F A, Espehaug B, Indrekvam K. Randomised clinical trial comparing Hydrofiber and alginate dressings post-hip replacement Journal of Wound Care 2011; 20(3) 136–142.
13. Thomas S. Observations on the fluid handling properties of alginate dressings. Pharm J 1992; 248: 850–851.
14. Wiegand C, Heinze T, Hipler U (2009) Comparative in vitro study on cytotoxicity,
antimicrobial activity, and binding capacity for pathophysiological factors in chronic wounds of alginate and silver-containing alginate.Wound Repair and Regen 17(4): 511–21.
15. Percival SL, Slone W, Linton S, Okel T, Corum L, Thomas JG (2011) The antimicrobial efficacy of a silver alginate dressing against a broad spectrum of clinically relevant wound isolates. Int Wound J 8: 237–43.
16. Hooper SJ, Percival SL, Hill KE, Thomas DW, Hayes AJ, Williams DW. The visualisation
and speed of kill of wound isolates on a silver alginate dressing. 2012; Available at: http://
onlinelibrary.wiley.com/doi/10.1111/j.1742-481X.2012.00927.x/abstract (accessed 8 May, 2012).
17. Best Practice Statement: The use of topical antiseptic/antimicrobial agents in wound management. 2nd edition. 2011; Wounds UK, London.
18. Dumville JC, O'Meara S, Deshpande S, Speak K. Alginate dressings for healing diabetic
foot ulcers. Cochrane Database of Systematic Reviews 2012; Issue 2. Art. No. CD009110. DOI: 10.1002/
14651858.CD009110.pub2.
19. Dumville JC, Deshpande S, O'Meara S, Speak K. Hydrocolloid dressings for healing diabetic foot ulcers. Cochrane Database of Systematic Reviews 2012; Issue 2. Art. No. CD009099. DOI: 10.1002/
14651858.CD009099.pub2.
20. Vowden KR, Vowden P. The prevalence, management, equipment provision and outcome for patients with pressure ulceration identified in a wound care survey within one English health care district. J Tiss Viab 2009; 18(1): 20–26.
if addressed might strengthen the role for alginate dressings in wound management: Can the chemical composition of alginates be related to healing and wound infection rates?
Do alginates rich in mannuronic acid stimulate the production of cytokines?
Do alginates with a high mannuronic acid content absorb bacteria, proteolytic enzymes and toxins?
Are alginates rich in mannuronic acid help treat infected or malodorous wounds?
To these could be added questions concerning the value of using alginate dressings in exudate that contains blood. Positive answers to these questions should
lead to an increased interest in, and use of, alginate dressings and may form the basis for new research and clinical studies. Thirty years after the first commercial alginate dressing, these are new areas of investigation that could help blend the composition of alginate dressings, thus achieving improved patient outcomes.
AUTHOR DETAILS Michael Clark, PhD, is Visiting Professor in Tissue Viability, Birmingham City University, Birmingham, UK
28 Wounds International Vol 3 | Issue 2 | ©Wounds International 2012
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