Antimicrobial Wound Dressings in all Types: Sponges, Film Dressings, Island Dressings

What are Antimicrobial Dressings?

Antimicrobial wound dressings are available in many forms like sponges, silver dressings, foam dressing, hydrogel dressing, island dressings, non-adherent dressings, adherent dressings etc. These dressings are meant to cover the wound and alter the wound bed bioburden through their antimicrobial activity. The ability of antimicrobial dressings to handle exudate depends largely on the characteristics and composition of the dressing. In cases of infection in partial- and full-thickness wounds, tracheostomies, over percutaneous line sites and surgical incisions, etc. antimicrobial dressings are recommended. Example - Derma Algicell Ag Dressings

Benefits of Antimicrobial Wound Dressings

Antimicrobial dressings offer many benefits.

• Relatively easy to use
• Widely available
• Frequently cost less than antibiotics
• Available without prescription
• Have less risk of resistance

How do Antimicrobial Dressings work?

Antimicrobial dressings lowers the potential toxicity to host cells by giving out a continuous and uniform release of antimicrobial agents to the wound bed and lowering the concentration of microbial agents. These dressings use antimicrobial agents like silver, iodine or polyhexamethylene biguanide (PHMB) that are known to reduce microbial activities. Antimicrobial dressings can be left in place for several days depending upon the wound drainage and amount of dead cells present.

How to use Antimicrobial Dressings?

• Get a wound swab
• Clean wound and peri-wound skin, eliminating as much necrotic tissue as possible and wound debris/slough
• To protect the periwound skin, select the appropriate barrier product to protect the periwound skin
• Consider if the antimicrobial dressing is appropriate at this stage — Yes
• Consider wound requirement and area to be treated — select product with high absorbency and high levels of available antimicrobial agent
• The dressing should be known to function under compression
• Increase dressing change frequency until exudate leakage is controlled
• Continue debridement and wound cleaning at each dressing change session
• Monitor carefully for signs of spreading infection and cellulitis and review bacterial swab results
• Add systemic treatment based on sensitivity findings if the wound continues to deteriorate.
• Set treatment goals and review date, planning to discontinue antimicrobial dressing after 14–21 days

When to use Antimicrobial Dressings?

Antimicrobial dressings can be used as a primary or secondary dressing for the treatment of draining, exuding, infected and non-healing wounds where a bacterial contamination present, including:

Choosing the right Antimicrobial Wound dressing

The selection of the appropriate dressing depends greatly upon the type of wound and the requirement of the patient. Silver antimicrobial dressings provide a topical antimicrobial surface that reduces the bacteria and fungi counts on the wound surface as in the case of Argentum Silverlon Antimicrobial Wound Contact Dressing. The Derma Algicell Ag dressing provides an effective barrier to pathogens with its seven-day effect. Another variation in antimicrobial dressings are those with nanocrystalline silver that conform to the body contours for eg. The Acticoat Flex 3 Antimicrobial Dressing form Smith & Nephew that comes with a low adherent polyester layer which helps minimize wound trauma at dressing changes. In some cases powder dressings may work better than other dressings. When a wound which produces high exudates needs to be dressed alginate powder dressings are preferred by medical professionals. The powder turns into a gel as it come in contact with the wound by absorbing the fluid from the wound. Powder dressing is ideal for deep, tunneling, highly exuding hard to dress wounds. Try the Medline Arglaes Antimicrobial Powder Dressing for high exudate wounds.

What parameters should be considered when choosing which antimicrobial dressing to be used on a patient?

Some of the many parameters that should be considered are:

• Depth/size location of wound
• Exudate volume and type
• Ability to conform wound bed and any dead space
• Any contraindications for the patient or the wound aetiology and site
• Any patient allergies
• Patient age, i.e. is it safe to be used on neonates or children
• Possible toxins released/effect on patient/wound
• Manufacturers guidelines to be followed
• Patients comorbidities and contraindications
• Patient choice — acceptance and comfort