Manage infected wounds covering all stages of the wound infection continuum
Acute and chronic wounds have a tendency to become infected, which compromises the normal healing process. This leads to a greater burden on the health systems, long-term disabilities and an overall reduction in the patients’ quality of life.
The wound infection continuum2) describes the different stages of how microbes impact a wound and consequently shows when antimicrobials are indicated and when not. This helps wound care practitioners to find the best strategy to prevent, diagnose and manage wound infections.
Get to know our unique therapy concept that covers all stages of the wound infection continuum: Prontosan® to prevent the formation of biofilm and to decrease the bacterial burden3) , and Askina® Calgitrol® whose silver alginate matrix in the presence of wound exudate helps maintain a moist wound environment conducive to natural healing conditions.
Askina® Calgitrol®
In contact with wound exudate, the silver alginate matrix of Askina® Calgitrol® forms a soft gel.
This helps both maintain a moist wound environment conducive to natural healing conditions as well as prevent contamination from external bacteria.
Case report: The use of Prontosan® in combination with Askina® Calgitrol®
An independent case series6)
The following case studies were carried out to evaluate the efficacy of a biofilm remover/cleanser in gel form - Prontosan® together with the use of an ionic releasing silver alginate - Askina® Calgitrol® Paste or Askina® Calgitrol® Thin - when used on infected wounds.
Treatment protocol
The following treatment protocol was followed for all wounds in the study:
- Wounds were soaked for 15–20 minutes with Prontosan® gel or Prontosan® irrigation solution moistened gauze. Both the gel and the soaked gauze was kept in place by using cling film, gel was wiped away with saline gauze and soaked Prontosan gauze was used to wipe the wound
- After wound cleansing, Calgitrol® Thin or Calgitrol® paste was applied depending on wound size and depth
- The secondary dressing applied varied from non-adhesive foam to high-absorbent composite dressing depending on exudate levels
Results: Infection resolve time
All wounds showed a signi cant reduction in terms of clinical signs of infection within the first week of treatment. Some 50% of all wound infections were completely resolved by week 2. Eighty-one per cent of all wounds had no clinical signs of infection in less than 3 weeks. None of the patients were given any oral orintravenous antibiotics while on the study; all patients were only treated by using local antimicrobials. There was also a decrease in odour in all wounds.
Antimicrobial resistance and misuse of antibiotics
Antimicrobial resistance (AMR) develops when microbes adapt and build immunity against antimicrobial drugs such as antibiotics. Over- and misuse of antibiotics increase this problem and present a serious health threat, since infections with antibiotic-resistant bacteria are associated with longer hospital stays and higher death rates. Antimicrobial resistant infections currently cause at least 50,000 deaths across Europe each year.7) And estimates are that by 2050 antimicrobial resistance will account for 10 million deaths worldwide per year, leading to annual global costs of US$100 trillion.7)
AMR is a worldwide problem involving multiple sectors that is being addressed from different angles. The key strategy of this battle against the rise of antimicrobial resistance and healthcare-associated preventable infections is the adoption of local and national antimicrobial stewardship programs facilitating more prudent prescribing of antibiotics.
Antimicrobial stewardship
Regarding wound management, it is the European Wound Management Association (EWMA) which has taken the lead in introducing a tailored stewardship concept to wound care practitioners. The aim of this Antimicrobial Stewardship program, which B. Braun is proud to sponsor, is to reduce the inappropriate use of antibiotics in wound care by promoting the use of non-antibiotic antimicrobials across all healthcare settings.8)
Did you know?
Did you know?
Biofilm
60% of chronic wounds contain biofilm with a role in wound infection(11).
Infection
50% of chronic wounds are estimated to be infected(12).
Wound care blog
Wound Care Blog
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The Use of Prontosan Solution and Prontosan Debridement Pad in Kyperkeratosis on the Foot
Read MoreBeth Williams, High Risk Podiatrist, Manchester Local Care Organisation, shares her experience of using Prontosan Debridement Pad. This is adapted from an article originally presented at Wounds UK 7th – 9th November 2022
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Clinical experience of the Prontosan® Debridement Pad
Read MoreIn 2021 an article reviewed 111 responses which were collected from 56 clinicians over a broad range of specialties including leg ulcer clinic staff, podiatrists and practice nurses asking their opinion on a microfibre debridement pad and how it performed in clinical practice
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Wound Bed Preparation - A Practical Perspective
Read MoreKatie Bennett shares her experiences of using the Prontosan® wound bed preparation system for lower limb wound care.
References:
1) Instruction for use: Askina® Calgitrol® Ag, Askina® Calgitrol® THIN, Askina® Calgitrol® Paste.
2) International Wound Infection Institute (IWII). Wound infection in clinical practice. Wounds International 2016. https://www.woundinfection-institute.com/wp-content/uploads/2017/03/IWII-Wound-infection-in-clinical-practice.pdf
3) To, E The effectivness of PHMB agents for the treatment of chronic wounds: A systematic review, Advance wound healing, 2016.
4) Moore, M 0.1% Polyhexanide-Betaine Solution as an Adjuvant in a Case-Series of Chronic Wounds, Surg Technology International, 2016.1) Instruction for use: Askina® Calgitrol® Ag, Askina® Calgitrol® THIN, Askina® Calgitrol® Paste.
5) Opasanon S, Magnette A, Meuleniere F, Harding K. Askina® Calgitrol® Made Easy. Wounds International 2012; 3(1). Available from www.woundsinternational.com
6) Naude L. The use of Prontosan® in combination of Askina® Calgitrol®: an independent case series. Wounds International, 2018 ; 9(1): 44-48. Available at (accessed 16.03.2018).
7) Review on Antimicrobial Resistance. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations. Review on AMR, Wellcome Trust, HM Government, 2014. Available at: http://bit.ly/1VOck4o (accessed 31.03.2017)
8) https://ewma.org/what-we-do/antimicrobial-stewardship/
9) Dolk FC, Pouwels KB, Smith DR et al. Antibiotics in primary care in England: which antibiotics are prescribed and for which conditions? J Antimicrob Chemother 2018;73:ii2–10. https://doi.org/10.1093/jac/dkx504
10) Oien RF, Forssell HW. Ulcer healing time and antibiotic treatment before and after the introduction of the Registry of Ulcer Treatment: an improvement project in a national quality registry in Sweden. BMJ Open. 2013;3(8):e003091. Published 2013 Aug 19. doi:10.1136/bmjopen-2013-003091 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753517/
11) T. Swanson et al: International Wound Infection Institute (IWII) Wound infection in clinical practice. Wounds International 2016
12) C. Dowsett: Adopting the two-week challenge in practice: making the case for silver dressings, Wounds UK, Vol. 10, N°2, 2014