An expanded evaluation of a dressing with negatively charged fibers in an outpatient wound center

Introduction: Two well understood and documented components of wound bed preparation (WBP) include removal of devitalized tissue and management of surface bioburden. A new absorbent fiber dressing incorporating negatively charged fibers* combined with silver salts has reports of interesting attraction to positively charged slough, particularly following cleansing/soaks with a pure hypochlorous acid preserved cleanser to enhance the positive charge.Methods:We were evaluating this new dressing technology for continuous debridement of visually apparent slough in a variety of wounds. We then further expanded our use to other wounds stalled for a variety of reasons including poor tolerance of maintenance debridement, atypical wounds with concerns for pathergy, and hypergranulation tissue. We also experimented with application techniques including application of an appropriate size as the primary dressing, cutting the dressing to fit in wounds with depth and bolstering with a secondary absorbent dressing, as well as fenestrating the dressing followed by a secondary superabsorbent for heavily draining wounds.Results:We found interesting and consistent results with liquefaction of slough and learned that education on expected visual results was important for the patient and other caregivers. We also noted improvement in wounds stalled for other reasons with suspicion of increased bacterial loads in the absence of signs and symptoms of infection leading to increased exudate and hypergranulation tissue.  We present data on results with 15 patients, with an assortment of photographic examples included.Discussion: The early successful results led us to expand our usage to wounds not necessarily thought to be necrotic but requiring improvement in WBP. The ease of use for both clinic staff and patient self-application has been noted. Of significance is the ability to leave the dressing in place for debridement versus daily dressing changes and the cost savings versus topical enzymatic ointments. An additional bonus is that we were already utilizing a pure hypochlorous acid preserved cleanser which newer evidence suggests enhances the effectiveness of the dressing technology.References:Meaume, S., Dissemond, J., Addala, A. Evaluation of two fibrous wound dressings for the management of leg ulcers: results of a European randomised controlled trial (EARTH RCT). J Wound Care 2014; 23: 3, 105–116. Lazareth I, et al. 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. Wounds. 2008;20(6):158–66 Couch K. et al. The use of a Negatively Charged Fiber (NCF)* antimicrobial barrier dressing to manage slough and necrotic tissue in wounds in acute settings. Poster presentation, SAWC Spring 2024, Orlando, Florida. Chakravarthy D. The engineered structure based ability of a highly charged absorbent (polyacrylate) dressing* to adhere to slough like material in a preferential way compared to other absorbent fibers found in advanced dressings. Poster presentation, SAWC Spring 2024, Orlando, Florida.