Use of an Innovative Silver Impregnated Active Fluid Management Dressing in Heavily Exudating Venous Leg Wounds: An Expanded Case Series

Introduction: Venous leg ulcers (VLUs) are notoriously heavily draining and slough-covered wounds. During the inflammatory response, blood vessel walls dilate and become more porous, allowing leakage of protein-rich fluid into the wounded area. When this normal physiologic process is compounded with venous insufficiency found in PVD, the amount of exudate can increase exponentially. Managing exudate, while maintaining a moist wound environment, is a constant challenge. This increase in drainage also contributes to the formation of a significant amount of bioburden, comprised of devitalized tissue, proteinaceous exudates, spent white blood cells, and most specifically microorganisms, which can be a substantial barrier to wound healing. Surface-associated bacteria organize into biofilms, so they are the most notable component of wound bioburden.

Method: A prospective study was conducted in the outpatient wound care setting and consisted of a sample of patients with heavily draining VLUs. At the clinicians’ discretion, following appropriate wound bed preparation, an antimicrobial moisture management dressing was applied to the wound/peri-wound. The innovative dressing combines a proprietary ceramic controlled silver ion technology to inhibit a broad spectrum of infection-causing microbes, including MRSA, with a powerful moisture transfer system that traps excess exudate. Two-layer compression was utilized on top of the dressing, since compression is the gold standard for VLUs. The wounds were examined on a weekly basis for wound size and quality of the peri-wound, and any adverse events were recorded.

Conclusion: By using this advanced wound dressing in conjunction with multilayer compression wrap therapy, we were able to facilitate healing in a difficult to treat patient population. The antimicrobial moisture management dressing managed the excess exudate, which helped to protect the peri-wound of venous leg ulcers under compression. The antimicrobial within the dressing decreased the incidence of infection and bioburden in the wounds, thus allowing for rapid wound closure without complications.