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

World Union of Wound Healing Societies Evidence in Wound Care

Wound management research improves patient care and clinical
outcomes by standardising assessment, planning and implementation
of treatment. In the field of wound care, high-level evidence is
possible, but it can be difficult to conduct due to the wide-ranging
nature of wounds and patients.
Additionally, there is an ever-growing variety of products and devices available to practitioners to improve healing rates and patient outcomes. In many cases, these products have enabled practitioners to heal more complex wounds and manage more
challenging and difficult cases. However, practitioners must be able to critically appraise evidence to make appropriate and effective evidence-based changes to practice.

UrgoStart Plus in Real Life

The prevalence of patients with chronic wounds continues to grow year-on-year and this places a substantial burden on health care resources. It is estimated that the NHS treats more than 2.2 million wounds annually, equating to 4.5% of the adult population, and the total cost of managing these wounds and associated co-morbidities is calculated to be £5.3 billon per year (Guest et al, 2015). However, it has been recognised that there are considerable unwarranted
variations in wound care services across the UK and that standardising practices offers opportunities to improve healing rates, reduce patient suffering and provide cost efficiencies
(NWCSP, 2020). In 2019 the National Institute for Health and Care Excellence published medical technologies guidance in relation to the UrgoStart treatment range. The committee reviewed five empirical
research papers, three of which were randomised controlled clinical trials. The committee critically appraised the publications and concluded that there was evidence to support the case
for adopting the UrgoStart treatment range to treat patients with diabetic foot ulcers and venous leg ulcers in the NHS, as the use of the UrgoStart treatment range was found to be associated
with increased rates of wound healing when compared with non-interactive dressings. Furthermore, they suggested that using the UrgoStart treatment range as part of the overall
management of diabetic foot ulcers and venous leg ulcers could reduce costs for the NHS.

Evaluation of NOSF in Neuropathic Diabetic Foot Ulcers

Both case studies feature neuropathic patients who have good lower limb arterial blood flow and there is an expectancy these wounds will heal. However, it is the speed of healing that is interesting, as well as the fact
that these wounds were progressed from a non/slow-healing state into a healed state. Of particular interest is the fact that Case Study 1 healed without the use of adequate pressure relief (the patient was non-compliant with the use of an Aircast boot). Pressure relief is an integral part of wound healing (NICE, 2004) and this factor alone could have been the cause of non-healing. Since the wound healed despite pressure relief not being adequate, this would indicate that, in this case, Urgostart Contact dressing was effective.UrgoStart Contact can be used effectively in the management of neuropathic diabetic foot wounds, however, the author has not been involved in case studies that demonstrate its effectiveness on diabetic neuroischaemic wounds.