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

Using Urgotul Dressing for the Management of Epidermolysis Bullosa Skin Lesions

l Objective: To evaluate the acceptability, tolerance and efficacy of Urgotul wound dressing in the
management of epidermolysis bullosa (EB) skin lesions.
l Method: This was an open-label uncontrolled clinical trial involving 20 patients (11 adults and nine
children) with EB simplex or dystrophic EB. Patients were selected from the register of EB patients at
the investigating centre and included if they presented with at least one skin lesion requiring
management with a non-adherent wound dressing. Lesions were treated with the study dressing for a
maximum of four weeks. All dressing changes, wound parameters, pain and effect on quality of life were
recorded.
l Results: All patients completed the trial. Nineteen out of 20 wounds healed within 8.7 ± 8.5 days.
Overall, 11 patients (55%) considered that their quality of life had improved following use of the dressing,
which was also reported to be pain free and ‘very easy’ or ‘easy’ to remove at most dressing changes.
Nineteen out of 20 patients stated that they would use the study dressing to manage their lesions
in future.
l Conclusion: This study confirmed the very good acceptability and efficacy of Urgotul in the
treatment of skin lesions in patients with EB.

Evaluation of Technology Lipido Colloid with Silver (TLC-Ag) Dressing Qinzhou (China) A Case Series

Safe management and prevention of wound infection has been
discussed and advocated by expert group consensus documents. Infection
is a significant problem in wound management and early identification
and intervention are considered as key to the patient’s wellbeing and
healing outcomes. Various agents have been applied topically to treat
infected wounds. A well-recognised option is the use of silver as a viable
antimicrobial, and in recent decades, safer modes of application have been
introduced. Here we discuss three cases from Qinzhou (China), where the
author evaluated a Technology Lipido-Colloid with silver (TLC-Ag) dressing.
Positive outcomes were reported in all cases, concordant with the clinical
outcomes documented in publications the results of other publications both
from Europe and Asia.

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)

URGOTUL® AG/Silver Dressing as an Intermediate Layer in Negative Pressure Wound Therapy in a Patient with a Chronic Wound and History of Multiple Laparotomies

Treating of postoperative complications in patients after numerous laparotomies is
difficult. In the case of dehiscence the surgical wound, infection and the coexisting formation of
intestinal fistulas requires a multidisciplinary approach. In these cases, vacuum assisted thera py is very useful. However, it is necessary to protect the intestines, fistula and surrounding tissu es from the action of polyurethane foam – protect the intestines and skin against ingrowing into
the black foam. A 54-years-old male patient, with a history of numerous laparotomies was admit ted to Clinic to treat complications after left-sided nephrectomy. The patient developed intestinal
and enterocutaneous fistulas. Wound dehiscence and necrosis of surrounding tissues was pre sent. Negative pressure wound therapy was applied. Dressing was changed three times. Correc tion of the stomy was performed. UrgoTul® Ag/Silver was applied each time between the wound
and the polyurethane foam as a protective intermediate layer. The use of UrgoTul® Ag/Silver (in
patients with infection, dehiscence of wounds, and with enterocutaneous fistulas) showed a si gnificant decrease in the secretion from the intestinal fistula. Healing and closure of the surgical
wound, its epithelialization and elimination of inflammation of the abdominal wall was observed.

Wound management with Technology Lipido-Colloid Silver Non-Adherent dressing a case series from Chinese clinicians

Prevention and appropriate management of wound infection is central
to promote the healing process. While not all wounds will necessitate
use of systemic antibiotics, some may benefit from the use of topical
antimicrobials as part of a holistic standard of care. This article describes
five different cases, from China, where the clinicians used Technology
Lipido-Colloid Silver Non-Adherent (TLC-Ag) dressings as part of their
holistic multidisciplinary wound management strategy. The wounds
discussed were mainly chronic, including two venous leg ulcers and
lymphoedema ulcer, a post-amputation wound as well as a case of
pyoderma gangrenosum. Managing these wounds with TLC-Ag as a part
of the standard holistic multidisciplinary care provided resulted in positive
outcomes for the patients.

When the Tissue Viability Nurse becomes a patient reflections on a personal journey

This paper presents a reflection of my journey as a patient following a breast
abscess. As an experienced community nurse with a specialist interest in tissue
viability, we daily assess a range of different wound types and are adept at early
identification and management of an infected wound. We instinctively know which
dressing type to use to manage localised wound infection and slough and reduce
pain for patients; however, when the nurse becomes the patient with a wound and
has welcomed a new born child into the world, we can suddenly lose the specialist
knowledge. This paper reflects on a journey I recently experienced.

Silver Dressings for the Healing of Venous Leg Ulcer a Meta-Analysis and Systematic Review

Abstract
This study was aimed to evaluate whether silver-containing dressings were superior to other types of dressings in the treatment of
venous leg ulcers (VLU) and their specific advantages.
Eight databases (Cochrane Library, PubMed, Web of Science, Ovid-Medline, Wanfang, VIP, China Biology Medicine, and China
National Knowledge Infrastructure) were systematically reviewed from inception to May 2019 for randomized controlled trials (RCTs).
The primary outcome was complete wound healing, and the secondary outcomes included absolute wound size changes (change of
cm2 area since baseline), relative changes (percentage change of area relative to baseline), and healing rate. Two reviewers
independently evaluated the risk of bias using the Cochrane Collaboration assessment tool and extracted the data according to the
predesigned table. All analyses were performed using the latest Review Manager Software (version 5.3).
A total of 8 studies qualified and were included in the meta-analysis, including 1057 patients (experiment: 526, control: 531). Both
complete wound healing and wound healing rates were reported in 5 studies. Two and 3 studies reported the effect of silver
dressings on absolute and relative wound size changes, respectively. Most of the studies used intention-to-treat analysis.
There was sufficient evidence that silver-containing dressings can accelerate the healing rate of chronic VLU and improve their
healing in a short duration of time. However, compared with other dressings, clinical trials with long-term follow-up data are needed to
confirm whether silver dressings have advantages regarding complete wound healing.
Abbreviations: CBM = China Biology Medicine, CI = confidence interval, CNKI = China National Knowledge Infrastructure,
PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Q test = Chi-Squared test, RCTs = randomized
controlled trials, RD = risk difference, SMD = standardized mean difference, VLU = venous leg ulcers, WMD = weighted mean
difference.
Keywords: silver dressings, venous leg ulcer, wound healing, meta-analysis

Addressing Wound Chronicity Factors UrgoClean AG® and UrgoStart® Case Studies

Chronic wounds are a perennial problem in clinical practice and place a burden
on patients, their families and healthcare providers. By addressing factors that
contribute to chronicity (slough, biofilm, elevated levels of metalloproteinases
and impaired angiogenesis), in addition to managing a patient’s comorbidities,
nutritional status and lifestyle, there is a greater chance of healing. This article
discusses the mechanisms by which UrgoClean Ag and UrgoStart support a
healthy wound environment, along with two case studies of their use in practice.