A 20 Patient Case Series to Explore New Ionized Silver Dressing for Critically Colonized, Stalled Chronic Leg &

Foot Ulcers
Patricia
1 Wound

1 Coutts

Grace

2 Modelski

Laurie

2 Goodman

Judy

3 Ryan

R Gary

4 Sibbald

Care Nurse & Clinical Trials Coordinator, Debary Dermatological Clinic, Mississauga, Ontario, Canada 2 Advanced Practice Nurse & Wound Educator, Toronto Regional Wound Healing Clinic, Mississauga, ON Canada 3 Registered Nurse, Mississauga ON Canada 4 Dept of Medicine, Women's College Hospital and Della Lana School of Public Health, University of Toronto , ON, Canada.

INTRODUCTION:
Healable lower extremity leg & foot ulcers can become stalled due to many etiological factors including superficial critical colonization vs. deep & surrounding infection. An approach to chronic wounds is outlined in the Wound Bed Preparation 2011 paradigm (Sibbald et al, 2011). This model stresses the need to treat the whole patient before the hole in the patient: Treatment of the cause and patient centered concerns before the components of local wound care: Debridement, Infection & Inflammation, Moisture balance & finally Edge effect for healable chronic wounds that are stalled. All chronic wounds are contaminated & subsequently colonized by microorganisms representing a complex wound environment but the level of critical colonization is associated with bacterial damage & delayed healing. The ideal silver topical antimicrobial agent should be: Non-toxic to the host Activity vs. broad spectrum of pathogens Silver in the +1, +2 and +3 valence states Excellent biocompatibility Slow pH shift The purpose of this study was to evaluate the effectiveness of a new silver antimicrobial wound dressing (Exsalt SD7 Wound Dressing- Exciton, Edmonton, Alberta) Although there is a plethora of silver dressings on the market, we wanted to investigate the new low cost alternative.

Visit 0

Visit 8

RESULTS / OUTCOMES:
Pain was measured on an 11 point verbal rating scale.

Cumulative Pain Totals 17 out of 20 subjects with pain Type of # ulcer Leg Ulcers Foot Ulcers Total 10 10 20 size Wk. 8 8 8 16

Week 0 44.5

Week 8 33

50% size Healed Wk. 8 4 3 7 0 1 1

METHODS:
Ethics Approval / subject ethics consent Enrolled Twenty patients with leg and foot ulcers (10 leg ulcers, 10 foot ulcers) were enrolled in an 8 week study Visits were at week 0, 2, 4 and 8 Dressing changes with the ionized silver dressing 3 times a week were utilized for signs of superficial critical colonization.

CONCLUSIONS: A cost effective, ionized silver dressing was clinically effective in reducing wound size for 16 out of 20 stalled chronic wounds with critical colonization There were no study dressing associated adverse events REFERENCE
Sibbald RG, Goodman L, Woo KY, Krasner DL, Smart H, Tariq G, et al. Special considerations in wound bed preparation 2011: an update . Adv Skin wound Care 2011;24:415-436 Freely downloadable www.WoundPedia.com

exsalt SD7 Silver Dressing