Det er værd at bekæmpe kroniske sår
AQUACEL® Ag+ Extra™
AQUACEL® Ag+ Extra™ - Det er værd at bekæmpe kroniske sår
AQUACEL® bandager
Man regner med, at kroniske sår berører 1 % af befolkningen i den udviklede verden1, og tallet forventes at stige på grund af aldrende befolkninger og fedme.2,3
Den årlige forventede omkostning til behandling af et sår koster 6.000-10.000 EUR . I Europa estimeres det, at 2-4 % af sundhedsudgifterne bruges på sårbehandling.4-6
I Storbritannien estimeres det, at disse omkostninger er sammenlignelige med behandling af fedme.7
Overforbrug af antibiotika
Der er rapporteret om stor hyppighed af ordinering af antibiotika (60 %-75 %) hos patienter med kroniske, ikke-helende sår,8,9 og der er bekymring vedrørende overforbrug.10
Omkostning ved inficerede sår
Omkostningen per patient med et diabetisk fodsår var 4 x højere for dem, der var inficerede. Omkostninger, der overvejende blev tilskrevet antibiotika, amputationer og hospitalsindlæggelse.11
Biofilm er en fjende, der er værd at bekæmpe
I kampen for at hele kroniske sår, er der en usynlig fjende. Biofilm er en primær årsag til kronisk infektion14 og blokerer den effektive virkning af antibiotika og antiseptiske midler.15
Et in-vivo studie af stagnerede sår,13 bekræftede metaanalysens12 resultater for prævalens af biofilm:
- Der blev udvalgt 16 stagnerede sår, hvor den primære årsag til manglende heling blev tilskrevet tilstedeværelsen af biofilm.
- Biopsi og en efterfølgende mikroskopisk analyse bekræftede tilstedeværelsen af biofilm i 75 % af sårene. af biofilm i 75 % af sårene.
Biofilm er overalt
I sundhedsvæsenet står biofilm for mere end 80 % af alle mikrobielle infektioner.16 I naturen findes 99 % af alle bakterier i biofilm.1
Vanskelig at udrydde
Det er svært helt at fjerne biofilm selv med debridering. Den gendannes hurtigt18 og er en forløber for infektion.15 Den tåler antiseptika og antibiotika og kan undgå kroppens immunforsvar.15, 19
Forsinker sårheling 20,21
Biofilm skaber en vedvarende, men ineffektiv inflammatorisk respons.22 Den forringer desuden granulering, vævsdannelse og epitelialisering.22
Kend din fjende
Biofilm kan defineres som mikroorganismer, der sætter sig på en levende eller ikke-levende overflade, og som er indlejret i en selvproduceret ekstracellulær polymerisk substans (EPS). Biofilm tolererer antimikrobielle stoffer og kan resultere i vedvarende inflammation og infektion.22, 23
Hvis du ønsker at vide mere om AQUACEL™ Ag+ Extra™ bandagen, eller ønsker du at få et besøg af din lokale ConvaTec-produktspecialist, kan du ringe til vores kundeservice på tlf. 4816 7474.
- Sen CK, Gordillo GM, Roy S, et al. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009;17(6):763-71. 2. Ortman JM, Velkoff VA, Hogan H. An Aging Nation: The Older Population in the United States: U.S. Department of Commerce; 2014 [Available from: https://www.census.gov/prod/2014pubs/p25-1140.pdf (assessed 16 January 2018). 3. Ro-senthal RJ, Morton J, Brethauer S, Mattar S, De Maria E, Benz JK, et al. Obesity in America. Surg Obes Relat Dis. 2017;13(10):1643-50. 4. Purwins S, Herberger K, Debus S, et al. Cost-of-illness of chronic leg ulcers in Germany. Int Wound J. 2010;7(2):97–102. 5. Hjort A, Gottrup F. Cost of wound treatment to increase significantly in Denmark over the next decade. J Wound Care. 2010;19(5):173–4, 176, 178, 180, 182, 184. 6. Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009;18(4):154–161.1. 7. Guest JF, Ayoub N, McIlwraith T, et al. Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open 2015;5:e009283. doi:10.1136/bmjopen-2015-009283. 8. Tammelin, A, Lindholm, C, Hambraeus, A. Chronic ulcers and antibiotic treatment. J Wound Care. 1998; 7:435-437. 9. Gürgen, M. Excess use of antibiotics in patients with non-healing ulcers. EWMA Journal. 2014; 14:17-22. 10. Bowler PG. Antibiotic resistance and biofilm tolerance: A combined threat in the treatment of chronic infections. J Wound Care. 2018; 27:273-277. 11. Prompers L, Huijberts M, Schaper N, Apelqvist J et al. Resource utilisation and costs associated with the treatment of diabetic foot ulcers. Prospective date from the Eurodiale Study. Diabetologica, 2008; 51:1826-1834. 12. Malone M et al. 2017. The prevalence of biofilm in chronic wounds: a systematic review and meta-analysis of published data. JWC; 20-25. 13. Hurlow, Blanz, Gaddy. Clinical investigation of biofilm in non-healing wounds by high resolution microscopy techniques. J Wound Care WUWHS Suppl 2016; 25: S11-S22 14. Wolcott R, Sanford N, Gabrilska R et al. Microbiota is a primary cause of pathogenesis of chronic wounds. J Wound Care WUWHS Suppl 2016:25(10): S33-S43. 15. Percival SL, Bowler PG, 2004. Biofilms and their potential role in wound healing. WOUNDS, 16: 234-240. 16. National Institutes of Health, 2002. Research on microbial biofilms. https://grants.nih.gov/grants/guide/pa-fi-les/PA-03-047.html. Accessed October 2017. 17. Donlan RM, Costerton JW. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Micro Rev. 2002; 15:167-193. 18. Wolcott RD et al. Biofilm maturity studies indicate sharp debridement opens a time dependent therapeutic window. J Wound Care. 2010; 19:320-328. 19. Bowler. Antibiotic resistance and biofilm tolerance: a combined threat in the treatment of chronic infections. JWC Vol 27;No 5; 2018. 20. Hurlow, J., Couch, K., Laforet, K., Bolton, L., Metcalf, D. et al. (2015). Clinical Biofilms: A Challenging Frontier in Wound Care. Advances in Wound Care, 4(5), 295-301. 21. Metcalf, Bowler. Biofilm delays wound healing: a review of the evidence. Burns Trauma 2013; 1: 5-12. 22. Gurjala AN et al. Development of a novel, highly quantitative in vivo model for the study of biofilm-impaired cutaneous wound healing. Wound Rep Reg (2011) 19 400-410 23. Hall-Stoodley L I et al. Towards diagnostic guidelines for biofilm-associated infections. FEMS Immunol Med Microbiol. 2012; 65:127–145 24. Costerton JW, Stewart PS, Greenberg EP. Bacterial Biofilms: A Common Cause of Persistent Infections. 1999: 284 Science. 25. Saye D.E. Recurring and antimicrobial-resistant infections: Considering the potential role of biofilms in clinical practice Ostomy Wound Management 2007 53:4 (46-62). 26. Bowler PG, Parsons, D. Combatting wound biofilm and recalcitrance with a novel anti-biofilm Hydrofiber® wound dressing. Wound Medicine 14 (2016) 6–11 27. N Høiby et al. ESCMID guideline for the diagnosis and treatment of biofilm infections 2014. Clin Microbiol Infect 2015; 21: S1–S25 28. Hurlow, Bowler. Potential implications of biofilm in chronic wounds: a case series. J Wound Care 2012; 21: 109-119. 29. Parsons D, Meredith K, Rowlands VJ, Short D, Metcalf DG, Bowler PG. Enhanced Performance and Mode of Action of a Novel Antibiofilm Hydrofiber® Wound Dressing. Biomed Res Int. 2016;2016:7616471. 30. Said J, Walker M, Parsons D, Stapleton P, Beezer AE, Gaisford S. An in vitro test of the efficacy of an anti-biofilm wound dressing. Int J Pharmaceutics. 2014; 474: 177–181. DOI: 10.1016/j ijpharm.2014.08.034. 31. Composition comprising antimicrobial metal ions and a quaternary cationic surfactant WO12136968 Parsons World patent application 11th October 2012 32. Banin E., Brady K.M. & Greenberg E.P. (2006). Chelator Induced Dispersal and Killing of Pseudomonas aeruginosa Cells in Biofilm. Appl. Environ. Microbiol. 72. 2064 2069. 33. Chen X, Stewart PS, 2000. Biofilm removal caused by chemical treatments. Wat. Res.,34: 4229 4233. 34. Seth AK, Zhong A, Nguyen KT, Hong SJ, Leung KP, Galiano RD, Mustoe TA. Impact of a novel, antimicrobial dressing on in vivo, Pseudomonas aeruginosa wound biofilm: quantitative comparative analysis using a rabbit ear model. Wound Repair Regen. 2014; 22: 712–719. DOI: 10.1111/wrr.12232. 35. Hobot JA, Walker M, Newman GN, Bowler PG, 2008. Effect of Hydrofiber® wound dressings on bacterial ultrastructure. J Electr Micro; 57: 67-75. 36. T. J. Be-veridge, W. S. Fyfe. Metal fixation by bacterial cell walls. Canadian Journal of Earth Sciences, 1985, 22(12): 1893-1898, https://doi.org/10.1139/e85-204. 37. WHRI5860 MA322-In Vitro Antimicrobial Activity of AQUACEL Ag + Extra and AQUACEL Ag Extra against Acticoat 7, Silvercel NA and Urgotul Ag -V1. ConvaTec data on file. 27 November 2018. 38. Assessment of the Anti-biofilm activity of silver-containing gelling fibre wound dressings, using a multi-species CDC reactor model. Hannah Thomas, Perfectus Biomed. Presented at Wounds UK November 2018. https://epostersonline.com/wounds2018/node/171 Accessed November 2018. 39. Metcalf DG, Parsons D, Bowler PG. Clinical safety and effectiveness evaluation of a new antimicrobial wound dressing designed to manage exudate, infection and biofilm. Int Wound J 2017; 14: 203-213.
AQUACEL, AQUACEL Extra og Hydrofiber er varemærker tilhørende ConvaTec Inc. Alle varemærker tilhører deres respektive ejere. © 2018 ConvaTec Inc. AP-019832-MM