Cover der Ausgabe Wundmanagement 1/2012

Wundmanagement 1/2012

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About the Journal

Original Article

  • The Role of a Silver Releasing Lipido-colloid Contact Layer in Venous Leg Ulcers Presenting Inflammatory Signs Suggesting Heavy Bacterial Colonization: Results of a Randomized Controlled Study

    I. Lazareth, S. Meaume, M. Léa Sigal-Grinberg, P. Combemale, T. Le Guyadec, A. Zagnoli, J. -L. Perrot, A. Sauvadet, S. Bohbot

    Objective: Clinical interest of silver in the management of chronic wounds is not fully established. The main objective of this clinical study was to assess the ability of a new silver releasing lipido-colloid contact layer to promote the healing process of venous leg ulcers (VLU) presenting inflammatory signs suggesting a heavy bacteria colonization and then a delayed healing, in comparison to the same wound dressing not impregnated with silver salts.
    Methods: This was an open-labeled, randomized, controlled trial. VLU presenting at least 3 out of 5 clinical signs suggesting heavy bacterial colonization were recruited. Patients were treated with contact layer silver dressing ([CLS], Restore® Contact Layer, Silver* (Hollister Wound Care, Libertyville, Ill) or contact layer dressing ([CL] Restore® Contact Layer**, Hollister Wound Care, Libertyville, Ill) for 4 weeks, then all treated ulcers were treated with CL for the 4 additional weeks. Wound evaluation and area measurements were conducted weekly during the first 4 weeks and then at week 6 and 8. Main efficacy criterion was absolute wound area decrease (AD) at week 4 and week 8.
    Results: Patients (N = 102) were randomized and treated. Ulcers were present for nearly 11 months on average; 65 % were recurrent and mean area was 20.0 ± 17.8 cm2. Almost 80 % of the treated VLU were stagnating/aggravating with their previous treatment. By week 4, mean surface area decreased by 6.5 ± 13.4 cm2 (median: 4.2 cm2) and 1.3 ± 9.0 cm2 (median: 1.1 cm2) in CLS and CL groups, respectively (P = 0.023). At week 8, median decrease was 5.9 cm2 versus 0.8 cm2 (P = 0.002) with a wound percentage decrease of 47.9% and 5.6% (P = 0.036). Median closure rate was 0.145 versus 0.044 cm2/day (P = 0.009) at week 4 and remained higher in the CLS group up to week 8 even after switching to CL dressing in these patients (P = 0.01). Odds ratio (multinomial logistic regression) of the chance to reach a ! 40% wound area
    reduction was 2.7 (95% CI: 1.1 to 6.7; P = 0.038) for silver treated ulcers. Dressing tolerance was good in both groups. Conclusion: A 4-week treatment with silver releasing lipido-colloid contact layer promotes a sustained increase of closure rate of venous leg ulcers presenting inflammatory signs suggesting a high bacterial load.
    Also marketed as *Urgotul® Silver and **Urgotul®, Laboratoires Urgo, (France).

Case Study

  • Clinical experience with a glucoseoxidase-containing dressing on recalcitrant wounds

    P. Davis, L. Wood, J. Wilkins, B. Baum

    case study programme was undertaken with the oxygenating wound dressing with recalcitrant chronic wounds of various aetiologies, to gain practical experience with this innovative, enzyme containing wound dressing technology. The results for the German patients who completed or healed within the 6 weeks of the study are summarized here. More than two thirds of the 35 German patients either healed completely within 6 weeks or showed a significant clinical improvement (11 % healed and 69 % showed clinical improvement, i. e. reduction in the wound area and/or improvement in wound condition). The average age of the patients was 69 years, and the average wound duration was 60.2 months. The majority of patients and clinicians were satisfied or very satisfied with the outcome of their treatment.
    Conclusions: The enzyme containing dressing delivered encouraging outcomes for sufferers of various types of chronic wounds.