Problem: Venous leg ulcers are usually exudative wounds, frequently slow healing due the presence of microorganisms, though obvious clinical signs of infection may be absent. The availability of products containing the potent antimicrobial agent, the silver ion, in non cytotoxic concentrations have made it possible for the clinician to provide an effective antimicrobial barrier at the wound site, reducing the chances of the development of infection and promoting healing. It is desirable that such products also have associated benefits, such as high degree of absorbency, low fiber shedding, and high wet integrity.

Past Management: We have used the Hydrofiber ® based dressings as the means to manage exudate while providing an effective antimicrobial barrier. The low wet integrity of the fiber usually leads to time consuming removal of the dressing debris during dressing changes.

Current Clinical Approach: An alternative product, a CMC/Alginate dressing with antimicrobial ionic silver (silver sodium hydrogen zirconium phosphate) was used on 6 patients over 3 months . Chronic wounds treated with this dressing are covered with a secondary gauze dressing. In the 3 months of study, we treated 6 patients, and achieved an average wound closure rate of 75% in the first 12 weeks of therapy. 50% of wounds were clinically infected prior to treatment. During treatment with the product, no wounds developed infection. Conclusion: Based on our observations of these patients, we found the CMC/alginate treatment with silver led to satisfactory treatment outcomes. Due to the high wet integrity of the product, nursing time spent in cleanup during dressing changes was reduced. The economy and ease of use for the CMC/Silver Alginate has made this the current standard of care in our unit.

The support of Medline Industries, Inc. for this project is gratefully acknowledged.