title: A next-generation antimicrobial wound dressing: a real-life clinical evaluation in the UK and Ireland.
abstract: OBJECTIVE
  To assess the effectiveness of a new, next-generation antimicrobial dressing (NGAD; AQUACEL Ag+ EXTRA dressing) in managing wound exudate, infection and biofilm, and facilitating progression toward healing.
  
  
  METHODS
  Clinicians from the UK and Ireland selected stalled or deteriorating wounds that were considered to be compromised by infection and/or biofilm. Only the primary dressing was replaced by the NGAD, for up to 4 weeks or as deemed clinically appropriate; otherwise, standard protocols of care were used. Evaluation forms captured the baseline and final assessment characteristics of wound status, exudate levels, skin health, wound bed appearance, signs of infection and biofilm, and wound dimensions.
  
  
  RESULTS
  In all, 29 wounds were suitable for inclusion in the final analysis. Following the NGAD evaluation, wound statuses were shifted from stagnant/deteriorating to mainly improved, exudate levels were shifted from moderate/high to moderate/low, and skin health was improved in 20 wounds (69%). Wound bed tissue types were shifted from largely suspected biofilm/sloughy tissue (76%) to largely granulation tissue (53%). All signs of clinical infection were reduced in average frequency, with biofilm suspicion falling from 76% to 45% of the cases. The median management period with the NGAD was 4.5 weeks, after which 26 wounds (90%) became smaller in size and 10 wounds (34%) completely healed.
  
  
  CONCLUSIONS
  This real-life clinical evaluation of the NGAD suggests that its successful management of exudate, infection and biofilm is generally accompanied by notable improvements in wound health and size, and in some cases, complete healing.
  
  
  BACKGROUND
  The authors are all employed by ConvaTec Ltd. but have no other conflict of interest to declare. Dressings were provided to the clinicians free of charge.
authors.affiliation: Associate Director, Research & Development, at ConvaTec Ltd., Global Development Centre, First Avenue, Deeside Industrial Park, Flintshire, UK.
authors.forename: D
authors.initials: D
authors.lastname: Metcalf
authors.affiliation: Director, Science & Technology, at ConvaTec Ltd., Global Development Centre, First Avenue, Deeside Industrial Park, Flintshire, UK.
authors.forename: D
authors.initials: D
authors.lastname: Parsons
authors.affiliation: Vice President, Science & Technology, at ConvaTec Ltd., Global Development Centre, First Avenue, Deeside Industrial Park, Flintshire, UK.
authors.forename: P
authors.initials: P
authors.lastname: Bowler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001458:Bandages; D018441:Biofilms; D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006097:Granulation Tissue; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D012834:Silver / Q000627:therapeutic use*; D016896:Treatment Outcome; D006113:United Kingdom; D014647:Varicose Ulcer / Q000628:therapy*; D014945:Wound Healing; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D000890:Anti-Infective Agents; D012834:Silver; D002266:Carboxymethylcellulose Sodium
keywords: AQUACEL Ag+ EXTRA; biofilm; exudate; healing; infection