Introduction to Optimizing Wound Care: Wound Progression, Bacterial Balance, and the Use of an Absorbent Silver-containing Hydro

A dvances in the understanding of a favorable wound micro-environment and the growing socio-economic burden of infected wounds have prompted the development of a new generation of wound dressings. These state-of-the-art dressings offer improved clincal outomes and greater comfort for patients and contain antimicrobial agents, such as ionic silver, to help in the fight against wound infection. Such dressings, along with managing underlying pathophysiological causes and addressing patient concerns, will lead to improved clinical outcomes and improved patient quality of life. This supplement reports on some highlights of a recent satellite symposium, “The Role of Bacteria in Wound Healing and Topical Alternatives,” presented at the 16th Annual Symposium on Advanced Wound Care and 13th Annual Medical Research Forum on Wound Repair, held in Las Vegas, Nev., April 28 – May 1, 2003. The satellite symposium focused on the use of modern dressings in the management of wound surface bacterial burden. Wound infection is an ongoing problem for many patients with chronic wounds. Infected wounds can cause great distress in terms of associated morbidity and mortality, increased length of hospital stay, delayed wound healing, and increased discomfort. They also increase healthcare costs significantly.1 The emergence of antibiotic-resistant wound pathogens is also a key clinical concern in the healthcare profession.2 Dr. Bowler's presentation elucidates mechanisms by which bacteria work together to overwhelm the host and lead to infection (ie, quorum sensing and microbial synergy) and how the host response can be augmented through the combination of moist healing, exudate management, and antibacterial agents. Dr. Lee describes his clinical experience with the latest in modern dressings in a case series of patients with a variety of indolent wounds. As these case studies illustrate, a new silver-containing Hydrofiber(R) dressing (AQUACEL(R) Ag) is designed to provide a controlled, effective, long-lasting concentration of ionic silver and handle the increased levels of wound exudate frequently associated with increased bacterial burden. This new dressing also has the ability to fight against significant antibiotic-resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). A personal study3 of 30 patients has highlighted many additional benefits of the dressing beyond improved wound healing. Most notably, pain was reduced at the time of application and during wear time. Additionally, because the dressing can be cut and is easy to use, time for preparation is reduced compared to other antimicrobial dressings. This supplement discusses how to achieve optimal wound management by combining issues of patient concerns, treatment of the cause, and use of innovative wound dressings.

1. Plowman R, Graves N, Griffin M, et al. The Socio-Economic Burden of Hospital-acquired Infection. London, UK: Public Health Laboratory Service. 1999.2. Wright JB, Lam K, Burrell RE. Wound management in an era of increasing bacterial antibiotic resistance: a role for topical silver treatment. Am J Infect Control. 1998;26:572-577.3. Sibbald RG, Coutts P, Queen D. An open-labeled, pilot study to determine the effect of a nanocrystalline silver-coated dressing in the treatment of chronic wounds. Poster presented at Symposium on Advanced Wound Care, Las Vegas, Nev. April 28-May 1, 2003.