In an in vitro biofilm model, AQUACEL® Ag+ Extra dressing demonstrated superior ability to destroy biofilm and prevent reformation.28,30
In an adapted DFA-recognized in vivo biofilm model19, Ag+ Technology in combination with Hydrofiber® Technology demonstrated:*
• 95% greater reduction by day 6 (p<0.05)39††
A significantly greater rate of epithelialization and granulation vs. PHMB gauze39.
• 48% more granulation tissue by day 6 (p<0.05)
• 24% more epithelial tissue by day 6 (p<0.05)
In a prospective, multi-center, non-comparative study on 42 chronic venus leg ulcer patients with at-risk or infected wounds^ where biofilm is highly likely. Ag+ Technology in combination with Hydrofiber® Technology demonstrated*††.
• 54% reduction in ulcer area for all wounds
• 70% reduction in ulcer area for infected wounds
1. Physical Disruption of Biofilm by AQUACEL® Ag+ Wound Dressing. Scientific Background Report. WHRI3850 MA232, 2013, Data on file, ConvaTec Inc.
2. Antimicrobial activity and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA dressing. Scientific Background Report. WHRI3857 MA236, 2013, Data on file, ConvaTec Inc.
3. Antimicrobial activity against CA-MRSA and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA dressing. Scientific Background Report. WHRI3875 MA239, 2013, Data on file, ConvaTec Inc.
4. Newman GR, Walker M, Hobot JA, Bowler PG, 2006. Visualisation of bacterial sequestration and bacterial activity within hydrating Hydrober™ wound dressings. Biomaterials; 27: 1129-1139.
5. Walker M, Hobot JA, Newman GR, Bowler PG, 2003. Scanning electron microscopic examination of bacterial immobilization in a carboxymethyl cellulose (AQUACEL™) and alginate dressing. Biomaterials; 24: 883-890.
6. Bowler PG, Jones SA, Davies BJ, Coyle E, 1999. Infection control properties of some wound dressings. J. Wound Care; 8: 499-502.
7. Walker M, Bowler PG, Cochrane CA, 2007. In vitro studies to show sequestration of matrix metalloproteinases by silver-containing wound care products. Ostomy/Wound Management. 2007; 53: 18-25.
8. Assessment of the in vitro Physical Properties of AQUACEL EXTRA, AQUACEL Ag EXTRA and AQUACEL Ag+ EXTRA dressings. Scientific background report. WHRIA3817 TA297, 2013, Data on file, ConvaTec Inc.
9. Bjarnsholt T, 2013. The role of bacterial biofilms in chronic infections. APMIS. 121. 1-51.
10. Research on microbial biofilms. National Institute of Dental and Craniofacial Research. http://grants.nih.gov/grants/guide/pa-files/PA-03-047.html; Sept. 9, 1997.
11. Marsh PD, Bradshaw DJ, 1995. Dental plaque as a biofilm. J. Industr. Microbial; 15: 169-175.
12. Trautner BW, Darouiche RO, 2004. Role of biofilm in catheter-associated urinary tract infection. Am J Infect Control; 32: 177-183.
13. Elder MJ, Stapleton F, Evans E, Dart JK, 1995. Biofilm-related Infections in Ophthalmology. Eye (Lond.) 9: 102-109.
14. James GA, Swogger E, Wolcott R, Pulcini EL, Secor P, Sestrich J, et al, 2008. Biofilms in Chronic Wounds. Wound Rep Regen; 16: 37-44.
15. Metcalf D, Bowler P, 2013. Biofilm delays wound healing: A review of the evidence. Burns & Trauma. 1: 5-12.
16. Percival SL, Bowler PG, 2004. Biofilms and their potential role in wound healing. WOUNDS, 16: 234-240.
17. Wolcott RD, Rumbaugh KP, James G, Schultz G, Phillips P, Yang O, et al, 2010. Biofilm maturity studies indicate sharp debridement opens a time-dependent therapeutic window. J Wound Care; 19: 320-328.
18. Wolcott RD, Kennedy JP, Dowd SE, 2009. Regular debridement is the main tool for maintaining a healthy wound bed in most chronic. J Wound Care; 18: 54-56.
19. Gurjala AN, Geringer MR, Seth AK, Hong SJ, Smeltzer MS, Galiano RA, et al, 2011. Development of a novel, highly quantitative in vivo model for the study of biofilm-impaired cutaneous wound healing. Wound Rep Reg. 19: 400-410.
20. Brackman G, De Meyer L, Nelis HJ, Coenye T, 2013. Biofilm inhibitory and eradicating activity of wound care products against Staphylococcus aureus and Staphylococcus epidermidis biofilms in an in vitro chronic wound model. J Appl Miocrobial; 114: 1833-42.
21. Darouiche RO, Mansouri MD, Gawande PV, Madhyastha S. Antimicrobial and antibiofilm efficacy of triclosan and DispersinB combination. J Antimicrob Chemother. 2009 Jul;64(1):88-93.
22. Thorn RM, Greenman J. A novel in vitro flat-bed perfusion biofilm model for determining the potential antimicrobial efficacy of topical wound treatments. J Appl Microbiol. 2009 Dec 1;107(6):2070-9.
23. Bjarnsholt B, Kirketerp-Moller K, Kristiansen S, Phipps R, Nielsen AK, Jensen Po, et al, 2007. Silver against Pseudomonas aeruginosa biofilms. APMIS 115: 921-8.
24. Stewart PS, Costerton JW, 2001. Antibiotic resistance of bacteria in biofilms. Lancet; 358: 135-138.
25. Thurlow LR, Hanke ML, Fritz T, Angie A, Aldrich A, Williams SH, Engebretsen IL, et al, 2011. Staphylococcus aureus biofilms prevent macrophage phago-cytosis and attenuate inflammation in vivo. J Immunol; 186: 6585-96.
26. Composition comprising antimicrobial metal ions and a quaternary cationic surfactant. Scientific Background Report. WO 2012136968 A1, 2012, Data on file, ConvaTec Inc.
27. Bowler PG, Welsby S, Towers V, Booth V, Hogarth A, Rowlands V, Joseph A, et al, 2012. Multidrug-resistant organisms, wounds and topical antimicrobial protection. Int Wound J. 9: 387-396.
28. Antimicrobial activity against CA-MRSA and prevention of biofilm reformation by AQUACEL™ Ag+ EXTRA Dressing and Acticoat 7 Dressing. Scientific Background Report. WHRI3876 MA240, 2013, Data on file, ConvaTec Inc.
29. Antimicrobial Activity and Prevention of Biofilm Reformation by AQUACEL® Ag+ EXTRA Dressing and Acticoat 7 Dressing. WHRI3858 MA237, 2013, Data on file, ConvaTec Inc.
30. Antimicrobial Activity and Prevention of Biofilm Reformation by AQUACEL® Ag EXTRA Dressing and Silvercel® Non Adherent Dressing. WHRI3877 MA241, 2013, Data on file, ConvaTec Inc.
31. Walker M and Parsons D, 2010. Hydrofiber Technology: its role in exudate management. Wounds UK; 6: 31-38.
32. Parsons D, Bowler PG, Myles V, Jones SA, 2005. Silver antimicrobial dressings in wound management: A comparison of antibacterial, physical and chemical characteristics. WOUNDS; 17: 222-232.
33. Jones SA, Bowler PG, Walker M, 2005. Antimicrobial activity of silver-containing dressings is influenced by dressing conformability with a wound surface. WOUNDS; 17: 263-270.
34. Bowler P, Jones S, Towers V, Booth R, Parsons D, Walker M, 2010. Dressing conformability and silver-containing wound dressings. Wounds UK; 6: 14-20.
35. Walker M, Jones S, Parsons D, Booth R, Cochrane C, Bowler P, 2011. Evaluation of low-adherent antimicrobial dressings. Wounds UK; 7: 32-45. 36. Barnea Y, Armir A, Leshem D, Zaretski A, Weiss J, Shafir R, et al, 2004. Clinical comparative study of Aquacel and paraffin gauze dressing for split-skin donor site treatment. Ann Plast Surg; 53: 132-136.
37. Kogan L, Moldavsky M, Szvalb S, Govrin-Yehudain J, 2004. Comparative study of Aquacel and Silverol treatment in burns. Ann Burns Fire Disasters; 17: 201-207.
38. Brunner U, Eberlein T, 2000. Experiences with hydrofibres in the moist treatment of chronic wounds, in particular of diabetic foot. VASA; 29: 253-257.
39. Parsons D, Mustoe T, Seth A. A new anti-biofilm Hydrofiber™ dressing: an in vivo investigation. Poster presented at Wounds UK; Nov 11-13 2013; Harrogate, UK.
40. Harding K, Ivans N, Cains J, Peters K, Parsons D. A new anti-biofilm dressing – a clinical study. Poster presented at EWMA; May 15-17 2013; Copenhagen, Denmark.
All pictures used with permission of their respective owners.
†Demonstrated ability to manage excess exudate, infection and biofilm.
††Dressing did not contain strengthening fibre or have the additional absorptive capacity or AQUACEL® Ag+ Extra™Dressing.
^ 10 infected and 32 at-risk wounds.