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Clinical Evaluation of UrgoClean AG (Poly-Absorbent Dressing based on Technology Lipido-Colloid with Silver Ions) in the Management of Infected Wounds in Asia

Wound infections, including biofilms play a significant role in delaying
wound healing and are considered to be one of the major challenges in
wound management. The presence of non-viable tissue, such as slough, is a
prominent feature of chronic wounds and is considered as a barrier against
successful wound healing. A key component in wound care is to integrate
in our care evidence-based dressings that provides continuous cleaning,
antimicrobial activity and which are also effective against biofilms.
UrgoClean Ag is a dressing composed of cohesive poly-absorbent fibres
impregnated with a silver lipido-colloid matrix (Technology Lipido-Coloid Ag healing matrix [TLC-Ag]) that has shown very good results in clinical trials,
including a prospective, multicentre, non-comparative clinical trial, but also
large scale observational studies. In this article, we attempt to replicate the
results obtained in Europe in patients from different countries in the Asian
Continent by means of a case series.

Management of Burn Wounds by a Technology Lipido-Colloid Polyacrylate Dressing Impregnated with Silver A Case Series from Vietnam

Burn injuries are a mostly avoidable trauma that affect millions of people
worldwide every year. Wound healing in burn patients is complex, and
infection is one of the main clinical complications associated with wound
care in burn patients. Biofilms are mostly associated with chronic wounds,
but have also been identified in acute, traumatic wounds. This article
shows an evaluation of a TLC-polyacrylate fibre dressing impregnated with
silver to manage burn wounds of different severities, in nine patients of
different ages from Vietnam. The outcomes show encouraging results in
the management of burns when considering healing properties, and also
management of infection, desloughing and wound healing outcomes.

UrgoClean AG in Real Life

In 2019, the International Diabetes Federation (IDF) reported
that over 77 million individuals have diabetes in India, which
will increase to over 100 million by 2030 (IDF, 2019). Of these
people with diabetes, 25% will develop a diabetic foot ulcer
(DFU), equating to 5 million by 2030. Overall, half of ulcers
become infected during the healing process, necessitating
hospitalisation, while 20% of these patients require amputation.
DFUs contribute to approximately 80% of all non-traumatic
amputations performed annually in India (Ghosh and Valia,
2017). It is indicated that social epidemiology regarding DFU in
India differs from the West due to many factors including socio economic and cultural factors. This can lead to significant delay
in specialist referral, with patients still relying on treatment based
on local ethnic methods and not based on scientific data. This
results in patients presenting with highly infected ulcers (Rastogi
and Bhansali, 2016).
Infections in wound management are closely associated with
delayed healing, increased complications such as amputation,
and, moreover, have a negative impact on patients’ quality of life
(Cutting, 2016; Armstrong et al, 2017). Furthermore, due to the
complications that ensue, infections can increase the economic
burden on healthcare facilities related to wound management
and increase hospital stay (Nussbaum et al, 2018). The overall
management plan for people with DFUs (and for that matter any
chronic wound) should include six spheres: mechanical control
or pressure offloading, medical/metabolic control of the diabetes
and comorbidities, microbiological/infection management,
vascular control ensuring adequate blood flow, wound control
and education aimed at increasing patient awareness of foot care
over their lifetime.
Management of wound infection needs to include understanding
and involvement of the patient’s response and the local wound
healing environment, as well as a reduction of the microbial load
as part of the standard of care. This will include wound cleansing,
debridement, and appropriate use of topical antimicrobials
(International Wound Infection Institute, 2016).
The use of technology lipido-colloid with silver (TLC-Ag) is
supported by high-quality clinical evidence in the management of
wounds at risk or presenting with clinical signs of local infection;
TLC-Ag dressings show superior efficacy in reducing wound
bioburden, while also promoting wound healing. Additionally,
results demonstrate high tolerance and acceptability of TLC-Ag
dressings because of their atraumatic properties (Lazareth et al,
2007; 2008; Schäfer et al, 2008; Lazareth et al, 2012; Allaert,
2014). TLC-Ag dressings with cohesive poly-absorbent fibres
(UrgoClean Ag) have been developed to manage wounds with
higher levels of exudate and trap sloughy residues and can be
used throughout the stages of wound healing (Meaume et al,
2012; 2014; Dissemond al, 2020).
This document showcases the outcomes of UrgoClean Ag
in a real-world environment, demonstrating enhancement in
the management of DFU in India with improvement in wound
conditions and, furthermore, enhancing the patients’ quality
of life and clinicians’ satisfaction. Clinicians and organisations
worldwide need to understand that appropriate wound
management interventions based on high-level evidence should
be used to formulate local guidelines and DFU care pathways

Management of Burn patients with Technology Lipido-Colloid with Silver Sulphate to Fight Local Infection and Restore the Healing Process

Burn wounds are predisposed to infection and topical antimicrobial
preparations are used both to prevent and treat infection. The choice
of topical antimicrobial should be based on the ability of the agent to
inhibit microorganisms that may be harmful within the wound bed and
on the host. Silver is indicated when a local negative impact of bacterial
colonisation is suspected and/or confirmed, because it has a broad
antimicrobial effect. Technology Lipido-Colloid (TLC) is a matrix containing
hydrocolloid and lipophilic substances that has been shown to promote
the proliferation of fibroblasts and to be atraumatic for patients. TLC-Ag
incorporates silver sulphate (3.5%) into the TLC matrix. When it is in contact
with the wound, the dressing releases a constant supply of antibacterial
silver. This article will discuss the use of antimicrobials in burn wound
management, show the evidence for the TLC-Ag antimicrobial healing
matrix and portray outcomes of cases of burns patients in India who have
been managed with TLC-Ag.

The Use of a Non-adherent Lipido-Colloid Dressings with Silver in the Management of Wounds

Silver has been used in wound care throughout the millennia for its
antimicrobial properties. It was used by many cultures, predominantly in
times of war, as an antimicrobial reservoir for food and water, from the
ancient Phoenicians, Greeks, Romans and Egyptians, up to the Second
World War (Alexander, 2009). The first mention of silver as a medicine
comes from Hippocrates, who used silver particles in wounds for its
beneficial therapeutic effects and anti-disease properties (Fong, 2005).
Meanwhile, John Woodall recommended the use of silver nitrate in
chronic wound management as early as 1617 (Klasen, 2000)