A Randomized Controlled Trial to Evaluate an Antimicrobial Dressing with Silver Alginate Powder for the Management of Chronic Wounds Exhibiting Signs of Critical Colonization

Abstract

Silver alginate powder is an effective treatment option for wounds with increased bacterial burden.

The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice

“…Ten studies used a bacterial load >10 5 CFU of bacteria per gram of tissue or per mL of wound fluid to diagnose infection in chronic wounds (Table ). This popular threshold of 10 5 CFU has been used as a critical criterion for diagnosis of infection in chronic wounds, reasoning on the induction of local tissue damage in the wound because of the increase in the levels of bacterial‐related toxins and inflammatory mediators . Historically, the bacterial load at ≥10 5 CFU per one gram of tissue that was obtained from wound swabbing, biopsy, or ≥ 10 5 CFU/mL wound fluid can be seen as an indicator for wound infection .…”

“…3,39 Many experts categorised infection in chronic wounds into localised, spreading, and systemic infection; whilst others divided it into superficial and deeper wound infection. 14,40,41 In fact, this current review showed that the terms "infection in chronic wounds" and/or "infection in CLUs" were the most frequently used compared with "critical colonisation" and "localised infection" in chronic wounds and/or in CLUs. Thus, the term "infection in CLUs" was used throughout this literature review.…”

“…The level of evidence for most of the studies in relation to diagnosis of infection was low (level II-IV), with only one study meeting the criteria for level II evidence. The details of level of evidence of these 73 articles are as follows: twelve randomised controlled trials (level II), however, these studies focused on testing the effectiveness of dressings or treatment-related on patients with infected leg ulcers [11][12][13][14][15][16][17][18][19][20][21] ; one cohort study (level II) examined the effectiveness of a dressing on the bacteria in patients with venous leg ulcers (VLUs) 22 ; 40 level III evidence studies; and nineteen level IV evidence studies, including case series, case studies, and case series with pretest/post-test outcomes. There was one systematic review that focused on the effectiveness of silver dressing in treatment of chronic wound infection.…”

“…Malodour was used in 25 studies with a total of 1298 CLUs and erythema was used in 25 studies with 811 CLUs 12,14,22,34,37,38,41,45,47,50,51,[53][54][55][56][57][58][59][60][61][62][63][64][65][66] (Table 4). Malodour has been used in combination with other clinical signs 41,58,62 and/or microbial indicators.…”

Silver and Alginates: Role in Wound Healing and Biofilm Control

“…Another recent study by Woo et al 50 reported on the use of a silver alginate powder in managing chronic wounds that exhibited clinical signs of critical colonization, or more specifically biofilm infected. The study was a 4-week randomized controlled trial (prospective, open label) with an end point of changes in signs of critical colonization and wound surface area.…”