Where To Buy Aquacel Ag Dressings
AQUACEL Ag SURGICAL cover dressings are an easy-to-use, single-product solution to the post-operative management of surgical incisions. They are designed to enhance clinical outcomes and facilitate patient mobility. Added ionic silver provides sustained antimicrobial activity for up to 14 days as demonstrated by in vitro studies1.
where to buy aquacel ag dressings
Evidence supports that, compared to a non-woven post-operative surgical cover dressing regimen, AQUACEL Ag SURGICAL cover dressings.2a, 3b: Reduce surgical site infection (SSI)Reduce skin blisteringReduce delayed dischargeRequire fewer dressing changes
Aquacel Ag is intended for the management of a wide range of acute and chronic wounds, based on the clinical experience with Aquacel hydrofiber dressing. Various silver-impregnated wound dressings are available for the management of critically colonized and locally infected wounds. These dressings differ in structure and physical properties, the form and amount of silver contained in the dressing, and the mechanism by which silver is delivered.
Further evidence of the in vitro cytotoxic effect of Aquacel Ag was presented by Burd and colleagues,8 who found Aquacel Ag to be lethal to monolayer cultured keratinocytes and fibroblasts in a comparative study of the cytotoxicity of silver-based dressings. Furthermore, epidermal reepithelialization, examined in a pig mid-dermis explant culture model, was delayed in silver-based dressings compared to non-silver controls. Explants treated with Aquacel Ag had a significantly smaller re-epithelialization area per hair follicle compared to non-silver control.8
Other studies showed superior antibacterial activity of nanocrystalline dressings compared to Aquacel Ag,16,17 although Castellano and colleagues16 demonstrated that both Aquacel Ag and nanocrystalline dressings have inferior antibacterial properties compared to commonly used topical antimicrobial agents, including silver sulfadiazine, mafenide acetate, and silver calcium alginate.
Gaisford and colleagues22 reported an in vitro method for the quantitative determination of the antimicrobial efficacy of silver-containing dressings. By using isothermal calorimetric measurements, the authors estimated the silver load and bioavailability in the wound environment. Results showed that not all of the silver in Aquacel Ag was bioavailable, reducing the potential for silver toxicity and extending the bactericidal effect over time.22
The cytotoxic effect of Aquacel Ag was studied on an excisional mouse wound model.8 Silver-based dressings showed delayed or inhibited wound re-epithelialization compared to non-silver control dressing. The authors commented that previous studies demonstrating enhanced wound healing with silver was performed on acute incisional wounds where keratinocyte proliferation is not a major feature.8,26
Aquacel Ag was also evaluated for the treatment of chronic wounds,29,30,38,39 which have an increased bacterial burden that can impair healing, albeit without all the clinical signs of infection. Silver can provide a mechanism for controlling the wound bacterial burden. Two open-label noncomparative case studies evaluated Aquacel Ag in the management of chronic wounds of different etiologies, including clinically infected wounds.29,39 Most patients treated with Aquacel Ag had a decrease in wound size, improved maceration, and decreased slough.29 There were no serious adverse events. One patient reported temporary burning and stinging on initial application, and one on malposition of the dressing.29,39 In an economic analysis of one month treatment of chronic venous leg ulcers with various silver dressings, Aquacel Ag was less cost effective than silver-releasing foam dressings.38
ConvaTec Aquacel Ag Advantage Wound Dressings are antimicrobial primary dressings for use in chronic and acute wounds that are infected or at risk of infection with varying exudate levels. Ag Advantage dressings incorporate two powerful technologies working together to help eliminate the key barriers to healing: exudate, infection, and bioburden.
Problem: There are many silver-containing wound dressings available for managing and preventing wound infection. Each claims to provide effective antimicrobial activity due to the presence of silver in the dressing. However, assuming effectiveness on the basis of an antimicrobial alone ignores the importance of the carrier dressing and its overall role in wound healing.
New technology: AQUACEL Ag dressing combines patented Hydrofiber Technology with ionic silver, a proven broad-spectrum antimicrobial. Recent in vitro testing suggests that dressing technology may impact the antimicrobial effectiveness of silver-containing dressings as well as other factors relevant to wound healing. Specifically, a comparative in vitro study demonstrated how the ability of a dressing to micro-contour to the wound bed is critical to antimicrobial effectiveness. Compared with other silver dressings tested, AQUACEL Ag dressing minimized voids and spaces where bacteria can thrive, allowing the silver within the dressing to be in contact with the wound. AQUACEL Ag dressing was observed to kill more bacteria and control the spread of pathogens.
Caution: Not all silver dressings are created equal. Selection of an antimicrobial dressing should take into account in vitro data regarding antimicrobial efficacy of a dressing in addition to its ability to promote wound healing.
Minimally invasive surgery (MIS) has gained popularity in TKA with the advantages of shortened wound length, decreased rehabilitation period, and quicker return to work compared to standard TKA . MIS-TKA also has higher wound complications, which are related to greater tension on wound edges during surgery . Therefore, an improved wound care modality is essential. In our institution, the standard dressing care after MIS-TKA is an antimicrobial dressing (Sofra-Tulle, Royal Chem. & Pharm. Co., Ltd., Kaohsiung, Taiwan) on the inner layer and gauzes with tape on the outer layer. However, patients often complained of pain during dressing change and discomfort during knee range-of-motion exercise after surgery by the use of gauze dressings . Furthermore, skin blistering and infection are common problems because postoperative movement around the knee joint causes friction between the skin and traditional gauze .
We hypothesized that AQUACEL Ag Surgical dressing would have a significant improvement in the efficacy of wound care, patient satisfaction, and surgical site infection compared with standard dressings after MIS-TKA.
The categorical data were summarized as an absolute value and percentage. The continuous data were presented as mean and standard deviation. Independent samples t-test was used to compare the continuous variables and the chi-squares test was used to compare the categorical variables. Wound complication rates and patient satisfaction were expressed by calculation of proportion and a 95% confidence interval (CI). The primary prespecified analysis was an intention-to-treat analysis. The intention-to-treat population included all 240 patients who underwent randomization. We also performed a prespecified per-protocol analysis. The per-protocol population included patients in both groups who had used the same dressings throughout the study. Multivariate logistic regression was used to determine whether AQUACEL Ag Surgical dressing was an independent predictor for surgical site infection. The multivariate logistic regression incorporated the following demographics: age, sex, BMI, ASA, and comorbidities. A 5% statistically significant level was prescribed (). All data were analyzed with the use of MedCalc software (version 17.4, Ostend, Belgium).
A total of 240 patients underwent randomization (Figure 1). Five patients had skin allergies after application of AQUACEL Ag Surgical dressing and were switched to standard dressing. Three patients in the control group refused to participate in the study after allocation due to the lack of family care after discharge and then switched to use AQUACEL Ag Surgical dressing. All 240 patients were included in the intention-to-treat analysis, whereas 115 of 120 patients (95.8%) in the study group and 117 of 120 patients (97.5%) in the control group were included in the per-protocol analysis. No patients were lost during two-year follow-up.
Our study also showed that AQUACEL Ag Surgical dressing had increased patient satisfaction in terms of pain, comfort, and ease of use compared to standard of care. However, five patients in the study group dropped out of the study because they had skin itching and erythema after application of the AQUACEL Ag Surgical dressings. According to Dobbelaere et al. , skin irritation and redness were not found in the AQUACEL Ag Surgical group, but 12.9% of the patients experienced these reactions in the conventional dressing group. They also found that AQUACEL Ag Surgical dressing had better scores for pain, freedom of movement, and general comfort compared to the conventional dressing. In a prospective randomized clinical trial, hydrofiber dressing with ionic silver was better for managing pain, overall comfort, wound trauma upon dressing removal, exudate handling, and ease of use compared to povidone-iodine gauze for the treatment of open surgical and traumatic wounds . Similar results were reported when hydrofiber dressing was applied for chronic leg ulcerations . The reasons for better patient satisfaction in AQUACEL Ag Surgical dressing are attributed to the hydrofiber layer and hydrocolloid layer. The individual fibers in hydrofiber dressings are fine and flexible. The hydrocolloid layer is skin-friendly and comfortable during body movement . With those two characteristics, the AQUACEL Ag Surgical dressing is extensible to accommodate skin movement during physiotherapy and that is associated with reduced blistering after TKA. 041b061a72