Introducing ReliaTect Post-Op Dressing

Eloquest Healthcare recently introduced ReliaTect Post-Op Dressing featuring BeneHold CHG Adhesive Technology. ReliaTect is the post-op dressing that integrates the antimicrobial properties of chlorhexidine gluconate (CHG), the practicality of absorbency, and the convenience of transparency.

THE ANTIMICROBIAL
POST-OP DRESSING WITH
ABSORB&SEE

ReliaTect has convenience features for staff1:

  • ABSORBS EXUDATE to protect against dehydration and facilitate wound healing
  • TRANSPARENT to facilitate site inspection; no need to remove for up to 7 days
  • WATERPROOF and impermeable to external contaminants
  • PROTECTS PATIENTS (and hospitals) by reducing SSI risk
  • EASY APPLICATION

ReliaTect has comfort features for patients1:

  • THIN PROFILE conforms to body contours
  • NON-IRRITATING, non-cytotoxic and non-sensitizing for patient comfort
  • BREATHABLE to allow oxygen and moisture
Comprehensive protection1
[GRAM– BACTERIA]
Escherichia coli
Pseudomonas aeruginosa
Klebsiella pneumonia
Enterobacter aerogene
[GRAM+ BACTERIA]
Staphylococcus aureus
Staphylococcus aureus [MRSA]
Staphylococcus epidermidis
Enterococcus faecalis [VRE][OTHER]
Candida albicans (yeast)
Aspergillus brasiliensis (mold)

ReliaTect has utility across a wide range of post-operative sites:

NOTE: ReliaTect Post-Op is not a primary wound closure device.
Ensure closure by suturing or other methods prior to application.

For more information about ReliaTect Post-Op Dressing, please contact your sales consultant or Eloquest Healthcare®, Inc., call 1-877-433-7626 or visit www.reliatectpostop.com

References

  1. Data on file. Avery Dennison Corporation.

Antimicrobial Dressings: The Silver Mystique

As mentioned in our last posting, SSIs are the most common and costly of all hospital-acquired infections in the US.1 If you happened to have missed it, read it here. Accordingly, efforts to reduce SSI rates have led to the development of post-op dressings with antimicrobial agents impregnated within the dressing. These dressing inhibit the growth of, or kill a broad spectrum of microbes, at the surgical site.2

Dressings currently on the market incorporate three different antimicrobial agents:

  • Polyhexamethylene biguanide (PHMB) is an antimicrobial agent used in wound dressings, contact lens solutions, mouth wash and perioperative cleansing products; PHMB kills microorganisms by disrupting the cell membrane3
  • Silver’s (Ag) antimicrobial properties stem from its ability to be absorbed into the microorganism and bind DNA, resulting in cell death2
  • Chlorhexidine Gluconate (CHG) has been used worldwide as an antiseptic since 19544 and is effective against a broad spectrum of gram-positive and gram-negative bacteria, yeasts, and some viruses; chlorhexidine is the active antimicrobial agent, and chlorhexidine gluconate is a commonly used form of chlorhexidine because it is colorless, odorless, and easily dissolves in water.5

A closer look at silver
The use of silver in wound care was documented as early as 69 BC.6 Silver has broad spectrum antimicrobial activity against bacteria, yeast, fungi and mold. Topical silver-containing creams and ointments have been a mainstay of wound management in burn patients for years.7 Silver has been incorporated into various medical devices, including hemodialysis catheters, endotracheal tubes and urinary catheters.5

In order to have an antimicrobial effect, silver must be in the form of a charged particle (or ion).2 These silver ions are absorbed by bacteria, which in turn bind to the DNA structures to affect cell function and respiration. The overall effect is an interruption of bacterial replication and reduced formation of colonies.

There is a wide range of silver dressings and their methods of antimicrobial action is diverse.2 The variations stem from those that actively deliver silver to the wound surface either in low or high concentrations, and others that retain and kill bacteria within the structures of the dressing.

While the industry has widely debated the safety of silver in relation to systemic absorption and toxicity to human cells, it is thought that this occurs when silver ions are released into the wound bed too quickly over a sustained period of time.2 It is important to note, however—that in extensive recent reviews—the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO,) and the Cochrane Library) found no evidence that the use of dressings containing silver reduces rates of SSI.8-10

The aim of post-operative wound care is to allow the wound to quickly heal without complications, avoiding unnecessary discomfort for the patient, minimizing scarring, and preventing blood loss.11-12 The choice of post-op dressing is a critical component of wound management. Attributes of an ideal wound healing environment dictate the characteristics of an ideal post-op wound dressing.

Be sure to join us next time for a big announcement from Eloquest Healthcare.

References:

  1. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224(1):59-74.
  2. Hewish J. Understanding the role of antimicrobial dressings. Wounds Essentials 2012;1:84-90. http://www.wounds-uk.com/pdf/content_10457.pdf. Accessed February 13, 2017.
  3. Mulder GD, Cavorsi JP, Lee, DK. Wounds. Medscape website. 2007;19:173-82. http://www.medscape.com/viewarticle/561512_3. Accessed February 15, 2017.
  4. Krishna MT, Huissoon A. Peri-operative anaphylaxis: Beyond drugs and latex. Int Arch Allergy Immunol 2015;167:101-21.
  5. ChlorhexidineFacts.com website. http://www.chlorhexidinefacts.com/the-molecule.html. Accessed February 15, 2017.
  6. Murphy PS, Evans GRD. Advances in wound healing: a review of current wound healing products. Plastic Surg Int. 2012: doi:10.1155/2012/190436.
  7. Parsons D, Bowler PG, Myles V, Jones S. Silver antimicrobial dressings in wound management: a comparison of antibacterial, physical, and chemical characteristics. Medscape website. http://www.medscape.com/viewarticle/513362_3. Accessed February 15, 2017.
  8. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Healthcare infection control practices advisory committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. eAppendix 2. JAMA Surg. Published online May 3, 2017. Doi:10.1001/ jamasurg.2017.0904.
  9. Allegranzi B, Zayed B, Bischoff P, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet. 2016;16:e288-303.
  10. Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection (review). Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD003091. DOI: 10.1002/14651858.CD003091.pub4.
  11. Yao K, Bae L, Yew WP. Post-operative wound management. Australian Fam Physic. 2013;42:867-70.
  12. Incision Care. Encyclopedia of Surgery Website. http://www.surgeryencyclopedia. com/Fi-La/Incision-Care.html. Accessed February 14, 2017.

SSIs and Post-Op Dressings: What’s Missing?

You might remember from our previous blogs that certain measures, like surgical site infections (SSIs) are penalized in multiple programs of the Affordable Care Act—in the Value-Based Purchasing Program as well as the Hospital-Acquired Conditions Reduction Program. View Blog #2 and Blog #3 here.

SSIs are the most common and costly of all hospital-acquired infections in the US.1 Approximately 160,000-300,000 SSIs occur each year in the US and each SSI is associated with approximately 7–11 additional postoperative hospital-days per infection.2 SSIs are believed to total $3.5 billion to $10 billion annually in healthcare expenditures.2

Morbidity rates of SSIs are also concerning. Seventy-seven percent of deaths in patients with an SSI are directly attributable to the SSI.2 And did you know that patients with an SSI have a 2- to 11-times higher risk of death compared with operative patients without an SSI?2

Post-operative dressings have become a critical component of wound management and prevention of SSIs. A number of dressings are currently available that offer variable levels of desirable features:

Basic wound contact dressings3

  • Absorbent dressings: applied directly to the wound
  • Surgical absorbents: used as secondary absorbent layers in the management of heavily-exuding wound

Advanced dressings3

  • Vapor-permeable films: permeable to water vapor and oxygen, but not to water or micro-organisms; normally transparent
  • Hydrocolloid dressings: occlusive dressings composed of a hydrocolloid matrix attached to a base (possibly film or foam); fluid absorbed from the wound causes the hydrocolloid to liquify
  • Fibrous hydrocolloid dressings: composed of sodium carboxymethyl cellulose, which forms a gel when it comes into contact with fluid
  • Polyurethane matrix hydrocolloid dressings: consist of 2 layers—a polyurethane gel matrix and a waterproof polyurethane film designed to act as a bacterial barrier

Antimicrobial dressings3

  • Polyhexamethylene biguanide (PHMB) dressings: impregnated with the antimicrobial agent polyhexanide
  • Topical skin adhesives (glue-as-dressing): for closure of minor skin wounds and additional suture support; also used on an already closed wound as a dressing without an additional covering
  • Silver dressings4: release silver ions to bind to the DNA structures to affect cell function and respiration, effecting the cessation of bacterial replication
  • Chlorhexidine Gluconate (CHG) dressings: effective against a broad spectrum of gram-positive and gram-negative bacteria, yeasts, and some viruses; chlorhexidine is the active antimicrobial agent, and chlorhexidine gluconate is a commonly used form of chlorhexidine because it is colorless, odorless, and easily dissolves in water.5
  • Iodine dressings4: thought to disrupt microbial enzymes, proteins, and cell membranes through reacting with cell amino acids
  • Honey dressings4: used for centuries for its broad spectrum antimicrobial activity and ability to reduce the potential for wound infection and accelerate wound healing

Differentiations in dressings include varying degrees and combinations of transparency, absorbency, antimicrobial agent, adherence, conformability and water-resistance. What we have yet to see in a post-op dressing is one that integrates absorbency, transparency and antimicrobial. Perhaps soon?

Join us next time for our blog, “Antimicrobial Dressings: The Silver Mystique.”

References:

  • Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224(1):59-74.
  • Anderson DJ, Podgorny K, Berrior-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:605-27.
  • Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection (review). Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD003091. DOI: 10.1002/14651858.CD003091.pub4.
  • Hewish J. Understanding the role of antimicrobial dressings. Wounds Essentials 2012;1:84-90. http://www.wounds-uk.com/pdf/content_10457.pdf. Accessed February 13, 2017.
  • ChlorhexidineFacts.com website. http://www.chlorhexidinefacts.com/the-molecule.html. Accessed June 1, 2017.