Securing Cellular and Tissue-Based Products Using a Soft Silicone Wound Contact Layer: A Novel Approach

Clinical Problem: Cellular and Tissue-Based Products (CTBPs) provide many benefits to the well prepared wound bed. Many CTBPs have anti-inflammatory and bacteriostatic properties while simultaneously promoting cell signaling and fibroblast proliferation in the proliferative phase. CTBPs are traditionally secured with sutures, staples or wound closure strips and covered with a secondary dressing. Use of wound closure strips, sutures and staples have known complications¹ but use of silicone wound contact layers have not been reported. Secondary dressings are often changed in between evaluations of wound response to the CTBP. These are done by clinic staff, or frequently performed by nursing staff at Skilled Nursing Facilities (SNFs) or Home Health Agencies (HHA’s) that have little familiarity with CTBPs, risking loss of CTBP adherence.

Treatment Approach:  After application of a CTBP, a soft silicone wound contact layer (SSWCL)* was applied over the CTBP with overlap extending 1.5 cm onto intact peri-wound skin in 15 patients for a total of 64 CTBP applications. A secondary dressing of provider choice (foams or gelling fiber with and without antimicrobial activity) was then placed over the SSWCL. Secondary dressings were changed by staff in HHAs/SNFs in 13 of 15 patients between office visits.

Clinician/Patient Outcomes: SSWCL applications were rated “very easy” and “highly cost effective” by providers. Large fenestrations in the SSWCL allowed free flow of drainage with loss of one SSWCL integrity noted at one week after CTBP application. HHAs/SNFs nursing staff were able to easily change secondary dressings without disruption of the CTBP. 4 of 15 patients were able to remove the secondary dressing and shower. Pain scores on SSWCL dressing removal was consistently 2 or less (mean .5). No other adverse events were seen.

Conclusion: A SSWCL is a viable option for securing CTBPs. Further study is warranted.

*Silflex. Advancis Medical. Nottinghamshire, UK.