title: A cohort study on the efficacy of a polyhexanide-containing biocellulose dressing in the treatment of biofilms in wounds.
abstract: OBJECTIVE
  This cohort study evaluated the clinical efficacy of a polyhexanide-containing biocellulose dressing, Suprasorb X+PHMB (Lohmann & Rauscher GmbH), for the eradication of biofilms in non-healing wounds. Polyhexanide (PHMB) has been shown to have microbicidal activity when applied to chronic wounds and burns.
  
  
  METHODS
  Twenty-eight patients, aged over 18 years, who presented at an outpatient wound clinic with non-healing locally infected and/or critically colonised wounds of various aetiologies that showed clinical signs of biofilm were included in the study. Sixteen patients (nine females), with a mean age of 60.9±21.6 years, were included in the analysis. The patients were prospectively followed for a maximum of 24 weeks or until healing for analysis of safety and efficacy endpoints. Evolution of wound size was conducted with tracings and standardised digital photographs as well as for determining healing rates.
  
  
  RESULTS
  At 24 weeks,12 wounds (75%) had healed (complete epithelialisation with no drainage). Of those wounds that had not closed, the mean wound area had reduced by 61% at week 24. Ten patients (63%) had a good reduction of the biofilm, five (32%) scored moderate and one (6%) had no reduction noted at week 24. The mean percentage of granulation tissue had increased significantly (p<0.04) when comparing day 0 (38%) with week 24 (77%). Yellow tissue present in the wound bed decreased (p<0.01): 62% (day 0) versus 23% (week 24). All patients reported reduced pain after dressing change.
  
  
  CONCLUSIONS
  The results suggest that continuous application of PHMB, using a biocellulose wound dressing, reduced biofilm in the stagnating wounds treated, thus promoting healing. The treatment was comfortable, safe and reduced wound pain at dressing change. The PHMB-containing biocellulose dressing seems to be suitable for lightly to moderately exuding wounds.
  
  
  BACKGROUND
  This study was supported by a scientific grant from Lohmann & Rauscher.
authors.affiliation: Medical Center Haaglanden, Den Haag, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Lenselink
authors.forename: A
authors.initials: A
authors.lastname: Andriessen
mesh_terms: D001645:Biguanides / Q000627:therapeutic use*; D018441:Biofilms; D002482:Cellulose / Q000627:therapeutic use*; D002908:Chronic Disease; D004202:Disinfectants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009779:Occlusive Dressings; D011446:Prospective Studies; D014945:Wound Healing; D014946:Wound Infection / Q000628:therapy*
chemical_list: D001645:Biguanides; D004202:Disinfectants; C031233:polihexanide; D002482:Cellulose