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Alternative to antibiotics in wound care
In developed countries, it has been estimated that 1 to 2 percent of the population will experience a chronic wound during their lifetime. The burden of chronic wounds and wound treatment is rapidly growing.[1] Wound infections can compromise the healing process and let wounds develop into chronic wounds, with a significant negative impact on health-related quality of life.[2,3] Even worse, they bear the risk of amputation and lethal sepsis.[4] Additionally, infected wounds provide a great burden to the healthcare system.[2,3]
It is of mayor importance to find the best strategy to prevent, diagnose and manage wound infections.
More than
0%
of chronic wounds are estimated to be infected.[5,6]
Up to
0%
of chronic wounds contain biofilm with a role in wound infection.[7,8,9,10]
Chronic wounds
The wound infection continuum looks at the different stages of wound infection progressing from initial contamination up to overt sepsis.[11,12] This concept can help wound care practitioners to find the best strategy to prevent, diagnose and manage wound infection. Get to know our therapy concept that covers all stages of the wound infection continuum: Prontosan® to prevent the formation of biofilm and to decrease the bacterial burden, and Askina® Calgitrol®, a range of wound dressings consisting of a silver alginate matrix, which provides an ancillary antimicrobial activity and helps prevent contamination from external bacteria.
A thorough wound assessment is essential for preventing and treating wound infections and all types of complications that can accompany them.[13,14] Proper diagnosis and product selection strategies can help you prevent and treat wound infections. Prontosan® and Askina® Calgitrol® make a great match in the combat against wound infections.
This combination has helped to restore health to the patient Miguel whose clinical case history was presented during our symposium at EWMA 2022 to provide practical insights. In this symposium, we focused on the importance of recognizing the signs of a developing wound infection and how to assess them using the Wound Infection Continuum.
Your choice matters – how would you have treated Miguel’s wound? We invite you to watch our symposium video.
Expert opinion
The following case studies were carried out to evaluate the efficacy of a biofilm remover/cleanser in gel form - Prontosan® together with the use of an ionic releasing silver alginate - Askina® Calgitrol® Paste or Askina® Calgitrol® Thin - when used on infected wounds.
All wounds showed a significant reduction in terms of clinical signs of infection within the first week of treatment. Some 50% of all wound infections were completely resolved by week 2. Eighty-one per cent of all wounds had no clinical signs of infection in less than 3 weeks. None of the patients were given any oral or intravenous antibiotics while on the study; all patients were only treated by using local antimicrobials. There was also a decrease in odour in all wounds.
Read the complete case reportWound infections are caused by the deposit and profileration of microorganisms in the surgical site of a susceptible host. There are numerous ways microorganisms can enter the wound bed. The infection can result in sepsis when bacteria spreads into the blood stream, called bacteriemia, which can turn into life-threatening sepsis with multi-organ failure.[15]
The main objective is to prevent infections rather than to treat them.
In contact with wound exudate, the silver alginate matrix of Askina® Calgitrol® forms a soft gel. This helps both maintain a moist wound environment conducive to natural healing conditions as well as prevent contamination from external bacteria.[16]
Learn more about silver dressingsOver- and misuse of antibiotics in medicine are known to have mainly contributed to the problem. As a result, AMR emerges as an progressive risk for global public health and has been appraised as the highest health endangerment in the 21st century.[17,18]
If an effective action plan is not implemented, the annual death rate is expected to reach 10 million deaths per year by 2050.[19,20]
The loss of capital caused by antimicrobial resistance is globally estimated to be approximately $300 billion to $1 trillion by 2050.[17]
Help to implement a strategy to avoid the overuse of antibiotics and thus slow down antimicrobial resistance.
[1] Sen CK, Gordillo GM, Roy S, Kirsner R, Lambert L, Hunt TK, Gottrup F, Gurtner GC, Longaker MT. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009 Nov-Dec;17(6):763-71. doi: 10.1111/j.1524-475X.2009.00543.x. PMID: 19903300; PMCID: PMC2810192.
[2] Phillips CJ, Humphreys I, Fletcher J, Harding K, Chamberlain G, Macey S. Estimating the costs associated with the management of patients with chronic wounds using linked routine data. Int Wound J. 2016 Dec;13(6):1193-1197. doi: 10.1111/iwj.12443. Epub 2015 Mar 26. PMID: 25818405; PMCID: PMC7949824.
[3] Purwins S, Herberger K, Debus ES, Rustenbach SJ, Pelzer P, Rabe E, Schäfer E, Stadler R, Augustin M. Cost-of-illness of chronic leg ulcers in Germany. Int Wound J. 2010 Apr;7(2):97-102. doi: 10.1111/j.1742-481X.2010.00660.x. PMID: 20529149; PMCID: PMC7951196.
[4] Yammine K, El Alam A, Alqaysi B, Assi C. The internal pedal amputation as a salvage procedure in diabetic and ischemic foot infection. A meta-analysis. Foot Ankle Surg. 2022 Feb;28(2):159-165. doi: 10.1016/j.fas.2021.03.008. Epub 2021 Mar 16. PMID: 33752981
[5] Reitan RL, McBroom RM, Gilder RE. The Risk of Infection and Indication of Systemic Antibiotics in Chronic Wounds. Wounds. 2020 Jul;32(7):186-194. PMID: 33166266.
[6] Schollemann F, Kunczik J, Dohmeier H, Pereira CB, Follmann A, Czaplik M. Infection Probability Index: Implementation of an Automated Chronic Wound Infection Marker. J Clin Med. 2021 Dec 29;11(1):169. doi: 10.3390/jcm11010169. PMID: 35011910; PMCID: PMC8745914
[7] Malone M, Bjarnsholt T, McBain AJ, James GA, Stoodley P, Leaper D, Tachi M, Schultz G, Swanson T, Wolcott RD. The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data. J Wound Care. 2017 Jan 2;26(1):20-25. doi: 10.12968/jowc.2017.26.1.20. PMID: 28103163.
[8] Honorato-Sampaio K, Guedes AC, Lima VL, Borges EL. Bacterial biofilm in chronic venous ulcer. Braz J Infect Dis. 2014 May-Jun;18(3):350-1. doi: 10.1016/j.bjid.2014.01.003. Epub 2014 Mar 21. PMID: 24662137
[9] Hurlow J, Bowler PG. Acute and chronic wound infections: microbiological, immunological, clinical and therapeutic distinctions. J Wound Care. 2022 May 2;31(5):436-445. doi: 10.12968/jowc.2022.31.5.436. PMID: 35579319.
[10] Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999 May 21;284(5418):1318-22. doi: 10.1126/science.284.5418.1318. PMID: 10334980.
[11] Kingsley A. The wound infection continuum and its application to clinical practice. Ostomy Wound Manage. 2003 Jul;49(7A Suppl):1-7. PMID: 12883156.
[12] Deeth M. A closer look at the wound infection continuum. Br J Community Nurs. 2017 Dec 1;22(Sup12):S48-S50. doi: 10.12968/bjcn.2017.22.Sup12.S48. PMID: 29189070.
[13] Gottrup F. A specialized wound-healing center concept: importance of a multidisciplinary department structure and surgical treatment facilities in the treatment of chronic wounds. Am J Surg. 2004 May;187(5A):38S-43S. doi: 10.1016/S0002-9610(03)00303-9. PMID: 15147991.
[14] Falcone M, De Angelis B, Pea F, Scalise A, Stefani S, Tasinato R, Zanetti O, Dalla Paola L. Challenges in the management of chronic wound infections. J Glob Antimicrob Resist. 2021 Sep;26:140-147. doi: 10.1016/j.jgar.2021.05.010. Epub 2021 Jun 16. PMID: 34144200.
[15] Brun-Buisson C. The epidemiology of the systemic inflammatory response. Intensive Care Med. 2000;26 Suppl 1(Suppl 1):S64-74. doi: 10.1007/s001340051121. PMID: 10786961; PMCID: PMC7094973
[16] Naude L. The use of Prontosan® in combination with Askina® Calgitrol®: an independent case series. Wounds International 2018; 9 (1): 44-8. Brun-Buisson C. The epidemiology of the systemic inflammatory response. Intensive Care Med. 2000;26 Suppl 1(Suppl 1):S64-74. doi: 10.1007/s001340051121. PMID: 10786961; PMCID: PMC7094973
[17] Christaki E, Marcou M, Tofarides A. Antimicrobial Resistance in Bacteria: Mechanisms, Evolution, and Persistence. J Mol Evol. 2020 Jan;88(1):26-40. doi: 10.1007/s00239-019-09914-3. Epub 2019 Oct 28. PMID: 31659373.
[18] Dhingra S, Rahman NAA, Peile E, Rahman M, Sartelli M, Hassali MA, Islam T, Islam S, Haque M. Microbial Resistance Movements: An Overview of Global Public Health Threats Posed by Antimicrobial Resistance, and How Best to Counter. Front Public Health. 2020 Nov 4;8:535668. doi: 10.3389/fpubh.2020.535668. PMID: 33251170; PMCID: PMC7672122.
[19] Samreen, Ahmad I, Malak HA, Abulreesh HH. Environmental antimicrobial resistance and its drivers: a potential threat to public health. J Glob Antimicrob Resist. 2021 Dec;27:101-111. doi: 10.1016/j.jgar.2021.08.001. Epub 2021 Aug 25. PMID: 34454098.
[20] Pires D, de Kraker MEA, Tartari E, Abbas M, Pittet D. ‘Fight antibiotic resistance—it’s in your hands’: call from the World Health Organization for 5th May 2017. Clin Infect Dis 2017;64:1780–3. doi: 10.1093/cid/cix226 .
[21] O’Neill J. Review on Antimicrobial Resistance. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations. 2014. https://amr-review.org/Publications.html. Accessed July 12, 2023.
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