Addressing Exudate in Patients with Refractory Leg Ulcers: Novel Bilayered Polymeric Silver Dressing*

Background

Wound exudate is a generic term given to fluid produced from acute and chronic wounds once hemostasis has been achieved.  Bacterial by-products (proteolytic enzymes) and dead white cells increase the viscosity of exudate and create a characteristic odor.  These proteolytic enzymes can actually delay healing by reducing fibrinlytic activity and are also associated with maceration of intact skin.    Chronic Venous Insufficiency (CVI) changes the skin’s microcirculation causing hypoxia, edema and ulceration secondary to excess exudate.  standard care includes compression bandages, management of wound bioburden and exudate. 

Purpose

A novel bilayered polymeric silver dressing* designed to actively move fluid away from the wound, instead of absorption or donation of fluid, was evaluated as an approach to addressing wound exudate, with improved fluid management.

Methods

Ten patients with refractory leg ulcers, including CVI ulcers, were identified for this study.  A bilayered polymeric silver dressing* was used to manage wound exudate.  All of the patients had undergone conservative wound management for at least 2 months prior to enrollment including:  sharp debridement, compression therapy, foam or silver alginate dressings.   Primary dressings were substituted with the bilayered polymeric silver dressing* and were changed every three to seven days.  Wound assessments and treatment evaluations were performed one to two times per week by the WOC Nurses. 

Outcomes

The study showed a very satisfactory response with the wounds either healing completely or responding positively to treatment.  No adverse events were reported. Management of wound exudate and bioburden is a key element in the care of chronic wounds.  The bilayered silver polymeric dressing* was useful, as a first line therapy, in creating the optimal wound environment for managing wound exudate in chronic venous and refractory leg ulcer cases. 

* SelectSilver. Milliken & Company, Spartanburg, SC.

We gratefully acknowledge the support of Milliken & Company, Spartanburg, SC.