title: A real-life clinical evaluation of a next-generation antimicrobial dressing on acute and chronic wounds.
abstract: OBJECTIVE
  To assess the effectiveness of a new, next-generation antimicrobial dressing (AQUACEL Ag+ dressing) in facilitating healing in a variety of hard-to-heal wounds that may have been compromised by infection and/or biofilm.
  
  
  METHODS
  This was an international, multi-centred, real-life, non-randomised evaluation involving patients with a wide variety of slow-, non-healing or deteriorating chronic and acute wounds. There were no strict inclusion or exclusion criteria and the clinicians were asked to use their discretion in the selection of patients. The clinicians continued to use their standard protocol of care but replaced their existing primary wound-contact dressing with the next-generation antimicrobial dressing (NGAD) for up to 4 weeks. Clinicians could extend the treatment period if this was deemed clinically appropriate. Baseline assessments included wound bed characteristics, exudate level, indicators of wound biofilm, and signs and symptoms of infection. At the final assessment, the investigators reported the wound size, wound bed characteristics, and exudate level.
  
  
  RESULTS
  A total of 121 patients were recruited into the original evaluation, of which eight were excluded for incomplete data sets. Most wounds (73; 64%) were either venous leg ulcers (59; 52%) or diabetic foot ulcers (14; 12%). At baseline, the wounds of (26; 23%) patients were slowly improving, 65 were stagnant (58%) and 22 (19%) were deteriorating. Just under three-quarters (74%) of the wounds had suspected biofilm (criteria including failure of a wound to heal, lack of response to topical and systemic antimicrobial agents, or the presence of slimy substances on the wound surface). Following the evaluations, the average wound closure achieved for all wounds was 72.6%, 19 (17%) wounds healed, 47 (42%) achieved at least 90% wound closure, and 71 (63%) achieved at least 75% closure. The average treatment period was 4.1 weeks; 35 wounds were treated with the dressing for more than 4 weeks. Cost analysis indicated that potential antimicrobial dressing cost reductions of approximately 30% were realised using the NGAD.
  
  
  CONCLUSIONS
  This real-life, non-randomised evaluation provides encouraging evidence that the NGAD may have a role to play in facilitating wound progression towards healing by helping to eliminate the biofilm barrier.
  
  
  BACKGROUND
  M. Walker, D. Metcalf, D. Parsons and P. Bowler are all employees of ConvaTec Ltd. Aysha Mendes da Mata is an independent writer and Annemarie Brown is an independent clinician, both received a fee and support from MA Healthcare to write up the evaluation using data supplied by ConvaTec.
authors.affiliation: Senior Research Advisor, Infection Prevention, at the ConvaTec Global Development Centre, First Avenue, Deeside, Flintshire, CH5 2NU.
authors.forename: M
authors.initials: M
authors.lastname: Walker
authors.forename: D
authors.initials: D
authors.lastname: Metcalf
authors.forename: D
authors.initials: D
authors.lastname: Parsons
authors.forename: P
authors.initials: P
authors.lastname: Bowler
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001458:Bandages / Q000382:microbiology* / Q000639:trends; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*; D014946:Wound Infection / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: AQUACEL Ag+; biofilm; chronic wounds; debridement; leg ulcers; wound dressings; wound healing