A Multi-Center Prospective Clinical Evaluation and Cost

Comparison of a New Silver Oxysalts Dressing

Purpose.
Some commonly used silver dressings release silver
into the wound causing stinging and pain; others have
not demonstrated 7 day antimicrobial sustainability.
1-3

In addition, the high cost of silver dressings can be a
detriment to their use. Clinicians in multiple clinical
sites evaluated wound healing outcomes using a new
3-layer dressing coated with silver oxysalts
*
. The
dressing utilizes 75% less silver than competitive
products to achieve 7-day sustained antimicrobial
activity.
4
A concentration of approximately 0.4
mg/cm
2
results in a slow pH shift which reduces
stinging, pain, and tissue staining.
Methodology.
A prospective open label non-blinded clinical
evaluation of 50 patients with wounds of various
etiologies was conducted in multiple outpatient
facilities across the U.S. Investigators evaluated
subjects for 4 weeks or less, based on wound
characteristics. The silver primary dressing
*
was left
on wounds for up to 7 days. Clinicians documented
weekly using the BWAT Assessment Tool; patient pain
was assessed using the Visual Analog Pain Scale.
Clinicians evaluated the bacterial balance or critical
colonization levels using common key characteristics:
change in wound size, increased pain, exudate and
necrotic tissue.
5-9
In addition, clinicians calculated
total treatment cost using the new
dressing compared with the silver dressing currently
used in their facility.
Results.
A total of 50 patients (25 men and 25 women) were
enrolled in the study. The median and mean patient age
was 69 years (range 33-95 years) and the median
duration of the wound prior to enrollment in the study
was 3.6 months (range, 2 days to 24 months). Due to
incorrect dressing application in the second week of
evaluation, one patient (ET01-047) was excluded from
the analysis. There were no reported adverse effects.
Wound types evaluated in the clinical case series
included; venous (n=18), diabetic (n=5), pressure (n=3),
and arterial (n=3) ulcers; surgical (n=10); skin tears
(n=3); trauma (n=3); and other wounds (n=4) including
edema and lymphedema.
Clinicians reported improvement in most wound
characteristics, most notably increase in granulation
tissue, and decrease of inflammation, pain, debris and
odor. For many patients, pain level dropped to zero
within 1 week. Upon treatment with the silver oxysalts
dressing, previously stalled wounds healed in less than
4 weeks. No stinging and little or no staining as
compared to other silver dressings were consistently
reported. The new dressing cost was 25-30% lower that
other silver dressings.

References.
1) Schorrock SM, M.Sc. Thesis, Science and Biomed. Eng. Worchester Polytechnic Institute, May, 2000; 2) Gethin G, Wounds UK, 2007, 3(3), 52-55; 3) Parsons D, Bowler PG, Myles V, Jones S, Wounds, 2005, 17(8), 222-232; 4) Djokic SS, J. Electrochem. Soc., 2004, 151(6), C659-C364; 5) Cutting KF, Harding MB., JWC, 1994, 3(4), 198-201; 6) Gardner SE, et al., Wound Rep. Regen., 2001, 9(3), 178-185; 7)
Sibbald RG, et al., 2003, OWM, 49(11), 24-51; 8) Sibbald RG, et al., Wounds UK, 2007, 3(2), 25-46; 9) Woo KY, Sibbald RG, OWM, 55(8), 40-48; 10) Bates-Jensen BM, UCLA Dissertation Abstracts International, 1999, 59(11)


*
exsalt SD7 Wound Dressing, Exciton Technologies, Inc., Edmonton, Alberta, Canada..
Glenda Motta, RN, MPH, ET, GM Associates, Inc. Loveland, CO
Diane Merkle APRN, MSN, CWOCN, PhD(c),
Bridgeport Hospital Wound Healing and Hyperbaric Center , Bridgeport, CT
Catherine T. Milne APRN, MSN, BC-ANP/CNS, CWOCN Darlene Saucier APRN, MSN, BC-FNP, CWCN
Connecticut Clinical Nursing Associates, LLC, Bristol, CT

ET01-008 Week 1
ET01-008 Week 2
ET01-008 Week 3
Conclusions.
The higher oxidation state silver oxysalts dressing is effective for chronic and critically colonized wounds
45 % of patients wounds healed in an average of 2.9 weeks
80 % (CI = 95%, R
2
0.85) of patients wounds were predicted to heal within 12 weeks as per BWAT projections
10

Complete remission of indicators of critical colonization observed in > 60 % of patients during the course of treatment
5-9

93 % of patients perceived reduced pain over the course of treatment and no patient reported pain upon application or removal
Clinicians observed null or minimal staining
The higher oxidation state silver oxysalts wound dressing was observed to be safe and gentle for various wound etiologies
On average, the cost savings using the new silver oxysalts wound dressing was 48% per dressing change in comparison to the currently used product

Participating Investigators.
Mary Haddow RN-BC, CWCN, Community Care; Lawrence LoDico III,
Atlantic Medical Supply; Eric Lullove, DPM, CWS, FACCWS, Happy
Healthy Feet; Diane Merkle, APRN, CWOCN, Bridgeport Hospital;
Catherine Milne, ARPN, MSN, CS, CWOCN; Marta Ostler, PT, CWS, CLT,
Northeast Wyoming Wound Clinic; Tim Paine, PT, CWS, FACCWS,
Symmetry Physical Therapy; Michael Clark Reed, MSPT, PT; Cheryl
Salmon, PT, Wound Care at Ogden Regional; and Darlene Saucier,
Connecticut Clinical Nursing Associates LLC.